須田 剛生 (スダ ゴウキ)

医学研究院 内科系部門 内科学分野講師
北海道大学病院講師
Last Updated :2024/12/06

■研究者基本情報

学位

  • 医学博士, 東京医科歯科大学

Researchmap個人ページ

研究者番号

  • 20447460

研究分野

  • ライフサイエンス, 消化器内科学

■経歴

経歴

  • 2013年
    北海道大学, 大学病院

■研究活動情報

受賞

  • 2024年10月, 日本肝臓病学会, 日本肝臓病学会冠アワード               
  • 2024年02月, 国立大学法人北海道大学, 国立大学法人北海道大学教育研究総長表彰(研究受賞)               
  • 2023年12月, ロシュ・ダイアグノスティックス株式会社, Roche Infectious Disease Award               
  • 2022年, The 31st Conference of the Asian Pacific Association for Study of the liver (APASL) Travel Award.               
  • 2021年, APDWF-JGHF Emerging Leader Award               
  • 2020年, 寿原記念財団研究助成               
  • 2019年, The 3rd Joint Session between TDDW-JDDW-KDDW Rising Star Award               
  • 2019年, Journal of Gastroenterology High Citation Award               
  • 2018年, G-Plus 優秀演題賞               
    須田剛生
  • 2018年, AASLD 2018 Poster of Distinction               
    須田剛生
  • 2017年, ウイルス肝炎財団研究奨励賞               
    須田剛生
  • 2016年, 肝臓病学会研究奨励賞               
    須田剛生
  • 2015年, Liver Forum in Kyoto 研究奨励賞               
    須田剛生
  • 2011年, 国際科学振興財団フォーラム研究奨励賞               
    須田剛生
  • 2011年, 第47回肝臓病学会総会 優秀演題賞               
    須田剛生

論文

  • Lenvatinib versus sorafenib second-line therapy in patients with hepatocellular carcinoma progressed to atezolizumab plus bevacizumab: a retrospective real-world study.
    Mara Persano, Andrea Casadei-Gardini, Toshifumi Tada, Goki Suda, Shigeo Shimose, Masatoshi Kudo, Federico Rossari, Changhoon Yoo, Jaekyung Cheon, Fabian Finkelmeier, Ho Yeong Lim, José Presa, Gianluca Masi, Francesca Bergamo, Elisabeth Amadeo, Francesco Vitiello, Takashi Kumada, Naoya Sakamoto, Hideki Iwamoto, Tomoko Aoki, Hong Jae Chon, Vera Himmelsbach, Massimo Alberto Iavarone, Giuseppe Cabibbo, Margarida Montes, Francesco Giuseppe Foschi, Caterina Vivaldi, Caterina Soldà, Takuya Sho, Takashi Niizeki, Naoshi Nishida, Christoph Steup, Mariangela Bruccoleri, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hironori Ochi, Satoshi Yasuda, Hidenori Toyoda, Chikara Ogawa, Takashi Nishimura, Takeshi Hatanaka, Satoru Kakizaki, Noritomo Shimada, Kazuhito Kawata, Atsushi Hiraoka, Fujimasa Tada, Hideko Ohama, Kazuhiro Nouso, Asahiro Morishita, Akemi Tsutsui, Takuya Nagano, Norio Itokawa, Tomomi Okubo, Michitaka Imai, Hisashi Kosaka, Atsushi Naganuma, Yohei Koizumi, Shinichiro Nakamura, Masaki Kaibori, Hiroko Iijima, Yoichi Hiasa, Luigi Mascia, Silvia Foti, Silvia Camera, Fabio Piscaglia, Mario Scartozzi, Stefano Cascinu, Margherita Rimini
    Oncology, 1, 27, 2024年10月11日, [国際誌]
    英語, 研究論文(学術雑誌), INTRODUCTION: the most frequently used first-line treatment in patients with advanced hepatocellular carcinoma (HCC) is atezolizumab plus bevacizumab. Upon progression after this treatment, the standard of care in many countries is sorafenib, due to the lack of reimbursement for other drugs. Several randomized trials are currently underway to clarify the best second-line therapy in patients with HCC. This real-world study aims to compare outcomes reached by lenvatinib and sorafenib second-line therapy in this setting. METHODS: the overall cohort included 891 patients with HCC from 5 countries treated with atezolizumab plus bevacizumab in first-line setting between October 2018 and April 2022. At data cut-off (May 2022), 41.5% of patients were continuing first-line treatment, 5.5% were lost at follow up, and 53.0% of patients had progressive disease after first-line therapy. 51.5% of patients with progressive disease received a second-line treatment, while 48.5% didn't receive any subsequent therapy. Between patients receiving second-line treatment, 11.1% patients underwent transarterial chemoembolization, 21.0% received sorafenib, 35.4% underwent lenvatinib, and 32.5% were treated with other drugs. RESULTS: lenvatinib second-line subgroup achieved a median overall survival (mOS) of 18.9 months, significative longer (p = 0.01; HR: 2.24) compared to sorafenib subgroup that reached a mOS of 14.3 months. The multivariate analysis highlighted Albumin-Bilirubin 1 grade [p < 0.01; hazard ratio (HR): 5.23] and lenvatinib second-line therapy (p = 0.01; HR: 2.18) as positive prognostic factors for OS. The forest plot highlighted a positive trend in terms of OS in favor of patients treated with lenvatinib second-line regardless of baseline characteristics before first-line therapy. CONCLUSION: these results suggest that, in patients with HCC progressed to first-line atezolizumab plus bevacizumab, lenvatinib second-line therapy is associated to an improved survival compared to sorafenib.
  • Disease Etiology Impact on Outcomes of Hepatocellular Carcinoma Patients Treated with Atezolizumab plus Bevacizumab: A Real-World, Multicenter Study.
    Federico Rossari, Toshifumi Tada, Goki Suda, Shigeo Shimose, Masatoshi Kudo, Changhoon Yoo, Jaekyung Cheon, Fabian Finkelmeier, Ho Yeong Lim, José Presa, Gianluca Masi, Francesca Bergamo, Elisabeth Amadeo, Francesco Vitiello, Takashi Kumada, Naoya Sakamoto, Hideki Iwamoto, Tomoko Aoki, Hong Jae Chon, Vera Himmelsbach, Massimo Iavarone, Giuseppe Cabibbo, Margarida Montes, Francesco Giuseppe Foschi, Caterina Vivaldi, Caterina Soldà, Takuya Sho, Takashi Niizeki, Naoshi Nishida, Christoph Steup, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hironori Ochi, Satoshi Yasuda, Hidenori Toyoda, Chikara Ogawa, Takashi Nishimura, Takeshi Hatanaka, Satoru Kakizaki, Noritomo Shimada, Kazuhito Kawata, Atsushi Hiraoka, Fujimasa Tada, Hideko Ohama, Kazuhiro Nouso, Asahiro Morishita, Akemi Tsutsui, Takuya Nagano, Norio Itokawa, Tomomi Okubo, Michitaka Imai, Hisashi Kosaka, Atsushi Naganuma, Yohei Koizumi, Shinichiro Nakamura, Masaki Kaibori, Hiroko Iijima, Yoichi Hiasa, Mara Persano, Silvia Foti, Silvia Camera, Bernardo Stefanini, Mario Scartozzi, Stefano Cascinu, Andrea Casadei-Gardini, Margherita Rimini
    Liver cancer, 13, 5, 522, 536, 2024年10月, [国際誌]
    英語, 研究論文(学術雑誌), INTRODUCTION: The impact of etiology on response to immunotherapy in advanced hepatocellular carcinoma (HCC) is being debated, with contrasting findings between early and recent post hoc analyses of IMbrave-150 and metanalyses of clinical trials of PD-1/PD-L1 blockers. As a results, it is not clear whether the first-line systemic treatment atezolizumab plus bevacizumab (A + B) is equally effective in viral and nonviral patients. METHODS: We retrospectively analyzed 885 HCC patients treated with the first-line A + B from multiple centers from Eastern and Western countries, 53.9% having viral and 46.1% nonviral etiology. Baseline clinical and laboratory characteristics were analyzed with uni- and multivariate models to explore potential differences on overall survival (OS), time-to-progression (TTP), disease control rates (DCRs) based on etiology and to identify putative prognostic factors in etiology subgroups. Treatment toxicities and access to the second-line treatments and outcomes were also reported and compared between etiologies. RESULTS: Overall, no statistically significant differences were found in median OS (mOS: viral 15.9 months; nonviral 16.3 months), TTP (mTTP: viral 8.3 months; nonviral 7.2 months), and DCRs (viral 78.1%; nonviral 80.8%) based on etiology. Prognostic factors of survival and progression were mainly shared between viral and nonviral etiologies, including alpha-fetoprotein, aspartate transaminase, neutrophil-to-lymphocyte ratio (NLR) and ALBI score. Exploratory analyses highlighted a possible stronger association of immunological factors, i.e., NLR and eosinophil count, to treatment outcomes in viral patients. The toxicity profile, the access to and type of the second-line treatments and their outcome in terms of OS almost overlap in the two etiology subgroups. CONCLUSION: Atezolizumab plus bevacizumab efficacy does not vary according to underlying etiology of HCC in a multicenter, real-world population, matching recent post hoc findings from the IMbrave-150 trial. Preliminary analyses suggest that some prognostic factors differ between viral and nonviral patients, potentially due to biological and immunological differences. Prospective and comparative trials stratifying by etiology are warranted to validate these findings and guide clinical practice.
  • Positivity of high-sensitivity HBsAg test, not previous HBV infection, indicates poor prognosis in patients with non-HBV-related HCC.
    Naohiro Yasuura, Goki Suda, Masatsugu Ohara, Akimitsu Meno, Takuya Sho, Risako Kohya, Takashi Sasaki, Tomoka Yoda, Sonoe Yoshida, Qingjie Fu, Zijian Yang, Shunichi Hosoda, Osamu Maehara, Shunsuke Ohnishi, Tomoya Saitou, Masaya Sugiyama, Takasuke Fukuhara, Masaru Baba, Takashi Kitagataya, Naoki Kawagishi, Masato Nakai, Mitsuteru Natsuizaka, Koji Ogawa, Akinobu Taketomi, Naoya Sakamoto
    Alimentary pharmacology & therapeutics, 2024年09月04日, [国際誌]
    英語, 研究論文(学術雑誌), BACKGROUND AND AIMS: The prognostic impact of previous-HBV-infection (pHBV) in non-HBV-related hepatocellular carcinoma (non-HBV-related-HCC) and the prevalence, characteristics and significance of recently developed high-sensitivity HBs antigen positivity (hHBsAg+) in these patients remain unclear. We aimed to close these gaps. METHODS: We retrospectively screened patients with newly diagnosed non-HBV-related-HCC (standard HBsAg-test negative) at Hokkaido University. Patients with complete clinical information and preserved serum for hHBsAg+ were included. We evaluated the prevalence, characteristics and prognostic impact of pHBV and hHBsAg+ in non-HBV-related-HCC. RESULTS: A total of 401 non-HBV-related-HCC patients were included (288 with pHBV/113 without pHBV). In non-HBV-related-HCC, pHBV did not affect overall survival (OS). Among non-HBV-related-HCC patients with pHBV, 11.8% (34/288) were hHBsAg+ and had more advanced stages of HCC, higher AFP levels, higher vascular invasion rates, and significantly shorter OS than others (OS: 19.3 vs. 61.4 months, p = 0.012). Comparison of OS among non-HBV-related-HCC patients without pHBV (group 1), those with pHBV and without hHBsAg+ (group 2), and those with pHBV and hHBsAg+ (group 3) revealed significantly shorter OS in group 3 (19.3, 56.6 and 66.4 months in groups 1, 2 and 3, respectively; p = 0.036). Multivariate Cox regression indicated that compared with group 1, only group 3 was significantly and independently associated with shorter OS (HR: 2.044, p = 0.011). Subgroup analysis revealed that this association was particularly evident in non-HBV-related-HCC patients with non-B-non-C aetiology and advanced HCC. CONCLUSIONS: In non-HBV-related-HCC patients, hHBsAg+, not pHBV, is significantly and independently associated with poor prognosis.
  • Serum growth differentiation factor 15 is a novel biomarker with high predictive capability for liver cancer occurrence in patients with MASLD regardless of liver fibrosis.
    Shusuke Kumazaki, Hayato Hikita, Yuki Tahata, Ji Hyun Sung, Kenji Fukumoto, Yuta Myojin, Sadatsugu Sakane, Kazuhiro Murai, Yoichi Sasaki, Kumiko Shirai, Yoshinobu Saito, Takahiro Kodama, Naruyasu Kakita, Hirokazu Takahashi, Hidenori Toyoda, Goki Suda, Eiichi Morii, Takashi Kojima, Takeshi Ebihara, Kentaro Shimizu, Yutaka Sasaki, Tomohide Tatsumi, Tetsuo Takehara
    Alimentary pharmacology & therapeutics, 60, 3, 327, 339, 2024年08月, [国際誌]
    英語, 研究論文(学術雑誌), BACKGROUND AND AIMS: Although metabolic dysfunction-associated steatotic liver disease (MASLD) patients with a Fib-4 index >1.3 are recommended for fibrosis evaluation via elastography or biopsy, a more convenient method identifying high-risk populations requiring follow-up is needed. We explored the utility of serum levels of growth differentiation factor-15 (GDF15), a cell stress-responsive cytokine related to metabolic syndrome, for stratifying the risk of clinical events in MASLD patients. METHODS: Serum GDF15 levels were measured in 518 biopsy-performed MASLD patients, 216 MASLD patients for validation, and 361 health checkup recipients with MASLD. RESULTS: In the biopsy-MASLD cohort, multivariate analysis indicated that the serum GDF15 level was a risk factor for liver cancer, independent of the fibrosis stage or Fib-4 index. Using a GDF15 cutoff of 1.75 ng/mL based on the Youden index, high-GDF15 patients, regardless of fibrosis status, had a higher liver cancer incidence rate. While patients with a Fib-4 index <1.3 or low-GDF15 rarely developed liver cancer, high-GDF15 patients with a Fib-4 index >1.3 developed liver cancer and decompensated liver events at significantly higher rates and had poorer prognoses. In the validation cohort, high-GDF15 patients had significantly higher incidences of liver cancer and decompensated liver events and poorer prognoses than low-GDF15 patients, whether limited to high-Fib-4 patients. Among health checkup recipients with MASLD, 23.0% had a Fib-4 index >1.3, 2.7% had a Fib-4 index >1.3 and >1.75 ng/mL GDF15. CONCLUSIONS: Serum GDF15 is a biomarker for liver cancer with high predictive capability and is useful for identifying MASLD patients requiring regular surveillance.
  • Proteomic analysis of serum extracellular vesicles reveals Fibulin-3 as a new marker predicting liver-related events in MASLD.
    Sadatsugu Sakane, Hayato Hikita, Kumiko Shirai, Tatsuya Sakamoto, Ryohei Narumi, Jun Adachi, Naruyasu Kakita, Yukinori Yamada, Hidenori Toyoda, Hirokazu Takahashi, Goki Suda, Machiko Kai, Yuki Tahata, Ryotaro Sakamori, Shusuke Kumazaki, Kenji Fukumoto, Yuta Myojin, Kazuhiro Murai, Takahiro Kodama, Tomohide Tatsumi, Takeshi Tomonaga, Naoya Sakamoto, Eiichi Morii, Tetsuo Takehara
    Hepatology communications, 8, 6, 2024年06月01日, [査読有り], [国際誌]
    英語, 研究論文(学術雑誌), BACKGROUND: There is a need for novel noninvasive markers for metabolic dysfunction-associated steatotic liver disease (MASLD) to stratify patients at high risk for liver-related events including liver cancer and decompensation. In the present study, we used proteomic analysis of proteins in extracellular vesicles (EVs) to identify new biomarkers that change with fibrosis progression and can predict the development of liver-related events. METHODS: We analyzed serum EVs from 50 patients with MASLD assessed for liver fibrosis by biopsy and identified proteins that altered with advanced fibrosis. A further evaluation was conducted on another cohort of 463 patients with MASLD with biopsy. RESULTS: Eight candidate proteins were identified by proteomic analysis of serum EVs. Among them, serum levels of Fibulin-3, Fibulin-1, and Ficolin 1 correlated with their EV levels. In addition, serum Fibulin-3 and serum Fibulin-1 levels changed significantly with advanced fibrosis. Using another cohort with biopsy, we found that the serum Fibulin-3 concentration was significantly greater in those with advanced fibrosis but that the serum Fibulin-1 concentration was not significantly different. Multivariate Cox proportional hazards analysis revealed that a higher Fibrosis-4 (FIB-4) index and higher serum Fibulin-3 concentration were independent risk factors for liver-related events. When the cutoff value for the serum Fibulin-3 concentration was 6.0 µg/mL according to the Youden index of AUROCs, patients with high serum Fibulin-3 significantly more frequently developed liver-related events than did other patients. Validation using another cohort of 226 patients with clinically diagnosed MASLD confirmed that high serum Fibulin-3 levels are associated with a greater frequency of liver-related events. CONCLUSIONS: Serum Fibulin-3 was identified as a biomarker for predicting liver-related events in patients with MASLD.
  • Adverse Events as Potential Predictive Factors of Activity in Patients with Advanced HCC Treated with Atezolizumab Plus Bevacizumab.
    Mara Persano, Margherita Rimini, Toshifumi Tada, Goki Suda, Shigeo Shimose, Masatoshi Kudo, Federico Rossari, Changhoon Yoo, Jaekyung Cheon, Fabian Finkelmeier, Ho Yeong Lim, José Presa, Gianluca Masi, Francesca Bergamo, Elisabeth Amadeo, Francesco Vitiello, Takashi Kumada, Naoya Sakamoto, Hideki Iwamoto, Tomoko Aoki, Hong Jae Chon, Vera Himmelsbach, Massimo Alberto Iavarone, Giuseppe Cabibbo, Margarida Montes, Francesco Giuseppe Foschi, Caterina Vivaldi, Caterina Soldà, Takuya Sho, Takashi Niizeki, Naoshi Nishida, Christoph Steup, Mariangela Bruccoleri, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hironori Ochi, Satoshi Yasuda, Hidenori Toyoda, Chikara Ogawa, Takashi Nishimura, Takeshi Hatanaka, Satoru Kakizaki, Noritomo Shimada, Kazuhito Kawata, Atsushi Hiraoka, Fujimasa Tada, Hideko Ohama, Kazuhiro Nouso, Asahiro Morishita, Akemi Tsutsui, Takuya Nagano, Norio Itokawa, Tomomi Okubo, Michitaka Imai, Hisashi Kosaka, Atsushi Naganuma, Yohei Koizumi, Shinichiro Nakamura, Masaki Kaibori, Hiroko Iijima, Yoichi Hiasa, Silvia Foti, Silvia Camera, Fabio Piscaglia, Mario Scartozzi, Stefano Cascinu, Andrea Casadei-Gardini
    Targeted oncology, 2024年04月30日, [国際誌]
    英語, 研究論文(学術雑誌), BACKGROUND: In the context of patients with hepatocellular carcinoma (HCC) treated with systemic therapy, the correlation between the appearance of adverse events (AEs) and reported efficacy outcomes is well-known and widely investigated. From other pathological settings, we are aware of the prognostic and predictive value of the occurrence of immune-related AEs in patients treated with immune-checkpoint inhibitors. OBJECTIVE: This retrospective multicenter real-world study aims to investigate the potential prognostic value of AEs in patients with HCC treated with atezolizumab plus bevacizumab in the first-line setting. PATIENTS AND METHODS: The study population consisted of 823 patients from five countries (Italy, Germany, Portugal, Japan, and the Republic of Korea). RESULTS: Of the patients, 73.3% presented at least one AE during the study period. The most common AEs were proteinuria (29.6%), arterial hypertension (27.2%), and fatigue (26.0%). In all, 17.3% of the AEs were grade (G) 3. One death due to bleeding was reported. The multivariate analysis confirmed the appearance of decreased appetite G < 2 [versus G ≥ 2; hazard ratio (HR) 0.60; 95% confidence interval (CI) 0.13-0.90; p < 0.01] and immunotoxicity G < 2 (versus G ≥ 2; HR: 0.70; 95% CI 0.24-0.99; p = 0.04) as independent prognostic factors for overall survival, and the appearance of decreased appetite G < 2 (versus G ≥ 2; HR: 0.73; 95% CI 0.43-0.95; p = 0.01), diarrhea (yes versus no; HR: 0.57, 95% CI 0.38-0.85; p = 0.01), fatigue (yes versus no; HR: 0.82, 95% CI 0.65-0.95; p < 0.01), arterial hypertension G < 2 (versus G ≥ 2; HR: 0.68, 95% CI 0.52-0.87; p < 0.01), and proteinuria (yes versus no; HR: 0.79, 95% CI 0.64-0.98; p = 0.03) as independent prognostic factors for progression-free survival. CONCLUSIONS: As demonstrated for other therapies, there is also a correlation between the occurrence of AEs and outcomes for patients with HCC for the combination of atezolizumab plus bevacizumab.
  • Etiological changes of liver cirrhosis and hepatocellular carcinoma-complicated liver cirrhosis in Japan: Updated nationwide survey from 2018 to 2021.
    Hirayuki Enomoto, Norio Akuta, Hayato Hikita, Goki Suda, Jun Inoue, Nobuharu Tamaki, Kiyoaki Ito, Takemi Akahane, Tomokazu Kawaoka, Asahiro Morishita, Eiichi Ogawa, Ryosuke Tateishi, Hitoshi Yoshiji
    Hepatology research : the official journal of the Japan Society of Hepatology, 2024年04月18日, [国際誌]
    英語, 研究論文(学術雑誌), AIM: A nationwide survey in 2018 showed decreasing involvement of viral hepatitis and increasing involvement of nonviral liver diseases in the etiology of liver cirrhosis (LC) in Japan. An updated nationwide survey was undertaken in 2023. METHODS: Cases of LC diagnosed between 2018 and 2021 were collected from 75 institutions, and the etiologies of LC were investigated. In addition, the data obtained were compared with the results of previous studies. RESULTS: Among the 15 517 cases, alcohol-related liver disease (ALD)-associated LC was the most frequent cause (n = 5,487, 35.4%). Hepatitis C virus-associated LC, nonalcoholic steatohepatitis (NASH)-associated LC, and hepatitis B virus-associated LC were ranked as second, third, and fourth, respectively. In comparison to the previous survey, the ratios of viral hepatitis-associated LC decreased (HBV: from 11.5% to 8.1%; HCV: from 48.2% to 23.4%), while the ratios of ALD-associated LC and NASH-associated LC increased (from 19.9% to 35.4% and from 6.3% to 14.6%, respectively). Regarding cases of LC with hepatocellular carcinoma (n = 5906), HCV-associated LC (1986 cases, 33.6%) was the most frequent cause. Alcohol-related liver disease-associated LC, NASH-associated LC, and HBV-associated LC were the second-, third-, and fourth-ranked causes, respectively. In comparison to the previous survey, as the cause of hepatocellular carcinoma-complicated LC, HCV-associated LC decreased from 60.3% to 33.6%, while the ratios of ALD-associated LC and NASH-associated LC increased from 14.2% to 28.6% and from 4.2% to 14.0%, respectively. CONCLUSIONS: The major causes of LC in Japan are suggested to have been shifting from viral hepatitis to nonviral chronic liver diseases.
  • Impact of body mass index on the prognosis of unresectable HCC patients receiving first-line Lenvatinib or atezolizumab plus bevacizumab.
    Margherita Rimini, Bernardo Stefanini, Toshifumi Tada, Goki Suda, Shigeo Shimose, Masatoshi Kudo, Fabian Finkelmeier, Changhoon Yoo, José Presa, Elisabeth Amadeo, Virginia Genovesi, Maria Caterina De Grandis, Massimo Iavarone, Fabio Marra, Francesco Foschi, Emiliano Tamburini, Federico Rossari, Francesco Vitiello, Linda Bartalini, Caterina Soldà, Francesco Tovoli, Caterina Vivaldi, Sara Lonardi, Marianna Silletta, Takashi Kumada, Naoya Sakamoto, Hideki Iwamoto, Tomoko Aoki, Vera Himmelsbach, Margarida Montes, Atsushi Hiraoka, Takuya Sho, Takashi Niizeki, Naoshi Nishida, Christoph Steup, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hironori Ochi, Satoshi Yasuda, Hidenori Toyoda, Chikara Ogawa, Takashi Nishimura, Takeshi Hatanaka, Satoru Kakizaki, Noritomo Shimada, Kazuhito Kawata, Fujimasa Tada, Hideko Ohama, Kazuhiro Nouso, Asahiro Morishita, Akemi Tsutsui, Takuya Nagano, Norio Itokawa, Tomomi Okubo, Taeang Arai, Michitaka Imai, Hisashi Kosaka, Atsushi Naganuma, Yohei Koizumi, Shinichiro Nakamura, Masaki Kaibori, Hiroko Iijima, Yoichi Hiasa, Mara Persano, Silvia Camera, Silvia Foti, Luca Aldrighetti, Stefano Cascinu, Andrea Casadei-Gardini, Fabio Piscaglia
    Liver international : official journal of the International Association for the Study of the Liver, 2024年03月22日, [国際誌]
    英語, 研究論文(学術雑誌), INTRODUCTION: Overweight is a negative prognostic factor in the general population in the long term. However, the role of body mass index (BMI) in the short-mid term in advanced tumours is unclear. The present analysis investigates the role of BMI weight classes in a large sample of patients affected by HCC and receiving atezolizumab plus bevacizumab or lenvatinib as first-line treatment. METHODS AND MATERIAL: The cohort included consecutive patients affected by BCLC-c and BCLC-B HCC patients from a multicenter international study group who received atezolizumab plus bevacizumab or lenvatinib as first-line therapy. Population was stratified according to the BMI in under-, over- and normal-weight according to the conventional thresholds. The primary objective of the study was to evaluate the prognostic and predictive impact of BMI in patients affected by advanced or intermediate HCC. Survival curves were estimated using the product-limit method of Kaplan-Meier. The role of stratification factors was analysed with log-rank tests. RESULTS: 1292 consecutive patients with HCC were analysed. 466 (36%) patients were treated with lenvatinib and 826 (64%) patients were treated with atezolizumab plus bevacizumab. In the atezolizumab plus bevacizumab arm, 510 (62%) patients were normal-weight, 52 (6%) underweight and 264 (32%) overweight. At the univariate analysis for OS, underweight patients had significantly shorter OS compared to normal-weight patients, whereas no differences were found between normal-weight versus overweight. Multivariate analysis confirmed that underweight patients had significantly shorter OS compared to normal-weight patients (HR: 1.7; 95% CI: 1.0-2.8; p = .0323). In the lenvatinib arm, 26 patients (5.6%) were categorized as underweight, 256 (54.9%) as normal-weight, and 184 (39.5%) as overweight. At the univariate analysis for OS, no significant differences were found between normal-weight versus underweight and between normal-weight versus overweight, which was confirmed at multivariate analysis. CONCLUSION: Our analysis highlighted a prognostic role of BMI in a cohort of patients with advanced HCC who received atezolizumab plus bevacizumab, while no prognostic role for low BMI was apparent in patients who received lenvatinib.
  • 食道胃静脈瘤に対し経皮経脾静脈瘤塞栓術を施行した1例               
    保浦 直弘, 大原 正嗣, めの 晃光, 甲谷 理紗子, 佐々木 貴志, 吉田 苑永, 細田 峻一, 北潟谷 隆, 中井 正人, 荘 拓也, 須田 剛生, 小川 浩司, 阿保 大介, 坂本 直哉
    日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集, 134回・128回, 46, 46, 日本消化器病学会-北海道支部, 2024年03月
    日本語
  • Safety and Efficacy of Lenvatinib in Very Old Patients with Unresectable Hepatocellular Carcinoma.
    Silvia Camera, Margherita Rimini, Federico Rossari, Toshifumi Tada, Goki Suda, Shigeo Shimose, Masatoshi Kudo, Changhoon Yoo, Jaekyung Cheon, Fabian Finkelmeier, Ho Yeong Lim, José Presa, Gianluca Masi, Francesca Bergamo, Francesca Salani, Mariarosaria Marseglia, Elisabeth Amadeo, Francesco Vitiello, Takashi Kumada, Naoya Sakamoto, Hideki Iwamoto, Tomoko Aoki, Hong Jae Chon, Vera Himmelsbach, Massimo Iavarone, Giuseppe Cabibbo, Margarida Montes, Francesco Giuseppe Foschi, Caterina Vivaldi, Sara Lonardi, Takuya Sho, Takashi Niizeki, Naoshi Nishida, Christoph Steup, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hironori Ochi, Satoshi Yasuda, Hidenori Toyoda, Chikara Ogawa, Takashi Nishimura, Takeshi Hatanaka, Satoru Kakizaki, Noritomo Shimada, Kazuhito Kawata, Atsushi Hiraoka, Fujimasa Tada, Hideko Ohama, Kazuhiro Nouso, Asahiro Morishita, Akemi Tsutsui, Takuya Nagano, Norio Itokawa, Tomomi Okubo, Michitaka Imai, Hisashi Kosaka, Atsushi Naganuma, Yohei Koizumi, Shinichiro Nakamura, Masaki Kaibori, Hiroko Iijima, Yoichi Hiasa, Mara Persano, Silvia Foti, Fabio Piscaglia, Mario Scartozzi, Stefano Cascinu, Andrea Casadei-Gardini
    Targeted oncology, 2024年01月22日, [国際誌]
    英語, 研究論文(学術雑誌), BACKGROUND: Data concerning the use of lenvatinib in very old patients (≥ 80 years) are limited, although the incidence of hepatocellular carcinoma (HCC) in this patient population is constantly increasing. OBJECTIVE: This analysis aimed to evaluate the efficacy and safety of lenvatinib in a large cohort of very old patients (≥ 80 years) with unresectable HCC. PATIENTS AND METHODS: The study was conducted on a cohort of 1325 patients from 46 centers in four Western and Eastern countries (Italy, Germany, Japan, and the Republic of Korea) who were undergoing first-line treatment with lenvatinib between July 2010 and February 2022. Patients were stratified according to age as very old (≥ 80 years) and not very old (< 80 years). RESULTS: The median overall survival (OS) was 15.7 months for patients < 80 years old and 18.4 months for patients ≥ 80 years old [hazard ratio (HR) = 1.02, 95% confidence interval (CI) 0.84-1.25, p = 0.8281]. Median progression free survival (PFS) was 6.3 months for patients < 80 years old and 6.5 months for patients ≥ 80 years old (HR = 1.07, 95% CI 0.91-1.25, p = 0.3954). No differences between the two study groups were found in terms of disease control rate (DCR; 80.8% versus 78.8%; p = 0.44) and response rate (RR; 38.2% versus 37.9%; p = 0.88). Patients < 80 years old experienced significantly more hand-foot skin reaction (HFSR) grade ≥ 2 and decreased appetite grade ≥ 2. Conversely, patients ≥ 80 years old experienced significantly more fatigue grade ≥ 2. In the very old group, parameters associated with prognosis were AFP, albumin-bilirubin (ALBI) grade, Barcelona Clinic Liver Cancer (BCLC), and Child-Pugh score. BCLC stage was the only independent predictor of overall survival (OS; HR = 1.59, 95% CI 1.11-2.29, p = 0.01115). CONCLUSIONS: Our study highlights the same efficacy and safety of lenvatinib between very old and not very old patients.
  • α-FAtE: A new predictive score of response to atezolizumab plus bevacizumab for unresectable hepatocellular carcinoma.
    Federico Rossari, Toshifumi Tada, Goki Suda, Shigeo Shimose, Masatoshi Kudo, Changhoon Yoo, Jaekyung Cheon, Fabian Finkelmeier, Ho Yeong Lim, José Presa, Gianluca Masi, Francesca Bergamo, Elisabeth Amadeo, Francesco Vitiello, Takashi Kumada, Naoya Sakamoto, Hideki Iwamoto, Tomoko Aoki, Hong Jae Chon, Vera Himmelsbach, Massimo Iavarone, Giuseppe Cabibbo, Margarida Montes, Francesco Giuseppe Foschi, Caterina Vivaldi, Caterina Soldà, Takuya Sho, Takashi Niizeki, Naoshi Nishida, Christoph Steup, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hironori Ochi, Satoshi Yasuda, Hidenori Toyoda, Chikara Ogawa, Takashi Nishimura, Takeshi Hatanaka, Satoru Kakizaki, Noritomo Shimada, Kazuhito Kawata, Atsushi Hiraoka, Fujimasa Tada, Hideko Ohama, Kazuhiro Nouso, Asahiro Morishita, Akemi Tsutsui, Takuya Nagano, Norio Itokawa, Tomomi Okubo, Michitaka Imai, Hisashi Kosaka, Atsushi Naganuma, Yohei Koizumi, Shinichiro Nakamura, Masaki Kaibori, Hiroko Iijima, Yoichi Hiasa, Mara Persano, Valentina Burgio, Fabio Piscaglia, Mario Scartozzi, Stefano Cascinu, Andrea Casadei-Gardini, Margherita Rimini
    International journal of cancer, 2023年11月23日, [国際誌]
    英語, 研究論文(学術雑誌), Atezolizumab plus bevacizumab (AB) and lenvatinib can be alternatively used as first-line systemic treatment of unresectable hepatocellular carcinoma (HCC). However, no direct comparison of the two regimens has been performed in randomized clinical trials, making the identification of baseline differential predictors of response of major relevance to tailor the best therapeutic option to each patient. Baseline clinical and laboratory characteristics of real-world AB-treated HCC patients were analyzed in uni- and multivariate analyses to find potential prognostic factors of overall survival (OS). Significant variables were incorporated in a composite score (α-FAtE) and it was tested for specificity and sensitivity in receiver operating characteristic (ROC) curve and in multivariate analysis for OS. The score was applied in uni- and multivariate analyses for OS of a comparable lenvatinib-treated HCC population. Finally, comparison between treatments was performed in patients with low and high α-FAtE scores and predictivity estimated by interaction analysis. Time-to-progression (TTP) was a secondary endpoint. OS of AB-treated HCC patients was statistically longer in those with α-fetoprotein <400 ng/mL (HR 0.62, p = .0407), alkaline phosphatase (ALP) <125 IU/L (HR 0.52, p = .0189) and eosinophil count ≥70/μL (HR 0.46, p = .0013). The α-FAtE score was generated by the sum of single points attributed to each variable among the above reported. In ROC curve analysis, superior sensitivity and specificity were achieved by the score compared to individual variables (AUC 0.794, p < .02). Patients with high score had longer OS (HR 0.44, p = .0009) and TTP (HR 0.34, p < .0001) compared to low score if treated with AB, but not with lenvatinib. Overall, AB was superior to lenvatinib in high score patients (HR 0.55, p = .0043) and inferior in low score ones (HR 1.75, p = .0227). At interaction test, low α-FAtE score resulted as negative predictive factor of response to AB (p = .0004). In conclusion, α-FAtE is a novel prognostic and predictive score of response to first-line AB for HCC patients that, if validated in prospective studies, could drive therapeutic choice between lenvatinib and AB.
  • Posttreatment liver function, but not baseline liver function stratifies patient survival after direct-acting antiviral treatment in decompensated cirrhosis with hepatitis C virus.
    Yuki Tahata, Hayato Hikita, Satoshi Mochida, Nobuyuki Enomoto, Akio Ido, Hidekatsu Kuroda, Daiki Miki, Masayuki Kurosaki, Yoichi Hiasa, Ryotaro Sakamori, Norifumi Kawada, Taro Yamashita, Goki Suda, Hiroshi Yatsuhashi, Hitoshi Yoshiji, Naoya Kato, Taro Takami, Kazuhiko Nakao, Kentaro Matsuura, Yasuhiro Asahina, Yoshito Itoh, Ryosuke Tateishi, Yasunari Nakamoto, Eiji Kakazu, Shuji Terai, Masahito Shimizu, Yoshiyuki Ueno, Norio Akuta, Masanori Miyazaki, Yasutoshi Nozaki, Masayuki Kabayama, Satoshi Sobue, Akihiro Moriuchi, Tomokatsu Miyaki, Takahiro Kodama, Tomohide Tatsumi, Tomomi Yamada, Tetsuo Takehara
    Journal of gastroenterology, 2023年10月13日, [査読有り], [国内誌]
    英語, 研究論文(学術雑誌), BACKGROUND: The prognosis of cirrhosis is clearly stratified by liver function. Although direct-acting antiviral (DAA) has recently been used to eliminate hepatitis C virus (HCV), it is not clear whether liver function stratifies the prognosis of decompensated cirrhotic patients treated with DAA. METHODS: A total of 206 HCV-associated decompensated cirrhotic patients who started DAA from February 2019 to December 2021 at 31 Japanese hospitals were prospectively registered. RESULTS: The median age was 68, and the proportions of patients with Child-Pugh class A (CP-A), CP-B and CP-C were 10% (20/206), 76% (156/206) and 15% (30/206), respectively. Twenty-six patients died, and two patients underwent liver transplantation (LT); the 2- and 3-year LT-free survival rates were 90.0% and 83.2%, respectively. We examined factors associated with LT-free survival using 2 models including either CP class (Model 1) or MELD score (Model 2). In multivariate Cox proportional hazard analysis, CP class at 12 weeks after the end of treatment (EOT) in Model 1 and MELD score at 12 weeks after the EOT in Model 2 were significant factors, while baseline CP class or MELD score was not. Two-year LT-free survival rates were 100%, 91.6% and 60.4% for patients with CP-A, CP-B and CP-C at 12 weeks after the EOT and 95.2% and 69.6% for patients with MELD < 15 and MELD ≥ 15 at 12 weeks after the EOT, respectively. CONCLUSIONS: The prognosis of decompensated cirrhotic patients receiving DAA was stratified by liver function at 12 weeks after the EOT, not by baseline liver function.
  • 【薬物療法によって変貌する肝細胞癌治療:2023 Update】Advanced stage肝細胞癌 Phase 3 HIMALAYA試験の結果とその解釈               
    荘 拓也, 須田 剛生, 北潟谷 隆, 大原 正嗣, 中井 正人, 小川 浩司, 坂本 直哉
    肝胆膵, 87, 4, 439, 446, (株)アークメディア, 2023年10月
    日本語
  • IMbrave150基準外進行肝細胞癌に対するアテゾリズマブ+ベバシズマブ併用療法の治療効果と肝予備能変化               
    荘 拓也, 須田 剛生, 大原 正嗣, 中井 正人, 小川 浩司, 出水 孝章, 目黒 高志, 中村 晃久, 高木 智史, 馬場 英, 古家 乾, 鈴木 和治, 山本 義也, 伊藤 淳, 山田 錬, 宮城島 拓人, 坂本 直哉
    肝胆膵, 87, 4, 508, 509, (株)アークメディア, 2023年10月
    日本語
  • 北海道における肝炎医療コーディネーター養成研修会の実施状況の変遷に関する検討               
    大原 正嗣, 小川 浩司, 長谷川 智子, 櫻井 菜々子, 中井 正人, 荘 拓也, 須田 剛生, 坂本 直哉
    肝臓, 64, Suppl.3, A808, A808, (一社)日本肝臓学会, 2023年10月
    日本語
  • IMbrave150基準外症例におけるアテゾリズマブ+ベバシズマブ併用療法の生存に寄与する因子の検討 多施設共同研究
    荘 拓也, 須田 剛生, 大原 正嗣, 中井 正人, 小川 浩司, 出水 孝章, 目黒 高志, 中村 晃久, 高木 智史, 馬場 英, 古家 乾, 山本 義也, 伊藤 淳, 山田 錬, 宮城島 拓人, 坂本 直哉
    日本消化器病学会雑誌, 120, 臨増大会, A813, A813, (一財)日本消化器病学会, 2023年10月
    日本語
  • 【薬物療法によって変貌する肝細胞癌治療:2023 Update】Advanced stage肝細胞癌 Phase 3 HIMALAYA試験の結果とその解釈               
    荘 拓也, 須田 剛生, 北潟谷 隆, 大原 正嗣, 中井 正人, 小川 浩司, 坂本 直哉
    肝胆膵, 87, 4, 439, 446, (株)アークメディア, 2023年10月
    日本語
  • IMbrave150基準外進行肝細胞癌に対するアテゾリズマブ+ベバシズマブ併用療法の治療効果と肝予備能変化               
    荘 拓也, 須田 剛生, 大原 正嗣, 中井 正人, 小川 浩司, 出水 孝章, 目黒 高志, 中村 晃久, 高木 智史, 馬場 英, 古家 乾, 鈴木 和治, 山本 義也, 伊藤 淳, 山田 錬, 宮城島 拓人, 坂本 直哉
    肝胆膵, 87, 4, 508, 509, (株)アークメディア, 2023年10月
    日本語
  • 肝肺症候群を合併したBudd-Chiari症候群の1例               
    保浦 直弘, 目野 晃光, 甲谷 理紗子, 佐々木 貴志, 細田 峻一, 吉田 苑永, 大原 正嗣, 中井 正人, 荘 拓也, 須田 剛生, 小川 浩司, 坂本 直哉
    日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集, 133回・127回, 40, 40, 日本消化器病学会-北海道支部, 2023年09月
    日本語
  • 腹腔鏡下横隔膜縫合術、腹腔静脈シャント術により体液コントロールされた肝硬変の1例               
    目野 晃光, 小川 浩司, 保浦 直弘, 甲谷 理紗子, 佐々木 貴志, 細田 峻一, 吉田 苑永, 得地 祐匡, 大原 正嗣, 中井 正人, 荘 拓也, 須田 剛生, 坂本 直哉, 武藤 潤
    日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集, 133回・127回, 40, 40, 日本消化器病学会-北海道支部, 2023年09月
    日本語
  • 消化器癌に対する免疫療法の現状と課題 非切除肝細胞癌患者における複合的がん免疫療法における治療後獲得薬剤耐性化に伴ってみられる血清増殖因子変化の検討               
    須田 剛生, 大原 正嗣, 坂本 直哉
    肝臓, 64, Suppl.2, A558, A558, (一社)日本肝臓学会, 2023年09月
    日本語
  • 肝癌患者におけるマニュアルトレース法による筋肉量と皮下脂肪CT値評価の有用性の検討               
    大原 正嗣, 須田 剛生, 佐々木 貴志, 甲谷 理紗子, 細田 峻一, 吉田 苑永, 得地 祐匡, 中井 正人, 荘 拓也, 小川 浩司, 坂本 直哉
    肝臓, 64, Suppl.2, A644, A644, (一社)日本肝臓学会, 2023年09月
    日本語
  • Sequential therapies after atezolizumab plus bevacizumab or lenvatinib first-line treatments in hepatocellular carcinoma patients.
    Mara Persano, Margherita Rimini, Toshifumi Tada, Goki Suda, Shigeo Shimose, Masatoshi Kudo, Jaekyung Cheon, Fabian Finkelmeier, Ho Yeong Lim, José Presa, Gianluca Masi, Changhoon Yoo, Sara Lonardi, Francesco Tovoli, Takashi Kumada, Naoya Sakamoto, Hideki Iwamoto, Tomoko Aoki, Hong Jae Chon, Vera Himmelsbach, Takashi Niizeki, Margarida Montes, Caterina Vivaldi, Caterina Soldà, Bernardo Stefanini, Atsushi Hiraoka, Takuya Sho, Naoshi Nishida, Christoph Steup, Massimo Iavarone, Giovanni Di Costanzo, Fabio Marra, Emiliano Tamburini, Giuseppe Cabibbo, Francesco Giuseppe Foschi, Marianna Silletta, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hironori Ochi, Satoshi Yasuda, Hidenori Toyoda, Chikara Ogawa, Takashi Nishimura, Takeshi Hatanaka, Satoru Kakizaki, Noritomo Shimada, Kazuhito Kawata, Fujimasa Tada, Hideko Ohama, Kazuhiro Nouso, Asahiro Morishita, Akemi Tsutsui, Takuya Nagano, Norio Itokawa, Tomomi Okubo, Taeang Arai, Michitaka Imai, Hisashi Kosaka, Atsushi Naganuma, Yohei Koizumi, Shinichiro Nakamura, Masaki Kaibori, Hiroko Iijima, Yoichi Hiasa, Claudia Campani, Elisabeth Amadeo, Federico Rossari, Valentina Burgio, Stefano Cascinu, Mario Scartozzi, Andrea Casadei-Gardini
    European journal of cancer (Oxford, England : 1990), 189, 112933, 112933, 2023年08月, [国際誌]
    英語, 研究論文(学術雑誌), INTRODUCTION: The aim of this retrospective proof-of-concept study was to compare different second-line treatments for patients with hepatocellular carcinoma and progressive disease (PD) after first-line lenvatinib or atezolizumab plus bevacizumab. MATERIALS AND METHODS: A total of 1381 patients had PD at first-line therapy. 917 patients received lenvatinib as first-line treatment, and 464 patients atezolizumab plus bevacizumab as first-line. RESULTS: 49.6% of PD patients received a second-line therapy without any statistical difference in overall survival (OS) between lenvatinib (20.6months) and atezolizumab plus bevacizumab first-line (15.7months; p = 0.12; hazard ratio [HR]= 0.80). After lenvatinib first-line, there wasn't any statistical difference between second-line therapy subgroups (p = 0.27; sorafenib HR: 1; immunotherapy HR: 0.69; other therapies HR: 0.85). Patients who underwent trans-arterial chemo-embolization (TACE) had a significative longer OS than patients who received sorafenib (24.7 versus 15.8months, p < 0.01; HR=0.64). After atezolizumab plus bevacizumab first-line, there was a statistical difference between second-line therapy subgroups (p < 0.01; sorafenib HR: 1; lenvatinib HR: 0.50; cabozantinib HR: 1.29; other therapies HR: 0.54). Patients who received lenvatinib (17.0months) and those who underwent TACE (15.9months) had a significative longer OS than patients treated with sorafenib (14.2months; respectively, p = 0.01; HR=0.45, and p < 0.05; HR=0.46). CONCLUSION: Approximately half of patients receiving first-line lenvatinib or atezolizumab plus bevacizumab access second-line treatment. Our data suggest that in patients progressed to atezolizumab plus bevacizumab, the systemic therapy able to achieve the longest survival is lenvatinib, while in patients progressed to lenvatinib, the systemic therapy able to achieve the longest survival is immunotherapy.
  • Neutrophil gelatinase-associated lipocalin predicts the efficacy of tolvaptan for ascites in patients with liver cirrhosis.
    Masato Nakai, Kenichi Morikawa, Takashi Sasaki, Risako Kohya, Sonoe Yoshida, Shunichi Hosoda, Akinori Kubo, Yoshimasa Tokuchi, Takashi Kitagataya, Ren Yamada, Masatsugu Ohara, Takuya Sho, Goki Suda, Koji Ogawa, Naoya Sakamoto
    Journal of gastroenterology, 58, 7, 656, 667, 2023年07月, [国内誌]
    英語, 研究論文(学術雑誌), BACKGROUND: Acute kidney injury (AKI) is associated with liver cirrhosis (LC), water retention, diuretics to treat water retention, and a poor prognosis. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) reportedly predicts a poor prognosis in decompensated LC. This study investigated the usefulness of uNGAL in predicting the short- and long-term effects of tolvaptan (TVP) and the incidence of AKI post-TVP administration. METHODS: Of the LC cases with water retention, 86 with available pre-treatment uNGAL were analyzed. A short-term response was defined as weight loss of ≥ 1.5 kg within the first week; a long-term response was defined as a short-term response without early recurrence. The uNGAL usefulness in predicting the short- and long-term effects of TVP and AKI incidence post-TVP administration was investigated. RESULTS: Short-term effects of TVP were observed in 52 patients. Of these, 15 patients had an early recurrence. In multivariate analysis, significant short-term predictive factors were C-reactive protein (CRP) < 1.4 mg/dl, uNa/K ratio ≥ 3.51, and uNGAL < 50.2 ng/ml. Patients were classified according to these three cut-off values, with short-term response rates of 92.9%, 68.8%, 26.7%, and 0% for 0, 1, 2, and 3 points, respectively. CRP < 0.94 mg/dl and uNGAL < 50.2 ng/ml were significant factors for predicting the long-term response of TVP. The AKI incidence post-TVP was 8.1% (n = 7) and was significantly higher among those with uNGAL ≥ 38.1 ng/mL. CONCLUSION: uNGAL is a useful predictor of the short- and long-term efficacy of TVP and can be useful in predicting AKI incidence post-TVP administration.
  • Potential Correlation between Changes in Serum FGF21 Levels and Lenvatinib-Induced Appetite Loss in Patients with Unresectable Hepatocellular Carcinoma.
    Risako Kohya, Goki Suda, Masatsugu Ohara, Takashi Sasaki, Tomoka Yoda, Naofumi Sakurai, Sonoe Yoshida, Qingjie Fu, Zijian Yang, Shunichi Hosoda, Osamu Maehara, Shunsuke Ohnishi, Yoshimasa Tokuchi, Takashi Kitagataya, Kazuharu Suzuki, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Koji Ogawa, Naoya Sakamoto
    Cancers, 15, 12, 2023年06月20日, [国際誌]
    英語, 研究論文(学術雑誌), Lenvatinib, used for unresectable hepatocellular carcinoma (HCC), causes appetite loss, but the underlying mechanisms, clinical impact, and predictive factors have been unclear. The endocrine factor FGF21 modulates appetite and is involved in cachexia. We evaluated the association between FGF21 level changes during lenvatinib treatment for unresectable HCC and appetite loss. Sixty-three eligible unresectable HCC patients who started lenvatinib treatment between 2018 and 2021 were included. We analyzed FGF21 levels at baseline; 1, 2, and 4 weeks after lenvatinib initiation, and before the onset of appetite loss. Grade ≥ 2 lenvatinib-induced appetite loss led to liver functional reserve deterioration at disease progression and a poor prognosis. Baseline characteristics and serum FGF21 levels were similar between patients with and without appetite loss. However, the serum FGF21 change rate increased significantly at 4 weeks post-lenvatinib initiation in patients with grade ≥ 2 appetite loss, as compared to those without appetite loss. Similar significant increases in the serum FGF21 level change rate were observed prior to grade ≥ 2 appetite loss onset. This suggests that changes in FGF21 levels can be used to predict patients with a greater risk of marked appetite loss and provides insights into the mechanisms underlying lenvatinib-induced appetite loss in patients with HCC.
  • Recent prevalence and characteristics of patients with hepatitis delta virus in Hokkaido, Japan.
    Takashi Sasaki, Goki Suda, Masatsugu Ohara, Shunichi Hosoda, Naoki Kawagishi, Risako Kohya, Tomoka Yoda, Osamu Maehara, Shunsuke Ohnishi, Sonoe Yoshida, Qingjie Fu, Zijian Yang, Yoshimasa Tokuchi, Takashi Kitagataya, Kazuharu Suzuki, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Sho Komukai, Koji Ogawa, Naoya Sakamoto
    Hepatology research : the official journal of the Japan Society of Hepatology, 2023年06月18日, [国際誌]
    英語, 研究論文(学術雑誌), AIM: Although hepatitis delta virus (HDV) coinfection with hepatitis B virus (HBV) is a global health concern, the global prevalence of HDV infections remains unknown due to insufficient data in many countries. In Japan, HDV prevalence has not been updated for over 20 years. We aimed to investigate the recent prevalence of HDV infections in Japan. METHODS: We screened 1264 consecutive patients with HBV infection at Hokkaido University Hospital between 2006 and 2022. Patients' serums were preserved and subsequently tested for HDV antibody (immunoglobulin-G). Available clinical information was collected and analyzed. We compared the changes in liver fibrosis using the Fibrosis-4 (FIB-4) index between propensity-matched patients with and without the evidence of anti-HDV antibodies and corrected for baseline FIB-4 index, nucleoside/nucleotide analog treatment, alcohol intake, sex, HIV coinfection, liver cirrhosis, and age. RESULTS: After excluding patients without properly stored serums and those lacking appropriate clinical information, 601 patients with HBV were included. Of these, 1.7% of patients had detectable anti-HDV antibodies. Patients with anti-HDV antibody serum positivity had a significantly higher prevalence of liver cirrhosis, significantly lower prothrombin time, and a higher prevalence of HIV coinfection than those who demonstrated serum anti-HDV antibody negativity. A propensity-matched longitudinal analysis revealed that liver fibrosis (FIB-4 index) progressed more rapidly in patients with positive results for anti-HDV antibody tests. CONCLUSIONS: The recent prevalence of HDV infections in Japanese patients with HBV was 1.7% (10/601). These patients experienced rapid liver fibrosis progression, highlighting the importance of routine HDV testing.
  • 【肝疾患-診療のチェックポイント2023】(第I部)診断のチェックポイント(第5章) 肝疾患鑑別診断のチェックポイント 肝炎ウイルス以外のウイルス性肝障害が疑われるとき
    大原 正嗣, 須田 剛生, 坂本 直哉
    臨床消化器内科, 38, 7, 807, 811, (株)日本メディカルセンター, 2023年06月
    日本語, <文献概要>▼肝炎ウイルス以外のウイルスでも肝障害の原因となることを念頭に,鑑別診断として,とくにEBウイルス,サイトメガロウイルスを想起する.▼COVID-19患者の肝障害については今後の研究報告により対応が変わってくる可能性がある.
  • Low Baseline CXCL9 Predicts Early Progressive Disease in Unresectable HCC with Atezolizumab Plus Bevacizumab Treatment.
    Shunichi Hosoda, Goki Suda, Takuya Sho, Koji Ogawa, Megumi Kimura, Zijian Yang, Sonoe Yoshida, Akinori Kubo, Yoshimasa Tokuchi, Takashi Kitagataya, Osamu Maehara, Shunsuke Ohnishi, Akihisa Nakamura, Ren Yamada, Masatsugu Ohara, Naoki Kawagishi, Mitsuteru Natsuizaka, Masato Nakai, Kenichi Morikawa, Ken Furuya, Masaru Baba, Yoshiya Yamamoto, Kazuharu Suzuki, Takaaki Izumi, Takashi Meguro, Katsumi Terashita, Jun Ito, Takuto Miyagishima, Naoya Sakamoto
    Liver cancer, 12, 2, 156, 170, 2023年06月, [国際誌]
    英語, 研究論文(学術雑誌), INTRODUCTION: Atezolizumab plus bevacizumab treatment is highly effective in patients with unresectable hepatocellular carcinoma (HCC). However, progressive disease (PD) occurs in approximately 20% of HCC patients treated with atezolizumab plus bevacizumab, resulting in a poor prognosis. Thus, the prediction and early detection of HCC is crucial. METHODS: Patients with unresectable HCC treated with atezolizumab plus bevacizumab and had baseline preserved serum (n = 68) were screened and classified according to their PD, 6 weeks after treatment initiation (early PD; n = 13). Of these, 4 patients each with and without early PD were selected for cytokine array and genetic analyses. The identified factors were validated in the validated cohort (n = 60) and evaluated in patients treated with lenvatinib. RESULTS: No significant differences were observed in the genetic alterations in circulating tumor DNA. Cytokine array data revealed that baseline MIG (CXCL9), ENA-78, and RANTES differed substantially between patients with and without early PD. Subsequent analysis in the validation cohort revealed that baseline CXCL9 was significantly lower in patients with early PD than that in patients without early PD, and the best cut-off value of serum CXCL9 to predict early PD was 333 pg/mL (sensitivity: 0.600, specificity: 0.923, AUC = 0.75). In patients with lower serum CXCL9 (<333 pg/mL), 35.3% (12/34) experienced early PD with atezolizumab plus bevacizumab, while progression-free survival (PFS) was significantly shorter relative to that in patients without (median PFS, 126 days vs. 227 days; HR: 2.41, 95% CI: 1.22-4.80, p = 0.0084). While patients with objective response to lenvatinib had significantly lower CXCL9 levels compared with those of patients without. CONCLUSION: Baseline low serum CXCL9 (<333 pg/mL) levels may predict early PD in patients with unresectable HCC treated with atezolizumab plus bevacizumab.
  • 肝臓と糖尿病・代謝研究10年間の進歩 非アルコール性脂肪性肝疾患における肝発癌高リスク群の絞り込みの検討               
    疋田 隼人, 熊崎 秀祐, 田畑 優貴, 垣田 成庸, 高橋 和宏, 豊田 秀徳, 須田 剛生, 小玉 尚宏, 竹原 徹郎
    糖尿病, 66, Suppl.1, S, 144, (一社)日本糖尿病学会, 2023年04月
    日本語
  • 肝疾患におけるサルコペニア診断と栄養・運動介入の課題 マニュアルトレース法による筋肉量評価及び皮下脂肪CT値と肝疾患患者の予後の検討               
    大原 正嗣, 須田 剛生, 坂本 直哉
    肝臓, 64, Suppl.1, A231, A231, (一社)日本肝臓学会, 2023年04月
    日本語
  • 免疫チェックポイント阻害剤の奏効率および副作用と腸内環境との関連
    杉田 萌々子, 北潟谷 隆, 福島 新弥, 長島 一哲, 山本 碩満, 楊 佳約, 平山 明由, 桂田 武彦, 須田 剛生, 福田 真嗣
    腸内細菌学雑誌, 37, 2, 113, 113, (公財)腸内細菌学会, 2023年04月
    日本語
  • 肝臓と糖尿病・代謝研究10年間の進歩 非アルコール性脂肪性肝疾患における肝発癌高リスク群の絞り込みの検討               
    疋田 隼人, 熊崎 秀祐, 田畑 優貴, 垣田 成庸, 高橋 和宏, 豊田 秀徳, 須田 剛生, 小玉 尚宏, 竹原 徹郎
    糖尿病, 66, Suppl.1, S, 144, (一社)日本糖尿病学会, 2023年04月
    日本語
  • Identification of Atezolizumab Plus Bevacizumab Prognostic Index via Recursive Partitioning Analysis in HCC: The ABE Index.
    Mara Persano, Margherita Rimini, Toshifumi Tada, Goki Suda, Shigeo Shimose, Masatoshi Kudo, Jaekyung Cheon, Fabian Finkelmeier, Ho Yeong Lim, José Presa, Gianluca Masi, Changhoon Yoo, Sara Lonardi, Tiziana Pressiani, Fabio Piscaglia, Takashi Kumada, Lorenza Rimassa, Mario Scartozzi, Stefano Cascinu, Andrea Casadei-Gardini
    Anticancer research, 43, 4, 1599, 1610, 2023年04月, [国際誌]
    英語, 研究論文(学術雑誌), BACKGROUND/AIM: The purpose of this study was to ascertain a novel prognostic index via recursive partitioning analysis (RPA) in hepatocellular carcinoma (HCC) patients being treated with the combination of atezolizumab plus bevacizumab (ABE) in first-line setting. PATIENTS AND METHODS: A total of 784 patients with HCC were included in the analysis. RESULTS: RPA identified three groups of patients: high-risk [Child-Pugh B (CP-B) patients; CP-A and Albumin-Bilirubin (ALBI)-2 patients; CP-A and ALBI-1 patients with macrovascular invasion (MVI), and alpha-fetoprotein (α-FP) ≥400 ng/ml]; intermediate-risk [CP-A and ALBI-1 patients with aspartate aminotransferase (AST) normal value (NV), and αFP ≥400 ng/ml, but without MVI; CP-A and ALBI-1 patients with AST increased value (IV), and neutrophil-lymphocyte ratio (NLR) ≥3, but without MVI]; low-risk (CP-A and ALBI-1 patients with AST NV, and αFP <400 ng/ml, but without MVI; CP-A and ALBI-1 patients with AST IV, and NLR <3, but without MVI; CP-A and ALBI-1 patients with MVI, and αFP <400 ng/ml). Overall survival was 7.0 months in high-risk patients (20.8%), 14.2 months in intermediate-risk patients (19.1%), and 22.5 months in low-risk patients (60.1%). CONCLUSION: The ABE index allows for easy stratification of HCC patients treated with the combination of ABE in first-line setting.
  • Survival outcomes from atezolizumab plus bevacizumab versus Lenvatinib in Child Pugh B unresectable hepatocellular carcinoma patients.
    Margherita Rimini, Mara Persano, Toshifumi Tada, Goki Suda, Shigeo Shimose, Masatoshi Kudo, Jaekyung Cheon, Fabian Finkelmeier, Ho Yeong Lim, José Presa, Francesca Salani, Sara Lonardi, Fabio Piscaglia, Takashi Kumada, Naoya Sakamoto, Hideki Iwamoto, Tomoko Aoki, Hong Jae Chon, Vera Himmelsbach, Marta Schirripa, Margarida Montes, Caterina Vivaldi, Caterina Soldà, Atsushi Hiraoka, Takuya Sho, Takashi Niizeki, Naoshi Nishida, Christoph Steup, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hironori Ochi, Satoshi Yasuda, Hidenori Toyoda, Chikara Ogawa, Takashi Nishimura, Takeshi Hatanaka, Satoru Kakizaki, Noritomo Shimada, Kazuhito Kawata, Fujimasa Tada, Hideko Ohama, Kazuhiro Nouso, Asahiro Morishita, Akemi Tsutsui, Takuya Nagano, Norio Itokawa, Tomomi Okubo, Taeang Arai, Michitaka Imai, Hisashi Kosaka, Atsushi Naganuma, Yohei Koizumi, Shinichiro Nakamura, Masaki Kaibori, Hiroko Iijima, Yoichi Hiasa, Valentina Burgio, Mario Scartozzi, Stefano Cascinu, Andrea Casadei-Gardini
    Journal of cancer research and clinical oncology, 149, 10, 7565, 7577, 2023年03月28日, [国際誌]
    英語, 研究論文(学術雑誌), INTRODUCTION: The best first-line treatment for patients with advanced hepatocellular carcinoma (HCC) and Child-Pugh (CP) class B remains unknown. The aim of the present study was to perform a real-world analysis on a large sample of patients with unresectable HCC with CP B treated with atezolizumab plus bevacizumab Vs Lenvatinib. METHODS: The study population included patients affected by advanced (BCLC-C) or intermediate (BCLC-B) HCC patients not suitable for locoregional therapies from both the Western and Eastern world (Italy, Germany, Republic of Korea and Japan), who received atezolizumab plus bevacizumab or Lenvatinib as first-line treatment. All the study population presented a CP class of B. The primary endpoint of the study was the overall survival (OS) of CP B patients treated with Lenvatinib compared to atezolizumab plus bevacizumab. Survival curves were estimated using the product-limit method of Kaplan-Meier. The role of stratification factors was analyzed with log-rank tests. Finally, an interaction test was performed for the main baseline clinical characteristics. RESULTS: 217 CP B HCC patients were enrolled in the study: 65 (30%) received atezolizumab plus bevacizumab, and 152 (70%) received lenvatinib. The mOS for patients receiving Lenvatinib was 13.8 months (95% CI: 11.6-16.0), compared to 8.2 months (95% CI 6.3-10.2) for patients receiving atezolizumab plus bevacizumab as first-line treatment (atezolizumab plus bevacizumab Vs Lenvatinib: HR 1.9, 95% CI 1.2-3.0, p = 0.0050). No statistically significant differences were highlighted in terms of mPFS. The multivariate analysis confirmed that patients receiving Lenvatinib as first-line treatment have a significantly longer OS compared to patients receiving atezolizumab plus bevacizumab (HR 2.01; 95% CI 1.29-3.25, p = 0.0023). By evaluating the cohort of patients who received atezolizumab plus bevacizumab, we found that Child B patients with ECOG PS 0, or BCLC B stage or ALBI grade 1 were those who had benefited from the treatment thus showing survival outcomes no significantly different compared to those receiving Lenvatinib. CONCLUSION: The present study suggests for the first time a major benefit from Lenvatinib compared to atezolizumab plus bevacizumab in a large cohort of patients with CP B class HCC.
  • Hepatitis C virus eradication by direct-acting antivirals causes a simultaneous increase in the prevalence of fatty liver and hyper low-density lipoprotein cholesterolemia without an increase in body weight.
    Yoshimasa Tokuchi, Goki Suda, Naoki Kawagishi, Masatsugu Ohara, Risako Kohya, Takashi Sasaki, Tomoka Yoda, Osamu Maehara, Shunsuke Ohnishi, Akinori Kubo, Sonoe Yoshida, Qingjie Fu, Zijian Yang, Shunichi Hosoda, Takashi Kitagataya, Kazuharu Suzuki, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Koji Ogawa, Naoya Sakamoto
    Hepatology research : the official journal of the Japan Society of Hepatology, 53, 7, 595, 606, 2023年03月21日, [国際誌]
    英語, 研究論文(学術雑誌), AIM: Hepatitis C virus (HCV) infection has been reported to cause liver steatosis. Thus, eradicating HCV with direct-acting antivirals (DAAs) is expected to reduce liver steatosis. We aimed to clarify long-term changes in the prevalence of fatty liver and hyper-low-density lipoprotein (LDL) cholesterolemia and their associations in patients who achieve successful HCV eradication using DAAs. METHODS: This retrospective study included patients with HCV who achieved sustained virologic response after interferon-free DAA and analyzed the changes in the prevalence of fatty liver diagnosed with controlled attenuation parameter (CAP), hyper-LDL cholesterolemia, and their relationships at baseline (n = 100) and 24 weeks (SVR24, n = 100), 96 weeks (SVR96, n = 100), and 144 weeks (SVR144, n = 90) after DAA. RESULTS: In 100 participants, the prevalence of fatty liver (19% vs. 32%, p = 0.0349) and hyper-LDL cholesterolemia (6% vs. 15%, p = 0.0379) significantly increased without changes in body weight at SVR96. Median total cholesterol, low-density lipoprotein cholesterol (LDL-C), and small-dense-LDL (sdLDL) levels and CAP values were significantly greater at SVR24, SVR96, and SVR144 than at baseline. Baseline CAP values and changes in CAP values were significantly negatively correlated at every observation point: r = -0.5305, p < 0.0001 at SVR24; r = -0.3617, p = 0.0005 at SVR96; and r = -0.4735, p < 0.0001 at SVR144. A similar relationship was observed in cholesterol levels. Unlike at baseline, CAP values were significantly positively correlated with LDL-C and sdLDL-C levels at all observation points after DAAs. CONCLUSIONS: Direct-acting antivirals may cause an increased prevalence of fatty liver accompanying hyper-LDL cholesterolemia without increased body weight. As post-SVR liver steatosis could cause HCC, careful follow-up may be required.
  • Real-World Data for Atezolizumab Plus Bevacizumab in Unresectable Hepatocellular Carcinoma: How Does Adherence to the IMbrave150 Trial Inclusion Criteria Impact Prognosis?
    Margherita Rimini, Mara Persano, Toshifumi Tada, Goki Suda, Shigeo Shimose, Masatoshi Kudo, Jaekyung Cheon, Fabian Finkelmeier, Ho Yeong Lim, José Presa, Gianluca Masi, Changhoon Yoo, Sara Lonardi, Fabio Piscaglia, Takashi Kumada, Naoya Sakamoto, Hideki Iwamoto, Tomoko Aoki, Hong Jae Chon, Vera Himmelsbach, Tiziana Pressiani, Margarida Montes, Caterina Vivaldi, Caterina Soldà, Atsushi Hiraoka, Takuya Sho, Takashi Niizeki, Naoshi Nishida, Christoph Steup, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hironori Ochi, Satoshi Yasuda, Hidenori Toyoda, Chikara Ogawa, Takashi Nishimura, Takeshi Hatanaka, Satoru Kakizaki, Noritomo Shimada, Kazuhito Kawata, Fujimasa Tada, Hideko Ohama, Kazuhiro Nouso, Asahiro Morishita, Akemi Tsutsui, Takuya Nagano, Norio Itokawa, Tomomi Okubo, Taeang Arai, Michitaka Imai, Hisashi Kosaka, Atsushi Naganuma, Yohei Koizumi, Shinichiro Nakamura, Masaki Kaibori, Hiroko Iijima, Yoichi Hiasa, Valentina Burgio, Lorenza Rimassa, Mario Scartozzi, Stefano Cascinu, Andrea Casadei-Gardini
    Targeted oncology, 18, 2, 221, 233, 2023年03月15日, [国際誌]
    英語, 研究論文(学術雑誌), BACKGROUND: Atezolizumab plus bevacizumab has recently been approved as a new first-line standard of care for patients with unresectable hepatocellular carcinoma (HCC). OBJECTIVE: We performed a real-world study to evaluate the impact of the IMbrave150 trial inclusion criteria on the safety and efficacy of treatment outside of clinical trials. METHODS: We analyzed patients treated with atezolizumab plus bevacizumab for unresectable HCC from four different countries. No specific inclusion and exclusion criteria were applied, except for the absence of previous systemic therapies for HCC. The entire population was split into two groups according to concordance with the inclusion criteria as reported in the IMbrave150 trial in 'IMbrave150-in' and 'IMbrave150-out' patients, and safety and efficacy in the two groups of patients were evaluated. RESULTS: Overall, 766 patients were included in the analysis: 561/766 (73%) in the 'IMbrave150-in' group and 205/766 (27%) in the 'IMbrave150-out' group. Median overall survival (OS) and median progression-free survival (PFS) were 16.3 versus 14.3 months (hazard ratio [HR] 0.48, 95% confidence interval [CI] 0.35-0.65; p < 0.0001] and 8.3 versus 6.0 months (HR 0.79, 95% CI 0.63-0.99; p = 0.0431) in 'IMbrave150-in' and 'IMbrave150-out' patients, respectively. Multivariate analysis confirmed that patients included in the 'IMbrave150-in' group had significantly longer OS compared with patients included in the 'IMbrave150-out' group (HR 0.76, 95% CI 0.47-0.97; p = 0.0195). In 'IMbrave150-in' patients, the albumin-bilirubin (ALBI) grade was not associated with OS, whereas in 'IMbrave150-out' patients, those with ALBI grade 1 reported a significant benefit in terms of OS compared with those with ALBI grade 2 (16.7 vs. 5.9 months; HR 4.40, 95% CI 2.40-8.08; p > 0.0001). No statistically significant differences were reported in the 'IMbrave150-in' and 'IMbrave150-out' groups in terms of safety profile. CONCLUSION: Adherence to the IMbrave150 trial inclusion criteria favorably impacts the prognosis of patients receiving atezolizumab plus bevacizumab. Among patients who did not meet the IMbrave150 inclusion criteria, those with ALBI grade 1 could benefit from the treatment.
  • 肝細胞腺腫との鑑別が困難であった限局性結節性過形成の1例               
    吉田 苑永, 小川 浩司, 佐々木 貴志, 甲谷 理紗子, 細田 峻一, 久保 彰則, 得地 祐匡, 大原 正嗣, 中井 正人, 荘 拓也, 須田 剛生, 坂本 直哉
    日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集, 132回・126回, 42, 42, 日本消化器病学会-北海道支部, 2023年03月
    日本語
  • BCLCステージB2肝癌に対してアテゾリズマブ+ベバシズマブ併用療法と焼灼療法にてCancer Freeが得られた1症例               
    細田 峻一, 荘 拓也, 佐々木 貴志, 甲谷 理紗子, 吉田 苑永, 得地 祐匡, 大原 正嗣, 中井 正人, 須田 剛生, 小川 浩司, 坂本 直哉
    日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集, 132回・126回, 46, 46, 日本消化器病学会-北海道支部, 2023年03月
    日本語
  • BavenoVI分類とYerdel分類を用いた肝疾患に伴う門脈血栓症に対するアンチトロンビンIII製剤の治療効果の検討
    中井 正人, 小川 浩司, 佐々木 貴志, 甲谷 理紗子, 吉田 苑永, 細田 俊一, 得地 祐匡, 北潟谷 隆, 大原 正嗣, 荘 拓也, 須田 剛生, 坂本 直哉
    日本消化器病学会雑誌, 120, 臨増総会, A417, A417, (一財)日本消化器病学会, 2023年03月
    日本語
  • Role of the prognostic nutritional index in predicting survival in advanced hepatocellular carcinoma treated with atezolizumab plus bevacizumab.
    Margherita Rimini, Mara Persano, Toshifumi Tada, Goki Suda, Shigeo Shimose, Masatoshi Kudo, Jaekyung Cheon, Fabian Finkelmeier, Ho Yeong Lim, José Presa Ramos, Gianluca Masi, Changhoon Yoo, Sara Lonardi, Bernardo Stefanini, Takashi Kumada, Naoya Sakamoto, Hideki Iwamoto, Tomoko Aoki, Hong Jae Chon, Vera Himmelsbach, Margarida Montes, Caterina Vivaldi, Caterina Soldà, Atsushi Hiraoka, Takuya Sho, Takashi Niizeki, Naoshi Nishida, Christoph Steup, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hironori Ochi, Satoshi Yasuda, Hidenori Toyoda, Chikara Ogawa, Takashi Nishimura, Takeshi Hatanaka, Satoru Kakizaki, Noritomo Shimada, Kazuhito Kawata, Fujimasa Tada, Hideko Ohama, Kazuhiro Nouso, Asahiro Morishita, Akemi Tsutsui, Takuya Nagano, Norio Itokawa, Tomomi Okubo, Taeang Arai, Michitaka Imai, Hisashi Kosaka, Atsushi Naganuma, Yohei Koizumi, Shinichiro Nakamura, Masaki Kaibori, Hiroko Iijima, Yoichi Hiasa, Valentina Burgio, Angelo Della Corte, Francesca Ratti, Francesco De Cobelli, Luca Aldrighetti, Mario Scartozzi, Stefano Cascinu, Andrea Casadei-Gardini
    Oncology, 101, 5, 283, 291, 2023年01月19日, [国際誌]
    英語, 研究論文(学術雑誌), INTRODUCTION: The prognostic nutritional index (PNI) is a multiparametric score introduced by Onodera based on the blood levels of lymphocytes and albumin in patients with gastrointestinal neoplasms. Regarding hepatocellular carcinoma (HCC), its prognostic role has been demonstrated in patients treated with sorafenib and lenvatinib. The aim of this real-world study is to investigate the association between clinical outcomes and PNI in patients being treated with atezolizumab plus bevacizumab. METHODS: The overall cohort of this multicentric study included 871 consecutive HCC patients from 4 countries treated with atezolizumab plus bevacizumab in first-line therapy. The PNI was calculated as follows: 10 × serum albumin concentration (g/dL) + 0.005 × peripheral lymphocyte count (number/mm3). RESULTS: For only 773 patients, data regarding lymphocyte counts and albumin levels were available, so only these patients were included in the final analysis. The cut-off point of the PNI was determined to be 41 by receiver operating characteristic (ROC) analysis. 268 patients (34.7%) were categorized as the PNI-low group, while the remaining 505 (65.3%) patients as the PNI-high group. At the univariate analysis, high PNI was associated with longer overall survival (OS) (22.5 vs. 10.1 months, HR 0.34, p < 0.01) and progression-free survival (PFS) (8.7 vs. 5.8 months, HR 0.63, p < 0.01) compared to patients with low PNI. At the multivariate analysis, high versus low PNI resulted as an independent prognostic factor for OS (HR 0.49 , p < 0.01) and PFS (HR 0.82, p = 0.01). There was no difference in objective response rate (ORR) between the two groups (high 26.1% vs. low 19.8%, p = 0.09), while disease control rate (DCR) was significantly higher in the PNI-high group (76.8% vs. 66.4%, p = 0.01). CONCLUSION: PNI is an independent prognostic factor for OS and PFS in HCC patients on first-line treatment with atezolizumab plus bevacizumab.
  • Changes in Serum Growth Factors during Resistance to Atezolizumab Plus Bevacizumab Treatment in Patients with Unresectable Hepatocellular Carcinoma.
    Zijian Yang, Goki Suda, Osamu Maehara, Masatsugu Ohara, Tomoka Yoda, Takashi Sasaki, Risako Kohya, Sonoe Yoshida, Shunichi Hosoda, Yoshimasa Tokuchi, Takashi Kitagataya, Kazuharu Suzuki, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Koji Ogawa, Shunsuke Ohnishi, Naoya Sakamoto
    Cancers, 15, 3, 2023年01月18日, [国際誌]
    英語, 研究論文(学術雑誌), The possible mechanisms of resistance to atezolizumab/bevacizumab for unresectable HCC, and the subsequent response to these therapies, remain underexplored. The sequential changes in serum growth factors, including VEGF-A, VEGF-C, VEGF-D, ANG-2, FGF-19, HGF, and EGF during atezolizumab/bevacizumab for unresectable HCC were evaluated in 46 patients. Patients who experienced PD after CR, PR, or SD to atezolizumab/bevacizumab were evaluated. A total of 4, 9, 19, and 14 patients showed CR, PR, SD, and PD, respectively. Of 32 patients with disease control, 28 experienced PD after CR, PR, or SD with atezolizumab/bevacizumab. Baseline growth factor levels were similar between patients with or without disease control and those with or without an objective response. Growth factor changes between the baseline and the best overall response points (BOR) for patients with disease control showed that FGF-19 significantly increased and ANG2 significantly decreased at the BOR. Growth factor changes between the BOR and the PD point in 28 patients who experienced PD after disease control showed that VEGF-D and ANG2 significantly increased at the PD point compared with that at the BOR. Summarily, increased serum VEGF-D and ANG-2 levels might contribute to developing resistance to atezolizumab/bevacizumab for unresectable HCC and might be target molecules in subsequent salvage therapies.
  • Serum Angiopoietin-2 Predicts the Occurrence and Recurrence of Hepatocellular Carcinoma after Direct-Acting Antiviral Therapy for Hepatitis C.
    Naoki Kawagishi, Goki Suda, Yoshiya Yamamoto, Masaru Baba, Ken Furuya, Osamu Maehara, Shunsuke Ohnishi, Sonoe Yoshida, Qingjie Fu, Zijian Yang, Shunichi Hosoda, Yoshimasa Tokuchi, Takashi Kitagataya, Masatsugu Ohara, Kazuharu Suzuki, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Koji Ogawa, Naoya Sakamoto
    Viruses, 15, 1, 2023年01月07日, [国際誌]
    英語, 研究論文(学術雑誌), Progressive liver fibrosis after anti-HCV treatment is a risk factor for HCC. Angiopoietin-2 (Ang2) is associated with non-regression of liver fibrosis after direct-acting antiviral (DAA). This study evaluated the predictive value of serum Ang2 levels for HCC occurrence or recurrence after DAA administration. In this retrospective study, 310 HCV-infected patients treated with DAAs in 2014-2020 were screened and evaluated for HCC occurrence or recurrence every three-six months. Multivariate Cox regression analysis revealed that age ≥ 75 years (HR: 2.92, 95% CI: 1.34-6.33; p = 0.007) and baseline Ang2 level ≥ 464 pg/mL (HR: 2.75, 95% CI: 1.18-6.37; p = 0.019) were significantly associated with HCC occurrence after DAA therapy. A high or low risk of HCC after DAA therapy could be distinguished by the combination of age and baseline Ang2 level. The cumulative incidences of de-novo HCC at two and four years were 0.8% and 3.8% in the low-risk group and 22.6% and 27.1% in the high-risk group, respectively. Baseline Ang2 level ≥ 402 pg/mL was significantly associated with HCC recurrence in patients who achieved sustained virological response with DAAs (HR: 3.68). In conclusion, serum Ang2 levels can predict HCC occurrence and recurrence after successful HCV eradication by DAAs.
  • Prophylactic tenofovir alafenamide for hepatitis B virus reactivation and reactivation-related hepatitis.
    Goki Suda, Masaru Baba, Yoshiya Yamamoto, Takuya Sho, Koji Ogawa, Megumi Kimura, Shunichi Hosoda, Sonoe Yoshida, Akinori Kubo, Qingjie Fu, Zijian Yang, Yoshimasa Tokuchi, Takashi Kitagataya, Osamu Maehara, Shunsuke Ohnishi, Ren Yamada, Masatsugu Ohara, Naoki Kawagishi, Mitsuteru Natsuizaka, Masato Nakai, Kenichi Morikawa, Ken Furuya, Kazuharu Suzuki, Takaaki Izumi, Takashi Meguro, Katsumi Terashita, Jun Ito, Tomoe Kobayashi, Izumi Tsunematsu, Naoya Sakamoto
    Journal of medical virology, 95, 2, e28452, 2023年01月04日, [国際誌]
    英語, 研究論文(学術雑誌), BACKGROUND: No prospective study on the efficacy of tenofovir alafenamide (TAF), a novel tenofovir prodrug, in preventing HBV reactivation has yet been reported. METHODS: This multicenter prospective study enrolled HBV-carriers who received TAF to prevent HBV reactivation before antitumor or immunosuppressive therapy, and patients with resolved HBV infection who experienced HBV-reactivation and received TAF to prevent HBV reactivation-related hepatitis. The efficacy of prophylactic TAF in preventing HBV reactivation and HBV reactivation-related hepatitis was evaluated at 6 and 12 months after initiating TAF. RESULTS: Overall, 110 patients were administered TAF to prevent HBV reactivation or HBV reactivation-related hepatitis. Three patients died owing to primary disease, whereas one patient was transferred to another hospital within 6 months after initiating TAF. Seven patients died due to primary disease, and five patients were transferred to another hospital within 12 months after initiating TAF. Therefore, 106 and 94 (77 patients with HBV infection, 17 with previous-HBV infection) patients were evaluated at 6 and 12 months after initiating TAF, respectively. No patient experienced HBV reactivation, HBV reactivation-related hepatitis, or treatment discontinuation due to HBV reactivation or adverse events of TAF after 6 and 12 months. CONCLUSION: TAF could effectively prevent HBV reactivation and HBV reactivation-related hepatitis. This article is protected by copyright. All rights reserved.
  • Coexistence of muscle atrophy and high subcutaneous adipose tissue radiodensity predicts poor prognosis in hepatocellular carcinoma.
    Masatsugu Ohara, Goki Suda, Risako Kohya, Takashi Sasaki, Tomoka Yoda, Sonoe Yoshida, Qingjie Fu, Zijian Yang, Shunichi Hosoda, Osamu Maehara, Shunsuke Ohnishi, Yoshimasa Tokuchi, Takashi Kitagataya, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Koji Ogawa, Naoya Sakamoto
    Frontiers in nutrition, 10, 1272728, 1272728, 2023年, [国際誌]
    英語, 研究論文(学術雑誌), INTRODUCTION: We aimed to assess the prognostic implications of muscle atrophy and high subcutaneous adipose tissue (SAT) radiodensity in patients with hepatocellular carcinoma (HCC). METHODS: In this retrospective study, muscle atrophy was assessed using the psoas muscle index (PMI) obtained from computed tomography. SAT radiodensity was evaluated based on radiodensity measurements. Survival and multivariate analyses were performed to identify factors associated with prognosis. The impact of muscle atrophy and high SAT radiodensity on prognosis was determined through survival analysis. RESULTS: A total of 201 patients (median age: 71 years; 76.6% male) with HCC were included. Liver cirrhosis was observed in 72.6% of patients, and the predominant Child-Pugh grade was A (77.1%). A total of 33.3% of patients exhibited muscle atrophy based on PMI values, whereas 12.9% had high SAT radiodensity. Kaplan-Meier survival analysis demonstrated that patients with muscle atrophy had significantly poorer prognosis than those without muscle atrophy. Patients with high SAT radiodensity had a significantly worse prognosis than those without it. Muscle atrophy, high SAT radiodensity, the Barcelona Clinic Liver Cancer class B, C, or D, and Child-Pugh score ≥ 6 were significantly associated with overall survival. Further classification of patients into four groups based on the presence or absence of muscle atrophy and high SAT radiodensity revealed that patients with both muscle atrophy and high SAT radiodensity had the poorest prognosis. CONCLUSION: Muscle atrophy and high SAT radiodensity are significantly associated with poor prognosis in patients with HCC. Identifying this high-risk subgroup may facilitate the implementation of targeted interventions, including nutritional therapy and exercise, to potentially improve clinical outcomes.
  • Simultaneous determination of heparan sulfate, chondroitin/dermatan sulfates, and hyaluronan glycosaminoglycan disaccharides by high-performance liquid chromatography using a reverse-phase column with adamantyl groups.
    Hisatoshi Hanamatsu, Satoshi Makino, Masatsugu Ohara, Goki Suda, Ikuko Yokota, Shoko Nishihara, Naoya Sakamoto, Jun-Ichi Furukawa
    Journal of chromatography. A, 1689, 463748, 463748, 2022年12月23日, [国際誌]
    英語, 研究論文(学術雑誌), Glycosaminoglycans (GAGs), which are one of the major components of proteoglycans, play a pivotal role in physiological processes such as signal transduction, cell adhesion, growth, and differentiation. Characterization of GAGs is challenging due to the tremendous structural diversity of heteropolysaccharides with numerous sulfate or carboxyl groups. In this present study, we examined the analysis of 2-aminobenzamide (2-AB) labeled GAG disaccharides by high-performance liquid chromatography (HPLC) using a reverse-phase (RP)-column with adamantyl groups. Under the analytical conditions, 17 types of 2-AB labeled GAG disaccharides derived from heparan sulfate, chondroitin/dermatan sulfates, and hyaluronan were sequentially separated in a single analysis. The analysis time was fast with high retention time reproducibility. Moreover, the RP-HPLC column with adamantyl groups allowed the quantification of GAGs in various biological samples, such as serum, cultured cells, and culture medium.
  • Clinical outcomes with atezolizumab plus bevacizumab or lenvatinib in patients with hepatocellular carcinoma: a multicenter real-world study.
    Mara Persano, Margherita Rimini, Toshifumi Tada, Goki Suda, Shigeo Shimose, Masatoshi Kudo, Jaekyung Cheon, Fabian Finkelmeier, Ho Yeong Lim, Lorenza Rimassa, José Presa, Gianluca Masi, Changhoon Yoo, Sara Lonardi, Francesco Tovoli, Takashi Kumada, Naoya Sakamoto, Hideki Iwamoto, Tomoko Aoki, Hong Jae Chon, Vera Himmelsbach, Tiziana Pressiani, Takumi Kawaguchi, Margarida Montes, Caterina Vivaldi, Caterina Soldà, Fabio Piscaglia, Atsushi Hiraoka, Takuya Sho, Takashi Niizeki, Naoshi Nishida, Christoph Steup, Massimo Iavarone, Giovanni Di Costanzo, Fabio Marra, Mario Scartozzi, Emiliano Tamburini, Giuseppe Cabibbo, Francesco Giuseppe Foschi, Marianna Silletta, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hironori Ochi, Satoshi Yasuda, Hidenori Toyoda, Chikara Ogawa, Takashi Nishimura, Takeshi Hatanaka, Satoru Kakizaki, Noritomo Shimada, Kazuhito Kawata, Fujimasa Tada, Hideko Ohama, Kazuhiro Nouso, Asahiro Morishita, Akemi Tsutsui, Takuya Nagano, Norio Itokawa, Tomomi Okubo, Taeang Arai, Michitaka Imai, Hisashi Kosaka, Atsushi Naganuma, Yohei Koizumi, Shinichiro Nakamura, Masaki Kaibori, Hiroko Iijima, Yoichi Hiasa, Antonella Cammarota, Valentina Burgio, Stefano Cascinu, Andrea Casadei-Gardini
    Journal of cancer research and clinical oncology, 149, 9, 5591, 5602, 2022年12月13日, [国際誌]
    英語, 研究論文(学術雑誌), PURPOSE: The purpose of this study is to compare response rates of lenvatinib and atezolizumab plus bevacizumab, in first-line real-world setting. METHODS: Overall cohort included Western and Eastern hepatocellular carcinoma (HCC) patient populations from 46 centres in 4 countries (Italy, Germany, Japan, and Republic of Korea). RESULTS: 1312 patients were treated with lenvatinib, and 823 patients were treated with atezolizumab plus bevacizumab. Objective response rate (ORR) was 38.6% for patients receiving lenvatinib, and 27.3% for patients receiving atezolizumab plus bevacizumab (p < 0.01; odds ratio 0.60). For patients who achieved complete response (CR), overall survival (OS) was not reached in both arms, but the result from univariate Cox regression model showed 62% reduction of death risk for patients treated with atezolizumab plus bevacizumab (p = 0.05). In all multivariate analyses, treatment arm was not found to be an independent factor conditioning OS. Comparing ORR achieved in the two arms, there was a statistically significant difference in favor of lenvatinib compared to atezolizumab plus bevacizumab in all subgroups except for Eastern patients, Child-Pugh B patients, presence of portal vein thrombosis, α-feto-protein ≥ 400 ng/mL, presence of extrahepatic disease, albumin-bilirubin (ALBI) grade 2, and no previous locoregional procedures. CONCLUSION: Lenvatinib achieves higher ORR in all patient subgroups. Patients who achieve CR with atezolizumab plus bevacizumab can achieve OS so far never recorded in HCC patients. This study did not highlight any factors that could identify patient subgroups capable of obtaining CR.
  • ウイルス肝炎治療ガイドラインの改訂点
    須田 剛生, 田中 篤
    肝臓, 63, 12, 509, 521, 一般社団法人 日本肝臓学会, 2022年12月01日
    日本語, 2022年6月に発行された「B型肝炎治療ガイドライン」第4版における主な改訂点として,新規に肝移植に伴うマネージメント,小児B型慢性肝炎,母子感染予防としての核酸アナログ治療,核酸アナログの種類による肝癌抑制効果の違いについて記述された.更に,治療目標―何を目指すべきか?,HBコア関連抗原,核酸アナログとIFNの併用療法,核酸アナログ治療効果良好例・不良例における治療戦略,免疫チェックポイント阻害剤によるHBV再活性化,急性肝炎・急性肝不全,HIV重複感染,についてこれまでに明らかとされたエビデンスのアップデートが行われた.2022年5月に発行された「C型肝炎治療ガイドライン」第8.1版における主な改訂点として販売中止となった薬剤を反映して推奨・治療フローチャートが変更された.本稿では,上記の改訂点を中心に,最新版のガイドラインについて解説する.
  • Real Life Study of Lenvatinib Therapy for Hepatocellular Carcinoma: RELEVANT Study.
    Andrea Casadei-Gardini, Margherita Rimini, Masatoshi Kudo, Shigeo Shimose, Toshifumi Tada, Goki Suda, Myung Ji Goh, Andre Jefremow, Mario Scartozzi, Giuseppe Cabibbo, Claudia Campani, Emiliano Tamburini, Francesco Tovoli, Kazuomi Ueshima, Tomoko Aoki, Hideki Iwamoto, Takuji Torimura, Takashi Kumada, Atsushi Hiraoka, Masanori Atsukawa, Ei Itobayashi, Hidenori Toyoda, Naoya Sakamoto, Takuya Sho, Wonseok Kang, Jürgen Siebler, Markus Friedrich Neurath, Valentina Burgio, Stefano Cascinu
    Liver cancer, 11, 6, 527, 539, 2022年12月, [国際誌]
    英語, 研究論文(学術雑誌), INTRODUCTION: In the REFLECT trial, lenvatinib was found to be noninferior compared to sorafenib in terms of overall survival. Here, we analyze the effects of lenvatinib in the real-life experience of several centers across the world and identify clinical factors that could be significantly associated with survival outcomes. METHODS: The study population was derived from retrospectively collected data of HCC patients treated with lenvatinib. The overall cohort included western and eastern populations from 23 center in five countries. RESULTS: We included 1,325 patients with HCC and treated with lenvatinib in our analysis. Median OS was 16.1 months. Overall response rate was 38.5%. Multivariate analysis for OS highlighted that HBsAg positive, NLR >3, and AST >38 were independently associated with poor prognosis in all models. Conversely, NAFLD/NASH-related etiology was independently associated with good prognosis. Median progression-free survival was 6.3 months. Multivariate analysis for progression-free survival revealed that NAFLD/NASH, BCLC, NLR, and AST were independent prognostic factors for progression-free survival. A proportion of 75.2% of patients suffered from at least one adverse effect during the study period. Multivariate analysis exhibited the appearance of decreased appetite grade ≥2 versus grade 0-1 as an independent prognostic factor for worse progression-free survival. 924 patients of 1,325 progressed during lenvatinib (69.7%), and 827 of them had a follow-up over 2 months from the beginning of second-line treatment. From first-line therapy, the longest median OS was obtained with the sequence lenvatinib and immunotherapy (47.0 months), followed by TACE (24.7 months), ramucirumab (21.2 months), sorafenib (15.7 months), regorafenib (12.7 months), and best supportive care (10.8 months). CONCLUSIONS: Our study confirms in a large and global population of patients with advanced HCC, not candidates for locoregional treatment the OS reported in the registration study and a high response rate with lenvatinib.
  • Atezolizumab plus bevacizumab versus lenvatinib for unresectable hepatocellular carcinoma: a large real-life worldwide population.
    Andrea Casadei-Gardini, Margherita Rimini, Toshifumi Tada, Goki Suda, Shigeo Shimose, Masatoshi Kudo, Jaekyung Cheon, Fabian Finkelmeier, Ho Yeong Lim, Lorenza Rimassa, José Presa, Gianluca Masi, Changhoon Yoo, Sara Lonardi, Francesco Tovoli, Takashi Kumada, Naoya Sakamoto, Hideki Iwamoto, Tomoko Aoki, Hong Jae Chon, Vera Himmelsbach, Tiziana Pressiani, Margarida Montes, Caterina Vivaldi, Caterina Soldà, Fabio Piscaglia, Atsushi Hiraoka, Takuya Sho, Takashi Niizeki, Naoshi Nishida, Christoph Steup, Massimo Iavarone, Giovanni Di Costanzo, Fabio Marra, Mario Scartozzi, Emiliano Tamburini, Giuseppe Cabibbo, Francesco Giuseppe Foschi, Marianna Silletta, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hironori Ochi, Satoshi Yasuda, Hidenori Toyoda, Chikara Ogawa, Takashi Nishimura, Takeshi Hatanaka, Satoru Kakizaki, Noritomo Shimada, Kazuhito Kawata, Fujimasa Tada, Hideko Ohama, Kazuhiro Nouso, Asahiro Morishita, Akemi Tsutsui, Takuya Nagano, Norio Itokawa, Tomomi Okubo, Taeang Arai, Michitaka Imai, Hisashi Kosaka, Atsushi Naganuma, Yohei Koizumi, Shinichiro Nakamura, Masaki Kaibori, Hiroko Iijima, Yoichi Hiasa, Valentina Burgio, Mara Persano, Angelo Della Corte, Francesca Ratti, Francesco De Cobelli, Luca Aldrighetti, Stefano Cascinu, Alessandro Cucchetti
    European journal of cancer (Oxford, England : 1990), 180, 9, 20, 2022年11月25日, [査読有り], [国際誌]
    英語, 研究論文(学術雑誌), BACKGROUND AND AIMS: Atezolizumab plus bevacizumab and lenvatinib have not been compared in a randomised controlled trial. We conducted a retrospective multi-centre study to compare the clinical efficacy and safety of lenvatinib and atezolizumab with bevacizumab as a first-line treatment for patients with unresectable HCC in the real-world scenario. METHODS: Clinical features of lenvatinib and atezolizumab plus bevacizumab patients were balanced through inverse probability of treatment weighting (IPTW) methodology, which weights patients' characteristics and measured outcomes of each patient in both treatment arms. Overall survival (OS) was the primary end-point. RESULTS: The analysis included 1341 patients who received lenvatinib, and 864 patients who received atezolizumab plus bevacizumab. After IPTW adjustment, atezolizumab plus bevacizumab did not show a survival advantage over lenvatinib HR 0.97 (p = 0.739). OS was prolonged by atezolizumab plus bevacizumab over lenvatinib in viral patients (HR: 0.76; p = 0.024). Conversely, OS was prolonged by lenvatinib in patients with non-alcoholic steatohepatitis/non-alcoholic fatty liver disease (HR: 1.88; p = 0.014). In the IPTW-adjusted population, atezolizumab plus bevacizumab provided better safety profile for most of the recorded adverse events. CONCLUSION: Our study did not identify any meaningful difference in OS between atezolizumab plus bevacizumab and lenvatinib. Although some hints are provided suggesting that patients with non-alcoholic steatohepatitis/non-alcoholic fatty liver disease might benefit more from lenvatinib therapy and patients with viral aetiology more from atezolizumab plus bevacizumab.
  • Genetic Analyses of Cell-Free DNA in Pancreatic Juice or Bile for Diagnosing Pancreatic Duct and Biliary Tract Strictures
    Kosuke Nagai, Masaki Kuwatani, Koji Hirata, Goki Suda, Hajime Hirata, Yunosuke Takishin, Ryutaro Furukawa, Kazuma Kishi, Hiroki Yonemura, Shunichiro Nozawa, Ryo Sugiura, Kazumichi Kawakubo, Naoya Sakamoto
    Diagnostics, 12, 11, 2704, 2704, MDPI AG, 2022年11月05日
    研究論文(学術雑誌), Poor prognosis of pancreaticobiliary malignancies is attributed to intrinsic biological aggressiveness and the lack of reliable methods for early diagnosis. This study aimed to evaluate the feasibility and availability of pancreatic juice- and bile-derived cell-free DNA (cfDNA) for diagnosing pancreaticobiliary strictures. From October 2020 to February 2022, pancreatic juice or bile was obtained from 50 patients with pancreaticobiliary strictures during endoscopic retrograde cholangiopancreatography. cfDNAs extracted from the samples were analyzed using next-generation sequencing and a cancer gene panel. The obtained cfDNAs, genetic data and clinical information were analyzed for diagnosis. cfDNA concentrations in pancreatic juice were higher in the intraductal papillary mucinous neoplasm group than in the other groups, whereas those in bile were similar in all groups. In pancreatic juice, the sensitivity, specificity and positive and negative predictive values of cfDNA analyses were 33%, 100%, 100% and 71.4%, respectively, whereas those of cytological analyses were 0%, 100%, 0% and 62.5%, respectively. In bile, those of cell-free DNA analyses were 53%, 75%, 89.5% and 28.6%, respectively, whereas those of cytological analyses were 19%, 100%, 100% and 16%, respectively. In conclusion, pancreatic juice- and bile-derived cfDNA is a novel liquid biopsy tool that can diagnose pancreaticobiliary strictures.
  • Incidence of post-transplant hepatitis B virus reactivation with the use of kidneys from donors with resolved hepatitis B virus infection.
    Ren Yamada, Kenichi Morikawa, Kiyohiko Hotta, Daiki Iwami, Tatsu Tanabe, Sachiyo Murai, Nobuo Shinohara, Sonoe Yoshida, Shunichi Hosoda, Akinori Kubo, Yoshimasa Tokuchi, Takashi Kitagataya, Megumi Kimura, Koji Yamamoto, Masato Nakai, Takuya Sho, Goki Suda, Mitsuteru Natsuizaka, Koji Ogawa, Naoya Sakamoto
    Journal of viral hepatitis, 29, 11, 976, 985, 2022年11月, [国際誌]
    英語, 研究論文(学術雑誌), Donors with resolved hepatitis B virus (HBV) infection may be a solution for the organ shortage for kidney transplantation (KT). The purpose of this study was to clarify the current state of HBV markers after KT from donors with resolved HBV infection to HBV naïve recipients and the rate of HBV reactivation in recipients with resolved HBV infection. Furthermore, we investigated HBV covalently closed circular DNA (cccDNA) in transplanted organs from donors with resolved HBV infection and the capability of HBV replication in kidney cell lines. We retrospectively analysed the HBV status of 340 consecutive donors and recipients who underwent KT in a single centre. We prospectively measured cccDNA by real-time polymerase chain reaction in kidney biopsy specimens of 32 donors with resolved HBV infection. HBV reactivation was found in three recipients with resolved HBV infection (4.8%, 3/63) after KT. We analysed 45 cases of transplantation from donors with resolved HBV infection to HBV-naive recipients. One case (2.2%, 1/45) became seropositive for hepatitis B core antibody (anti-HBc) and in another case (2.2%, 1/45), HBV-DNA was detected qualitatively in an HBV naive recipient with a donor with resolved HBV infection. In the latter case, cccDNA was measured in the donor kidney during KT. HBV replication was observed in kidney cell lines with HBV plasmid transfection. In conclusion, the risk of reactivation in anti-HBc-positive donors is relatively low. However, post-transplant HBV monitoring should be conducted in all at-risk cases.
  • Serum IL-1β predicts de novo hepatitis B virus reactivation during direct-acting antiviral therapy for hepatitis C, not during anti-cancer/immunosuppressive therapy.
    Naoki Kawagishi, Goki Suda, Ryotaro Sakamori, Takeshi Matsui, Masahiro Onozawa, Zijian Yang, Sonoe Yoshida, Masatsugu Ohara, Megumi Kimura, Akinori Kubo, Osamu Maehara, Qingjie Fu, Shunichi Hosoda, Yoshimasa Tokuchi, Kazuharu Suzuki, Masato Nakai, Takuya Sho, Kenichi Morikawa, Mitsuteru Natsuizaka, Koji Ogawa, Hajime Sakai, Shunsuke Ohnishi, Masaru Baba, Tetsuo Takehara, Naoya Sakamoto
    Scientific reports, 12, 1, 16800, 16800, 2022年10月07日, [国際誌]
    英語, 研究論文(学術雑誌), De novo hepatitis B virus (HBV) reactivation occurs during direct-acting antiviral (DAA) treatment in hepatitis C virus (HCV)-infected patients with resolved HBV infection. We evaluated the predictive factors, mechanical insight, and differences of cytokine levels during anti-cancer/immunosuppressive and DAA. Eleven, 35, and 19 HCV-infected patients with previous HBV infection with HBV reactivation during DAA treatment, previous HBV infection without HBV reactivation during DAA treatment, and without HBV infection resolution receiving DAA treatment, respectively, were enrolled. Clinical data and baseline cytokine levels were analyzed. Low baseline serum interleukin (IL)-1β levels predicted de novo HBV reactivation during DAA treatment (odds ratio: 47.6, 95% confidence interval: 6.94-333.3). HCV-infected patients with the IL-1β gene single nucleotide polymorphism rs16944 AA allele had significantly higher IL-1β levels; no HCV-infected patient with the IL-1β AA allele experienced HBV reactivation during DAA treatment. Compared to HCV-infected patients with HBV infection resolution, non-HCV infected patients with or without HBV reactivation during anti-cancer/immunosuppressive therapy or bone marrow transplantation had remarkably lower baseline IL-1β levels. Low IL-1β levels were not associated with HBV reactivation. IL-1β levels before DAA for HCV-infected patients with resolved HBV infection could predict HBV reactivation during DAA treatment.
  • 肝疾患病態解明のための細胞生物学的アプローチ 肝細胞癌幹細胞維持機構の解析               
    須田 剛生, 大原 正嗣, 坂本 直哉
    肝臓, 63, Suppl.3, A691, A691, (一社)日本肝臓学会, 2022年10月
    日本語
  • 【進化する肝細胞癌の薬物療法:2022 update】免疫療法の基礎と臨床 免疫療法(単剤・複合療法)の効果は肝細胞癌のetiologyと関係するか               
    小川 浩司, 大原 正嗣, 中井 正人, 荘 拓也, 須田 剛生, 坂本 直哉
    肝胆膵, 85, 3, 393, 398, (株)アークメディア, 2022年09月
    日本語
  • 切除不能進行肝細胞癌に対するアテゾリズマブ+ベバシズマブ併用療法の治療効果と肝予備能変化               
    荘 拓也, 出水 孝章, 目黒 高志, 中村 晃久, 上林 実, 高木 智史, 馬場 英, 古家 乾, 鈴木 和治, 山本 義也, 伊藤 淳, 山田 錬, 宮城島 拓人, 須田 剛生, 大原 正嗣, 中井 正人, 小川 浩司, 坂本 直哉
    日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集, 131回・125回, 39, 39, 日本消化器病学会-北海道支部, 2022年09月
    日本語
  • 肝血管筋脂肪腫の1切除例               
    佐々木 貴志, 甲谷 理紗子, 細田 峻一, 吉田 苑永, 得地 祐匡, 久保 彰則, 大原 正嗣, 須田 剛生, 中井 正人, 荘 拓也, 小川 浩司, 坂本 直哉, 相山 健, 武冨 紹信, 岡崎 ななせ, 松野 吉宏
    日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集, 131回・125回, 40, 40, 日本消化器病学会-北海道支部, 2022年09月
    日本語
  • 日本人肥満2型糖尿病における腹腔鏡下スリーブ状胃切除術が脂肪肝と膵β細胞機能に及ぼす効果 前向きコホート研究               
    大江 悠希, 中村 昭伸, 曹 圭龍, 高瀬 崇宏, 小川 浩司, 海老原 裕磨, 吉川 仁人, 西田 睦, 宮 愛香, 野本 博司, 亀田 啓, 荘 拓也, 須田 剛生, 倉島 庸, 阿保 大介, 工藤 與亮, 坂本 直哉, 平野 聡, 渥美 達也, 三好 秀明
    糖尿病合併症, 36, Suppl.1, 172, 172, (一社)日本糖尿病合併症学会, 2022年09月
    日本語
  • 肝硬変体液貯留に対するトルバプタン投与症例における尿NGAL測定の有用性               
    中井 正人, 森川 賢一, 吉田 苑永, 細田 峻一, 久保 彰則, 得地 祐匡, 北潟谷 隆, 山田 錬, 大原 正嗣, 荘 拓也, 須田 剛生, 小川 浩司, 坂本 直哉
    肝臓, 63, Suppl.2, A592, A592, (一社)日本肝臓学会, 2022年09月
    日本語
  • No increased risk of hepatocellular carcinoma after eradication of hepatitis C virus by direct-acting antivirals, compared with interferon-based therapy.
    Masaaki Korenaga, Kazumoto Murata, Namiki Izumi, Nobuharu Tamaki, Osamu Yokosuka, Tetsuo Takehara, Naoya Sakamoto, Goki Suda, Shuhei Nishiguchi, Hirayuki Enomoto, Fusao Ikeda, Mikio Yanase, Hidenori Toyoda, Takuya Genda, Takeji Umemura, Hiroshi Yatsuhashi, Kazumi Yamasaki, Tatsuya Ide, Nobuo Toda, Tatsuo Kanda, Kazushige Nirei, Yoshiyuki Ueno, Hiroaki Haga, Yoichi Nishigaki, Kunio Nakane, Masao Omata, Hitoshi Mochizuki, Yoshihiko Aoki, Masatoshi Imamura, Tatsuya Kanto, Masashi Mizokami
    Global health & medicine, 4, 4, 216, 224, 2022年08月31日, [国内誌]
    英語, 研究論文(学術雑誌), It is well-known that sustained virological response (SVR) by interferon (IFN)-based therapy against hepatitis C virus (HCV) infection reduced the incidence of hepatocellular carcinoma (HCC). However, whether IFN-free direct-acting antivirals reduce the risk of HCC is controversial. Therefore, this study aims to compare the incidence of HCC after the achievement of SVR between sofosbuvir combined with ledipasvir (SOF/LDV) and simeprevir with pegylated interferon plus ribavirin (Sim+IFN). Japanese patients with HCV infection (genotype 1) who achieved SVR between January 2013 and December 2014 by SOF/LDV (NCT01975675, n = 320) or Sim+IFN (000015933, n = 289) therapy in two nationwide, multicenter, phase III studies were prospectively monitored for the development of HCC by ultrasonography for 5 years after the end of treatment (EOT). No HCC was detected before the treatment. HCC was detected in 9 and 7 patients in the SOF/LDV and the Sim+IFN group in 5 years, respectively. The cumulative incidences of HCC rates 1, 3, and 5 years after EOT were similar between the two groups (1.5%, 2.7%, and 3.2% for the SOF/LDV and 1.8%, 2.8%, and 3.0% for the Sim+IFN group, respectively). No HCC was developed 3.5 years after EOT. Interestingly, a retrospective careful review of imaging taken before therapy revealed hepatic nodules in 50% of HCC patients, suggesting HCC was pre-existed before therapy. In conclusion, we could not find any differences in the incidence of HCC after the HCV eradication between the two therapeutic regimens, suggesting no enhancement of HCC development by DAA.
  • Efficacy and Effect on Liver Functional Reserve of Atezolizumab and Bevacizumab for Unresectable Hepatocellular Carcinoma in Patients Who Do Not Meet Eligibility Criteria of IMbrave150.
    Takuya Sho, Goki Suda, Yoshiya Yamamoto, Ken Furuya, Masaru Baba, Koji Ogawa, Akinori Kubo, Yoshimasa Tokuchi, Qingjie Fu, Zijian Yang, Megumi Kimura, Takashi Kitagataya, Osamu Maehara, Shunsuke Ohnishi, Akihisa Nakamura, Ren Yamada, Masatsugu Ohara, Naoki Kawagishi, Mitsuteru Natsuizaka, Masato Nakai, Kazuharu Suzuki, Takaaki Izumi, Takashi Meguro, Katsumi Terashita, Tomofumi Takagi, Jun Ito, Tomoe Kobayashi, Takuto Miyagishima, Naoya Sakamoto
    Cancers, 14, 16, 2022年08月15日, [国際誌]
    英語, 研究論文(学術雑誌), The IMbrave150 trial demonstrated the high efficacy and safety of atezolizumab and bevacizumab for unresectable hepatocellular carcinoma (HCC). In this multicenter study, the efficacy of this combination and its effect on liver functional reserve were evaluated in patients not meeting the eligibility criteria of IMbrave150. Of 115 patients with unresectable HCC treated with atezolizumab and bevacizumab between October 2020 and January 2022, 72 did not meet the eligibility criteria of IMbrave150, most frequently due to a history of systemic therapy (60/72), platelet counts < 75 × 109/L (7/72), Child-Pugh B (9/72), and 2+ proteinuria (8/72). Atezolizumab and bevacizumab therapy was equally effective for patients who did or did not meet the eligibility criteria (PFS, 6.5 vs. 6.9 months, p = 0.765), consistent with subgroup analyses of histories of systemic therapy, platelet counts, Child-Pugh, and proteinuria. Baseline ALBI scores were worse in patients who did not meet the criteria than in those who did and significantly worsened after treatment initiation in patients not meeting the criteria (baseline vs. 12 weeks; 2.35 ± 0.43 vs. -2.18 ± 0.54; p = 0.007). Accordingly, atezolizumab plus bevacizumab was effective for patients not meeting the eligibility criteria of IMbrave150, although careful monitoring for changes in liver functional reserve is needed.
  • VALIDATION OF THE EASY-TO-USE LENVATINIB PROGNOSTIC (LEP) INDEX TO PREDICT PROGNOSIS IN ADVANCED HEPATOCELLULAR CARCINOMA PATIENTS TREATED WITH LENVATINIB.
    Margherita Rimini, Wonseok Kang, Valentina Burgio, Mara Persano, Tamoko Aoki, Shigeo Shimose, Toshifumi Tada, Takashi Kumada, Takuya Sho, Eleonora Lai, Ciro Celsa, Claudia Campani, Matteo Tonnini, Emiliano Tamburini, Atsushi Hiraoka, Koichi Takaguchi, Naoshi Nishida, Hideki Iwamoto, Ei Itobayashi, Kunihiko Tsuji, Naoya Sakamoto, Toru Ishikawa, Hidenori Toyoda, Masatoshi Kudo, Takumi Kawaguchi, Takeshi Hatanaka, Kazugiro Nouso, Goki Suda, Giuseppe Cabibbo, Fabio Marra, Angelo Della Corte, Francesca Ratti, Federica Pedica, Francesco De Cobelli, Luca Aldrighetti, Mario Scartozzi, Stefano Cascinu, Andrea Casadei-Gardini
    Hepatology research : the official journal of the Japan Society of Hepatology, 2022年08月12日, [国際誌]
    英語, 研究論文(学術雑誌), BACKGROUND: The identification of new prognostic factors able to stratify HCC patients candidate to first line therapy is an urgent. In the present work we validated the prognostic value of the LEP index. MATHERIALS AND METHODS: Data of Eastern and Western patients treated with lenvatinib as first-line for BCLC stage B or C HCC were recollected. LEP index was composed by three class of risk according with our previously study. The 'low risk'group includes patients with PNI >43.3 and with previous TACE. The 'medium risk' group includes patients with PNI >43.3 but without previous TACE and patients with PNI <43.3, ALBI grade 1 and BCLC-B. The 'high risk'group includes patients with PNI <43.3, ALBI grade 2 and patients with PNI <43.3, ALBI grade 1 and BCLC-C. RESULTS: 717 patients were included. Median OS was 20.7 months (95% CI 16.1-51.6) in patients with low risk (n = 223), 16.7 months (95% CI 13.3-47.0) in medium risk (n = 264) and 10.7 months (95% CI 9.3-12.2) in high risk (n = 230) [HR 1, 1.29 and 1.92 respectively; p < 0.0001]. Median PFS was 7.3 months (95% CI 6.3-46.5) in patients with low risk, 6.4 months (95% CI 5.3-8.0) in medium and 4.9 months (95% CI 4.3-5.5) in high risk [HR 1, 1.07, 1.47 respectively; p = 0.0009]. CONCLUSION: The LEP index confirms its prognostic value on an external cohort of HCC patients treated with Lenvatinib. This article is protected by copyright. All rights reserved.
  • 核酸アナログによるHBs抗原消失—Hepatitis B surface antigen (HBsAg) seroclearance by nucleos(t)ide analogs treatment—特集 B型肝炎診療の進歩
    山田 錬, 森川 賢一, 中村 晃久, 出水 孝章, 梅村 真知子, 大原 正嗣, 中井 正人, 荘 拓也, 須田 剛生, 小川 浩司, 坂本 直哉
    消化器・肝臓内科 = Gastroenterology & hepatology / 消化器・肝臓内科編集委員会 編, 12, 2, 184, 192, 科学評論社, 2022年08月
    日本語
  • B型肝炎治療オーバービュー—Overview of treatment for hepatitis B—特集 B型肝炎診療の進歩
    須田 剛生, 川岸 直樹, 大原 正嗣, 中井 正人, 荘 拓也, 小川 浩司, 坂本 直哉
    消化器・肝臓内科 = Gastroenterology & hepatology / 消化器・肝臓内科編集委員会 編, 12, 2, 172, 174, 科学評論社, 2022年08月
    日本語
  • Pre-sarcopenia and Mac-2 binding protein glycosylation isomer as predictors of recurrence and prognosis of early-stage hepatocellular carcinoma.
    Masato Nakai, Kenichi Morikawa, Shunichi Hosoda, Sonoe Yoshida, Akinori Kubo, Yoshimasa Tokuchi, Takashi Kitagataya, Ren Yamada, Masatsugu Ohara, Takuya Sho, Goki Suda, Koji Ogawa, Naoya Sakamoto
    World journal of hepatology, 14, 7, 1480, 1494, 2022年07月27日, [国際誌]
    英語, 研究論文(学術雑誌), BACKGROUND: The Mac-2 binding protein glycosylation isomer (M2BPGi), a fibrosis marker in various liver diseases, is reportedly a prognostic marker in patients with hepatocellular carcinoma (HCC) who underwent hepatectomy. AIM: To evaluate whether the M2BPGi value, M2BP, and pre-sarcopenia before radiofrequency ablation (RFA) could be useful recurrence and prognostic markers in patients with early-stage HCC. METHODS: In total, 160 patients with early-stage primary HCC treated with RFA were separately analyzed as hepatitis C virus (HCV)-positive and HCV-negative. Factors contributing to recurrence and liver-related death, including M2BP, M2BPGi, and skeletal muscle mass index, were statistically analyzed. Eighty-three patients were HCV-positive and 77 were HCV-negative. RESULTS: In HCV-positive patients, only des-γ-carboxy-prothrombin ≥ 23 mAU/mL was a significant poor prognostic factor affecting survival after RFA. In HCV-negative patients, M2BPGi ≥ 1.86 cutoff index was significantly associated with tumor recurrence, while M2BP was not. M2BPGi ≥ 1.86 cutoff index (hazard ratio, 4.89; 95% confidence interval: 1.97-12.18; P < 0.001) and pre-sarcopenia (hazard ratio, 3.34, 95% confidence interval: 1.19-9.37; P = 0.022) were independent significant poor prognostic factors in HCV-negative patients. CONCLUSION: In HCV-negative patients with primary HCC treated with RFA, lower M2BPGi contributed to a lower tumor recurrence rate and longer survival period. Pre-sarcopenia contributed to the poor prognosis independently in HCV-negative patients. These factors might be useful recurrence and prognostic markers for early-stage primary HCC.
  • Effects of nucleos(t)ide analogs on hepatitis B surface antigen reduction with interferon-lambda 3 induction in chronic hepatitis B patients.
    Machiko Umemura, Koji Ogawa, Kenichi Morikawa, Akinori Kubo, Yoshimasa Tokuchi, Ren Yamada, Takashi Kitagataya, Taku Shigesawa, Tomoe Shimazaki, Megumi Kimura, Kazuharu Suzuki, Akihisa Nakamura, Masatsugu Ohara, Naoki Kawagishi, Takaaki Izumi, Masato Nakai, Takuya Sho, Goki Suda, Mitsuteru Natsuizaka, Kota Ono, Kazumoto Murata, Masaya Sugiyama, Masashi Mizokami, Naoya Sakamoto
    Hepatology research : the official journal of the Japan Society of Hepatology, 52, 7, 586, 596, 2022年07月, [国際誌]
    英語, 研究論文(学術雑誌), BACKGROUND & AIMS: Benefits of nucleos(t)ide analogs (NAs) on hepatitis B surface antigen (HBsAg) reduction and interferon-lambda3 (IFN-λ3) induction are still not known. This study aimed to investigate the effects of NAs on HBsAg reduction and association with serum IFN-λ3 levels in chronic hepatitis B (CHB) patients. METHODS: A total of 91 patients [51 treated with nucleoside analog entecavir hydrate (ETV) and 40 treated with nucleotide analog adefovir dipivoxil (ADV) or tenofovir disoproxil fumarate (TDF)] with clinically evident CHB (chronic hepatitis, 57; liver cirrhosis, 34) were enrolled in this study. Serum IFN-λ3 levels among patients receiving ETV and ADV/TDF were measured before the initiation of therapy and 1, 3, and 5 years post-therapy. RESULTS: The change (mean ± standard deviation) in serum HBsAg levels from baseline to year five was -0.38 ± 0.46 and -0.84 ± 0.64 log10 IU/ml in ETV and ADV/TDF groups, respectively (p = 0.0004). Higher serum IFN-λ3 levels were observed in ADV/TDF group compared with ETV group during treatment (p < 0.001). Serum IFN-λ3 levels showed negative correlation with HBsAg reduction in ADV/TDF group (r = -0.386, p = 0.038) at week 48. Nucleotide analogs (ADV/TDF) treatment has associated factors with -0.3 log HBsAg decline at 1 year, -0.5 log HBsAg decline at 3 years, and -0.8 log HBsAg decline at 5 years after NAs treatment on multivariate analysis. CONCLUSIONS: Nucleotide analog (ADV/TDF) treatment reduced HBsAg levels greater compared with nucleoside analog (ETV) in parallel with IFN-λ3 induction.
  • Small-molecule inhibitor cocktail promotes the proliferation of pre-existing liver progenitor cells.
    Qingjie Fu, Shunsuke Ohnishi, Goki Suda, Naoya Sakamoto
    Stem cell reports, 17, 7, 1589, 1603, 2022年06月13日, [国際誌]
    英語, 研究論文(学術雑誌), A recent study showed that a cocktail of three small molecules, Y-27632, A83-01, and CHIR99021 (YAC), converts mature hepatocytes (MHs) into proliferative bipotent cells that can be induced into MHs and cholangiocytes in rats. However, when we reproduced these experiments, it was found that bipotent cells may be derived from resident liver progenitor cells (LPCs), whose proliferative activity was promoted by YAC. A simple and efficient sorting scheme was also developed in this study to harvest high-purity and high-yield LPCs. The inducible bipotency of purified LPCs was verified; in addition, they were found to spontaneously differentiate into hepatocytes and cholangiocytes due to changes in proliferative status even without induction. Moreover, during the differentiation process, some hepatocytes spontaneously reconverted to LPCs under certain conditions, such as the release of contact inhibition. These findings may improve our understanding of LPCs and provide a cell source for regenerative medicine.
  • 日本人肥満2型糖尿病における腹腔鏡下スリーブ状胃切除術が脂肪肝に及ぼす効果 前向きコホート研究               
    大江 悠希, 高瀬 崇宏, 曹 圭龍, 小川 浩司, 海老原 裕磨, 吉川 仁人, 西田 睦, 宮 愛香, 野本 博司, 亀田 啓, 荘 拓也, 須田 剛生, 中村 昭伸, 倉島 庸, 阿保 大介, 工藤 與亮, 坂本 直哉, 平野 聡, 渥美 達也, 三好 秀明
    糖尿病, 65, Suppl.1, S, 139, (一社)日本糖尿病学会, 2022年04月
    日本語
  • 肝疾患における核酸医薬開発—Development of nucleic acid medicine in liver diseases—特集 革新的技術が変える肝疾患診療
    須田 剛生, 小川 浩司, 坂本 直哉
    消化器・肝臓内科 = Gastroenterology & hepatology / 消化器・肝臓内科編集委員会 編, 11, 4, 489, 493, 科学評論社, 2022年04月
    日本語
  • Overestimated Renal Function in Patients with Liver Cirrhosis Predicts Poor Prognosis.
    Sonoe Yoshida, Goki Suda, Masatsugu Ohara, Megumi Kimura, Zijian Yang, Osamu Maehara, Qingjie Fu, Shunichi Hosoda, Kubo Akinori, Yoshimasa Tokuchi, Ren Yamada, Takashi Kitagataya, Kazuharu Suzuki, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Shunsuke Ohnishi, Naoya Sakamoto
    Hepatology research : the official journal of the Japan Society of Hepatology, 52, 7, 603, 613, 2022年03月30日, [国際誌]
    英語, 研究論文(学術雑誌), AIM: A high prevalence of overestimated renal function in patients with liver cirrhosis (LC) has been reported; nonetheless, its impact on prognosis remains unclear. We aimed to evaluate the impact of overestimated renal function on prognosis in patients with LC. METHODS: An overestimated renal function was defined as a >20% increase in the creatinine-based estimated glomerular filtration rate (eGFR), compared with cystatin C-based eGFR. LC patients with conserved serum, who were evaluated for muscle atrophy and had proper clinical information were included, and their prognostic factors were analyzed. RESULTS: A total of 215 consecutive patients with LC were included. The prevalence of overestimated renal function was 29.8% (64/215). Kaplan-Meier survival analysis revealed that patients with overestimated renal function had a poorer prognosis than those without overestimated renal function (hazard ratio [HR]: 2.217 95% confidence interval [CI]: 1.290-3.810; P=0.001). Subgroup analysis showed that overestimated renal function was a significant prognostic factor, irrespective of sex and the presence of hepatocellular carcinoma (HCC). Multivariate Cox regression analyses revealed that overestimated renal function was a significant and independent factor predictive of poor prognosis in the entire cohort (HR: 2.050; 95% CI: 1.041-4.037; P=0.038) and in subgroups classified by Child-Pugh class A (HR: 2.131; 95% CI: 1.019-4.458; P=0.044), Model for End-Stage Liver Disease score <9 (HR: 2.303; 95% CI: 1.038-5.109; P=0.04), and presence of HCC (HR: 2.290; 95% CI: 1.128-4.651; P=0.022). CONCLUSION: Overestimated renal function is a significant and independent prognostic factor in patients with LC. This article is protected by copyright. All rights reserved.
  • 再活性化が疑われた急性E型肝炎の1例               
    久保 彰則, 小川 浩司, 吉田 苑永, 細田 峻一, 得地 祐匡, 山田 錬, 北潟谷 隆, 中井 正人, 荘 拓也, 須田 剛生, 森川 賢一, 石田 勢津子, 坂本 直哉
    日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集, 130回・124回, 55, 55, 日本消化器病学会-北海道支部, 2022年03月
    日本語
  • 若年女性に見られた肝細胞腺腫症の1例               
    北潟谷 隆, 吉田 苑永, 細田 俊一, 久保 彰則, 得地 祐匡, 山田 錬, 中井 正人, 荘 拓也, 須田 剛生, 森川 賢一, 小川 浩司, 坂本 直哉, 高桑 恵美, 中島 収
    日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集, 130回・124回, 56, 56, 日本消化器病学会-北海道支部, 2022年03月
    日本語
  • 肝癌に対する新世代マイクロ波凝固療法の治療成績               
    中井 正人, 吉田 苑永, 細田 峻一, 久保 彰則, 得地 祐匡, 北潟谷 隆, 山田 錬, 荘 拓也, 須田 剛生, 森川 賢一, 小川 浩司, 坂本 直哉
    日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集, 130回・124回, 70, 70, 日本消化器病学会-北海道支部, 2022年03月
    日本語
  • The potential of soluble CD14 in discriminating nonalcoholic steatohepatitis from nonalcoholic fatty liver disease.
    Akihisa Nakamura, Koji Yamamoto, Rei Takeda, Ren Yamada, Akinori Kubo, Kenichi Morikawa, Sayaka Ando, Tomoe Shimazaki, Takaaki Izumi, Machiko Umemura, Takashi Kitagataya, Taku Shigesawa, Kazuharu Suzuki, Megumi Kimura, Masato Nakai, Takuya Sho, Goki Suda, Mitsuteru Natsuizaka, Koji Ogawa, Shunsuke Ohnishi, Toshiro Sugiyama, Hiroshi Takeda, Naoya Sakamoto
    Hepatology research : the official journal of the Japan Society of Hepatology, 52, 6, 508, 521, 2022年02月07日, [国際誌]
    英語, 研究論文(学術雑誌), BACKGROUND AND AIMS: Although various noninvasive markers and prediction formulas for nonalcoholic steatohepatitis (NASH) have been reported, they are of value only in the diagnosis of the advanced fibrosis stage of NASH. In this study, we evaluated soluble CD14 (sCD14) as a diagnostic marker for discriminating NASH from nonalcoholic fatty liver disease (NAFLD) using an animal model and clinical specimens. METHODS: Serum sCD14 levels were measured in samples derived from mice with diet-induced NASH and patients using an enzyme-linked immunosorbent assay. Our cohort enrolled 126 patients with liver needle biopsy-proven NAFLD. RESULTS: The intestinal defense mechanism in NASH model mice was altered as a consequence of the unique gut environment. Elevated serum levels of sCD14 were observed in mice with diet-induced NASH, and the condition of the liver was exacerbated as a result of exposure to gut-derived endotoxin. We confirmed that the serum sCD14 levels in NAFL patients significantly differed from those in NASH patients. The area under the curve for distinguishing between NAFL and NASH was 0.891. Moreover, we found that serum sCD14 levels were weakly correlated with the inflammation grade based on the NAFLD activity score (NAS), the grade of fibrosis according to the Brunt fibrosis classification, and a positive correlation with the grade of ballooning based on NAS in patients with NAFLD. CONCLUSION: sCD14 could be a useful pathophysiological marker and diagnostic adjunct distinguishing NASH from NAFLD. The use of sCD14 may allow the screening and identification of high-risk groups for NASH development and support early therapeutic interventions.
  • Liver-related events after direct-acting antiviral therapy in patients with hepatitis C virus-associated cirrhosis.
    Yuki Tahata, Hayato Hikita, Satoshi Mochida, Nobuyuki Enomoto, Norifumi Kawada, Masayuki Kurosaki, Akio Ido, Daiki Miki, Hitoshi Yoshiji, Yasuhiro Takikawa, Ryotaro Sakamori, Yoichi Hiasa, Kazuhiko Nakao, Naoya Kato, Yoshiyuki Ueno, Hiroshi Yatsuhashi, Yoshito Itoh, Ryosuke Tateishi, Goki Suda, Taro Takami, Yasunari Nakamoto, Yasuhiro Asahina, Kentaro Matsuura, Taro Yamashita, Tatsuya Kanto, Norio Akuta, Shuji Terai, Masahito Shimizu, Satoshi Sobue, Tomokatsu Miyaki, Akihiro Moriuchi, Ryoko Yamada, Takahiro Kodama, Tomohide Tatsumi, Tomomi Yamada, Tetsuo Takehara
    Journal of gastroenterology, 57, 2, 120, 132, 2022年02月, [国内誌]
    英語, 研究論文(学術雑誌), BACKGROUND: Direct-acting antiviral (DAA) therapy enables a high rate of sustained virologic response (SVR) in patients with hepatitis C virus associated cirrhosis. However, the impact of DAA therapy on liver-related events in patients with cirrhosis is unclear. METHODS: A total of 350 patients with compensated and decompensated cirrhosis administered DAA therapy at 29 Japanese hospitals were enrolled (Child-Pugh class A [CP-A]: 195 patients, CP-B: 131 patients and CP-C: 24 patients). RESULTS: The SVR rates of patients with CP-A, CP-B and CP-C were 96.9%, 93.1% and 83.3%, respectively (p = 0.006). Seventy patients developed hepatocellular carcinoma (HCC), and male sex, previous HCC treatment, platelet counts < 10.0 × 104/µl, alpha-fetoprotein levels ≥ 5.0 ng/ml and CP-C were identified as significant factors in the multivariate analysis. The cumulative HCC occurrence/recurrence rates at 1 year were 6.6%/45.2%. The cumulative rate of decompensated cirrhotic events requiring hospital admission at 1 year was 9.1%. In the multivariate analysis, CP-B and CP-C were identified as significant factors. During the median observation period of 14.9 months, 13 patients died and one patient received liver transplant. The overall survival rates at 1 year were 98.4% in patients with CP-A, 96.4% in those with CP-B and 85.6% in those with CP-C (CP-A vs. CP-B: p = 0.759, CP-A vs. CP-C: p = 0.001 and CP-B vs. CP-C: p = 0.005). CONCLUSIONS: HCC development and mortality in patients with CP-B were not different from those with CP-A. On the other hand, in patients with CP-C, the development of HCC and decompensated cirrhotic events requiring hospital admission, and death were frequent. TRIAL REGISTRATION: University Hospital Medical Information Network (UMIN000036150).
  • Prediction of hepatocellular carcinoma using age and liver stiffness on transient elastography after hepatitis C virus eradication.
    Masato Nakai, Yoshiya Yamamoto, Masaru Baba, Goki Suda, Akinori Kubo, Yoshimasa Tokuchi, Takashi Kitagataya, Ren Yamada, Taku Shigesawa, Kazuharu Suzuki, Akihisa Nakamura, Takuya Sho, Kenichi Morikawa, Koji Ogawa, Ken Furuya, Naoya Sakamoto
    Scientific reports, 12, 1, 1449, 1449, 2022年01月27日, [国際誌]
    英語, 研究論文(学術雑誌), Liver stiffness measurement (LSM) is a useful tool for assessing advanced liver fibrosis, an important risk factor for hepatocellular carcinoma (HCC) following hepatitis C (HCV) eradication. This study aimed to clarify the non-invasive factors associated with HCC following sustained virological response (SVR) and to identify the low-risk group. 567 patients without history of HCC who achieved SVR at 24 weeks (SVR24) after IFN-free treatment were retrospectively analyzed. The cumulative incidence of HCC and the risk factors were examined using pre-treatment and SVR24 data. The median observation period was 50.2 months. Thirty cases of HCC were observed, and the 4-year cumulative incidence of HCC was 5.9%. In multivariate analysis, significant pre-treatment factors were age ≥ 71 years (hazard ratio [HR]: 3.402) and LSM ≥ 9.2 kPa (HR: 6.328); SVR24 factors were age ≥ 71 years (HR: 2.689) and LSM ≥ 8.4 kPa (HR: 6.642). In cases with age < 71 years and LSM < 8.4 kPa at the time of SVR24, the 4-year cumulative incidence of HCC was as low as 1.1%. Both pre-treatment LSM (≥ 9.2 kPa) and SVR24 LSM (≥ 8.4 kPa) and age (≥ 71 years) are useful in predicting the risk of HCC after SVR with IFN-free treatment. Identification of low-risk individuals may improve the efficiency of follow-up.
  • Changes in Serum Growth Factors during Lenvatinib Predict the Post Progressive Survival in Patients with Unresectable Hepatocellular Carcinoma.
    Zijian Yang, Goki Suda, Osamu Maehara, Masatsugu Ohara, Sonoe Yoshida, Shunichi Hosoda, Megumi Kimura, Akinori Kubo, Yoshimasa Tokuchi, Qingjie Fu, Ren Yamada, Takashi Kitagataya, Kazuharu Suzuki, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Shunsuke Ohnishi, Naoya Sakamoto
    Cancers, 14, 1, 2022年01月04日, [国際誌]
    英語, 研究論文(学術雑誌), Serum growth factor changes and their effect on prognosis during lenvatinib for unresectable hepatocellular carcinoma (HCC) remain underexplored. The sequential changes in serum growth factors during lenvatinib for unresectable HCC were evaluated in 58 patients using complete clinical data, and preserved serum was used to investigate changes in FGF-19, ANG-2, HGF, VEGF, and EGF. Patients with a complete response (CR), partial response (PR), and stable disease (SD) were evaluated for growth factor changes between the best response and progressive disease (PD) points, classified based on these changes, and evaluated by post progression survival (PPS). A total of 8, 24, 18, and 8 patients showed CR, PR, SD, and PD, respectively. Multivariate analysis revealed that age, relative dose intensity, and baseline ANG-2 were significantly associated with treatment response. Growth factor changes between the best response and PD points revealed that patients could be classified into four groups based on the EGF, ANG-2, and HGF changes. Although patient characteristics at baseline and PD, their response to lenvatinib, and PFS were similar among those groups, patients with an increase in all growth factors had significantly shorter PPS (median PPS was 553, 323, and 316 versus 173 days in groups 1-4 p = 0.032). We revealed that the evaluation of the changes in growth factors during lenvatinib could predict PPS.
  • Efficacy of rifaximin against covert hepatic encephalopathy and hyperammonemia in Japanese patients.
    Masato Nakai, Goki Suda, Koji Ogawa, Sonoe Yoshida, Shunichi Hosoda, Akinori Kubo, Yoshimasa Tokuchi, Takashi Kitagataya, Ren Yamada, Taku Shigesawa, Masatsugu Ohara, Takuya Sho, Kenichi Morikawa, Naoya Sakamoto
    PloS one, 17, 7, e0270786, 2022年, [国際誌]
    英語, 研究論文(学術雑誌), Covert hepatic encephalopathy (CHE) impairs patient quality of life and occurs in approximately 30% of liver cirrhosis (LC) cases. Japanese clinical practice guidelines recommend rifaximin to treat overt HE (OHE). However, the usefulness of rifaximin against CHE is not thoroughly investigated in Japanese patients. We aimed to investigate the efficacy of rifaximin against hyperammonemia and CHE in Japan. We observed 102 patients with HE showing hyperammonemia secondary to LC and examined various biochemical and behavioral parameters following rifaximin treatment. CHE was diagnosed when the patients exhibited two or more abnormal neuropsychological test (NPT) scores but did not indicate OHE symptoms. In the 102 cases, a significant therapeutic effect of rifaximin on hyperammonemia was observed from 2 to 48 weeks after starting treatment. Excluding 10 patients diagnosed with OHE upon starting rifaximin treatment, 12 of the 92 remaining patients (11.8%) transitioned to OHE within 1 year. The 1 year cumulative OHE transition rate was 14.5%. Among the 24 patients with CHE diagnosed by the NPT for whom NPT results could be evaluated at 4 and 12 weeks after starting treatment, 10 (41.6%) had recovered from CHE at 12 weeks. When the factors contributing to recovery from CHE were examined by multivariate analysis, an ammonia level <129 μg/dL was a significant factor. Rifaximin was thus significantly effective against both hyperammonemia and CHE in Japanese patients.
  • Effect of switching from tenofovir disoproxil fumarate to tenofovir alafenamide on lipid profiles in patients with hepatitis B.
    Kazuharu Suzuki, Goki Suda, Yoshiya Yamamoto, Satoshi Abiko, Kenji Kinoshita, Shuichi Miyamoto, Ryo Sugiura, Megumi Kimura, Osamu Maehara, Ren Yamada, Takashi Kitagataya, Taku Shigesawa, Masatsugu Ohara, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    PloS one, 17, 1, e0261760, 2022年, [国際誌]
    英語, 研究論文(学術雑誌), For long-term treatment of hepatitis B virus (HBV) infection, switching from tenofovir-disoproxil-fumarate (TDF) to tenofovir-alafenamide (TAF) may prevent renal dysfunction and bone loss. However, the precise effects of this switch on the blood lipid profile remain to be clarified. This is an important issue as TDF is known to have effects on both low- and high-density lipids. Therefore, our retrospective multi-center study aimed to evaluate the effects of switching from TDF to TAF on the lipid profile of patients with HBV infection. Samples were obtained prior to the switch from TDF to TAF and at 6-12 months after TAF initiation. In some cases, additional samples obtained pre- and post-TDF administration were available for analysis. Serum cholesterol levels, including oxidized-low-density lipoprotein (LDL) and non-high-density lipoprotein-cholesterol (HDL-c), and the rate of dyslipidemia, according to the NCEP-ATP III lipid risk classification, were analyzed. The data from 69 patients were analyzed, including 33 patients with pre- and post-TDF-initiation serum samples. Total cholesterol (T-chol), HDL-c, LDL-c, non-HDL-c, and oxidized LDL levels increased significantly after switching to TAF. With regard to sequential changes pre- to post-TAF, TDF was associated with significantly lower serum T-chol, HDL-c, and oxidized LDL-c levels, with T-chol, HDL-c, LDL-c, and oxidized LDL-c levels increasing significantly after the switch. The switch from TDF to TAF was also associated with an increase in the rate of dyslipidemia, from 33% to 39%, with an increase in the rate of severe dyslipidemia of 1.4% and 5.8%, based on T-chol and LDL-c levels. Of note, no cases of severe dyslipidemia were detected pre-TAF treatment. As oxidized LDL-c and non-HDL-c are strongly associated with atherosclerosis development, careful monitoring of lipid is needed after switching from TDF to TAF in this clinical population.
  • Prospect of lenvatinib for unresectable hepatocellular carcinoma in the new era of systemic chemotherapy.
    Takuya Sho, Kenichi Morikawa, Akinori Kubo, Yoshimasa Tokuchi, Takashi Kitagataya, Ren Yamada, Taku Shigesawa, Mugumi Kimura, Masato Nakai, Goki Suda, Mitsuteru Natsuizaka, Koji Ogawa, Naoya Sakamoto
    World journal of gastrointestinal oncology, 13, 12, 2076, 2087, 2021年12月15日, [国際誌]
    英語, 研究論文(学術雑誌), The phase III clinical trial of the novel molecular targeted agent (MTA) lenvatinib for patients with advanced hepatocellular carcinoma (HCC) (REFLECT trial) found that lenvatinib was non-inferior to sorafenib in overall survival. Recently, the efficacy of multiple MTAs, including lenvatinib, in practice has been reported, and therapeutic strategies for Barcelona Clinic Liver Cancer (BCLC) intermediate stage HCC are undergoing major changes. Based on these results, lenvatinib could be recommended for patients with transcatheter arterial chemoembolization (TACE)-refractory, ALBI grade 1, within the up-to-seven criteria in the BCLC intermediate stage. Lenvatinib provides a more favorable outcome than TACE, even in cases with large or multinodular HCC beyond the up-to-seven criteria with Child-Pugh grade A. When patients meet the definitions of TACE-refractory or TACE-unsuitable, switching to systemic chemotherapy, including lenvatinib, is for favorable for preserving liver function. If initial treatment, including MTA, has a significant therapeutic effect and downstaging of HCC is obtained, additional TACE or surgical resection should be considered. Lenvatinib also has a therapeutic effect for poorly differentiated type and non-simple nodular type HCC thanks to the survival-prolonging effect of this drug. Furthermore, a significant therapeutic effect is expected in tumors with more than 50% liver involvement or main portal vein invasion, which have traditionally been considered to have a poor prognosis in patients. This suggests that at the start of lenvatinib treatment, HCC patients with ALBI grade 1 may be able to maintain liver functional reserve.
  • 特集 肝不全・肝硬変に対する再生療法-最先端の今 4.開発中の肝再生医療(7)肝星細胞に対するビタミンAを介した肝線維化改善療法の開発
    小川 浩司, 中井 正人, 荘 拓也, 須田 剛生, 森川 賢一, 坂本 直哉
    臨床消化器内科, 36, 13, 1690, 1694, 日本メディカルセンター, 2021年11月20日
  • 連載 〔学会だより〕 第57回 肝臓学会総会
    須田 剛生
    臨床消化器内科, 36, 13, 1707, 1707, 日本メディカルセンター, 2021年11月20日
  • 【肝胆膵疾患におけるバイオマーカーの意義を探る】肝疾患のバイオマーカー NASHにおける新規糖鎖バイオマーカー(AAT-A3F)               
    小川 浩司, 中井 正人, 荘 拓也, 須田 剛生, 森川 賢一, 坂本 直哉
    肝胆膵, 83, 4, 527, 533, (株)アークメディア, 2021年10月
    日本語
  • 当院における切除不能肝細胞癌に対するAtezolizumab+Bevacizumab併用療法の使用経験               
    吉田 苑永, 荘 拓也, 久保 彰則, 得地 祐匡, 細田 峻一, 北潟谷 隆, 山田 錬, 中井 正人, 須田 剛生, 森川 賢一, 小川 浩司, 坂本 直哉
    日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集, 129回・123回, 40, 40, 日本消化器病学会-北海道支部, 2021年09月
    日本語
  • Lenvatinib加療後にCRに至りconversion surgeryを施行した肝内多発転移を伴う肝細胞癌の1例               
    細田 峻一, 中井 正人, 吉田 苑永, 久保 彰則, 得地 祐匡, 北潟谷 隆, 山田 錬, 荘 拓也, 須田 剛生, 森川 賢一, 小川 浩司, 坂本 直哉, 岡崎 ななせ, 大塚 拓也, 三橋 智子
    日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集, 129回・123回, 42, 42, 日本消化器病学会-北海道支部, 2021年09月
    日本語
  • Transient elastographyによるLSMと年齢を用いたSVR後肝発癌低リスク群の囲い込み               
    中井 正人, 山本 義也, 馬場 英, 久保 彰則, 得地 祐匡, 北潟谷 隆, 山田 錬, 重沢 拓, 荘 拓也, 須田 剛生, 森川 賢一, 小川 浩司, 古家 乾, 坂本 直哉
    肝臓, 62, Suppl.2, A543, A543, (一社)日本肝臓学会, 2021年09月
    日本語
  • 除不能進行肝細胞癌に対するアテゾリズマブ+ベバシズマブ併用療法の初期治療経験:多施設共同研究               
    荘 拓也, 須田 剛生, 久保 彰則, 北潟谷 隆, 山田 錬, 重沢 拓, 中井 正人, 森川 賢一, 小川 浩司, 坂本 直哉
    肝臓, 62, Suppl.2, A550, A550, (一社)日本肝臓学会, 2021年09月
    日本語
  • Early response and safety of atezolizumab plus bevacizumab for unresectable hepatocellular carcinoma in patients who do not meet IMbrave150 eligibility criteria.
    Takuya Sho, Goki Suda, Koji Ogawa, Megumi Kimura, Akinori Kubo, Yoshimasa Tokuchi, Takashi Kitagataya, Osamu Maehara, Shunsuke Ohnishi, Taku Shigesawa, Akihisa Nakamura, Ren Yamada, Masatsugu Ohara, Naoki Kawagishi, Mitsuteru Natsuizaka, Masato Nakai, Kenichi Morikawa, Ken Furuya, Masaru Baba, Yoshiya Yamamoto, Kazuharu Suzuki, Takaaki Izumi, Takashi Meguro, Katsumi Terashita, Jun Ito, Takuto Miyagishima, Naoya Sakamoto
    Hepatology research : the official journal of the Japan Society of Hepatology, 51, 9, 979, 989, 2021年09月, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), AIM: A clinical trial (IMbrave150) indicated the efficacy and safety of atezolizumab plus bevacizumab for patients with unresectable hepatocellular carcinoma (HCC). In this study, we evaluated this therapeutic combination in a real-world setting, with a focus on patients who did not meet the IMbrave150 eligibility criteria. METHODS: In this multicenter study, patients with unresectable HCC treated with atezolizumab plus bevacizumab between October 2020 and May 2021 were screened. In patients who did not meet IMbrave150 eligibility criteria, treatment responses and safety at 6 and 12 weeks were evaluated. RESULTS: Atezolizumab plus bevacizumab was initiated in 64 patients, including 46 patients (71.9%) who did not meet IMbrave150 eligibility criteria. Most of these patients had a history of systemic therapy (44/46). The objective response rate and disease control rate observed using Response Evaluation Criteria in Solid Tumors 1.1 were 5.2% and 82.8% at 6 weeks and 10.0% and 84.0% at 12 weeks, respectively; these rates were similar between patients who met and did not meet the IMbrave150 criteria. Ten patients experienced progressive disease (PD) at 6 weeks. Portal vein tumor thrombosis was significantly associated with PD (p = 0.039); none of the 15 patients with hepatitis B virus-related HCC experienced PD (p = 0.050). The most common adverse events of grade 3 or higher were aspartate aminotransferase elevation (n = 8, 13.8%) and the safety profile was similar between patients who met and did not meet the IMbrave150 criteria. CONCLUSION: Most patients treated with atezolizumab plus bevacizumab did not meet the IMbrave150 criteria; however, the combination therapy showed good safety and efficacy at the early treatment phase.
  • Genomic profiling of intestinal/mixed-type superficial non-ampullary duodenal epithelial tumors.
    Shuichi Miyamoto, Goki Suda, Marin Ishikawa, Hideyuki Hayashi, Satoshi Nimura, Yoshihiro Matsuno, Ryo Mori, Shigeki Tanishima, Takahiko Kudo, Tomofumi Takagi, Yoshiya Yamamoto, Shoko Ono, Yuichi Shimizu, Naoya Sakamoto
    JGH open : an open access journal of gastroenterology and hepatology, 5, 9, 1071, 1077, 2021年09月, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), Background and Aim: The mechanism underlying carcinogenesis and the genomic features of superficial non-ampullary duodenal epithelial tumors (SNADETs) have not been elucidated in detail. In this study, we examined the genomic features of incipient SNADETs, such as small lesions resected via endoscopic treatment, using next-generation sequencing (NGS). Methods: Twenty consecutive patients who underwent endoscopic treatment for SNADETs of less than 20 mm between January and December 2017 were enrolled. Targeted genomic sequencing was performed through NGS using a panel of 160 cancer-related genes. Furthermore, the alteration/mutation frequencies in SNADETs were examined. Results: The maximum size of the SNADETs examined in this study was 12 mm in diameter. Five SNADETs were classified as low-grade dysplasia (LGD) tumors, while 14 SNADETs were classified as high-grade dysplasia tumors. Only one carcinoma in situ was detected. NGS data for 16 samples were obtained. APC alterations were detected in 81% of samples (13/16). KRAS, BRAF, and TP53 alterations were detected in 25% (4/16), 18.8% (3/16), and 6.3% (1/16) of cases, respectively. Conclusion: We detected APC alterations in most small SNADETs resected via endoscopic treatment, from LGD to carcinoma samples. Even in SNADETs classified as small LGD exhibited KRAS and BRAF alterations.
  • Possible correlation between increased serum free carnitine levels and increased skeletal muscle mass following HCV eradication by direct acting antivirals.
    Yoshimasa Tokuchi, Goki Suda, Megumi Kimura, Osamu Maehara, Takashi Kitagataya, Akinori Kubo, Sonoe Yoshida, Qingjie Fu, Zijian Yang, Shunichi Hosoda, Masatsugu Ohara, Ren Yamada, Kazuharu Suzuki, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Shunsuke Ohnishi, Naoya Sakamoto
    Scientific reports, 11, 1, 16616, 16616, 2021年08月16日, [査読有り], [筆頭著者, 最終著者], [国際誌]
    英語, 研究論文(学術雑誌), We aimed to evaluate factors associated with changes in skeletal muscle mass in hepatitis C virus (HCV)-infected patients after treatment with direct-acting antivirals (DAAs). Consecutive HCV-infected patients after treatment with DAA were recruited into the study. Patients who achieved sustained virological response (SVR); and had complete clinical information, preserved serum samples at baseline and SVR48, and skeletal muscle mass evaluations based on the psoas muscle mass index (PMI) on computed tomography at baseline and ≥ 12 months were included. Altogether, 70.7% of patients (41/58) showed increased PMI after DAA therapy, and mean relative PMI was significantly higher after DAA therapy than at baseline. There were no significant associations between baseline clinical factors routinely examined in clinical practice and increased PMI. Among factors reported to be associated with skeletal muscle loss in patients with chronic liver disease, serum zinc levels and total and free carnitine levels increased significantly after DAA therapy and only changes in serum free carnitine levels were significantly associated with an increased PMI (r = 0305, P = 0.020). In conclusion, increased skeletal muscle mass after successful HCV eradication by DAAs was significantly associated with increased serum-free carnitine levels. L-carnitine supplementation may be beneficial in patients with low skeletal muscle mass after DAA.
  • 【ここまできた肝細胞癌の薬物療法:2021 update】免疫療法の動向 アテゾリズマブ+ベバシズマブによるCR例の特徴
    小川 浩司, 中井 正人, 荘 拓也, 須田 剛生, 森川 賢一, 坂本 直哉
    肝胆膵, 83, 2, 259, 263, (株)アークメディア, 2021年08月
    日本語
  • 【ここまできた肝細胞癌の薬物療法:2021 update】免疫療法の動向 アテゾリズマブ+ベバシズマブによるCR例の特徴               
    小川 浩司, 中井 正人, 荘 拓也, 須田 剛生, 森川 賢一, 坂本 直哉
    肝胆膵, 83, 2, 259, 263, (株)アークメディア, 2021年08月
    日本語
  • Characteristics and Lenvatinib Treatment Response of Unresectable Hepatocellular Carcinoma with Iso-High Intensity in the Hepatobiliary Phase of EOB-MRI.
    Akinori Kubo, Goki Suda, Megumi Kimura, Osamu Maehara, Yoshimasa Tokuchi, Takashi Kitagataya, Masatsugu Ohara, Ren Yamada, Taku Shigesawa, Kazuharu Suzuki, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Shunsuke Ohnishi, Naoya Sakamoto
    Cancers, 13, 14, 2021年07月20日, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), In hepatocellular carcinoma (HCC), CTNNB-1 mutations, which cause resistance to immune checkpoint inhibitors, are associated with HCC with iso-high intensity in the hepatobiliary phase of gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) in resectable HCC; however, analyses on unresectable HCC are lacking. This study analyzed the prevalence, characteristics, response to lenvatinib, and CTNNB-1 mutation frequency in unresectable HCC with iso-high intensity in the hepatobiliary phase of EOB-MRI. In 52 patients with unresectable HCC treated with lenvatinib, the prevalence of iso-high intensity in the hepatobiliary phase of EOB-MRI was 13%. All patients had multiple HCCs, and 3 patients had multiple HCCs with iso-high intensity in the hepatobiliary phase of EOB-MRI. Lenvatinib response to progression-free survival and overall survival were similar between patients with or without iso-high intensity in the hepatobiliary phase of EOB-MRI. Seven patients (three and four patients who had unresectable HCC with or without iso-high intensity in the hepatobiliary phase of EOB-MRI, respectively) underwent genetic analyses. Among these, two (67%, 2/3) who had HCC with iso-high intensity in the hepatobiliary phase of EOB-MRI carried a CTNNB-1 mutation, while all four patients who had HCC without iso-high intensity in the hepatobiliary phase of EOB-MRI did not carry the CTNNB-1 mutation. This study's findings have clinical implications for the detection and treatment of HCC with iso-high intensity in the hepatobiliary phase of EOB-MRI.
  • Frequency and Characteristics of Overestimated Renal Function in Japanese Patients with Chronic Liver Disease and Its Relation to Sarcopenia.
    Sonoe Yoshida, Goki Suda, Masatsugu Ohara, Qingjie Fu, Zijian Yang, Shunichi Hosoda, Megumi Kimura, Kubo Akinori, Yoshimasa Tokuchi, Ren Yamada, Takashi Kitagataya, Kazuharu Suzuki, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Osamu Maehara, Shunsuke Ohnishi, Naoya Sakamoto
    Nutrients, 13, 7, 2021年07月14日, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), Renal dysfunction and sarcopenia are important prognostic factors in patients with chronic liver disease (CLD). Muscle atrophy can cause the overestimation of renal function based on serum creatinine. However, the frequency of overestimated renal function in Japanese patients with CLD and its relationship with sarcopenia are unclear. In present study, we evaluated the frequency of overestimated renal function, defined as a >20% higher eGFR using creatinine than using cystatin C, in 307 patients with CLD as well as its relationship with indicators of sarcopenia. In total, 24.8% of patients had overestimated renal function. In a multivariate regression analysis, liver cirrhosis (p = 0.004) and psoas muscle mass index (p = 0.049) were significantly associated with overestimated renal function. Loss of skeletal muscle mass was significantly more frequent in both male and female patients with overestimated renal function than without. In males, the loss of muscle strength and rate of sarcopenia, defined as loss of muscle mass and strength, were significantly higher in patients with than without overestimated renal function. The high frequency of overestimated renal function in Japanese patients suggests that indicators of renal function should be carefully considered; furthermore, monitoring and interventions for both renal function and sarcopenia are needed in patients with CLD.
  • 【ガイドライン2020から読み解くNAFLD/NASH】診断 NAFLD/NASHの超音波診断
    小川 浩司, 中井 正人, 荘 拓也, 須田 剛生, 森川 賢一, 坂本 直哉
    肝胆膵, 83, 1, 67, 73, (株)アークメディア, 2021年07月
    日本語
  • Special Populationの治療—特集 C型肝疾患の今後の課題 : 肝炎,肝硬変,肝癌
    須田 剛生, 坂本 直哉
    消化器内科 = Gastroenterology, 3, 7, 32, 36, 医学出版, 2021年07月
    日本語
  • 【ガイドライン2020から読み解くNAFLD/NASH】診断 NAFLD/NASHの超音波診断               
    小川 浩司, 中井 正人, 荘 拓也, 須田 剛生, 森川 賢一, 坂本 直哉
    肝胆膵, 83, 1, 67, 73, (株)アークメディア, 2021年07月
    日本語
  • FGFR2 maintains cancer cell differentiation via AKT signaling in esophageal squamous cell carcinoma.
    Osamu Maehara, Goki Suda, Mitsuteru Natsuizaka, Taku Shigesawa, Gouki Kanbe, Megumi Kimura, Masaya Sugiyama, Masashi Mizokami, Masato Nakai, Takuya Sho, Kenichi Morikawa, Koji Ogawa, Shinya Ohashi, Shingo Kagawa, Hideaki Kinugasa, Seiji Naganuma, Naoto Okubo, Shunsuke Ohnishi, Hiroshi Takeda, Naoya Sakamoto
    Cancer biology & therapy, 22, 5-6, 372, 380, 2021年06月03日, [査読有り], [国際誌]
    英語, 研究論文(学術雑誌), Fibroblast growth factors (FGFs) and their receptors (FGFRs) are important for signaling to maintain cancer stem-like cells (CSCs) in esophageal squamous cell carcinoma (ESCC). However, which FGF receptor, 1, 2, 3, 4, and L1, is essential or whether FGFRs have distinct different roles in ESCC-CSCs is still in question. This study shows that FGFR2, particularly the IIIb isoform, is highly expressed in non-CSCs. Non-CSCs have an epithelial phenotype, and such cells are more differentiated in ESCC. Further, FGFR2 induces keratinocyte differentiation through AKT but not MAPK signaling and diminishes CSC populations. Conversely, knockdown of FGFR2 induces epithelial-mesenchymal transition (EMT) and enriches CSC populations in ESCC. Finally, data analysis using The Cancer Genome Atlas (TCGA) dataset shows that expression of FGFR2 significantly correlated with cancer cell differentiation in clinical ESCC samples. The present study shows that each FGFR has a distinct role and FGFR2-AKT signaling is a key driver of keratinocyte differentiation in ESCC. Activation of FGFR2-AKT signaling could be a future therapeutic option targeting CSC in ESCC.
  • Changes in the estimated renal function after hepatitis C virus eradication with direct-acting antiviral agents: Impact of changes in skeletal muscle mass.
    Yoshimasa Tokuchi, Goki Suda, Megumi Kimura, Osamu Maehara, Takashi Kitagataya, Masatsugu Ohara, Ren Yamada, Taku Shigesawa, Kazuharu Suzuki, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    Journal of viral hepatitis, 28, 5, 755, 763, 2021年05月, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), Hepatitis C virus (HCV) infection can cause renal dysfunction, expected to improve upon HCV eradication. However, adverse effects of HCV eradication using direct-acting antiviral agents (DAAs) on renal function have been recently reported. This retrospective study aimed to evaluate renal function with glomerular filtration rate (eGFR) estimated using creatinine (eGFRcre) and cystatin C (eGFRcys). Complete clinical information and preserved serum samples were collected from 207 patients with HCV infection treated with interferon-free DAA at baseline and SVR48 (SVR48). Patients who underwent paired computed tomography (CT) at baseline and ≥12 months after DAA were evaluated for changes in skeletal muscle mass using the psoas muscle mass index (PMI). eGFRcre significantly worsened at SVR48, while eGFRcys was similar at baseline and SVR48. At baseline, eGFRcre was significantly higher than eGFRcys; eGFRcre and eGFRcys were similar at SVR48. Multivariate analysis revealed that the presence of liver cirrhosis and low-albumin level, as well as cirrhosis and age, was significantly associated with the overestimation of renal function by eGFRcre at baseline and SVR48, respectively. In the 57 patients who underwent paired CT at baseline and ≥12 months after DAA, relative values of PMI significantly increased after DAA. After DAA, in patients with increased PMI (65% 37/57), eGFRcre significantly worsened but did not change in patients without increased PMI. eGFRcre significantly worsened after DAAs; however, this might not reflect accurate changes in renal function, partially because of changes in skeletal muscle mass. eGFRcys did not change after DAAs, and it is a potential alternative to eGFRcre.
  • Baseline elevated serum angiopoietin-2 predicts long-term non-regression of liver fibrosis after direct-acting antiviral therapy for hepatitis C.
    Naoki Kawagishi, Goki Suda, Megumi Kimura, Osamu Maehara, Ren Yamada, Yoshimasa Tokuchi, Akinori Kubo, Takashi Kitagataya, Taku Shigesawa, Kazuharu Suzuki, Masatsugu Ohara, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Yusuke Kudo, Mutsumi Nishida, Naoya Sakamoto
    Scientific reports, 11, 1, 9207, 9207, 2021年04月28日, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), We previously revealed that Angiopoietin-2 (Ang2) predicts non-regression of liver fibrosis based on liver stiffness measurement (LSM) at 24 weeks after anti-hepatitis C virus (HCV) treatment. In this study, we extended the observational period to 96 weeks to investigate the factors associated with non-regression after treatment with direct-acting-antivirals (DAAs). Patients treated with DAAs who underwent transient elastography at baseline and 24 and 96 weeks after DAA therapy were included. Baseline and post-treatment serum Ang2 levels were measured. Liver fibrosis stages were defined based on LSM. Multivariate regression was used to evaluate factors associated with non-regression of liver fibrosis between various time points. In total, 110 patients were included. Of these, 11% showed non-regression of LSM-based fibrosis stage at 96 weeks after DAA therapy. In multivariate analysis, advanced liver fibrosis stage and high baseline Ang2 levels were significantly associated with non-regression at 96 weeks. In patients with advanced liver fibrosis (F3/4), baseline Ang2 levels were associated with non-regression of liver fibrosis stage. Between SVR24 and SVR96, post-treatment Ang2 levels and controlled attenuation parameter values at SVR24 were significantly associated with non-regression of liver fibrosis stage in patients with F3/4. Thus, serum Ang2 levels are an important target for monitoring and therapy.
  • Successful treatment by on-demand glecaprevir and pibrentasvir for hepatitis C flare during R-CHOP in patients with diffuse large B-cell lymphoma: a case report.
    Machiko Umemura, Goki Suda, Shihori Tsukamoto, Ko Ebata, Shinjiro Takahash, Takashi Sasaki, Sae Nakajima, Koji Hirata, Mariko Ozasa, Masatoshi Takano, Masaki Katagiri, Naoya Sakamoto
    BMC infectious diseases, 21, 1, 389, 389, 2021年04月27日, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), BACKGROUND: In patients with hepatitis C virus (HCV) and malignant lymphoma, hepatitis C flare during R-CHOP can result in discontinuation of treatment. However, appropriate therapeutic strategies for managing hepatitis C flare during R-CHOP have not been established, and this issue is complicated by conflicting results regarding the use of direct-acting antivirals in patients with uncontrolled malignancies. CASE PRESENTATION: We report the first case of effective and safe treatment with on-demand 8-week glecaprevir and pibrentasvir for hepatitis C flare during R-CHOP in a patient with diffuse large B-cell lymphoma (DLBCL). The patient completed five additional courses of R-CHOP without hepatic toxicity. A complete response of DLBCL and a sustained virological response were observed at 24 weeks after glecaprevir and pibrentasvir completion. CONCLUSION: On-demand, direct-acting antivirals could be a novel strategy for managing hepatitis C flare during R-CHOP.
  • IL28B遺伝子多型の発見から臨床応用②臨床応用
    須田 剛生, 小川 浩司, 坂本 直哉
    肝臓, 62, 4, 209, 211, 一般社団法人 日本肝臓学会, 2021年04月01日
    日本語
  • 肝疾患におけるビックデータとAI(人工知能)の臨床応用 日本人の大規模ゲノムデータを基盤とした解析手法の開発とその応用 C型慢性肝炎のSVR後肝発がんに関連する遺伝要因の探索               
    杉山 真也, 須田 剛生, 溝上 雅史
    肝臓, 62, Suppl.1, A207, A207, (一社)日本肝臓学会, 2021年04月
    日本語
  • 部分的脾動脈塞栓術(PSE)、バルーン閉塞下逆行性経静脈的塞栓術(B-RTO)の肝予備能、線維化マーカー、予後への影響               
    中井 正人, 小川 浩司, 坂本 直哉, 久保 彰則, 得地 祐匡, 北潟谷 隆, 山田 錬, 重沢 拓, 荘 拓也, 須田 剛生, 森川 賢一
    肝臓, 62, Suppl.1, A332, A332, (一社)日本肝臓学会, 2021年04月
    日本語
  • 胆嚢転移を来した原発性肝細胞癌再発の1例               
    得地 祐匡, 須田 剛生, 久保 彰則, 北潟谷 隆, 山田 錬, 重沢 拓, 中井 正人, 荘 拓也, 小川 浩司, 森川 賢一, 坂本 直哉
    日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集, 128回・122回, 57, 57, 日本消化器病学会-北海道支部, 2021年03月
    日本語
  • 経過観察中に増大傾向がみられ、肝切除術に至った肝原発神経内分泌腫瘍の1例               
    久保 彰則, 小川 浩司, 得地 祐匡, 山田 錬, 北潟谷 隆, 重沢 拓, 中井 正人, 荘 拓也, 須田 剛生, 森川 賢一, 坂本 直哉
    日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集, 128回・122回, 58, 58, 日本消化器病学会-北海道支部, 2021年03月
    日本語
  • 肝機能障害を契機に診断された肝ヘモクロマトーシスの一例               
    吉田 苑永, 中井 正人, 久保 彰則, 得地 祐匡, 北潟谷 隆, 山田 錬, 重沢 拓, 荘 拓也, 須田 剛生, 森川 賢一, 小川 浩司, 坂本 直哉
    日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集, 128回・122回, 67, 67, 日本消化器病学会-北海道支部, 2021年03月
    日本語
  • Lenvatinib suppresses cancer stem-like cells in HCC by inhibiting FGFR1-3 signaling, but not FGFR4 signaling.
    Taku Shigesawa, Osamu Maehara, Goki Suda, Mitsuteru Natsuizaka, Megumi Kimura, Tomoe Shimazaki, Koji Yamamoto, Ren Yamada, Takashi Kitagataya, Akihisa Nakamura, Kazuharu Suzuki, Masatsugu Ohara, Naoki Kawagishi, Machiko Umemura, Masato Nakai, Takuya Sho, Kenichi Morikawa, Koji Ogawa, Shunsuke Ohnishi, Masaya Sugiyama, Masashi Mizokami, Hiroshi Takeda, Naoya Sakamoto
    Carcinogenesis, 42, 1, 58, 69, 2021年02月11日, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), In hepatocellular carcinoma (HCC), a subset of cells defined by high CD44 and CD133 expression has been reported to possess cancer stem-like cell (CSC) characteristics and to be associated with a poor prognosis. Since the approval of the multikinase inhibitor, lenvatinib, for patients with unresectable HCC, two such inhibitors (sorafenib and lenvatinib) have been employed as first-line systemic chemotherapeutics for these patients. Based on differences in the kinase-affinity profiles between these two drugs, evidence has suggested that both exert different effects on HCC, although these differences are not fully characterized. In this study, using in vitro and a preclinical in vivo xenograft mouse model, we showed that lenvatinib alone (not sorafenib or the cytotoxic agent, 5-fluorouracil) diminished CD44High/CD133High CSCs in HCC. Furthermore, western blotting and reverse transcriptase-polymerase chain reaction analysis revealed that the expression of fibroblast growth factor receptor (FGFR)-1-4 differed between CD44High/CD133High CSCs and control cells. Analysis of the effects of selective FGFR inhibitors and FGFR small interfering RNAs on CSCs in HCC revealed that lenvatinib diminished CSCs in HCC by inhibiting FGFR1-3 signaling, however, FGFR4 signaling was not impacted. Finally, we showed that FGF2 and FGF19 were involved in maintaining CD44High/CD133High CSCs in HCC, potentially, via FGFR1-3. The findings provide novel mechanistic insights into the effects of lenvatinib on CSCs in HCC and provide clues for developing effective targeted therapies against CSCs in HCC.
  • Tenofovir-disoproxil-fumarate modulates lipid metabolism via hepatic CD36/PPAR-alpha activation in hepatitis B virus infection.
    Kazuharu Suzuki, Goki Suda, Yoshiya Yamamoto, Ken Furuya, Masaru Baba, Akinobu Nakamura, Hideaki Miyoshi, Megumi Kimura, Osamu Maehara, Ren Yamada, Takashi Kitagataya, Koji Yamamoto, Taku Shigesawa, Akihisa Nakamura, Masatsugu Ohara, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Shunsuke Ohnishi, Naoya Sakamoto
    Journal of gastroenterology, 56, 2, 168, 180, 2021年02月, [査読有り], [筆頭著者, 責任著者], [国内誌]
    英語, 研究論文(学術雑誌), BACKGROUND: Entecavir and tenofovir-disoproxil-fumarate are first-line nucleos(t)ide analogs (NA) for treatment of hepatitis B virus (HBV) infections; however, their long-term administration can impact extrahepatic organs. Herein, we sought to examine the effect of NA on lipid metabolism while also characterizing the associated mechanism. METHODS: A retrospective study was performed on HBV patients administered entecavir or tenofovir-disoproxil-fumarate. Patient clinical information, as well as their preserved serum samples obtained at baseline and 6-12 months after treatment initiation, were analyzed. A 1:1 propensity score matching was applied to the assignment of tenofovir-disoproxil-fumarate or entecavir treatment. Changes in serum cholesterol, including oxidized-LDL, were analyzed. Subsequently, in vitro analysis elucidated the mechanism associated with the effect of NAs on lipid metabolism. RESULTS: Administration of tenofovir-disoproxil-fumarate, not entecavir, to chronic HBV patients, decreased serum cholesterol levels, including non-HDL and oxidized-LDL, which are strongly associated with arteriosclerosis. In vitro analysis revealed that tenofovir-disoproxil-fumarate reduced supernatant cholesterol, and upregulated the scavenger receptor, CD36, in hepatocytes. Meanwhile, silencing of hepatic CD36 increased supernatant cholesterol and negated the cholesterol-reducing effect of tenofovir-disoproxil-fumarate in HepG2-cells. Reporter, microarray, and RT-PCR analyses further revealed that tenofovir-disoproxil-fumarate treatment activates PPAR-α-mediated signaling, and upregulates PPAR-α target genes, including CPT1 and CD36. Alternatively, silencing of PPAR-α reversed the effects of tenofovir-disoproxil-fumarate on CD36. CONCLUSIONS: Tenofovir-disoproxil-fumarate modulates lipid metabolism by upregulating hepatic CD36 via PPAR-α activation. Since dyslipidemia could be associated with arteriosclerosis and hepatocarcinogenesis, these discoveries provide novel insights into anti-HBV therapies, as well as the associated extrahepatic effects of NA.
  • 【肝・胆道系症候群(第3版)-その他の肝・胆道系疾患を含めて-肝臓編(上)】血行異常 肝内動静脈短絡(A-V shunt)               
    小川 浩司, 中井 正人, 荘 拓也, 須田 剛生, 森川 賢一, 坂本 直哉
    日本臨床, 別冊, 肝・胆道系症候群I, 303, 306, (株)日本臨床社, 2021年01月
    日本語
  • Sofosbuvir plus velpatasvir treatment for hepatitis C virus in patients with decompensated cirrhosis: a Japanese real-world multicenter study.
    Yuki Tahata, Hayato Hikita, Satoshi Mochida, Norifumi Kawada, Nobuyuki Enomoto, Akio Ido, Hitoshi Yoshiji, Daiki Miki, Yoichi Hiasa, Yasuhiro Takikawa, Ryotaro Sakamori, Masayuki Kurosaki, Hiroshi Yatsuhashi, Ryosuke Tateishi, Yoshiyuki Ueno, Yoshito Itoh, Taro Yamashita, Tatsuya Kanto, Goki Suda, Yasunari Nakamoto, Naoya Kato, Yasuhiro Asahina, Kentaro Matsuura, Shuji Terai, Kazuhiko Nakao, Masahito Shimizu, Taro Takami, Norio Akuta, Ryoko Yamada, Takahiro Kodama, Tomohide Tatsumi, Tomomi Yamada, Tetsuo Takehara
    Journal of gastroenterology, 56, 1, 67, 77, 2021年01月, [査読有り], [国内誌]
    英語, 研究論文(学術雑誌), BACKGROUND: Real-world data on the efficacy and safety of sofosbuvir plus velpatasvir (SOF/VEL) treatment for patients with hepatitis C virus (HCV)-related decompensated cirrhosis are limited in Japan. METHODS: A total of 190 patients with compensated (108) or decompensated (82) cirrhosis who initiated direct-acting antiviral (DAA) treatment between February 2019 and August 2019 were enrolled. Sustained virologic response (SVR) was defined as undetectable serum HCV-RNA at 12 weeks after the end of treatment (EOT). RESULTS: The SVR12 rates were 92.6% in patients with compensated cirrhosis and 90.2% in patients with decompensated cirrhosis (p = 0.564), and the treatment completion rates were 98.1% and 96.3%, respectively (p = 0.372). In patients with decompensated cirrhosis, 3 patients discontinued treatment and 2 patients died because of liver-related events. In patients with decompensated cirrhosis with SVR12, 50% of patients with Child-Pugh class B at baseline showed improvement to class A at SVR12, and 27% and 9% of patients with Child-Pugh class C at baseline showed improvement to class B and class A at SVR12, respectively. Patients who achieved SVR12 showed elevated serum albumin levels at the EOT, which were further elevated at SVR12, but no elevated serum albumin levels after the EOT were observed in patients with baseline serum albumin levels less than 2.8 g/dl. CONCLUSIONS: Real-world efficacy of SOF/VEL treatment for patients with decompensated cirrhosis was similar to Japanese phase 3 study, although treatment discontinuation and death related to liver disease occurred. In patients with poor hepatic reserve, whether it improves continuously after viral clearance requires further evaluation.
  • Baseline serum angiopoietin-2 and VEGF levels predict the deterioration of the liver functional reserve during lenvatinib treatment for hepatocellular carcinoma.
    Taku Shigesawa, Goki Suda, Megumi Kimura, Osamu Maehara, Yoshimasa Tokuchi, Akinori Kubo, Ren Yamada, Ken Furuya, Masaru Baba, Takashi Kitagataya, Kazuharu Suzuki, Masatsugu Ohara, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    PloS one, 16, 3, e0247728, 2021年, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), A deteriorated liver functional reserve during systemic therapy for unresectable hepatocellular carcinoma (HCC) causes poor patient outcomes. We aimed to identify predictive factors associated with the deterioration of Child-Pugh score at 8 weeks after lenvatinib initiation. Patients with adequate clinical data and baseline preserved serum samples available were included. Baseline fibroblast growth factor (FGF)19 and 21, angiopoietin (ANG)2, and vascular endothelial growth factor (VEGF) levels were evaluated. Thirty-seven patients were included, and 6, 15, 14, and 2 experienced complete response, partial response, stable disease, and progressive disease, respectively. Twenty-four (65%) and 13 (35%) patients showed a maintained/improved and deteriorated Child-Pugh-score, respectively. While baseline clinical data, treatment response, and laboratory data were similar between these two patient groups, baseline ANG2 and VEGF levels were significantly higher (P = 0.0017) and lower (P = 0.0231), respectively, in patients with deteriorated Child-Pugh score than in those without. Based on receiver operating characteristic curve analysis, cut-off values for ANG2 and VEGF were found to be 3,108 pg/mL and 514.9 pg/mL, respectively. Among patients with low VEGF and high ANG2, 89% (8/9) exhibited a deteriorated Child-Pugh score, whereas none of the patients (0/9) with high VEGF and low ANG2 did. The deterioration of the Child-Pugh score in patients with unresectable HCC who are treated with lenvatinib may be predictable based on combined baseline serum ANG2 and VEGF levels.
  • Durable response without recurrence to Tolvaptan improves long-term survival.
    Masato Nakai, Goki Suda, Akinori Kubo, Yoshimasa Tokuchi, Takashi Kitagataya, Ren Yamada, Taku Shigesawa, Kazuharu Suzuki, Akihisa Nakamura, Naoki Kawagishi, Masatsugu Ohara, Machiko Umemura, Takuya Sho, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    Journal of gastroenterology, 55, 12, 1150, 1161, 2020年12月, [査読有り], [国内誌]
    英語, 研究論文(学術雑誌), BACKGROUND: Decompensated liver cirrhosis patients with refractory ascites or pleural effusion have a poor prognosis. Tolvaptan has been used for treating water retention associated with cirrhosis. However, despite the short-term response, water retention recurrence is still observed in some cases. This study aimed to clarify the water retention recurrence rate and the relationship between long-term response without recurrence and prognosis. METHODS: Altogether, 100 patients with decompensated cirrhosis treated with tolvaptan were retrospectively analyzed. Recurrence was evaluated according to the criteria of the EASL clinical practice guideline. The recurrence rate and prognosis of non-responders, patients with recurrence, and long-term responders were analyzed. The baseline factors related to short-term response, recurrence, and long-term response were also evaluated. RESULTS: Approximately 31.0% of the short-term responders had recurrence. Although there was no significant difference in the prognosis by short-term response (p = 0.07), the long-term responders had a significantly better prognosis than those with recurrence and non-responders (p < 0.01). Low CRP levels and high urinary Na/K ratios were significant factors related to short-term response, and the presence of acute kidney injury was also a factor related to non-response. The low CRP level (relapse: < 1.10 mg/dl, long-term response: < 0.94 mg/dl) was identified as a factor related to recurrence and long-term response. CONCLUSION: The long-term responders without recurrence had a significantly better prognosis. CRP was a useful predictor for long-term response, whereas renal function parameters were useful predictors for short-term response. Inflammation control may be important for long-term response and prognosis in cirrhosis patients with water retention.
  • 【肝細胞癌治療のパラダイムチェンジ-進化する薬物療法2020 Update Part II-(分子標的治療)】カボザンチニブ CELESTIAL試験の総括とサブ解析               
    小川 浩司, 中井 正人, 荘 拓也, 須田 剛生, 森川 賢一, 坂本 直哉
    肝胆膵, 81, 5, 986, 992, (株)アークメディア, 2020年11月
    日本語
  • 当院における門脈血栓症に対するアンチトロンビンIII製剤の使用成績               
    北潟谷 隆, 小川 浩司, 山田 錬, 重沢 拓, 鈴木 和治, 中村 晃久, 梅村 真知子, 中井 正人, 荘 拓也, 須田 剛生, 森川 賢一, 坂本 直哉
    日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集, 127回・121回, 44, 44, 日本消化器病学会-北海道支部, 2020年10月
    日本語
  • ソホスブビル/ベルパタスビル投与によりSVR12が得られたC型非代償性肝硬変の1例               
    山田 錬, 小川 浩司, 北潟谷 隆, 重沢 拓, 鈴木 和治, 中村 晃久, 梅村 真知子, 中井 正人, 荘 拓也, 須田 剛生, 森川 賢一, 坂本 直哉
    日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集, 127回・121回, 45, 45, 日本消化器病学会-北海道支部, 2020年10月
    日本語
  • 【肝細胞癌治療のパラダイムチェンジ-進化する薬物療法2020 Update Part I-(免疫療法)】免疫チェックポイント阻害剤による単剤治療 進行肝細胞癌に対するニボルマブ第III相試験(CheckMate 459試験)のUpdate results               
    小川 浩司, 中井 正人, 荘 拓也, 須田 剛生, 森川 賢一, 坂本 直哉
    肝胆膵, 81, 4, 651, 657, (株)アークメディア, 2020年10月
    日本語
  • 肝性脳症〜わが国における現状と課題〜 肝性脳症の疫学               
    中井 正人, 小川 浩司, 久保 彰則, 得地 祐匡, 北潟谷 隆, 山田 錬, 重沢 拓, 荘 拓也, 須田 剛生, 森川 賢一, 坂本 直哉
    日本門脈圧亢進症学会雑誌, 26, 3, 75, 75, (一社)日本門脈圧亢進症学会, 2020年10月
    日本語
  • Time-dependent changes in the seroprevalence of COVID-19 in asymptomatic liver disease outpatients in an area in Japan undergoing a second wave of COVID-19.
    Goki Suda, Koji Ogawa, Megumi Kimura, Osamu Maehara, Takashi Kitagataya, Masatsugu Ohara, Yoshimasa Tokuchi, Akinori Kubo, Ren Yamada, Taku Shigesawa, Kazuharu Suzuki, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Naoya Sakamoto
    Hepatology research : the official journal of the Japan Society of Hepatology, 50, 10, 1196, 1200, 2020年10月, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), AIM: Coronavirus disease 2019 (COVID-19) is a serious public health concern, with unclarified prevalence in Japan. Concomitant liver disease could increase the severity of COVID-19 disease, and chronic liver disease patients sometimes require frequent admission and gastrointestinal endoscopy. Thus, clarifying the prevalence of asymptomatic COVID-19 in outpatients with liver disease is essential for preventing nosocomial infections. We aimed to clarify the time-dependent changes in COVID-19 seroprevalence in liver disease outpatients, who were asymptomatic for COVID-19, in an area of Japan experiencing a second wave of COVID-19. METHODS: We included the preserved sera of 100, 300, and 300 consecutive liver disease outpatients, who were asymptomatic for COVID-19, from May 2019, March 2020, and May 2020, respectively. The sera were analyzed immunochromatographically to detect immunoglobulin G against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (KURABO) and by Elecsys Anti-SARS-CoV-2-assay (Roche Diagnostics). RESULTS: Analysis of 100 cases from May 2019, before COVID-19 became pandemic, revealed that the specificity of immunochromatographic tests and Elecsys were 98% (95% confidence interval [CI], 93-99.8%) and 100% (95% CI, 97-100%), respectively. Analysis of 300 cases from March 2020 revealed a seroprevalence of 0.3% (1/300; 95% CI, 0-1.8%) for COVID-19 by Elecsys Anti-SARS-CoV-2 assay. Analysis of 300 cases from May 2020 revealed a seroprevalence of 0% (0/300; 95% CI, 0-1.0%). CONCLUSIONS: The Elecsys Anti-SARS-CoV-2 assay has high specificity. The cumulative seroprevalence of COVID-19 by the Elecsys Anti-SARS-CoV-2 assay in outpatients with liver disease in Sapporo, who were asymptomatic for COVID-19, was 0.17% (1/600; 95% CI, 0.0-0.9%) until May 2020.
  • Baseline angiopoietin-2 and FGF19 levels predict treatment response in patients receiving multikinase inhibitors for hepatocellular carcinoma.
    Taku Shigesawa, Goki Suda, Megumi Kimura, Tomoe Shimazaki, Osamu Maehara, Ren Yamada, Takashi Kitagataya, Kazuharu Suzuki, Akihisa Nakamura, Masatsugu Ohara, Machiko Umemura, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    JGH open : an open access journal of gastroenterology and hepatology, 4, 5, 880, 888, WILEY, 2020年10月, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), Background: Sorafenib and lenvatinib are first-line systemic therapies for unresectable hepatocellular carcinoma (HCC). However, the criteria for their selection remain unclear. Methods: We identified patients with unresectable HCC who were treated with sorafenib or lenvatinib between August 2009 and January 2019 at the Hokkaido University Hospital. Patients who continued treatment for >2 months, underwent evaluation by computed tomography every 2-3 months, and had complete clinical data were included. Responders were patients with objective response (OR) for lenvatinib and patients with stable disease (SD) exceeding 6 months (long-SD) or OR for sorafenib. The predictive factors for treatment response, including fibroblast growth factor (FGF)19 and 21, angiopoietin 2 (ANG2), hepatocyte growth factor, and vascular endothelial growth factor, were evaluated. Results: Overall, 27 and 29 patients treated with lenvatinib and sorafenib, respectively, were included. The responders for lenvatinib and sorafenib were 63% (17/27) and 38% (11/29), respectively. No significant predictive factors for treatment response were identified in patients treated with sorafenib. However, baseline serum FGF19 and ANG2 levels were significantly associated with treatment response to lenvatinib. All (9/9) patients with low baseline ANG2 and FGF19 levels who received lenvatinib achieved OR. Conversely, the OR was low (13%; 1/9) in patients with high baseline ANG2 and FGF19 levels. Responder rate was 40% (2/5) in patients with high baseline ANG2 and FGF19 levels who received sorafenib. Conclusion: This study is, to our knowledge, the first to demonstrate that baseline ANG2 and FGF19 levels may aid in selecting optimal systemic therapy for patients with unresectable HCC.
  • Prevalence, clinical course, and predictive factors of immune checkpoint inhibitor monotherapy-associated hepatitis in Japan.
    Takashi Kitagataya, Goki Suda, Kazunori Nagashima, Takehiko Katsurada, Koji Yamamoto, Megumi Kimura, Osamu Maehara, Ren Yamada, Taku Shigesawa, Kazuharu Suzuki, Akihisa Nakamura, Masatsugu Ohara, Machiko Umemura, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Shunsuke Ohnishi, Yoshito Komatsu, Hiroo Hata, Satoshi Takeuchi, Takashige Abe, Jun Sakakibara-Konishi, Takanori Teshima, Akihiro Homma, Naoya Sakamoto
    Journal of gastroenterology and hepatology, 35, 10, 1782, 1788, 2020年10月, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), BACKGROUND AND AIM: Immune checkpoint inhibitors (ICI) have revolutionized anti-malignancy therapy and thus have been increasingly used. Although ICI may cause immune-related adverse events (irAE) in various organs, including the liver, the prevalence and predictive factors of irAE have not been clarified. METHODS: In this retrospective study, consecutive patients who had malignancies and were treated with ICI without other chemotherapeutic agents at Hokkaido University Hospital between 2014 and 2019 were screened. Patients were excluded if they were < 20 years old and had insufficient clinical data. RESULTS: Of the 233 patients screened, 202 patients met the inclusion criteria and were included in the analysis. The patients were aged 25-92 years, and 60.9% were male. The patients received nivolumab (n = 137), pembrolizumab (n = 45), ipilimumab (n = 17), atezolizumab (n = 2), and avelumab (n = 1). The prevalence of any grade and grade ≥ 3 irAE hepatitis was 8.4% (17/202) and 4.0% (8/202), respectively. irAE hepatitis occurred at a median duration of 42 days in any grade and 36 days in grade ≥ 3 after ICI initiation. The clinical course of grade ≥ 3 irAE hepatitis was generally favorable; however, 50% required corticosteroid treatment and two patients required additional mycophenolate mofetil. Female sex and history of ICI treatment were significantly associated with the incidence of grade ≥ 3 irAE hepatitis. CONCLUSIONS: Grade ≥ 3 irAE hepatitis was observed in 4.0% of the patients who were treated with ICI. Female sex and history of ICI treatment were significantly associated with the incidence of grade ≥ 3 irAE hepatitis.
  • HCC既往の無いC型肝炎SVR後の初発肝発癌の囲い込み因子としての肝弾性度の有用性               
    中井 正人, 山本 義也, 馬場 英, 古家 乾, 北潟谷 隆, 山田 錬, 重沢 拓, 荘 拓也, 須田 剛生, 森川 賢一, 小川 浩司, 坂本 直哉
    肝臓, 61, Suppl.2, A682, A682, (一社)日本肝臓学会, 2020年09月
    日本語
  • 免疫チェックポイント阻害剤関連肝炎の頻度、予測因子、臨床経過の検討               
    北潟谷 隆, 須田 剛生, 中井 正人, 荘 拓也, 森川 賢一, 小川 浩司, 坂本 直哉
    肝臓, 61, Suppl.2, A705, A705, (一社)日本肝臓学会, 2020年09月
    日本語
  • Lenvatinib in patients with unresectable hepatocellular carcinoma who do not meet the REFLECT trial eligibility criteria.
    Takuya Sho, Goki Suda, Koji Ogawa, Taku Shigesawa, Kazuharu Suzuki, Akihisa Nakamura, Masatsugu Ohara, Machiko Umemura, Naoki Kawagishi, Mitsuteru Natsuizaka, Masato Nakai, Kenichi Morikawa, Ken Furuya, Masaru Baba, Jun Ito, Yoshiya Yamamoto, Tomoe Kobayashi, Takashi Meguro, Akiyoshi Saga, Takuto Miyagishima, Katsumi Terasita, Tomofumi Takagi, Toshiya Kamiyama, Akinobu Taketomi, Naoya Sakamoto
    Hepatology research : the official journal of the Japan Society of Hepatology, 50, 8, 966, 977, 2020年08月, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), AIM: This study aimed to determine the efficacy and safety of lenvatinib for patients with unresectable hepatocellular carcinoma (HCC) who did not meet REFLECT eligibility criteria (phase 3 clinical trial). METHODS: In this multicenter retrospective study, patients with unresectable HCC treated with lenvatinib between 2018 and 2019 and had adequate clinical data were included. Objective response rate, progression-free-survival (PFS) and safety were evaluated according to meeting or not meeting the REFLECT eligibility criteria and according to the criteria of the REFLECT trial. RESULTS: Of the 105 patients included, 61% (64 of 105) did not meet the REFLECT eligibility criteria. Safety and median PFS of lenvatinib were similar between the patients who did and those who did not meet the criteria. Among the patients who did not meet the criteria, 28, 27, 14, six, seven and five had a history of tyrosine kinase inhibitor (TKI) treatment, Child-Pugh score B, HCC in ≥50% of the liver, reduced platelet count, bile duct invasion and main portal vein invasion, respectively. The efficacy and safety of lenvatinib for patients with or without Child-Pugh-score B or HCC in ≥50% of the liver were similar. Although treatment outcome was not significantly different, patients with TKI treatment history tended to have longer median PFS, whereas those with main portal vein invasion tended to have shorter median PFS. CONCLUSION: Lenvatinib was effective for patients who did not meet the REFLECT inclusion criteria. However, the treatment outcome may vary according to several factors, such as a history of TKI treatment and tumor invasion.
  • Recent advances in the treatment of hepatitis C virus infection for special populations and remaining problems.
    Goki Suda, Naoya Sakamoto
    Journal of gastroenterology and hepatology, 36, 5, 1152, 1158, 2020年07月15日, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), Hepatitis C virus (HCV) infection is one of the primary causes of liver cirrhosis, hepatocellular carcinoma (HCC), and liver transplantation (LT). The rate of HCV infection is high in patients on hemodialysis and in patients infected with human immunodeficiency virus (HIV). In liver transplant patients with HCV infection, recurrent HCV infection of the transplanted liver is universal and results in rapid liver fibrosis progression. In patients with HCV/HIV coinfection as well, liver fibrosis advances rapidly. Thus, there is an urgent need for prompt HCV infection treatment in these special populations (i.e. HIV/HCV coinfection, HCV infection after LT, and dialysis patients). Interferon (IFN)-based therapy for HCV infection could not achieve a high rate of sustained viral response and could cause severe adverse events in the aforementioned special populations. Direct-acting antivirals (DAAs) have recently been developed, and clinical trials have shown that IFN-free DAA-based therapies are associated with a significantly better safety and therapeutic profile than IFN-based therapies. However, the majority of the initial DAA trials excluded special populations; thus, the efficacy and safety of IFN-free DAA-based therapy in special populations remained to be clearly established. Although recent clinical trials and clinical studies have shown the high efficacy and safety of this therapy even in special populations, several unresolved problems, including emergence of resistance-associated variants after failure to respond to DAAs and HCC occurrence after DAA therapy, still exist. Hence, in this review, we discuss the recent advances in anti-HCV therapy for special populations and the remaining problems regarding this therapy.
  • 各ゲノタイプにおけるDAA不成功例に対する治療—Retreatment for patients who failed to respond to DAAs according to HCV genotype—特集 最新C型肝炎治療up-to-date
    須田 剛生, 木村 恵, 北潟谷 隆, 重沢 拓, 鈴木 和治, 坂本 直哉
    消化器・肝臓内科 = Gastroenterology & hepatology / 消化器・肝臓内科編集委員会 編, 8, 1, 70, 75, 科学評論社, 2020年07月
    日本語
  • Computed tomography, not bioelectrical impedance analysis, is the proper method for evaluating changes in skeletal muscle mass in liver disease
    Masatsugu Ohara, Goki Suda, Megumi Kimura, Osamu Maehara, Tomoe Shimazaki, Taku Shigesawa, Kazuharu Suzuki, Akihisa Nakamura, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    JCSM Rapid Communications, 3, 2, 103, 114, Wiley, 2020年07月
    研究論文(学術雑誌)
  • 進行肝細胞癌に対するREFLECT内/外におけるレンバチニブの治療効果と安全性の検討
    荘 拓也, 須田 剛生, 北潟谷 隆, 山田 錬, 重沢 拓, 鈴木 和治, 中村 晃久, 梅村 真知子, 中井 正人, 森川 賢一, 小川 浩司, 坂本 直哉
    日本消化器病学会雑誌, 117, 臨増総会, A253, A253, (一財)日本消化器病学会, 2020年07月
    日本語
  • 部分的脾動脈塞栓術(PSE)により肝予備能は改善するか
    中井 正人, 小川 浩司, 北潟谷 隆, 山田 錬, 鈴木 和治, 中村 晃久, 梅村 真知子, 荘 拓也, 須田 剛生, 森川 賢一, 坂本 直哉
    日本消化器病学会雑誌, 117, 臨増総会, A367, A367, (一財)日本消化器病学会, 2020年07月
    日本語
  • High serum angiopoietin-2 level predicts non-regression of liver stiffness measurement-based liver fibrosis stage after direct-acting antiviral therapy for hepatitis C.
    Naoki Kawagishi, Goki Suda, Megumi Kimura, Osamu Maehara, Tomoe Shimazaki, Ren Yamada, Takashi Kitagataya, Taku Shigesawa, Kazuharu Suzuki, Akihisa Nakamura, Masatsugu Ohara, Machiko Umemura, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Yusuke Kudo, Mutsumi Nishida, Naoya Sakamoto
    Hepatology research : the official journal of the Japan Society of Hepatology, 50, 6, 671, 681, 2020年06月, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), AIM: Factors associated with improvement of liver fibrosis after successful hepatitis C virus (HCV) eradication by interferon (IFN)-free direct-acting antiviral agents (DAAs) have been not clarified well. Angiopoietin-2 (Ang2) is reported to be associated with vascular leak and inflammation observed in patients with advanced liver fibrosis. METHODS: In this retrospective study, patients treated with IFN-free DAAs who underwent transient elastography before and at 24-weeks post-treatment and achieved sustained viral response were enrolled. Baseline serum Ang2 was measured, and its relationship with other clinical factors was analyzed. Liver fibrosis stage was defined based on liver stiffness according to a previous report. Predictive factors for regression of liver fibrosis stage after DAA therapy were evaluated. RESULTS: Overall, 116 patients were analyzed. Baseline serum Ang2 levels were significantly associated with liver stiffness, spleen index, and liver stiffness-based liver fibrosis stage. Moreover, 75% of patients experienced regression of liver fibrosis stage after DAA therapy. Multivariate analysis revealed that advanced liver fibrosis stage and Ang2 levels were significantly associated with regression of liver fibrosis stage after DAA therapy. In patients with advanced liver fibrosis (F3/4), baseline Ang2 level alone could predict regression of liver fibrosis stage. A baseline Ang2 cut-off value (354 pg/ML) could predict regression of liver fibrosis stage after DAA therapy with high accuracy (sensitivity 0.882, specificity 0.733). CONCLUSIONS: Evaluation of serum Ang2 levels before DAA therapy is important. Our results provide a novel mechanistic insight into non-regression of liver stiffness after DAA therapy. Long-term and larger studies are required.
  • Analysis of the optimal psoas muscle mass index cut-off values, as measured by computed tomography, for the diagnosis of loss of skeletal muscle mass in Japanese people.
    Masatsugu Ohara, Goki Suda, Megumi Kimura, Osamu Maehara, Tomoe Shimazaki, Taku Shigesawa, Kazuharu Suzuki, Akihisa Nakamura, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Tomoe Kobayashi, Minoru Uebayashi, Ryo Takagi, Isao Yokota, Tsuyoshi Shimamura, Naoya Sakamoto
    Hepatology research : the official journal of the Japan Society of Hepatology, 50, 6, 715, 725, 2020年06月, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), This study aimed to determine the optimal psoas muscle mass index (PMI) cut-off values for diagnosis of skeletal muscle mass loss. METHODS: We evaluated PMI in two groups of normal controls: a medical check-up group and a liver donation candidate group. We analyzed two novel PMI cut-off values, one based on the mean - two standard deviations (2SD) and one based on the lower 5%. Skeletal muscle mass index (SMI) evaluations using computed tomography (sliceOmatic; TomoVision) and bioelectrical impedance analysis and PMI evaluation were undertaken simultaneously. We analyzed the correlation between our PMI cut-off values and the Japan Society of Hepatology-defined SMI cut-off values. The prevalence of skeletal muscle mass loss in patients with liver disease was assessed using the novel PMI cut-off values. RESULTS: In 504 normal controls aged ≤50 years, the PMI cut-off values based on mean -2SD and the lower 5% were set at 3.30 cm2 /m2 for men and 1.69 cm2 /m2 for women and 3.74 cm2 /m2 for men and 2.29 cm2 /m2 for women, respectively. The PMI cut-off values based on the lower 5% alone showed that skeletal muscle mass loss increased with age. Furthermore, they correlated well with Japan Society of Hepatology-defined SMI (sliceOmatic) cut-off values and showed a significantly higher prevalence of skeletal muscle mass loss in patients with liver cirrhosis than those without liver cirrhosis. CONCLUSIONS: We propose the following PMI cut-off values: 3.74 cm2 /m2 for male individuals and 2.29 cm2 /m2 for female individuals. These cut-off values can facilitate accurate diagnosis and management of sarcopenia in patients with chronic liver disease.
  • 特集 検査値を読む2020 11章 肝・胆道機能検査 アルブミン非結合型ビリルビン
    佃 曜子, 須田 剛生
    内科, 125, 4, 714, 714, 南江堂, 2020年04月01日
  • 特集 検査値を読む2020 11章 肝・胆道機能検査 総ビリルビン(直接,間接ビリルビンを含む)
    佃 曜子, 須田 剛生
    内科, 125, 4, 713, 713, 南江堂, 2020年04月01日
  • ストレス応答と肝疾患進展 ストレス応答よりみえてくるB型およびC型肝炎ウイルスの戦略               
    森川 賢一, 須田 剛生, 坂本 直哉
    肝臓, 61, Suppl.1, A99, A99, (一社)日本肝臓学会, 2020年04月
    日本語
  • トルバプタン奏効後の再燃と炎症および尿L-FABP値の関連               
    中井 正人, 北潟谷 隆, 山田 錬, 重沢 拓, 鈴木 和治, 中村 晃久, 梅村 真知子, 荘 拓也, 須田 剛生, 森川 賢一, 小川 浩司, 坂本 直哉
    肝臓, 61, Suppl.1, A347, A347, (一社)日本肝臓学会, 2020年04月
    日本語
  • 大規模健常人データ(肝移植ドナー・検診受験者)を用いた低骨格筋量に対する最適psoas muscle mass index cut-off値検討と肝疾患患者における評価               
    須田 剛生, 大原 正嗣, 小川 浩司, 荘 拓也, 中井 正人, 森川 賢一, 坂本 直哉
    肝臓, 61, Suppl.1, A474, A474, (一社)日本肝臓学会, 2020年04月
    日本語
  • NAFLD患者におけるMRエラストグラフィ診断能の検討               
    山田 錬, 小川 浩司, 北潟谷 隆, 重沢 拓, 鈴木 和治, 中村 晃久, 梅村 真知子, 中井 正人, 荘 拓也, 須田 剛生, 森川 賢一, 坂本 直哉
    肝臓, 61, Suppl.1, A495, A495, (一社)日本肝臓学会, 2020年04月
    日本語
  • 進行肝細胞癌に対するレンバチニブ治療成績からみた適格使用時期の検討 多施設共同研究               
    荘 拓也, 須田 剛生, 北潟谷 隆, 山田 錬, 重沢 拓, 鈴木 和治, 梅村 真知子, 中井 正人, 森川 賢一, 小川 浩司, 川岸 直樹, 宮城島 拓人, 馬場 英, 古家 乾, 山本 義也, 小林 智絵, 目黒 高志, 高木 智史, 神山 俊哉, 武冨 紹信, 坂本 直哉
    肝臓, 61, Suppl.1, A334, A334, (一社)日本肝臓学会, 2020年04月
    日本語
  • Early response and safety of lenvatinib for patients with advanced hepatocellular carcinoma in a real-world setting
    Takuya Sho, Goki Suda, Koji Ogawa, Megumi Kimura, Tomoe Shimazaki, Osamu Maehara, Taku Shigesawa, Kazuharu Suzuki, Akihisa Nakamura, Masatsugu Ohara, Machiko Umemura, Naoki Kawagishi, Mitsuteru Natsuizaka, Masato Nakai, Kenichi Morikawa, Ken Furuya, Masaru Baba, Yoshiya Yamamoto, Tomoe Kobayashi, Takashi Meguro, Akiyoshi Saga, Takuto Miyagishima, Hideki Yokoo, Toshiya Kamiyama, Akinobu Taketomi, Naoya Sakamoto
    JGH OPEN, 4, 1, 54, 60, WILEY, 2020年02月, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), Background and AimLenvatinib has been recently approved as a first-line systematic therapy for patients with advanced hepatocellular carcinoma (HCC) based on the results of the phase 3 clinical trial REFLECT. This trial excluded patients with a history of systemic chemotherapy, bile duct invasion, and Child-Pugh grade B. We aimed to investigate the efficacy and safety of lenvatinib for these patients and in the real-world setting.MethodsAmong patients who were administered lenvatinib for advanced HCC between April and October 2018 in Hokkaido University Hospital and related hospitals, we evaluated those who were followed for more than 2 months and whose treatment response was evaluated via dynamic computed tomography at baseline and 2 months after treatment initiation. Meanwhile, patients were excluded if they had decompensated liver cirrhosis, were followed up less than 2 months, or were not evaluated at 2 months. Patients were also stratified according to compliance with the REFLECT inclusion criteria for further analysis.ResultsA total of 41 patients were included; more than 50% did not meet the REFLECT inclusion criteria. In total, 5 (12.2%), 20 (48.8%), 12 (29.3%), and 4 (9.3%) showed complete response, partial response, stable disease, and progressive disease, respectively. The objective response rate was 61.2%. The objective response rate and disease control rate were similar between patients who did and did not meet the REFLECT inclusion criteria. Moreover, the safety profile was also similar between the two patient groups.ConclusionLenvatinib showed high early response rate and tolerability in patients with advanced HCC. Favorable outcomes were similarly observed in patients who did not meet the REFLECT inclusion criteria.
  • Tri-antennary tri-sialylated mono-fucosylated glycan of alpha-1 antitrypsin as a non-invasive biomarker for non-alcoholic steatohepatitis: a novel glycobiomarker for non-alcoholic steatohepatitis.
    Koji Ogawa, Takashi Kobayashi, Jun-Ichi Furukawa, Hisatoshi Hanamatsu, Akihisa Nakamura, Kazuharu Suzuki, Naoki Kawagishi, Masatsugu Ohara, Machiko Umemura, Masato Nakai, Takuya Sho, Goki Suda, Kenichi Morikawa, Masaru Baba, Ken Furuya, Katsumi Terashita, Tomoe Kobayashi, Manabu Onodera, Takahiro Horimoto, Keisuke Shinada, Seiji Tsunematsu, Izumi Tsunematsu, Takashi Meguro, Tomoko Mitsuhashi, Megumi Hato, Kenichi Higashino, Yasuro Shinohara, Naoya Sakamoto
    Scientific reports, 10, 1, 321, 321, 2020年01月15日, [査読有り], [国際誌]
    英語, 研究論文(学術雑誌), Non-alcoholic steatohepatitis (NASH) is a progressive form of non-alcoholic fatty liver disease (NAFLD) that may lead to liver cirrhosis or hepatocellular carcinoma. Here, we examined the diagnostic utility of tri-antennary tri-sialylated mono-fucosylated glycan of alpha-1 antitrypsin (AAT-A3F), a non-invasive glycobiomarker identified in a previous study of NASH diagnosis. This study included 131 biopsy-proven Japanese patients with NAFLD. We evaluated the utility of AAT-A3F in NASH diagnosis, and conducted genetic analysis to analyse the mechanism of AAT-A3F elevation in NASH. Serum AAT-A3F concentrations were significantly higher in NASH patients than in NAFL patients, and in patients with fibrosis, lobular inflammation, and ballooning. Hepatic FUT6 gene expression was significantly higher in NASH than in NAFL. IL-6 expression levels were significantly higher in NASH than in NAFL and showed a positive correlation with FUT6 expression levels. The serum-AAT-A3F levels strongly correlated with hepatic FUT6 expression levels. AAT-A3F levels increased with fibrosis, pathological inflammation, and ballooning in patients with NAFLD and may be useful for non-invasive diagnosis of NASH from the early stages of fibrosis.
  • FGFR阻害剤およびMEK阻害剤は食道扁平上皮癌(ESCC)がん幹細胞を減少させる               
    前原 経, 夏井坂 光輝, 須田 剛生, 大西 俊介, 坂本 直哉, 武田 宏司
    日本消化管学会雑誌, 4, Suppl., 301, 301, (一社)日本消化管学会, 2020年01月
    日本語
  • Comparative Glycomic Analysis of Sialyl Linkage Isomers by Sialic Acid Linkage-Specific Alkylamidation in Combination with Stable Isotope Labeling of α2,3-Linked Sialic Acid Residues.
    Hanamatsu H, Nishikaze T, Tsumoto H, Ogawa K, Kobayashi T, Yokota I, Morikawa K, Suda G, Sho T, Nakai M, Miura N, Higashino K, Sekiya S, Iwamoto S, Miura Y, Furukawa JI, Tanaka K, Sakamoto N
    Analytical chemistry, 91, 21, 13343, 13348, 2019年11月05日, [査読有り], [国際誌]
    英語, 研究論文(学術雑誌), Sialic acids form the terminal sugars in glycan chains on glycoproteins via α2,3, α2,6, or α2,8 linkages, and structural isomers of sialyl linkages play various functional roles in cell recognition and other physiological processes. We recently developed a novel procedure based on sialic acid linkage-specific alkylamidation via lactone ring opening (aminolysis-SALSA). Herein, we have investigated an isotope labeling of α2,3-linked sialic acid residues (iSALSA) using amine hydrochloride salts. One limitation of SALSA using amine hydrochloride salts may be solved by adding only tert-butylamine (t-BA) as an acid scavenger, and comparative and quantitative glycomic analyses can be performed using iSALSA. We also developed quantitative glycomic analysis using dual isotope-labeled glycans by derivatizing with aminooxy-functionalized tryptophanylarginine methyl ester (aoWR) and iSALSA at the reducing and nonreducing end, respectively. Furthermore, we demonstrate that the amount of α2,3-linked sialoglycans in serum are altered during liver fibrosis using matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) and liquid chromatography MS (LC/MS) analyses. We revealed that the ratio of A33,6,6 to A3F3,6,6 was gradually decreased along with liver fibrosis progression. Therefore, these glycan alterations are potential diagnostic markers of nonalcoholic steatohepatitis (NASH) fibrosis progression.
  • Entecavir treatment of hepatitis B virus-infected patients with severe renal impairment and those on hemodialysis.
    Kazuharu Suzuki, Goki Suda, Yoshiya Yamamoto, Ken Furuya, Masaru Baba, Megumi Kimura, Osamu Maehara, Tomoe Shimazaki, Koji Yamamoto, Taku Shigesawa, Akihisa Nakamura, Masatsugu Ohara, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    Hepatology research : the official journal of the Japan Society of Hepatology, 49, 11, 1294, 1304, 2019年11月, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), AIM: Entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide (TAF) are first-line nucleos(t)ide analogues for hepatitis B virus (HBV)-infected patients. However, consecutive TDF treatment causes renal dysfunction, and the safety and efficacy of TAF have not been established in severe renal dysfunction patients, including hemodialysis patients. The efficacy and safety of ETV in these populations has not been clarified. The study aimed to clarify this. METHODS: In this retrospective multicenter study, between 2006 and 2018, a total of 567 HBV-infected patients treated with ETV monotherapy were screened. Patients were included if >20 years old, treated with ETV monotherapy for >1 year, and had proper clinical information. The efficacy of ETV and changes in renal function were evaluated according to renal function. RESULTS: A total of 273 patients were included: 9.2% (25/273), 1.8% (5/273), and 3.7% (10/273) had chronic kidney disease (CKD) stage G3, CKD stage G4/5, and were on hemodialysis, respectively. Overall, 84.2%, 94.0%, and 96.2% of patients experienced serum HBV-DNA disappearance at 1, 2, and 3 years, respectively, after treatment initiation. In patients with CKD stage G3-5, estimated glomerular filtration rate tended to restore with time, which was in contrast to patients without renal dysfunction. The rate of disappearance in serum HBV-DNA, alanine transaminase normalization, and virological breakthrough was similar between patients with or without renal dysfunction. ETV showed high efficacy for all 10 hemodialysis patients without virological breakthrough. CONCLUSIONS: Entecavir for HBV-infected patients with severe renal dysfunction, including hemodialysis patients, is highly effective and does not affect renal function.
  • Effects of resistance-associated variants in genotype 2 hepatitis C virus on viral replication and susceptibility to antihepatitis C virus drugs.
    Goki Suda, Megumi Kimura, Taku Shigesawa, Kazuharu Suzuki, Akihisa Nakamura, Masatsugu Ohara, Naoki Kawagishi, Masato Nakai, Takuya Sho, Osamu Maehara, Tomoe Shimazaki, Kenichi Morikawa, Mitsuteru Natsuizaka, Koji Ogawa, Naoya Sakamoto
    Hepatology research : the official journal of the Japan Society of Hepatology, 49, 11, 1275, 1285, 2019年11月, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), AIMS: Development of direct-acting antivirals (DAAs) has made antihepatitis C virus (HCV) treatment highly safe and effective. However, the emergence of resistant-associated variants (RAVs) after failure of DAA therapy affects retreatment outcomes. In particular, genotype 1 HCV with P32 deletion has been reported to be highly resistant to all approved non-structural protein (NS)5A inhibitors. However, analysis of RAVs in genotype 2 HCV has been limited. Accordingly, in this study, we evaluated the roles of genotype 2 HCV variants in antiviral drug efficacy. METHODS: We utilized HCV-2b/2a (JFH-1) chimeric virus (genotype 2a), which replicates more robustly than JFH-1. We constructed various genotype 2a JFH-1-based HCV cell culture systems with NS3 (D168E), NS5A (F28S, F28S/M31I, P32 deletion, and Y93H), and NS5B (S282 T) RAVs and analyzed the replication ability and sensitivity to various anti-HCV reagents. RESULTS: Genotype 2a-based HCV with NS5A-P32 deletion could not replicate even in long-term cultures. Genotype 2a-based HCV with NS5A-F28S/M31I showed significantly higher replication ability than the wild-type strain, and replication could not be suppressed, even with high concentrations of NS5A inhibitors, including pibrentasvir and velpatasvir (<1000-10 000 fold-resistance compared with the wild-type strain). However, genotype 2a-based HCV with NA5A-F28S/M31I was sensitive to HCV protease inhibitor, NS5B inhibitor, interferon-α, and ribavirin. Genotype 2a-based HCV with NS5B-S282 T was resistant to sofosbuvir, but was highly sensitive to ribavirin compared with the control. CONCLUSIONS: When undertaking retreatment for genotype 2a HCV-infected patients who fail to respond to DAAs, the optimized retreatment should be chosen according to the sensitivity of the emerging RAVs to anti-HCV drugs.
  • C型肝炎患者の血清Angiopoietin-2値はDAAs治療後の肝線維化非改善例を予測する               
    川岸 直樹, 須田 剛生, 中井 正人, 荘 拓也, 森川 賢一, 小川 浩司, 坂本 直哉
    肝臓, 60, Suppl.2, A653, A653, (一社)日本肝臓学会, 2019年10月, [査読有り]
    日本語
  • カルニチンは肝硬変患者における筋肉量減少を抑制する               
    大原 正嗣, 須田 剛生, 重沢 拓, 鈴木 和治, 中村 晃久, 川岸 直樹, 中井 正人, 荘 拓也, 森川 賢一, 小川 浩司, 坂本 直哉
    肝臓, 60, Suppl.2, A677, A677, (一社)日本肝臓学会, 2019年10月, [査読有り]
    日本語
  • 進行肝細胞癌に対するレンバチニブ投与症例からみた適格使用時期の検討               
    荘 拓也, 須田 剛生, 鈴木 和治, 中村 晃久, 大原 正嗣, 川岸 直樹, 中井 正人, 森川 賢一, 小川 浩司, 坂本 直哉
    肝臓, 60, Suppl.2, A705, A705, (一社)日本肝臓学会, 2019年10月, [査読有り]
    日本語
  • Assessing the risk of hepatocellular carcinoma by combining liver stiffness and the controlled attenuation parameter.
    Takaaki Izumi, Takuya Sho, Kenichi Morikawa, Taku Shigesawa, Kazuharu Suzuki, Akihisa Nakamura, Masatsugu Ohara, Naoki Kawagishi, Machiko Umemura, Tomoe Shimazaki, Megumi Kimura, Masato Nakai, Goki Suda, Mitsuteru Natsuizaka, Koji Ogawa, Yusuke Kudo, Mutsumi Nishida, Kota Ono, Masaru Baba, Ken Furuya, Naoya Sakamoto
    Hepatology research : the official journal of the Japan Society of Hepatology, 49, 10, 1207, 1217, 2019年10月, [査読有り], [国際誌]
    英語, 研究論文(学術雑誌), AIM: Ultrasound technology can now be used for liver stiffness measurement (LSM) and for evaluating the amount of hepatic fat quantitatively known as the controlled attenuation parameter (CAP). This study aimed to determine the applicable cut-off values of LSM and the CAP for primary hepatocellular carcinoma (HCC), and to investigate their clinical usefulness for assessing HCC risk in patients with chronic liver disease. METHODS: A total of 1054 patients (88 with primary HCC and 966 without HCC) whose LSM and the CAP were measured by transient elastography with clinically evident hepatitis C virus (419 patients), hepatitis B virus (377 patients), and non-alcoholic fatty liver disease (258 patients) were enrolled in this study. Subsequently, a total of 966 patients who did not have HCC initially were followed, and the usefulness of the cut-off values of LSM and CAP for HCC development were evaluated. RESULTS: In hepatitis C virus patients, the incidence of HCC development was significantly higher among those with a combination of LSM ≥8.0 kPa and CAP ≤221 dB/m than among those with other values (log-rank test 0.0239, hazard ratio 2.66, 95%CI 1.07-6.47, P = 0.0362). In non-alcoholic fatty liver disease patients, the incidence of HCC development was significantly higher among those with a combination of LSM ≥5.4 kPa and CAP ≤265 dB/m than among others (log-rank test 0.0040, hazard ratio 8.91, 95% CI 1.47-67.97, P = 0.0192). CONCLUSION: In the hepatitis C virus and non-alcoholic fatty liver disease groups, a combination of LSM and the CAP cut-off values would be useful for screening to identify the high-risk group for primary HCC development.
  • Correlation between Liver Elasticity by Ultrasound Elastography and Liver Functional Reserve.
    Ryo Sugiura, Masaki Kuwatani, Mutsumi Nishida, Koji Hirata, Itsuki Sano, Shin Kato, Kazumichi Kawakubo, Masato Nakai, Takuya Sho, Goki Suda, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    Ultrasound in medicine & biology, 45, 10, 2704, 2712, 2019年10月, [査読有り], [国際誌]
    英語, 研究論文(学術雑誌), No worldwide consensus on the assessment tool for liver functional reserve is currently available. The aim of this study was to evaluate the correlation between liver elasticity of both hepatic lobes and liver functional reserve tests. This prospective observational study comprised 40 patients scheduled for hepatectomy. Liver elasticity was assessed by Virtual Touch Quantification (VTQ). The mean VTQ value for the right and left lobes was defined as the mVTQ. Liver functional reserve was measured with technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin scintigraphy as LHL15 and HH15 and the indocyanine green (ICG) excretion test as ICG-R15 and ICG-K. All examinations were measured after biliary decompression confirmed serum a total bilirubin level ≤2 mg/dL. Mean VTQ values were moderately correlated with LHL15 (r = -0.42, p < 0.01), HH15 (r = 0.48, p < 0.01), ICG-R15 (r = 0.53, p < 0.01) and ICG-K (r = -0.61, p < 0.01) values. In conclusion, the liver elasticity determined by VTQ would be a useful predictor of liver functional reserve in patients scheduled for hepatectomy.
  • Budd-Chiari症候群に対しPercutaneous transluminal angioplastyが奏功した一例               
    吉田 苑永, 川岸 直樹, 小田 総一郎, 志藤 茜, 目野 晃光, 吉河 歩, 安孫子 怜史, 原田 一顕, 佐野 逸紀, 小田 寿, 須田 剛生, 小川 浩司, 吉野 裕紀, 阿保 大介, 宮城島 拓人, 坂本 直哉
    日本消化器病学会北海道支部例会プログラム・抄録集, 125回, 31, 31, 日本消化器病学会-北海道支部, 2019年09月
    日本語
  • Quantifying Protein-Specific N-Glycome Profiles by Focused Protein and Immunoprecipitation Glycomics.
    Takashi Kobayashi, Koji Ogawa, Jun-Ichi Furukawa, Hisatoshi Hanamatsu, Megumi Hato, Tomoyo Yoshinaga, Kenichi Morikawa, Goki Suda, Takuya Sho, Masato Nakai, Kenichi Higashino, Yoshito Numata, Yasuro Shinohara, Naoya Sakamoto
    Journal of proteome research, 18, 8, 3133, 3141, 2019年08月02日, [査読有り], [国際誌]
    英語, 研究論文(学術雑誌), Serum N-glycans have been reported to be potential diagnostic and therapeutic biomarkers for many diseases and conditions, such as inflammation, fibrosis, and cancer progression. We previously described the focused protein glycomic analysis (FPG) from gel-separated serum proteins. With this methodology, we sought novel glycan biomarkers for nonalcoholic steatohepatitis (NASH) and successfully identified some N-glycans that were significantly elevated in NASH patients compared to nonalcoholic fatty liver patients. Among them, trisialylated monofucosylated triantennary glycan (A3F) of alpha-1 antitrypsin showed the most dynamic change. For rapid identification of N-glycans on the focused proteins, we constructed a simplified method called immunoprecipitation glycomics (IPG), where the target proteins were immunoprecipitated with affinity beads and subsequently subjected to glycomic analysis by MALDI-TOF MS. Focusing on alpha-1 antitrypsin and ceruloplasmin as the target proteins, we compared the values of N-glycans determined by FPG and IPG. The quantified values of each N-glycan by these two methods showed a statistically significant correlation, indicating that high throughput and quantitative N-glycomics of targeted proteins can be achieved by the simplified IPG method. Thus, an analytical strategy combining FPG and IPG can be adapted to general biomarker discovery and validation in appropriate disease areas.
  • Nutrition is often ignored in management of chronic liver diseases.
    Naoya Sakamoto, Goki Suda, Kennichi Morikawa, Koji Ogawa
    Journal of gastroenterology and hepatology, 34, 7, 1127, 1128, 2019年07月, [査読有り], [国際誌]
    英語
  • Safety and efficacy of glecaprevir and pibrentasvir in Japanese hemodialysis patients with genotype 2 hepatitis C virus infection.
    Goki Suda, Chitomi Hasebe, Masami Abe, Masayuki Kurosaki, Jun Itakura, Namiki Izumi, Yoshihito Uchida, Satoshi Mochida, Hiroaki Haga, Yoshiyuki Ueno, Kazumichi Abe, Atsushi Takahashi, Hiromasa Ohira, Yoko Tsukuda, Ken Furuya, Masaru Baba, Yoshiya Yamamoto, Tomoe Kobayashi, Jun Inoue, Katsumi Terasita, Masatsugu Ohara, Naoki Kawagishi, Takaaki Izumi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    Journal of gastroenterology, 54, 7, 641, 649, 2019年07月, [査読有り], [筆頭著者, 責任著者], [国内誌]
    英語, 研究論文(学術雑誌), BACKGROUND: Until recently, interferon-free anti-hepatitis C virus (HCV) therapy for genotype 2 (GT2) HCV-infected hemodialysis patients was an unfulfilled medical need. Recent clinical trials of glecaprevir and pibrentasvir (G/P) for hemodialysis patients showed high efficacy and safety; however, the number of GT2 HCV-infected patients, especially Asian patients, was limited and most of them were treated with a 12-week regimen. In this prospective multicenter study, we aimed to investigate the efficacy and safety of G/P in Japanese hemodialysis patients with GT2 HCV infection. METHODS: Twenty-seven Japanese hemodialysis patients with GT2 HCV infection who were started on with 8- or 12-week G/P regimen between November 2017 and June 2018 were included and followed up for around 12 weeks after treatment completion. RESULTS: Among the 27 included patients, 13 non-liver cirrhosis (LC) and direct-acting antivirals (DAAs)-naïve patients were treated with 8 weeks of G/P and 14 patients with LC (n = 13) or history of failure of DAAs (n = 1) were treated with a 12-week regimen. The overall sustained virological response at 12 weeks after treatment completion (SVR 12) was 96.3% (26/27). All patients with 8 weeks of treatment achieved SVR12. Two patients discontinued the therapy at 2 and 11 weeks after treatment initiation. The patient who discontinued at 2 weeks due to pruritus alone failed to respond to G/P. No patients experienced lethal adverse events during the therapy, and the most common adverse event was pruritus. CONCLUSIONS: An 8- or 12-week G/P regimen is highly effective and safe in GT2 HCV-infected hemodialysis patients.
  • 腎機能低下症例 透析症例での治療—DAAs treatment for HCV infected patients with severe renal dysfunction, including on hemodialysis—特集 C型肝炎の治療 : 最終章を迎えて
    須田 剛生, 木村 恵, 川岸 直樹, 重沢 拓, 鈴木 和治, 坂本 直哉
    消化器・肝臓内科 = Gastroenterology & hepatology / 消化器・肝臓内科編集委員会 編, 5, 6, 628, 632, 科学評論社, 2019年06月
    日本語
  • Metformin Regulates the Expression of CD133 Through the AMPK-CEBPβ Pathway in Hepatocellular Carcinoma Cell Lines.
    Maehara O, Ohnishi S, Asano A, Suda G, Natsuizaka M, Nakagawa K, Kobayashi M, Sakamoto N, Takeda H
    Neoplasia (New York, N.Y.), 21, 6, 545, 556, 2019年06月, [査読有り]
  • Early response and safety of lenvatinib for patients with advanced hepatocellular carcinoma in a real-world setting
    Takuya Sho, Goki Suda, Koji Ogawa, Masato Nakai, Kenichi Morikawa, Naoya Sakamoto
    JOURNAL OF HEPATOLOGY, 70, 1, E621, E621, ELSEVIER, 2019年04月, [査読有り], [国際誌]
    英語, 研究論文(学術雑誌), Background and Aim: Lenvatinib has been recently approved as a first-line systematic therapy for patients with advanced hepatocellular carcinoma (HCC) based on the results of the phase 3 clinical trial REFLECT. This trial excluded patients with a history of systemic chemotherapy, bile duct invasion, and Child-Pugh grade B. We aimed to investigate the efficacy and safety of lenvatinib for these patients and in the real-world setting. Methods: Among patients who were administered lenvatinib for advanced HCC between April and October 2018 in Hokkaido University Hospital and related hospitals, we evaluated those who were followed for more than 2 months and whose treatment response was evaluated via dynamic computed tomography at baseline and 2 months after treatment initiation. Meanwhile, patients were excluded if they had decompensated liver cirrhosis, were followed up less than 2 months, or were not evaluated at 2 months. Patients were also stratified according to compliance with the REFLECT inclusion criteria for further analysis. Results: A total of 41 patients were included; more than 50% did not meet the REFLECT inclusion criteria. In total, 5 (12.2%), 20 (48.8%), 12 (29.3%), and 4 (9.3%) showed complete response, partial response, stable disease, and progressive disease, respectively. The objective response rate was 61.2%. The objective response rate and disease control rate were similar between patients who did and did not meet the REFLECT inclusion criteria. Moreover, the safety profile was also similar between the two patient groups. Conclusion: Lenvatinib showed high early response rate and tolerability in patients with advanced HCC. Favorable outcomes were similarly observed in patients who did not meet the REFLECT inclusion criteria.
  • Long-term effect of nucleos (t)ide analogs on hepatitis B surface antigen in chronic hepatitis B patients
    Kenichi Morikawa, Machiko Umemura, Koji Ogawa, Taku Shigesawa, Kazuharu Suzuki, Akihisa Nakamura, Masatsugu Ohara, Naoki Kawagishi, Tomoe Shimazaki, Megumi Kimura, Takaaki Izumi, Masato Nakai, Takuya Sho, Goki Suda, Mitsuteru Natsuizaka, Kota Ono, Kazumoto Murata, Masaya Sugiyama, Mizokami Masashi, Naoya Sakamoto
    JOURNAL OF HEPATOLOGY, 70, 1, E477, E477, ELSEVIER, 2019年04月, [査読有り]
    英語
  • The Successful Retreatment with Glecaprevir and Pibrentasvir of Genotype 1 or 2 HCV-infected Hemodialysis Patients who Failed to Respond to NS5A and Protease Inhibitor Treatment.
    Goki Suda, Masato Nakai, Takuya Sho, Megumi Kimura, Tomoe Shimazaki, Osamu Maehara, Taku Shigesawa, Kazuharu Suzuki, Akihisa Nakamura, Masatsugu Ohara, Machiko Umemura, Naoki Kawagishi, Masaru Baba, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    Internal medicine (Tokyo, Japan), 58, 7, 943, 947, 2019年04月01日, [査読有り], [筆頭著者, 責任著者], [国内誌]
    英語, 研究論文(学術雑誌), Clinical trials and real-world data have proven that hepatitis C virus (HCV) in most infected patients can be eradicated by direct-acting antivirals (DAAs). However, the proper retreatment regimen for hemodialysis patients with HCV infection who have previously failed to respond to DAAs has not been clarified. We herein report, for the first time, the successful retreatment with glecaprevir and pibrentasvir, of three hemodialysis patients with genotype 1 or 2 HCV infection, who had previously failed to respond to combination therapy with an HCV-NA5A inhibitor (daclatasvir) and an HCV protease inhibitor (asunaprevir).
  • Glecaprevir and Pibrentasvir for Japanese Patients with Human Immunodeficiency Virus and Genotype 3 Hepatitis C Virus Coinfection: A Report of Three Cases.
    Takuya Sho, Goki Suda, Megumi Kimura, Tomoe Shimazaki, Osamu Maehara, Taku Shigesawa, Kazuharu Suzuki, Akihisa Nakamura, Masatsugu Ohara, Machiko Umemura, Takaaki Izumi, Naoki Kawagishi, Masaru Baba, Masato Nakai, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    Internal medicine (Tokyo, Japan), 58, 6, 797, 802, 2019年03月15日, [査読有り], [筆頭著者, 責任著者], [国内誌]
    英語, 研究論文(学術雑誌), The efficacy and safety of glecaprevir and pibrentasvir in Japanese patients with human immunodeficiency virus (HIV) and/or genotype 3 hepatitis C virus (HCV) infection is yet to be clarified. This is because no or only a few patients have been included in Japanese phase 3 trials. We herein report for the first time the successful treatment of glecaprevir and pibrentasvir in three Japanese patients with HIV and genotype 3 HCV coinfection as well as hemophilia. Glecaprevir and pibrentasvir treatment is safe and effective for Japanese patients with genotype 3 HCV and HIV coinfection.
  • A Novel Approach for the Genetic Analysis of Biliary Tract Cancer Specimens Obtained Through Endoscopic Ultrasound-Guided Fine Needle Aspiration Using Targeted Amplicon Sequencing.
    Hirata K, Kuwatani M, Suda G, Ishikawa M, Sugiura R, Kato S, Kawakubo K, Sakamoto N
    Clinical and translational gastroenterology, 10, 3, e00022, 2019年03月, [査読有り], [国際誌]
    英語, 研究論文(学術雑誌), OBJECTIVES: Biliary tract cancer (BTC) is an aggressive malignant tumor, and biomarker-based clinical trials for this cancer are currently ongoing. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is a safe procedure and enables pathological diagnoses; however, it is uncertain whether a tiny tumor sample of BTC obtained through EUS-FNA can be analyzed for diverse genetic alterations in the development and tolerance of BTC. Thus, we aimed to verify the feasibility of genetic analyses with EUS-FNA samples of BTC. METHODS: Targeted amplicon sequencing using a cancer gene panel with 50 genes was performed with tissue samples of 21 BTC patients obtained through EUS-FNA with a novel rapid on-site process compared with paired peripheral blood samples. RESULTS: Pathogenic gene alterations were successfully identified in 20 out of 21 patients (95.2%) with EUS-FNA specimens of BTC, which included 19 adenocarcinomas and 2 adenosquamous carcinomas. Eighty single nucleotide variants and 8 indels in 39 genes were identified in total, and 28 pathogenic alterations in 14 genes were identified (average, 1.4 alterations per patient). The most common alterations were TP53, KRAS, and CDKN2A in gallbladder carcinoma; TP53, KRAS, PIK3CA, and BRAF in intrahepatic cholangiocarcinoma; and TP53 and SMAD4 in extrahepatic cholangiocarcinoma. Actionable gene alterations (BRAF, NRAS, PIK3CA, and IDH1) were identified in 7 out of 21 patients. CONCLUSIONS: A novel approach in genetic analysis using targeted amplicon sequencing with BTC specimens obtained through EUS-FNA was feasible and enabled us to identify genomic alterations.
  • Evaluation of clinical utility of PIVKA-II using a chemiluminescent immunoassay
    Koji Ogawa, Kazuharu Suzuki, Masato Nakai, Takuya Sho, Goki Suda, Kenichi Morikawa, Naoya Sakamoto
    Acta Hepatologica Japonica, 60, 11, 397, 404, Japan Society of Hepatology, 2019年
    日本語, 研究論文(学術雑誌), PIVKA-II is a tumor marker highly specific for hepatocellular carcinoma. We investigated the utility of Architect PIVKA-II, a chemiluminescent immunoassay, in 168 patients with liver disease (chronic hepatitis, n = 29
    liver cirrhosis, n = 28
    and hepatocellular carcinoma by stage: stage 1, n = 29
    stage 2, n = 29
    stage 3, n = 26
    and stage 4, n = 27). Architect PIVKA-II was measured in preserved serum and compared with LumipulseⓇ PIVKA-II and alpha fetoprotein (AFP) values measured that had been measured during patient evaluation. Both methods indicated increasing PIVKA-II levels with each higher stage of hepatocellular carcinoma. The diagnostic accuracy when combined with AFP was equivalent. Architect PIVKA-II has a diagnostic accuracy comparable to conventional tests in cases of hepatocellular carcinoma and should be useful in clinical practice.
  • Safety and efficacy of elbasvir and grazoprevir in Japanese hemodialysis patients with genotype 1b hepatitis C virus infection.
    Goki Suda, Masayuki Kurosaki, Jun Itakura, Namiki Izumi, Yoshihito Uchida, Satoshi Mochida, Chitomi Hasebe, Masami Abe, Hiroaki Haga, Yoshiyuki Ueno, Ikuto Masakane, Kazumichi Abe, Atsushi Takahashi, Hiromasa Ohira, Ken Furuya, Masaru Baba, Yoshiya Yamamoto, Tomoe Kobayashi, Atsuhiko Kawakami, Kenichi Kumagai, Katsumi Terasita, Masatsugu Ohara, Naoki Kawagishi, Machiko Umemura, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    Journal of gastroenterology, 54, 1, 78, 86, 2019年01月, [査読有り], [筆頭著者, 責任著者], [国内誌]
    英語, 研究論文(学術雑誌), BACKGROUND: The prevalence of hepatitis C virus (HCV) infection in hemodialysis patients is high and results in a poor prognosis. Thus, safer and more effective treatment regimens are required. In this prospective multicenter study, we investigated the efficacy and safety of the novel HCV-NS5A-inhibitor, elbasvir, and protease inhibitor, grazoprevir in Japanese hemodialysis patients with genotype 1b HCV infection. METHODS: This study is registered at the UMIN Clinical Trials Registry as UMIN00002578. A total of 23 Japanese dialysis patients with genotype 1b HCV infection who were treated with elbasvir and grazoprevir between January 2017 and March 2018 and followed for more than 12 weeks after treatment completion were included. We evaluated the sustained virologic response at 12 weeks after treatment completion (SVR12) and safety during treatment. RESULTS: Of the 23 patients, 7 had advanced liver fibrosis and 2 had a signature resistance-associated variant of NS5A (NS5A RAVs)-L31M/V or Y93H at baseline. All patients completed therapy, and 96.7% (22/23) of the patients achieved SVR12. All patients with advanced liver fibrosis and signature NS5A RAVs at baseline achieved SVR12 with a high safety profile. No patient experienced lethal or severe adverse events during therapy, and the most common adverse event was anemia. One patient, who was a non-responder to this therapy, had a history of failure with daclatasvir and asunaprevir therapies and had NS5A RAVs of A92K at baseline, but not signature NS5A RAVs. CONCLUSIONS: Grazoprevir and elbasvir combination is highly effective and safe for hemodialysis patients with genotype 1b HCV infection.
  • Higher Wisteria Floribunda Agglutinin-Positive Mac-2 Binding Protein (M2BPGi) Not M2BP and Pre-Sarcopenia Are Prognostic and Recurrence Markers of Primary Hepatocellular Carcinoma Treated By RFA in HCV-Negative and HCV-Eradicated Patients.
    Masato Nakai, Goki Suda, Koji Ogawa, Kazuharu Suzuki, Akihisa Nakamura, Masatsugu Ohara, Naoki Kawagishi, Machiko Umemura, Takuya Sho, Kenichi Morikawa, Naoya Sakamoto
    HEPATOLOGY, 68, 843A, 844A, WILEY, 2018年10月, [査読有り]
    英語
  • Hepatitis B Virus x Protein Attenuate Interferon Signaling Throughup-Regulation of SOCS3 and Protein Phosphatase 2A Via up-Regulation of ER Stress
    Kenichi Morikawa, Ogawa Koji, Goki Suda, Naoya Sakamoto
    HEPATOLOGY, 68, 345A, 345A, WILEY, 2018年10月, [査読有り]
    英語
  • The Risk of Hepatocellular Carcinoma Development after Sustained Virologic Response Are Similar between Japanese Patients with HCV Genotype 1 Infection Treated with Ledipasvir/Sofosbuvir and Protease Inhibitor with Peg-Interferon Plus Ribavirin.
    Korenaga Masaaki, Izumi Namiki, Tamaki Nobuharu, Yokosuka Osamu, Takehara Tetsuo, Sakamoto Naoya, Suda Goki, Nishiguchi Shuhei, Enomoto Hirayuki, Ikeda Fusao, Yanase Mikio, Toyoda Hidenori, Genda Takuya, Umemura Takeji, Yatsuhashi Hiroshi, Yamasaki Kazumi, Ide Tatsuya, Toda Nobuo, Kanda Tatsuo, Nirei Kazushige, Ueno Yoshiyuki, Haga Hiroaki, Nishigaki Yohichi, Omata Masao, Mochiduki Hitoshi, Kanto Tatsuya, Mizokami Masashi
    HEPATOLOGY, 68, 535A, 536A, WILEY, 2018年10月
    日本語, 研究論文(学術雑誌)
  • L-Carnitine Suppresses Loss of Skeletal Muscle Mass in Patients With Liver Cirrhosis.
    Masatsugu Ohara, Koji Ogawa, Goki Suda, Megumi Kimura, Osamu Maehara, Tomoe Shimazaki, Kazuharu Suzuki, Akihisa Nakamura, Machiko Umemura, Takaaki Izumi, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Shunsuke Ohnishi, Naoya Sakamoto
    Hepatology communications, 2, 8, 906, 918, 2018年08月, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), Liver cirrhosis (LC) is a major cause of secondary sarcopenia. Sarcopenia makes the prognosis worse; thus, novel therapeutic options for sarcopenia in patients with LC are urgently required as they are currently limited. In this retrospective study, 158 patients with LC were screened, and 35 of those patients who were treated with L-carnitine for more than 6 months and for whom skeletal muscle mass changes could be evaluated by computer tomography were enrolled. Of the 158 patients, 79 patients who did not receive L-carnitine supplementation served as controls. Cases and controls were propensity score matched for age, sex, presence of hepatocellular carcinoma, and branched chain amino acid administration, and changes in skeletal muscle mass and clinical data were compared. The 35 patients who received L-carnitine supplementation and 35 propensity score-matched patients who did not receive carnitine supplementation comprised the final enrollment. Compared with control patients, patients who received L-carnitine had significantly worse liver function, which is associated with rapid progress of skeletal muscle depletion. However, loss of skeletal muscle mass was significantly suppressed in patients receiving L-carnitine, and a significant effect was observed in patient subgroups stratified by age, sex, presence of hepatocellular carcinoma, and branched chain amino acid administration. The change ratios of most laboratory data, including vitamin D and insulin-like growth factor 1 levels, were similar in the two groups, but ammonia levels were significantly less in those receiving L-carnitine. However, even in patients receiving L-carnitine but not showing an ammonia decrease, loss of skeletal muscle was significantly suppressed. Conclusion: L-carnitine suppresses loss of skeletal muscle mass and may therefore be a novel therapeutic option for sarcopenia in patients with LC. (Hepatology Communications 2018; 00:000-000).
  • Safety and efficacy of sofosbuvir and ribavirin for genotype 2 hepatitis C Japanese patients with renal dysfunction.
    Takuya Sho, Goki Suda, Atsushi Nagasaka, Yoshiya Yamamoto, Ken Furuya, Kenichi Kumagai, Minoru Uebayashi, Katsumi Terashita, Tomoe Kobayashi, Izumi Tsunematsu, Manabu Onodera, Takashi Meguro, Megumi Kimura, Jun Ito, Machiko Umemura, Takaaki Izumi, Naoki Kawagishi, Masatsugu Ohara, Yuji Ono, Masato Nakai, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    Hepatology research : the official journal of the Japan Society of Hepatology, 48, 7, 529, 538, 2018年06月, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), AIM: The safety and efficacy of sofosbuvir (SOF) and ribavirin (RBV) have not been well clarified in patients with renal dysfunction because clinical trials have not included such patients. We evaluated the safety and efficacy of SOF and RBV for genotype 2 hepatitis C virus (HCV)-infected patients with renal dysfunction. METHODS: The study included genotype 2 HCV-infected patients who received SOF and RBV between July 2014 and May 2017. The sustained virologic response (SVR) after the treatment and safety during the therapy were evaluated according to renal function. RESULTS: A total of 231 patients were included in this study. The median age was 62 years old, and 45.9% (106/231) were men. Of the 231 patients, 191 (82.8%) and 40 (17.2%) were classified as having chronic kidney disease (CKD) stages G1/2 and G3, respectively. The overall SVR rate was 97% (224/231). The SVR rates in patients with CKD stages G1, 2, G3a, and G3b were 98.1%, 98.6%, 87.9%, and 100%, respectively, and this therapy was tolerated. Multivariate analysis indicated that renal dysfunction was significantly associated with a non-SVR (odds ratio, 6.963; 95% confidence interval, 1.494-32.41; P = 0.013). The patients with renal dysfunction were older, had advanced liver fibrosis, lower baseline platelet and hemoglobin levels, and a higher rate of RBV dose reduction. CONCLUSIONS: Sofosbuvir and RBV therapy is highly effective and safe for genotype 2 HCV-infected Japanese patients. However, attention should be paid to baseline renal function when SOF- and RBV-containing regimens are used for patients with renal dysfunction.
  • Treatment of hepatitis C in special populations.
    Goki Suda, Koji Ogawa, Kenichi Morikawa, Naoya Sakamoto
    Journal of gastroenterology, 53, 5, 591, 605, 2018年05月, [査読有り], [筆頭著者], [国内誌]
    英語, 研究論文(学術雑誌), Hepatitis C virus (HCV) infection is one of the primary causes of liver cirrhosis and hepatocellular carcinoma. In hemodialysis patients, the rate of HCV infection is high and is moreover associated with a poor prognosis. In liver transplantation patients with HCV infection, recurrent HCV infection is universal, and re-infected HCV causes rapid progression of liver fibrosis and graft loss. Additionally, in patients with HCV and human immunodeficiency virus (HIV) co-infection, liver fibrosis progresses rapidly. Thus, there is an acute need for prompt treatment of HCV infection in these special populations (i.e., hemodialysis, liver transplantation, HIV co-infection). However, until recently, the standard anti-HCV treatment involved the use of interferon-based therapy. In these special populations, interferon-based therapies could not achieve a high rate of sustained viral response and moreover were associated with a higher rate of adverse events. With the development of novel direct-acting antivirals (DAAs), the landscape of anti-HCV therapy for special populations has changed dramatically. Indeed, in special populations treated with interferon-free DAAs, the sustained viral response rate was above 90%, with a lower incidence and severity of adverse events.
  • Add-on effects of fluvastatin in simeprevir/pegylated-interferon/ribavirin combination therapy for patients with genotype 1 hepatitis C virus infection: A randomized controlled study.
    Goki Suda, Jun Ito, Atsushi Nagasaka, Yoshiya Yamamoto, Ken Furuya, Munenori Okamoto, Katsumi Terashita, Tomoe Kobayashi, Izumi Tsunematsu, Junichi Yoshida, Takashi Meguro, Masatsugu Ohara, Naoki Kawagishi, Megumi Kimura, Machiko Umemura, Takaaki Izumi, Yoko Tsukuda, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    Hepatology research : the official journal of the Japan Society of Hepatology, 48, 3, E146-E154, E154, 2018年02月, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), BACKGROUND: The Japan Society of Hepatology guidelines indicate that hepatitis C virus (HCV) protease inhibitor combination therapy with simeprevir (SMV), pegylated-interferon (Peg-IFN), and ribavirin (RBV) is a therapeutic option for patients who fail to respond to a direct direct-acting antiviral-containing regimen. However, treatment outcomes have room for improvement. Fluvastatin (FLV) add-on treatment in Peg-IFN and RBV combination therapy for HCV-infected patients significantly improved the sustained virologic response (SVR), but the add-on effect of FLV on SMV combination therapy is not well understood. METHODS: This was a prospective, randomized, multicenter study in which a total of 61 HCV genotype 1b-infected patients were recruited and 60 eligible patients were randomly allocated to two groups that received 12 weeks of SMV/Peg-IFN/RBV followed by 12 weeks of Peg-IFN/RBV with or without 24 weeks of FLV. The SVR rate and adverse events were compared between the two groups. RESULTS: Thirty-one patients were allocated to the FLV add-on group and 29 patients were allocated to the control group. Baseline clinical factors, including median age, baseline platelet count, alanine aminotransferase level, HCV RNA titer, Fibrosis-4 index, and rate of IL28B minor genotype, were all similar between the two groups. The rapid virologic response, end-of-treatment response rates, SVR rates at 24 weeks after treatment, and safety profiles were also similar between the two groups. CONCLUSIONS: This prospective, randomized, multicenter study indicated that FLV had no add-on effect when given with SMV/Peg-IFN/RBV combination therapy for genotype 1b HCV-infected patients.
  • Increased serum C-reactive protein and decreased urinary aquaporin 2 levels are predictive of the efficacy of tolvaptan in patients with liver cirrhosis.
    Masato Nakai, Koji Ogawa, Rei Takeda, Masatsugu Ohara, Naoki Kawagishi, Takaaki Izumi, Machiko Umemura, Jun Ito, Takuya Sho, Goki Suda, Kenichi Morikawa, Naoya Sakamoto
    Hepatology research : the official journal of the Japan Society of Hepatology, 48, 3, E311-E319, E319, 2018年02月, [査読有り], [国際誌]
    英語, 研究論文(学術雑誌), AIM: Water retention, hepatic ascites, and peripheral edema are significant problems in patients with liver cirrhosis (LC). Although furosemide and spironolactone are commonly used as treatment, they are often insufficient to treat hyponatremia and renal insufficiency in patients with LC. Tolvaptan (TVP) could provide an effective treatment alternative. However, predictive factors of a therapeutic response to TVP are unclear. Our aim was to examine clinical predictors of the response to TVP in patients with LC and water retention. METHODS: Fifty-two patients were treated with TVP, with therapeutic effects judged by a decrease in body weight (≥2 kg) and increase in urinary volume (≥500 mL) within 7 days. Blood biochemical tests were carried out at baseline and post-treatment, including serum soluble CD14 (sCD14) and urinary aquaporin 2 (AQP2) levels. Clinical and laboratory predictive factors of a TVP response were evaluated by univariate and multivariate analyses. RESULTS: The overall response to TVP was 55.8%. On univariate analyses, serum C-reactive protein (CRP) level, the neutrophil-to-lymphocyte ratio, urinary blood urea nitrogen, and urinary AQP2 were predictors of the TVP response, with only serum CRP retained on multivariate analysis. A higher serum sCD14 level was strongly associated with a non-response to TVP. A decrease in urinary AQP2 to undetectable level was associated with a response. CONCLUSION: Tolvaptan provides a rapid and strong effect to improve water retention in patients with LC. Baseline serum sCD14 and CRP levels are useful predictors of a response to TVP, with a decrease in urinary AQP2 during treatment indicating an early response.
  • Liver steatosis and dyslipidemia after HCV eradication by direct acting antiviral agents are synergistic risks of atherosclerosis.
    Naoki Kawagishi, Goki Suda, Akinobu Nakamura, Megumi Kimura, Osamu Maehara, Kazuharu Suzuki, Akihisa Nakamura, Masatsugu Ohara, Takaaki Izumi, Machiko Umemura, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Yusuke Kudo, Mutsumi Nishida, Hideaki Miyoshi, Naoya Sakamoto
    PloS one, 13, 12, e0209615, 2018年, [査読有り], [筆頭著者, 責任著者], [国際誌]
    英語, 研究論文(学術雑誌), AIM: We comprehensively analyzed how hepatitis C virus (HCV) eradication by interferon (IFN)-free direct-acting-antiviral-agents (DAAs) affects liver steatosis and atherogenic risk. METHODS: Patients treated with IFN-free-DAAs who underwent transient elastography before and at 24-weeks post-treatment, including controlled attenuation parameter (CAP), and achieved sustained viral response (SVR) were enrolled. The association between changes in liver steatosis, lipid-metabolism, and genetic and clinical factors was analyzed. RESULTS: A total of 117 patients were included. The mean CAP and low-density lipoprotein cholesterol (LDL-C) levels were significantly elevated at SVR24. However, baseline LDL-C and CAP values were significantly negatively correlated with changes in these values after HCV eradication, indicating that in patients with high baseline values, the values generally decreased after HCV eradication. Mean small-dense LDL-C (sdLDL-C), which has greater atherogenic potential, was significantly elevated only in patients with both dyslipidemia (LDL-C >140 mg/dL) and liver steatosis (CAP >248 dB/m) at SVR24. Those patients had significant higher baseline BMI, LDL-C, and total-cholesterol levels. CONCLUSIONS: Generally, successful HCV eradication by IFN-free-DAAs decreases CAP and LDL-C in patients with high baseline values. However, elevated LDL-C was accompanied with elevated sdLDL-C only in patients with liver steatosis and dyslipidemia at SVR24; therefore, those patients may require closer monitoring.
  • Extracellular Vesicles from Amnion-Derived Mesenchymal Stem Cells Ameliorate Hepatic Inflammation and Fibrosis in Rats.
    Ohara M, Ohnishi S, Hosono H, Yamamoto K, Yuyama K, Nakamura H, Fu Q, Maehara O, Suda G, Sakamoto N
    Stem cells international, 2018, 3212643, 3212643, 2018年, [査読有り], [国際誌]
    英語, 研究論文(学術雑誌), Background: There are no approved drug treatments for liver fibrosis and nonalcoholic steatohepatitis (NASH), an advanced stage of fibrosis which has rapidly become a major cause of cirrhosis. Therefore, development of anti-inflammatory and antifibrotic therapies is desired. Mesenchymal stem cell- (MSC-) based therapy, which has been extensively investigated in regenerative medicine for various organs, can reportedly achieve therapeutic effect in NASH via paracrine action. Extracellular vesicles (EVs) encompass a variety of vesicles released by cells that fulfill functions similar to those of MSCs. We herein investigated the therapeutic effects of EVs from amnion-derived MSCs (AMSCs) in rats with NASH and liver fibrosis. Methods: NASH was induced by a 4-week high-fat diet (HFD), and liver fibrosis was induced by intraperitoneal injection of 2 mL/kg 50% carbon tetrachloride (CCl4) twice a week for six weeks. AMSC-EVs were intravenously injected at weeks 3 and 4 in rats with NASH (15 μg/kg) and at week 3 in rats with liver fibrosis (20 μg/kg). The extent of inflammation and fibrosis was evaluated with quantitative reverse transcription polymerase chain reaction and immunohistochemistry. The effect of AMSC-EVs on inflammatory and fibrogenic response was investigated in vitro. Results: AMSC-EVs significantly decreased the number of Kupffer cells (KCs) in the liver of rats with NASH and the mRNA expression levels of inflammatory cytokines such as tumor necrosis factor- (Tnf-) α, interleukin- (Il-) 1β and Il-6, and transforming growth factor- (Tgf-) β. Furthermore, AMSC-EVs significantly decreased fiber accumulation, KC number, and hepatic stellate cell (HSC) activation in rats with liver fibrosis. In vitro, AMSC-EVs significantly inhibited KC and HSC activation and suppressed the lipopolysaccharide (LPS)/toll-like receptor 4 (TLR4) signaling pathway. Conclusions: AMSC-EVs ameliorated inflammation and fibrogenesis in a rat model of NASH and liver fibrosis, potentially by attenuating HSC and KC activation. AMSC-EV administration should be considered as a new therapeutic strategy for chronic liver disease.
  • Macrophage-Derived Extracellular Vesicles Induce Long-Lasting Immunity Against Hepatitis C Virus Which Is Blunted by Polyunsaturated Fatty Acids.
    Chengcong Cai, Benjamin Koch, Kenichi Morikawa, Goki Suda, Naoya Sakamoto, Sabrina Rueschenbaum, Sami Akhras, Julia Dietz, Eberhard Hildt, Stefan Zeuzem, Christoph Welsch, Christian M Lange
    Frontiers in immunology, 9, 723, 723, 2018年, [査読有り], [国際誌]
    英語, 研究論文(学術雑誌), Extracellular vesicles (EVs) are increasingly recognized as important mediators of intercellular communication. In this study, we aimed to further characterize the role of macrophage-derived EVs in immune responses against hepatitis C virus (HCV) and the potential of polyunsaturated fatty acids (PUFAs) to modulate this modality of innate immunity. To this end, EVs were isolated from interferon-stimulated macrophage cultures or from serum of patients with acute or chronic hepatitis C. EVs were characterized by electron microscopy, flow cytometry, RNA-sequencing, and Western blot analysis. The effect of EVs on replication of HCV was assessed in coculture models. Functional analyses were performed to assess the impact of PUFAs on EV-mediated antiviral immunity. We found that macrophages secreted various cytokines shortly after stimulation with type I and II IFN, which orchestrated a fast but short-lasting antiviral state. This rapid innate immune answer was followed by the production of macrophage-derived EVs, which induced a late, but long-lasting inhibitory effect on HCV replication. Of note, exposure of macrophages to PUFAs, which are important regulators of immune responses, dampened EV-mediated antiviral immune responses. Finally, EVs from patients with hepatitis C exhibited long-lasting antiviral activities during IFN therapy as well. The antiviral effect of EVs from Caucasian and Japanese patients differed, which may be explained by different nutritional uptake of PUFAs. In conclusion, our data indicate that macrophage-derived EVs mediate long-lasting inhibitory effects on HCV replication, which may bridge the time until efficient adaptive immune responses are established, and which can be blunted by PUFAs.
  • Palmitoylethanolamide Ameliorates Carbon Tetrachloride-Induced Liver Fibrosis in Rats.
    Ohara M, Ohnishi S, Hosono H, Yamamoto K, Fu Q, Maehara O, Suda G, Sakamoto N
    Frontiers in pharmacology, 9, 709, 709, 2018年, [査読有り], [国際誌]
    英語, 研究論文(学術雑誌), Background: Liver fibrosis is a complex inflammatory and fibrogenic process, and the progression of fibrosis leads to cirrhosis. The only therapeutic approaches are the removal of injurious stimuli and liver transplantation. Therefore, the development of anti-fibrotic therapies is desired. Palmitoylethanolamide (PEA) is an endogenous fatty acid amide belonging to the N-acylethanolamines family and contained in foods such as egg yolks and peanuts. PEA has therapeutic anti-inflammatory, analgesic, and neuroprotective effects. However, the effects and roles of PEA in liver fibrosis remain unknown. Here we investigated the therapeutic effects of PEA in rats with liver fibrosis. Methods: We conducted in vitro experiments to investigate the effects of PEA on the activation of hepatic stellate cells (HSCs, LX-2). Liver fibrosis was induced by an intraperitoneal injection of 1.5 mL/kg of 50% carbon tetrachloride twice a week for 4 weeks. Beginning at 3 weeks, PEA (20 mg/kg) was intraperitoneally injected thrice a week for 2 weeks. Then rats were sacrificed and we performed histological and quantitative reverse-transcription polymerase chain reaction analyses. Results: The expression of α-smooth muscle actin (SMA) induced by transforming growth factor (TGF)-β1 in HSCs was significantly downregulated by PEA. PEA treatment inhibited the TGF-β1-induced phosphorylation of SMAD2 in a dose-dependent manner, and upregulated the expression of SMAD7. The reporter gene assay demonstrated that PEA downregulated the transcriptional activity of the SMAD complex upregulated by TGF-β1. Administration of PEA significantly reduced the fibrotic area, deposition of type I collagen, and activation of HSCs and Kupffer cells in rats with liver fibrosis. Conclusion: Activation of HSCs was significantly decreased by PEA through suppression of the TGF-β1/SMAD signaling pathway. Administration of PEA produced significant improvement in a rat model of liver fibrosis, possibly by inhibiting the activation of HSCs and Kupffer cells. PEA may be a potential new treatment for liver fibrosis.
  • Daclatasvir and asunaprevir in hemodialysis patients with hepatitis C virus infection: a nationwide retrospective study in Japan.
    Goki Suda, Norihiro Furusyo, Hidenori Toyoda, Yoshiiku Kawakami, Hiroki Ikeda, Michihiro Suzuki, Keiko Arataki, Nami Mori, Keiji Tsuji, Yoshio Katamura, Koichi Takaguchi, Toru Ishikawa, Kunihiko Tsuji, Noritomo Shimada, Atsushi Hiraoka, Sho Yamsaki, Masato Nakai, Takuya Sho, Kenichi Morikawa, Koji Ogawa, Mineo Kudo, Atsushi Nagasaka, Ken Furuya, Yoshiya Yamamoto, Kanji Kato, Yoshiyuki Ueno, Etsuko Iio, Yasuhito Tanaka, Masayuki Kurosaki, Takashi Kumada, Kazuaki Chayama, Naoya Sakamoto
    Journal of gastroenterology, 53, 1, 119, 128, 2018年01月, [査読有り], [筆頭著者, 責任著者], [国内誌]
    英語, 研究論文(学術雑誌), BACKGROUND: Hepatitis C virus (HCV) infection is common in hemodialysis patients and worsens their prognosis, while antiviral therapy options are limited. Recently, clinical trial and real-world, small-scale studies have reported excellent responses to direct-acting antivirals in patients with advanced chronic kidney diseases. However, real-world, large-scale data were lacking. This large multicenter analysis included HCV-infected hemodialysis patients receiving combination therapy with a nonstructural protein 5A (NS5A) inhibitor, daclatasvir (DCV), and a protease inhibitor, asunaprevir (ASV). METHODS: Twenty-three centers in Japan participated in this study of 123 hemodialysis patients with genotype 1 HCV infection, who received DCV/ASV combination therapy between November 2014 and March 2016. We collected and analyzed data relating to treatment outcome, baseline clinical information, laboratory measurements (during and after the treatment), and adverse events. RESULTS: Thirty-nine patients (31.7%) had advanced liver fibrosis, 12 (9.8%) had histories of hepatocellular carcinoma (HCC), and 18 (14.6%) had baseline resistance-associated variants (RAVs) of NS5A. The overall sustained virological response (SVR)12 rate was 95.9% (118/123). Notably, all patients with HCC and 94.4% (17/18) of those with NS5A RAVs achieved SVR12. Significant factors associated with non-SVR were advanced fibrosis and the interleukin-28B non-TT genotype at rs8099917. Four patients (3.3%) discontinued therapy because of adverse events including elevated serum alanine transaminase levels (n = 2), rash (n = 1), and HCC (n = 1); all of these achieved SVR12. CONCLUSIONS: This real-world, nationwide study revealed that DCV/ASV combination therapy was safe and highly effective for hemodialysis patients with genotype 1 HCV infections. This study was registered at the UMIN Clinical Trials Registry (UMIN000024227).
  • Fibroblast growth factor-2-mediated FGFR/Erk signaling supports maintenance of cancer stem-like cells in esophageal squamous cell carcinoma
    Osamu Maehara, Goki Suda, Mitsuteru Natsuizaka, Shunsuke Ohnishi, Yoshito Komatsu, Fumiyuki Sato, Masato Nakai, Takuya Sho, Kenichi Morikawa, Koji Ogawa, Tomoe Shimazaki, Megumi Kimura, Ayaka Asano, Yoshiyuki Fujimoto, Shinya Ohashi, Shingo Kagawa, Hideaki Kinugasa, Seiji Naganuma, Kelly A. Whelan, Hiroshi Nakagawa, Koji Nakagawa, Hiroshi Takeda, Naoya Sakamoto
    CARCINOGENESIS, 38, 11, 1073, 1083, OXFORD UNIV PRESS, 2017年11月, [査読有り], [筆頭著者]
    英語, 研究論文(学術雑誌), In esophageal squamous cell carcinoma (ESCC), a subset of cells defined by high expression of CD44 and low expression of CD24 has been reported to possess characteristics of cancer stem-like cells (CSCs). Novel therapies directly targeting CSCs have the potential to improve prognosis of ESCC patients. Although fibroblast growth factor-2 (FGF-2) expression correlates with recurrence and poor survival in ESCC patients, the role of FGF-2 in regulation of ESCC CSCs has yet to be elucidated. We report that FGF-2 is significantly upregulated in CSCs and significantly increases CSC content in ESCC cell lines by inducing epithelial-mesenchymal transition (EMT). Conversely, the FGFR inhibitor, AZD4547, sharply diminishes CSCs via induction of mesenchym al-epithelial transition. Further experiments revealed that MAPK/Erk kinase (Mek)/extracellular signal-regulated kinases (Erk) pathway is crucial for FGF-2-mediated CSC regulation. Pharmacological inhibition of FGF receptor (FGFR)-mediated signaling via AZD4547 did not affect CSCs in Ras mutated cells, implying that Mek/Erk pathway, downstream of FGFR signaling, might be an important regulator of CSCs. Indeed, the Mek inhibitor, trametinib, efficiently suppressed ESCC CSCs even in the context of Ras mutation. Consistent with these findings in vitro, xenotransplantation studies demonstrated that inhibition of FGF-2-mediated FGFR/Erk signaling significantly delayed tumor growth. Taken together, these findings indicate that FGF-2 is an essential factor regulating CSCs via Mek/Erk signaling in ESCC. Additionally, inhibition of FGFR and/or Mek signaling represents a potential novel therapeutic option for targeting CSCs in ESCC.
  • Hepatitis B virus reactivation during hepatitis C direct-acting antiviral therapy in patients with previous HBV infection
    Naoki Kawagishi, Goki Suda, Masahiro Onozawa, Megumi Kimura, Osamu Maehara, Jun Ito, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    JOURNAL OF HEPATOLOGY, 67, 5, 1106, 1108, ELSEVIER SCIENCE BV, 2017年11月, [査読有り], [筆頭著者, 責任著者]
    英語
  • Safety and efficacy of daclatasvir and asunaprevir in hepatitis C virus-infected patients with renal impairment
    Goki Suda, Atsushi Nagasaka, Yoshiya Yamamoto, Ken Furuya, Kenichi Kumagai, Mineo Kudo, Katsumi Terashita, Tomoe Kobayashi, Izumi Tsunematsu, Junichi Yoshida, Takashi Meguro, Megumi Kimura, Jun Ito, Machiko Umemura, Takaaki Izumi, Seiji Tsunematsu, Fumiyuki Sato, Yoko Tsukuda, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    HEPATOLOGY RESEARCH, 47, 11, 1127, 1136, WILEY, 2017年10月, [査読有り], [筆頭著者, 責任著者]
    英語, 研究論文(学術雑誌), Aim: Hepatitis C virus (HCV) infection is a risk factor for end-stage renal disease, renal graft failure, and hemodialysis patient mortality. However, the efficacy of direct-acting antiviral therapy for HCV-infected patients with renal impairment is unclear. Additionally, the promising NS5B inhibitor sofosbuvir has not been recommended for patients with severe renal impairment. In this prospective, multicenter study, we evaluated the efficacy and safety of daclatasvir and asunaprevir combination therapy, with a focus on patients with renal impairment.Methods: The study included 322 genotype 1 HCV-infected patients who received daclatasvir and asunaprevir combination therapy. The safety and sustained virological response was examined at 12weeks after the end of treatment and safety was evaluated according to renal function.Results: Of 322 patients, 5% (16/322) and 2.5% (8/322) had chronic kidney disease stage G3b (estimated glomerular filtration rate [eGFR], 30-44mL/min/1.73m(2)) and stage G4/5 (eGFR, 15-29/<15mL/min/1.73m(2)), respectively. Baseline presence of the NS5A resistance-associated variant, previous simeprevir treatment, and HCV RNA titers, which were predictors of a sustained viral response, were similar between patients with eGFR <45mL/min/1.73m(2) and eGFR >45mL/min/1.73m(2). Notably, the 12-week sustained viral response rate was comparable in patients with eGFR <45mL/min/1.73m(2) (100%, 24/24) and those with eGFR >45mL/min/1.73m(2) (88.9%, 265/298; P=0.07). Treatment discontinuation rates and adverse events, including alanine aminotransferase elevation, anemia, and renal disorders, were similar between the two groups.Conclusion: Daclatasvir and asunaprevir combination therapy for patients with renal dysfunction was highly effective and safe.
  • Retreatment with sofosbuvir, ledipasvir, and add-on ribavirin for patients who failed daclatasvir and asunaprevir combination therapy
    Goki Suda, Koji Ogawa, Yoshiya Yamamoto, Masaki Katagiri, Ken Furuya, Kenichi Kumagai, Jun Konno, Megumi Kimura, Naoki Kawagishi, Masatsugu Ohara, Machiko Umemura, Jun Ito, Takaaki Izumi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Akihito Tsubota, Noritomo Shimada, Etsuko Iio, Yasuhito Tanaka, Naoya Sakamoto
    JOURNAL OF GASTROENTEROLOGY, 52, 10, 1122, 1129, SPRINGER JAPAN KK, 2017年10月, [査読有り], [筆頭著者, 責任著者]
    英語, 研究論文(学術雑誌), Background The optimal retreatment regimen for patients with hepatitis C virus (HCV) infection who failed interferon-free, direct-acting antiviral (DAA) therapy is undetermined. In this study, we aimed to evaluate the efficacy and safety of 12-week retreatment with ledipasvir (LDV) and sofosbuvir (SOF) with add-on ribavirin (RBV) for patients who previously failed to respond to HCV-NS5A inhibitor, daclatasvir (DCV), and HCV-NS3 inhibitor, asunaprevir (ASV), therapy.Methods This multicenter, prospective study enrolled 15 patients with genotype-1 HCV infection who failed DCV/ASV combination therapy. They were retreated with SOF, LDV, and RBV for 12 weeks and underwent physical examinations and blood tests at baseline, during treatment, and after therapy. At baseline and relapse, NS3/NS5A and NS5B resistance-associated variants (RAVs) were evaluated.Results Of the 15 enrolled patients, 73.3% (11/15), 86.7% (13/15), and 0% (0/15) had RAVs in NS3 D168A/V/T/E, NS5A L31I/M/F/V plus Y93H, and NS5B S282T, respectively. Overall, 86.7%(13/15) of patients achieved a sustained viral response, and all patients completed therapy. No patients experienced severe adverse events. Two patients who failed to respond to SOF, LDV, and RBV combination therapy were elderly women, had the IL28B non-TT genotype, and NS5A RAVs in L31I/Y93H or NS5A A92 K at baseline.Conclusions This study revealed that SOF, LDV, and RBV combination therapy was effective and well-tolerated for patients with genotype-1 HCV infection who failed DCV and ASV combination therapy. Thus, RBV added to DAA therapy for difficult-to-treat patients might improve treatment outcomes.
  • A Phase I Study of Combination Therapy with Sorafenib and 5-Fluorouracil in Patients with Advanced Hepatocellular Carcinoma.
    Takuya Sho, Mitsuru Nakanishi, Kenichi Morikawa, Masatsugu Ohara, Naoki Kawagishi, Takaaki Izumi, Machiko Umemura, Jun Ito, Masato Nakai, Goki Suda, Koji Ogawa, Makoto Chuma, Takashi Meguro, Michio Nakamura, Atsushi Nagasaka, Hiromasa Horimoto, Yoshiya Yamamoto, Naoya Sakamoto
    Drugs in R&D, 17, 3, 381, 388, 2017年09月, [査読有り], [国際誌]
    英語, 研究論文(学術雑誌), BACKGROUND AND AIMS: Sorafenib is the first molecular targeted drug approved for the treatment of advanced hepatocellular carcinoma (HCC) and is a potent small molecule inhibitor of multiple kinases. Combination therapy with sorafenib and other cytotoxic agents for HCC may result in additive anticancer activity. The purpose of this phase I study was to investigate the safety and tolerability of combination therapy with sorafenib and 5-fluorouracil (5-FU) and to determine the optimum dose of 5-FU for a phase II trial. METHODS: This phase I study used a conventional 3 + 3 dose-escalation design. The primary endpoint was to determine the maximum tolerated dose (MTD) of 5-FU in combination with sorafenib and to determine the recommended dosage (RD) for phase II. The secondary endpoints evaluated were toxicity and the tumor response rate. All patients received 800 mg of sorafenib daily and three different dosages of 5-FU (250, 350, and 450 mg/m2/day) for 20 days by intravenous infusion in 1 month as one cycle. RESULTS: Twelve patients with advanced HCC were evaluated. The MTD of 5-FU in combination with sorafenib was 450 mg/m2/day, and 350 mg/m2/day was selected as the RD for a phase II study. Thrombocytopenia, stomatitis, and hand-foot skin reaction were observed as grade 3 adverse events. Nine patients achieved stable disease (75%), and three patients (25%) were judged to have progressive disease. The disease control rate was 75%. CONCLUSIONS: Combination therapy with sorafenib and 5-FU appears to be well tolerated and may have the potential to be an option for advanced HCC.
  • ウイルソン病における各診断ガイドラインの有用性の検討
    中井 正人, 森川 賢一, 大原 正嗣, 川岸 直樹, 出水 孝章, 梅村 真知子, 伊藤 淳, 常松 聖司, 佐藤 史幸, 荘 拓也, 須田 剛生, 小川 浩司, 坂本 直哉
    日本消化器病学会雑誌, 114, 5, 839, 845, (一財)日本消化器病学会, 2017年05月, [査読有り]
    日本語, ウイルソン病は原因不明の肝機能障害、肝硬変における鑑別診断の1つである。多くは幼少期に診断されるが、成人後に肝硬変として発見される症例も経験する。血清セルロプラスミン、尿中銅などの測定にて診断可能な症例もあるが、診断に苦慮し、ATP7B遺伝子変異検査や肝組織中銅含有量測定が必要な場合もある。米国肝臓病学会、ヨーロッパ肝臓学会から診断ガイドラインが提唱されており、本邦でも2015年にウイルソン病診断ガイドラインが発表され、診断困難例においても、各ガイドラインに従った診断が可能となった。当科でのウイルソン病症例を各ガイドラインの診断基準、フローチャートを用いて検討し、その有用性を報告する。(著者抄録)
  • Combination of neutrophil-to-lymphocyte ratio and early des-γ-carboxyprothrombin change ratio as a useful predictor of treatment response for hepatic arterial infusion chemotherapy against advanced hepatocellular carcinoma.
    Tsunematsu S, Suda G, Yamasaki K, Kimura M, Takaaki I, Umemura M, Ito J, Sato F, Nakai M, Sho T, Morikawa K, Ogawa K, Kamiyama T, Taketomi A, Sakamoto N
    Hepatology research : the official journal of the Japan Society of Hepatology, 47, 6, 533, 541, WILEY, 2017年05月, [査読有り], [筆頭著者, 責任著者]
    英語, 研究論文(学術雑誌), AimHepatic arterial infusion chemotherapy (HAIC) is a potent therapeutic option for advanced hepatocellular carcinoma (HCC). However, there are few known predictive factors of treatment response to HAIC. We clarified the most accurate predictive factors early on in treatment.MethodsStudy subjects were 70 patients with advanced HCC who had been treated with HAIC. We assessed the relationships between patient characteristics, change ratios of early tumor markers, tumor response, progression-free survival (PFS), and overall survival.ResultsAfter two courses of HAIC, 1 (1.4%), 16 (22.9%), 30 (42.8%), and 23 (32.9%) of the 70 patients showed complete response, partial response, stable disease, and progressive disease, respectively. Overall survival was related to Child-Turcotte-Pugh score, extrahepatic metastasis, and the des--carboxyprothrombin (DCP) response. Univariate and multivariate analyses identified the neutrophil-to-lymphocyte ratio (NLR) and DCP response as significant determinants of treatment response and PFS. Progression-free survival with a low NLR (<2.87) was significantly longer than with a high NLR (median, 8.4months vs. 2.8months, respectively). Progression-free survival was 7.2months for patients with a responsive DCP (<0.7) and 2.3months for an unresponsive DCP (0.7). Additionally, even with baseline high NLR, patients with responsive DCP achieved better PFS.ConclusionBaseline NLR and early DCP response were significant predictors of treatment response and PFS after HAIC for patients with advanced HCC. The combination of baseline NLR and early DCP response could be accurate and useful predictive factors of response to HAIC and could help optimize treatments for patients with advanced HCC.
  • Anti-Adipogenic and Antiviral Effects of L-Carnitine on Hepatitis C Virus Infection
    Yoko Tsukuda, Goki Suda, Seiji Tsunematsu, Jun Ito, Fumiyuki Sato, Katsumi Terashita, Masato Nakai, Takuya Sho, Osamu Maehara, Tomoe Shimazaki, Megumi Kimura, Kenichi Morikawa, Mitsuteru Natsuizaka, Koji Ogawa, Shunsuke Ohnishi, Makoto Chuma, Naoya Sakamoto
    JOURNAL OF MEDICAL VIROLOGY, 89, 5, 857, 866, WILEY, 2017年05月, [査読有り], [筆頭著者, 責任著者]
    英語, 研究論文(学術雑誌), Hepatitis C virus (HCV) has been reported to hijack fatty acid metabolism in infected hepatocytes, taking advantage of lipid droplets for virus assembly. In this study, we analyzed the anti-HCV activity of L-carnitine, a substance involved in the transport of fatty acids into mitochondria. JFH-1 or HCV replicontransfected Huh7.5.1 cells were treated with or without L-carnitine to examine its anti-HCV effects. The effects of L-carnitine on HCV entry, HCV-induced adipogenesis and lipid droplet formation, and HCV-induced oxidative stress were examined. Treatment of JFH1-infected cells with L-carnitine inhibited HCV propagation in a concentration-dependent manner. In contrast, L-carnitine had no antiHCV activity in the HCV replicon system, which is lacking viral assembly. In addition, Lcarnitine did not affect HCV entry. However, Lcarnitine treatment decreased intracellular lipid droplets, which are crucial for HCV assembly in JFH-1-infected cells. The expression level of CPT-1 was decreased in JFH-1-infected cells, and L-carnitine treatment restored this expression. HCV-infected cells exhibited increased production of reactive oxygen species and glutathione oxidation. L-carnitine decreased oxidative stress induced by JFH-1-infection, as shown by glutathione/glutathione disulfide assays and MitoSOX staining. L-carnitine exhibited anti-HCV activity, possibly by inhibiting HCV assembly and through its anti-adipogenic activity in HCV-infected cells. Moreover, L-carnitine has antioxidant properties in HCVinfected hepatocytes. Overall, these results indicated that L-carnitine may be an effective adjunctive agent in antiviral therapies to treat chronic hepatitis C. (C) 2016 Wiley Periodicals, Inc.
  • Decreased RNA-binding motif 5 expression is associated with tumor progression in gastric cancer
    Takahiko Kobayashi, Junich Ishida, Yuichi Shimizu, Hiroshi Kawakami, Goki Suda, Tetsuhito Muranaka, Yoshito Komatsu, Masahiro Asaka, Naoya Sakamoto
    TUMOR BIOLOGY, 39, 3, 1010428317694547, SAGE PUBLICATIONS LTD, 2017年03月, [査読有り]
    英語, 研究論文(学術雑誌), RNA-binding motif 5 is a putative tumor suppressor gene that modulates cell cycle arrest and apoptosis. We recently demonstrated that RNA-binding motif 5 inhibits cell growth through the p53 pathway. This study evaluated the clinical significance of RNA-binding motif 5 expression in gastric cancer and the effects of altered RNA-binding motif 5 expression on cancer biology in gastric cancer cells. RNA-binding motif 5 protein expression was evaluated by immunohistochemistry using the surgical specimens of 106 patients with gastric cancer. We analyzed the relationships of RNA-binding motif 5 expression with clinicopathological parameters and patient prognosis. We further explored the effects of RNA-binding motif 5 downregulation with short hairpin RNA on cell growth and p53 signaling in MKN45 gastric cancer cells. Immunohistochemistry revealed that RNA-binding motif 5 expression was decreased in 29 of 106 (27.4%) gastric cancer specimens. Decreased RNA-binding motif 5 expression was correlated with histological differentiation, depth of tumor infiltration, nodal metastasis, tumor-node-metastasis stage, and prognosis. RNA-binding motif 5 silencing enhanced gastric cancer cell proliferation and decreased p53 transcriptional activity in reporter gene assays. Conversely, restoration of RNA-binding motif 5 expression suppressed cell growth and recovered p53 transactivation in RNA-binding motif 5-silenced cells. Furthermore, RNA-binding motif 5 silencing reduced the messenger RNA and protein expression of the p53 target gene p21. Our results suggest that RNA-binding motif 5 downregulation is involved in gastric cancer progression and that RNA-binding motif 5 behaves as a tumor suppressor gene in gastric cancer.
  • Hepatitis B virus X protein impairs α-interferon signaling via up-regulation of suppressor of cytokine signaling 3 and protein phosphatase 2A.
    Tsunematsu S, Suda G, Yamasaki K, Kimura M, Izumi T, Umemura M, Ito J, Sato F, Nakai M, Sho T, Morikawa K, Ogawa K, Tanaka Y, Watashi K, Wakita T, Sakamoto N
    Journal of medical virology, 89, 2, 267, 275, WILEY-BLACKWELL, 2017年02月, [査読有り], [筆頭著者]
    英語, 研究論文(学術雑誌), Hepatitis B Virus (HBV) causes liver cirrhosis and hepatocellular carcinoma. Standard therapy includes treatment with interferon (IFN); however, its efficacy is limited. HBV has been reported to impair IFN signaling; however, the mechanism is unclear. Here, the relationship between HBV X protein (HBx) and IFN signaling was investigated by establishing HepG2 cells, stably expressing HBx (HepG2/HBx) via retrovirus-mediated gene transfer. Subsequently, IFN negative-regulator expression and its mechanism were studied. HepG2/HBx cells showed reduced expression of IFN-stimulated genes and expressed higher levels of suppressor of cytokine signaling 3 (SOCS3) and protein phosphatase 2A (PP2A) suppressor compared with control cells. Knockdown of SOCS3 and PP2A restored IFN sensitivity. Moreover, HepG2/HBx cells showed higher phosphorylation levels of signal transducers and activators of transcription 3 and endoplasmic reticulum stress, which are inducers of SOCS3 and PP2A, respectively. Additionally, HBx-knockdown restored IFN sensitivity in HepG2.2.15.7 cells. It was also confirmed that SOCS3 and PP2A expression levels were up-regulated in the liver of patients with HBV infection. The results of this study demonstrated that HBx impairs IFN signaling via increased expression of SOCS3 and PP2A, a novel mechanistic insight, providing a potential therapeutic target to enhance the efficiency of IFN therapy. J. Med. Virol. 89:267-275, 2017. (c) 2016 Wiley Periodicals, Inc.
  • インターフェロンベース治療 : その存在意義—Interferon-based therapy, what is the significance of existence—特集 C型肝炎治療の新時代
    須田 剛生, 木村 恵, 坂本 直哉
    消化器・肝臓内科 = Gastroenterology & hepatology / 消化器・肝臓内科編集委員会 編, 1, 1, 66, 71, 科学評論社, 2017年01月
    日本語
  • Investigation of the utility of various diagnostic guidelines for Wilson's disease.
    Nakai M, Morikawa K, Ohara M, Kawagishi N, Izumi T, Umemura M, Ito J, Tsunematsu S, Sato F, Sho T, Suda G, Ogawa K, Sakamoto N
    Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology, 114, 5, 839, 845, 2017年, [査読有り]
  • Novel Treatment of Hepatitis C Virus Infection for Patients with Renal Impairment.
    Goki Suda, Koji Ogawa, Megumi Kimura, Masato Nakai, Takuya Sho, Kenichi Morikawa, Naoya Sakamoto
    Journal of clinical and translational hepatology, 4, 4, 320, 327, 2016年12月28日, [査読有り], [国際誌]
    英語, 研究論文(学術雑誌), Prevalence of hepatitis C virus (HCV) infection is high in patients with end-stage renal dysfunction, including patients undergoing hemodialysis (HD). The HCV infection itself can cause glomerulonephritis and puts individuals at increased risk of developing end-stage renal disease; fortunately, successful HCV eradication sometimes restore HCV-related renal dysfunction. Moreover, the prognosis of dialysis patients infected with HCV is significantly worse and the renal allograft survival in HCV-infected patients is also worse than in dialysis patients without HCV infection. If life prognosis is favorable, therefore, anti-HCV therapy is strongly recommended for HCV-infected patients with severe renal dysfunction. The standard therapy for HCV-infected patients with severe renal dysfunction has historically been interferon-based therapy. However, this therapy remains ineffective in achieving high, sustained viral response rates and the rate of adverse events and treatment discontinuation due to treatment-induced adverse events continues to be high in patients with severe renal dysfunction. Safe and effective anti-HCV therapies are urgently needed, and crucial, for patients with severe renal dysfunction. Recently, direct-acting antivirals (DAAs) that specifically target viral proteins have been developed, and these targets include the NS3, NS5A, and NS5B of HCV. Clinical trials have revealed high efficacy and safety of the DAA-based therapies, but patients with severe renal dysfunction were not included in the majority of these trials. However, several recent reports have shown high efficacy and safety for some regimens of DAA combination therapy for HCV-infected patients with severe renal dysfunction. In this review, we discuss novel treatments for HCV-infected patients with severe renal dysfunction and the pharmacokinetics of these drugs.
  • 【肝硬変を理解する-分子機構から実臨床に至るまで-】 治療 抗ウイルス治療(C型肝硬変)               
    中井 正人, 須田 剛生, 坂本 直哉
    肝・胆・膵, 73, 6, 1093, 1099, (株)アークメディア, 2016年12月
    日本語
  • Prevalence and characteristics of naturally occurring sofosbuvir resistance-associated variants in patients with hepatitis C virus genotype 1b infection
    Jun Ito, Goki Suda, Yoshiya Yamamoto, Atsushi Nagasaka, Ken Furuya, Kenichi Kumagai, Hideaki Kikuchi, Takuto Miyagishima, Tomoe Kobayashi, Megumi Kimura, Kazushi Yamasaki, Machiko Umemura, Takaaki Izumi, Seiji Tsunematsu, Fumiyuki Sato, Yoko Tsukuda, Katsumi Terashita, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    HEPATOLOGY RESEARCH, 46, 13, 1294, 1303, WILEY, 2016年12月, [査読有り]
    英語, 研究論文(学術雑誌), Aim: Sofosbuvir (SOF), a nucleotide analog pro-drug, targets hepatitis C virus (HCV) NS5B polymerase and shows potential for treating HCV infection, given its high efficacy and good barrier to resistance. However, in addition to the rare resistant-associated variant (RAV) of non-structural protein NS5B S282T, several new potential RAVs of SOF have been reported, especially related to HCV genotype 1b. However, the prevalence and characteristics of these RAVs have not been clarified.Methods: We analyzed the prevalence of variants in the NS3/NS5A/NS5B regions in 96 patients treated with simeprevir (SMV) combination therapy, and the prevalence of RAVs in patients showing treatment failure was determined by direct- or deep-sequencing methods. Associations between these potential RAVs and clinical factors were also analyzed.Results: Prevalence of NS5B RAV C316N was high (46.9%, 45/96), whereas that of NS5B L159F was relatively low (1.04%, 1/96); however, deep sequencing showed that 30.0% of patients with C316N also had NS5B RAV L159F. Additionally, there was no significant relationship between the existence of potential NS5B and NS5A or NS3 RAVs. However, the presence of NS5B C316N was significantly associated with an HCV core amino acid 91 substitution. No significant difference was detected between each RAV and sustained virological response in simeprevir combination therapy.Conclusion: We provide clear evidence of the high prevalence of two potential naturally occurring NS5B RAVs (C316N and L159F) in Japan. It may be important to pay particular attention to these new potential RAVs, especially when using SOF-based therapy in patients with RAVs due to previous direct-acting antiviral therapy failure.
  • Efficacy and tolerability of IFN-free direct acting antivirals therapy (daclatasvir and asunaprevir) in chronic hemodialysis patients with chronic hepatitis C
    Goki Suda, Koji Ogawa, Kenichi Morikawa, Masato Nakai, Naoya Sakamoto
    HEPATOLOGY, 64, 975A, 975A, WILEY, 2016年10月, [査読有り]
    英語
  • Viral life cycle of hepatitis B virus: Host factors and druggable targets
    Kenichi Morikawa, Goki Suda, Naoya Sakamoto
    HEPATOLOGY RESEARCH, 46, 9, 871, 877, WILEY-BLACKWELL, 2016年08月, [査読有り]
    英語, Hepatitis B virus (HBV) infection is a globally distributed health problem. The number of carriers of HBV is estimated to exceed 240million people worldwide. Compared with uninfected individuals, HBV carriers have an increased risk of developing hepatocellular carcinoma. The prevention of HBV infection is therefore strongly recommended, and a HBV vaccine is available. For carriers, treatment with nucleoside/nucleotide reverse transcriptase inhibitors is available, but infection frequently requires chronic treatment via a lifetime of medication. Thus, curing HBV infection remains a major challenge. However, despite the development of an infectious HBV cell culture system and recent intense research, many aspects of the HBV life cycle remain poorly characterized. In this review, we focus on the current understanding of the HBV life cycle and involved host factors, as well as potential targets for therapeutic intervention against HBV. We also consider possible immunotherapeutic strategies for eliminating HBV, including the removal of cccDNA from infected hepatocytes.
  • Efficacy and safety of daclatasvir and asunaprevir combination therapy in chronic hemodialysis patients with chronic hepatitis C
    Goki Suda, Mineo Kudo, Atsushi Nagasaka, Ken Furuya, Yoshiya Yamamoto, Tomoe Kobayashi, Keisuke Shinada, Miki Tateyama, Jun Konno, Yoko Tsukuda, Kazushi Yamasaki, Megumi Kimura, Machiko Umemura, Takaaki Izumi, Seiji Tsunematsu, Fumiyuki Sato, Katsumi Terashita, Masato Nakai, Hiromasa Horimoto, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    JOURNAL OF GASTROENTEROLOGY, 51, 7, 733, 740, SPRINGER JAPAN KK, 2016年07月, [査読有り]
    英語, 研究論文(学術雑誌), HCV infection in chronic hemodialysis patients is high, has a poor prognosis and high risk of renal graft failure, and requires nosocomial infection control measures. However, options of anti-HCV therapy in such patients are limited and unsatisfactory. In this study, we report effectiveness and safety of HCV-NS5A-inhibitor daclatasvir (DCV) and protease-inhibitor asunaprevir (ASV) combination therapy for hemodialysis patients with HCV infection.This study was registered at the UMIN Clinical Trials Registry as UMIN000016355. Thirty-four dialysis patients were treated with DCV/ASV combination therapy between January 2015 and November 2015. Of those, 21 patients who were followed more than 12 weeks after treatment ended were included. We evaluated the 12-week sustained virologic response (SVR12) and adverse events during treatment.Of the 21 patients, four had compensated liver cirrhosis and three had resistance-associated variant of NS5A (NS5A RAVs)-Y93H at baseline. Overall, total of 95.5 % (20/21) of the patients achieved SVR12. Of note, all patients with cirrhosis or NS5A RAVs achieved SVR12. One relapser patient at 4 weeks post-treatment had NS3 D168E RAVs at baseline. A total of 20 patients (95.5 %) completed the 24-week therapy. One patient discontinued treatment at week 12 due to ALT elevations and achieved SVR12.DAV and ASV combination therapy for chronic hemodialysis patients with HCV infection was highly effective and well tolerated, even in elderly patients and patients with liver cirrhosis and NS5A-RAVs.
  • 【肝不全-その常識は正しいか?-】 慢性肝不全 その常識は正しいか? ウイルス性慢性肝不全に対する抗ウイルス治療は有用である
    中井 正人, 須田 剛生, 坂本 直哉
    救急・集中治療, 28, 5-6, 377, 381, (株)総合医学社, 2016年05月
    日本語, <Point>B型慢性肝不全患者に核酸アナログを投与することで肝がん抑制、肝予備能改善、予後改善を得ることができる。インターフェロンを用いないDAAs(Direct Acting Antivirals)の登場により、海外のC型慢性肝不全患者に対する良好な抗ウイルス治療の成績が報告されつつある。C型慢性肝不全(非代償性肝硬変)患者に対する抗ウイルス治療の効果・安全性は、十分には確立していない。(著者抄録)
  • [Predictive factors of response to Direct Acting Antivirals therapy Drug resistance hepatitis C virus].
    Suda G, Yamasaki K, Sakamoto N
    Nihon rinsho. Japanese journal of clinical medicine, 73 Suppl 9, 189, 192, 2015年12月, [査読有り]
  • Dynamic Analysis Of Cellular Factors Modulated By Hepatitis B Virus Protein Expression And Replication
    Kenichi Morikawa, Tomoe Shimazaki, Takaaki Izumi, Machiko Umemura, Masato Nakai, Goki Suda, Darius Moradpour, Naoya Sakamoto
    HEPATOLOGY, 62, 1024A, 1024A, WILEY-BLACKWELL, 2015年10月, [査読有り]
    英語
  • The decreased urinary aquaporin2 excretion is a predictive factor for the efficacy of Tolvaptan in patients with hepatic cirrhosis
    Masato Nakai, Jun Itoh, Fumiyuki Sato, Seiji Tsunematsu, Takuya Sho, Goki Suda, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    HEPATOLOGY, 62, 358A, 358A, WILEY-BLACKWELL, 2015年10月, [査読有り]
    英語
  • Truncated Hepatitis B virus X protein up-regulates CD44+cancer stem like cells through LTBP1
    Goki Suda, Seiji Tsunematsu, Masato Nakai, Jun Itoh, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Naoya Sakamoto
    HEPATOLOGY, 62, 1157A, 1157A, WILEY-BLACKWELL, 2015年10月, [査読有り]
    英語
  • A pivotal role of Krüppel-like factor 5 in regulation of cancer stem-like cells in hepatocellular carcinoma.
    Maehara O, Sato F, Natsuizaka M, Asano A, Kubota Y, Itoh J, Tsunematsu S, Terashita K, Tsukuda Y, Nakai M, Sho T, Suda G, Morikawa K, Ogawa K, Chuma M, Nakagawa K, Ohnishi S, Komatsu Y, Whelan KA, Nakagawa H, Takeda H, Sakamoto N
    Cancer biology & therapy, 16, 10, 1453, 1461, TAYLOR & FRANCIS INC, 2015年10月, [査読有り]
    英語, 研究論文(学術雑誌), In hepatocellular carcinoma (HCC), there exists a highly tumorigenic subset of cells defined by high expression of CD44 and CD133 that has been reported to contain cancer stem-like cells (CSCs). Kruppel-like factor 5 (KLF5) regulates many factors involved in cell cycle, migration, inflammation, angiogenesis and stemness and has cancer-promoting effects in some cancers. While some reports have indicated that KLF5 may have important roles in regulation of CSCs, what role, if any, KLF5 plays in regulation of CSCs in HCC remains to be elucidated. Flow cytometric analysis of CD44 and CD133 in HCC cell lines revealed subpopulations of CD44(High)/CD133(High) and CD44(Low)/CD133(Low) cells. We subsequently sorted these subpopulations and identified KLF5 as a gene that is significantly upregulated in CD44(High)/CD44(High) cells via RNA sequencing using next generation sequencing technology. Moreover, KLF5 overexpression enriched the CD44(High)/CD133(High) subpopulation and, consistent with the up-regulation of CD44(High)/CD133(High) cells, KLF5 overexpressing cells were more resistant to anti-cancer drugs and displayed enhanced colony-formation capacity. By contrast, knock-down of KLF5 by siRNA diminished the CD44(High)/CD133(High) subpopulation. When KLF5 was acetylated by TGF-1, the KLF5-mediated CD44(High)/CD133(High) subpopulation enrichment was abrogated. Oppositely, ectopic expression of an acetylation-deficient KLF5 mutant further increased CD44(High)/CD133(High) subpopulations as compared to cell expressing wild-type KLF5. These findings provide novel mechanistic insight into a pivotal role for KLF5 in the regulation of CSCs in HCC.
  • Serum granulysin levels as a predictor of serious telaprevir-induced dermatological reactions
    Goki Suda, Yoshiya Yamamoto, Astushi Nagasaka, Ken Furuya, Mineo Kudo, Yoshimichi Chuganji, Yoko Tsukuda, Seiji Tsunematsu, Fumiyuki Sato, Katsumi Terasita, Masato Nakai, Hiromasa Horimoto, Takuya Sho, Mitsuteru Natsuizaka, Kouji Ogawa, Shunsuke Ohnishi, Makoto Chuma, Yasuyuki Fujita, Riichiro Abe, Miki Taniguchi, Mina Nakagawa, Yasuhiro Asahina, Naoya Sakamoto
    HEPATOLOGY RESEARCH, 45, 8, 837, 845, WILEY-BLACKWELL, 2015年08月, [査読有り]
    英語, 研究論文(学術雑誌), Aim: Telaprevir-based therapy for chronic hepatitis C patients is effective; however, the high prevalence of dermatological reactions is an outstanding issue. The mechanism and characteristics of such adverse reactions are unclear; moreover, predictive factors remain unknown. Granulysin was recently reported to be upregulated in the blisters of patients with Stevens-Johnson syndrome (SJS). Therefore, we investigated the risk factors for severe telaprevir-induced dermatological reactions as well as the association between serum granulysin levels and the severity of such reactions.
    Methods: A total of 89 patients who received telaprevir-based therapy and had complete clinical information were analyzed. We analyzed the associations between dermatological reactions and clinical factors. Next, we investigated the time-dependent changes in serum granulysin levels in five and 14 patients with grade 3 and non-grade 3 dermatological reactions, respectively.
    Results: Of the 89 patients, 57 patients had dermatological reactions, including nine patients with grade 3. Univariate analysis revealed that grade 3 dermatological reactions were significantly associated with male sex. Moreover, serum granulysin levels were significantly associated with the severity of dermatological reactions. Three patients with grade 3 dermatological reaction had severe systemic manifestations including SJS, drug-induced hypersensitivity syndrome, and systemic lymphoid swelling and high-grade fever; all were hospitalized. Importantly, among the three patients, two patients' serum granulysin levels exceeded 8ng/mL at onset and symptoms deteriorated within 6 days.
    Conclusion: Male patients are at high risk for severe telaprevir-induced dermatological reactions. Moreover, serum granulysin levels are significantly associated with the severity of dermatological reactions and may be a predictive factor in patients treated with telaprevir-based therapy.
  • Intratumoral artery on contrast-enhanced computed tomography imaging: differentiating intrahepatic cholangiocarcinoma from poorly differentiated hepatocellular carcinoma
    Seiji Tsunematsu, Makoto Chuma, Toshiya Kamiyama, Noriyuki Miyamoto, Satoshi Yabusaki, Kanako Hatanaka, Tomoko Mitsuhashi, Hirofumi Kamachi, Hideki Yokoo, Tatsuhiko Kakisaka, Yousuke Tsuruga, Tatsuya Orimo, Kenji Wakayama, Jun Ito, Fumiyuki Sato, Katsumi Terashita, Masato Nakai, Yoko Tsukuda, Takuya Sho, Goki Suda, Kenichi Morikawa, Mitsuteru Natsuizaka, Mitsuru Nakanishi, Koji Ogawa, Akinobu Taketomi, Yoshihiro Matsuno, Naoya Sakamoto
    ABDOMINAL IMAGING, 40, 6, 1492, 1499, SPRINGER, 2015年08月, [査読有り]
    英語, 研究論文(学術雑誌), Differentiating intrahepatic cholangiocarcinoma (ICC) from poorly differentiated hepatocellular carcinoma (p-HCC) is often difficult, but it is important for providing appropriate treatments. The purpose of this study was to examine the features differentiating ICC from p-HCC on contrast-enhanced dynamic-computed tomography (CT).This study examined 42 patients with pathologically confirmed ICC (n = 19) or p-HCC (n = 23) for which contrast-enhanced dynamic CT data were available. CT images were analyzed for enhancement patterns during the arterial phase, washout pattern, delayed enhancement, satellite nodules, capsular retraction, lesion shape, and presence of an intratumoral hepatic artery, intratumoral hepatic vein, intratumoral portal vein, and bile duct dilation around the tumor, portal vein tumor thrombus, lobar atrophy, or lymphadenopathy.Univariate analysis revealed the presence of rim enhancement (p = 0.037), lobulated shape (p = 0.004), intratumoral artery (p < 0.001), and bile duct dilation (p = 0.006) as parameters significantly favoring ICC, while a washout pattern significantly favored p-HCC (p < 0.001). Multivariate analysis revealed intratumoral artery as a significant, independent variable predictive of ICC (p = 0.037), and 15 ICCs (78.9%) showed this feature. Washout pattern was a significant, independent variable favoring p-HCC (p = 0.049), with 15 p-HCCs (65.2%) showing this feature.The presence of an intratumoral artery in the arterial phase on contrast-enhanced dynamic CT was a predictable finding for ICC, and the presence of a washout pattern was a predictable finding for p-HCC, differentiating between ICC and p-HCC.
  • EGFR inhibitors prevent induction of cancer stem-like cells in esophageal squamous cell carcinoma by suppressing epithelial-mesenchymal transition
    Fumiyuki Sato, Yoshimasa Kubota, Mitsuteru Natsuizaka, Osamu Maehara, Yutaka Hatanaka, Katsuji Marukawa, Katsumi Terashita, Goki Suda, Shunsuke Ohnishi, Yuichi Shimizu, Yoshito Komatsu, Shinya Ohashi, Shingo Kagawa, Hideaki Kinugasa, Kelly A. Whelan, Hiroshi Nakagawa, Naoya Sakamoto
    CANCER BIOLOGY & THERAPY, 16, 6, 933, 940, TAYLOR & FRANCIS INC, 2015年06月, [査読有り]
    英語, 研究論文(学術雑誌), There exists a highly tumorigenic subset of esophageal squamous cell carcinoma (ESCC) cells defined by high expression of CD44. A novel therapy targeting these cancer stem-like cells (CSCs) is needed to improve prognosis of ESCC. CSCs of ESCC have a mesenchymal phenotype and epithelial-mesenchymal transition (EMT) is critical to enrich and maintain CSCs. EGFR, frequently overexpressed in ESCC, has pivotal roles in EMT induced by TGF- in invasive fronts. Thus, EMT in invasive fronts of ESCC might be important for CSCs and EGFR could be a target of a novel therapy eliminating CSCs. However, effects of EGFR inhibitors on CSCs in ESCC have not been fully examined. EGFR inhibitors, erlotinib and cetuximab, significantly suppressed enrichment of CSCs via TGF-1-mediated EMT. Importantly, EGFR inhibitors sharply suppressed ZEB1 that is essential for EMT in ESCC. Further, EGFR inhibitors activated Notch1 and Notch3, leading to squamous cell differentiation. EGFR inhibition may suppress expression of ZEB1 and induce differentiation, thereby blocking EMT-mediated enrichment of CSCs. In organotypic 3D culture, a form of human tissue engineering, tumor cells in invasive nests showed high expression of CD44. Erlotinib significantly blocked invasion into the matrix and CD44 high expressing CSCs were markedly suppressed by erlotinib in organotypic 3D culture. In conclusion, EMT is a critical process for generation of CSCs and the invasive front of ESCC, where EMT occurs, might form a CSC niche in ESCC. EGFR inhibitors could suppress EMT in invasive fronts and be one therapeutic option targeting against generation of CSCs in ESCC.
  • [Progress in Examination and Treatment of Hepatitis C Virus].
    Suda G, Sakamoto N
    Rinsho byori. The Japanese journal of clinical pathology, 63, 6, 762, 767, 日本臨床検査医学会事務所 ; 1953-, 2015年06月, [査読有り]
    日本語
  • インターフェロンと経口抗ウイルス薬(DAA)の作用の違い—Different antiviral effect between Interferon and DAAs—特集 C型肝炎に対する抗ウイルス療法をどう選択するか
    須田 剛生, 坂本 直哉
    肝臓クリニカルアップデート / 肝臓クリニカルアップデート編集委員会 編, 1, 1, 3, 6, 医学図書出版, 2015年05月
    日本語
  • KLF5 Promotes Tumorigenicity of Hepatocellular Carcinoma by Upregulation of Cancer Stem-Like Cells
    Sato Fumiyuki, Natsuizaka Mitsuteru, Maehara Osamu, Asano Ayaka, Kubota Yoshimasa, Itoh Jun, Tsunematsu Seiji, Tsukuda Yoko, Terashita Katsumi, Nakai Masato, Sho Takuya, Suda Goki, Morikawa Kenichi, Ogawa Koji, Ohnishi Shunsuke, Sakamoto Naoya
    GASTROENTEROLOGY, 148, 4, S43, 2015年04月, [査読有り]
  • TGF-beta in tumor microenvironment changes a switch of Notch1-mediated signaling to maintain cancer stem-like cells in esophageal squamous cell carcinoma
    Natsuizaka Mitsuteru, Kagawa Shingo, Whelan Kelly, Ohashi Shinya, Ohnishi Shunsuke, Suda Goki, Sakamoto Naoya, Rustgi Anil K, Nakagawa Hiroshi
    CANCER RESEARCH, 75, 1, 2015年01月01日, [査読有り]
  • Human Amnion-Derived Mesenchymal Stem Cell Transplantation Ameliorates Dextran Sulfate Sodium-Induced Severe Colitis in Rats
    Reizo Onishi, Shunsuke Ohnishi, Ryosuke Higashi, Michiko Watari, Kenichi Yamahara, Naoto Okubo, Koji Nakagawa, Takehiko Katsurada, Goki Suda, Mitsuteru Natsuizaka, Hiroshi Takeda, Naoya Sakamoto
    CELL TRANSPLANTATION, 24, 12, 2601, 2614, COGNIZANT COMMUNICATION CORP, 2015年, [査読有り]
    英語, 研究論文(学術雑誌), Mesenchymal stem cells (MSCs) are a valuable cell source in regenerative medicine. Recently, several studies have shown that MSCs can be easily isolated from human amnion. In this study, we investigated the therapeutic effect of human amnion-derived MSCs (AMSCs) in rats with severe colitis. Colitis was induced by the administration of 8% dextran sulfate sodium (DSS) from day 0 to day 5, and AMSCs (1 x 10(6) cells) were transplanted intravenously on day 1. Rats were sacrificed on day 5, and the colon length and histological colitis score were evaluated. The extent of inflammation was evaluated using quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and immunohistochemistry. The effect of AMSCs on the inflammatory signals was investigated in vitro. AMSC transplantation significantly ameliorated the disease activity index score, weight loss, colon shortening, and the histological colitis score. mRNA expression levels of proinflammatory cytokines such as tumor necrosis factor (TNF)-alpha, interleukin (IL)-1 beta, and migration inhibitory factor (MIF) were significantly decreased in the rectums of AMSC-treated rats. In addition, the infiltration of monocytes/macrophages was significantly decreased in AMSC-treated rats. In vitro experiments demonstrated that activation of proinflammatory signals induced by TNF-alpha or lipopolysaccharide (LPS) in immortalized murine macrophage cells (RAW264.7) was significantly attenuated by coculturing with AMSCs or by culturing with a conditioned medium obtained from AMSCs. Although the phosphorylation of I kappa B induced by TNF-alpha or LPS was not inhibited by the conditioned medium, nuclear translocation of NF-kappa B was significantly inhibited by the conditioned medium. Taken together, AMSC transplantation provided significant improvement in rats with severe colitis, possibly through the inhibition of monocyte/macrophage activity and through inhibition of NF-kappa B activation. AMSCs could be considered as a new cell source for the treatment of severe colitis.
  • EGFR Inhibitors Eliminate Esophageal Cancer Stem Cells by Suppressing Epithelial-Mesenchymal Transition
    Mitsuteru Natsuizaka, Bongani Kaimila, Yoshimasa Kubota, Yutaka Hatanaka, Katsuji Marukawa, Katsumi Terashita, Fumiyuki Satou, Shunsuke Ohnishi, Goki Suda, Shinya Ohashi, Shingo Kagawa, Kelly A. Whelan, Anil K. Rustgi, Hiroshi Nakagawa, Naoya Sakamoto
    GASTROENTEROLOGY, 146, 5, S821, S821, W B SAUNDERS CO-ELSEVIER INC, 2014年05月, [査読有り]
    英語
  • Heat shock factor 1 accelerates hepatocellular carcinoma development by activating nuclear factor-κB/mitogen-activated protein kinase.
    Chuma M, Sakamoto N, Nakai A, Hige S, Nakanishi M, Natsuizaka M, Suda G, Sho T, Hatanaka K, Matsuno Y, Yokoo H, Kamiyama T, Taketomi A, Fujii G, Tashiro K, Hikiba Y, Fujimoto M, Asaka M, Maeda S
    Carcinogenesis, 35, 2, 272, 281, OXFORD UNIV PRESS, 2014年02月, [査読有り]
    英語, 研究論文(学術雑誌), Heat shock factor 1 (HSF1), a major transactivator of stress responses, has been implicated in carcinogenesis in various organs. However, little is known about the biological functions of HSF1 in the development of hepatocellular carcinoma (HCC). To clarify the functional role of HSF1 in HCC, we established HSF1-knockdown (HSF1 KD) KYN2 HCC cells by stably expressing either small hairpin RNA (shRNA) against HSF1 (i.e. HSF1 KD) or control shRNA (HSF1 control). Tumorigenicity was significantly reduced in orthotopic mice with HSF1 KD cells compared with those with HSF1 control cells. Reduced tumorigenesis in HSF1 KD cells appeared attributable to increased apoptosis and decreased proliferation. Tumor necrosis factor--induced apoptosis was increased in HSF1 KD cells and HSF1(/) mouse hepatocytes compared with controls. Decreased expression of IB kinase , a positive regulator of nuclear factor-B, was also observed in HSF1 KD cells and HSF1(/) mouse hepatocytes. Furthermore, expression of bcl-2-associated athanogene domain 3 (BAG3) was dramatically reduced in HSF1 KD cells and HSF1(/) mouse hepatocytes. We also found that epidermal growth factor-stimulated mitogen-activated protein kinase signaling was impaired in HSF1 KD cells. Clinicopathological analysis demonstrated frequent overexpression of HSF1 in human HCCs. Significant correlations between HSF1 and BAG3 protein levels and prognosis were also observed. In summary, these results identify a mechanistic link between HSF1 and liver tumorigenesis and may provide as a potential molecular target for the development of anti-HCC therapies.
  • インターフェロン少量長期療法の実際と新薬時代における役割
    須田 剛生, 坂本 直哉
    内科, 113, 681, 685, 2014年
    研究論文(学術雑誌)
  • A pivotal role of KLF5 in regulation of cancer stem-like cells in hepatocellular carcinoma
    Mitsuteru Natsuizaka, Osamu Maehara, Fumiyuki Sato, Yoshimasa Kubota, Goki Suda, Jun Itoh, Seiji Tsunematsu, Yoko Tsukuda, Katsumi Terashita, Masato Nakai, Takuya Sho, Koji Ogawa, Shunsuke Ohnishi, Naoya Sakamoto
    HEPATOLOGY, 60, 825A, 825A, WILEY-BLACKWELL, 2014年, [査読有り]
    英語
  • Characterization of a lymphotropic HCV-J6JFH1 replication in human primary B cells
    Masato Nakai, Tsukasa Seya, Misako Matsumoto, Hussein H. Aly, Jun Itoh, Seiji Tsunematsu, Fumiyuki Sato, Yoko Tsukuda, Katsumi Terashita, Takuya Sho, Goki Suda, Mitsuteru Natsuizaka, Koji Ogawa, Naoya Sakamoto
    HEPATOLOGY, 60, 1083A, 1084A, WILEY-BLACKWELL, 2014年, [査読有り]
    英語
  • Hepatosplenic Gamma-delta T-cell Lymphoma Associated with Epstein-Barr Virus
    Seiji Tsunematsu, Mitsuteru Natsuizaka, Hiromi Fujita, Noriyuki Otsuka, Katsumi Terashita, Fumiyuki Sato, Tomoe Kobayashi, Masato Nakai, Yoko Tsukuda, Hiromasa Horimoto, Takuya Sho, Goki Suda, Mitsuru Nakanishi, Satoshi Hashino, Makoto Chuma, Naoya Sakamoto
    INTERNAL MEDICINE, 53, 18, 2079, 2082, JAPAN SOC INTERNAL MEDICINE, 2014年, [査読有り]
    英語, 研究論文(学術雑誌), Hepatosplenic gamma-delta T-cell lymphoma (HSTCL) is a rare, aggressive subset of peripheral T-cell lymphoma. It has been reported that Epstein-Barr virus (EBV) infection can cause HSTCL; however, such cases are extremely rare, with only a few cases having been reported to date. We herein report an autopsy case of HSTCL associated with EBV infection. The presence of EBV infection was confirmed in serum EBV DNA and on in-situ hybridization, and cytotoxic molecules, such as granzyme B, perforin and T-cell intracytoplasmic antigen (TIA)-1, were all positive in lymphoma cells. These findings indicate that stimulation of persistent EBV infection may have caused HSTCL in this patient.
  • C型肝炎ウイルス蛋白によるシグナル伝達制御
    須田 剛生, 坂本 直哉
    分子消化器病, 10, 68, 72, 2013年
    研究論文(学術雑誌)
  • Analysis of Interferon Signaling by Infectious Hepatitis C Virus Clones with Substitutions of Core Amino Acids 70 and 91
    Yusuke Funaoka, Naoya Sakamoto, Goki Suda, Yasuhiro Itsui, Mina Nakagawa, Sei Kakinuma, Takako Watanabe, Kako Mishima, Mayumi Ueyama, Izumi Onozuka, Sayuri Nitta, Akiko Kitazume, Kei Kiyohashi, Miyako Murakawa, Seishin Azuma, Kiichiro Tsuchiya, Mamoru Watanabe
    JOURNAL OF VIROLOGY, 85, 12, 5986, 5994, AMER SOC MICROBIOLOGY, 2011年06月, [査読有り]
    英語, 研究論文(学術雑誌), Substitution of amino acids 70 and 91 in the hepatitis C virus (HCV) core region is a significant predictor of poor responses to peginterferon-plus-ribavirin therapy, while their molecular mechanisms remain unclear. Here we investigated these differences in the response to alpha interferon (IFN) by using HCV cell culture with R70Q, R70H, and L91M substitutions. IFN treatment of cells transfected or infected with the wild type or the mutant HCV clones showed that the R70Q, R70H, and L91M core mutants were significantly more resistant than the wild type. Among HCV-transfected cells, intracellular HCV RNA levels were significantly higher for the core mutants than for the wild type, while HCV RNA in culture supernatant was significantly lower for these mutants than for the wild type. IFN-induced phosphorylation of STAT1 and STAT2 and expression of the interferon-inducible genes were significantly lower for the core mutants than for the wild type, suggesting cellular unresponsiveness to IFN. The expression level of an interferon signal attenuator, SOCS3, was significantly higher for the R70Q, R70H, and L91M mutants than for the wild type. Interleukin 6 (IL-6), which upregulates SOCS3, was significantly higher for the R70Q, R70H, and L91M mutants than for the wild type, suggesting interferon resistance, possibly through IL-6-induced, SOCS3-mediated suppression of interferon signaling. Expression levels of endoplasmic reticulum (ER) stress proteins were significantly higher in cells transfected with a core mutant than in those transfected with the wild type. In conclusion, HCV R70 and L91 core mutants were resistant to interferon in vitro, and the resistance may be induced by IL-6-induced upregulation of SOCS3. Those mechanisms may explain clinical interferon resistance of HCV core mutants.
  • IL-6-mediated intersubgenotypic variation of interferon sensitivity in hepatitis C virus genotype 2a/2b chimeric clones
    Goki Suda, Naoya Sakamoto, Yasuhiro Itsui, Mina Nakagawa, Megumi Tasaka-Fujita, Yusuke Funaoka, Takako Watanabe, Sayuri Nitta, Kei Kiyohashi, Seishin Azuma, Sei Kakinuma, Kiichiro Tsuchiya, Michio Imamura, Nobuhiko Hiraga, Kazuaki Chayama, Mamoru Watanabe
    VIROLOGY, 407, 1, 80, 90, ACADEMIC PRESS INC ELSEVIER SCIENCE, 2010年11月, [査読有り]
    英語, 研究論文(学術雑誌), Mechanisms of difference in interferon sensitivity between hepatitis C virus (HCV) strains have yet to be clarified. Here, we constructed an infectious genotype2b clone and analyzed differences in interferon-alpha sensitivity between HCV-2b and 2a-JFH1 clones using intergenotypic homologous recombination. The HCV-2b/JFH1 chimeric virus able to infect Huh7.5.1 cells and was significantly more sensitive to IFN than JFH1. IFN-induced expression of MxA and 25-OAS was significantly lower in JFH1 than in 2b/JFH1-infected cells. In JFH1-infected cells, expression of SOCS3 and its inducer, IL-6, was significantly higher than in 2b/JFH1-infected cells. The IFN-resistance of JFH1 cells was negated by siRNA-knock down of SOCS3 expression and by pretreatment with anti-IL6 antibody. In conclusion, intergenotypic differences of IFN sensitivity of HCV may be attributable to the sequences of HCV structural proteins and can be determined by SOCS3 and IL-6 expression levels. (C) 2010 Elsevier Inc. All rights reserved.
  • Comparison of HCV-associated gene expression and cell signaling pathways in cells with or without HCV replicon and in replicon-cured cells
    Yuki Nishimura-Sakurai, Naoya Sakamoto, Kaoru Mogushi, Satoshi Nagaie, Mina Nakagawa, Yasuhiro Itsui, Megumi Tasaka-Fujita, Yuko Onuki-Karakama, Goki Suda, Kako Mishima, Machi Yamamoto, Mayumi Ueyama, Yusuke Funaoka, Takako Watanabe, Seishin Azuma, Yuko Sekine-Osajima, Sei Kakinuma, Kiichiro Tsuchiya, Nobuyuki Enomoto, Hiroshi Tanaka, Mamoru Watanabe
    JOURNAL OF GASTROENTEROLOGY, 45, 5, 523, 536, SPRINGER JAPAN KK, 2010年05月, [査読有り]
    英語, 研究論文(学術雑誌), Hepatitis C virus (HCV) replication is affected by several host factors. Here, we screened host genes and molecular pathways that are involved in HCV replication by comprehensive analyses using two genotypes of HCV replicon-expressing cells, their cured cells and na < ve Huh7 cells.
    Huh7 cell lines that stably expressed HCV genotype 1b or 2a replicon were used. The cured cells were established by treating HCV replicon cells with interferon-alpha. Expression of 54,675 cellular genes was analyzed by GeneChip DNA microarray. The data were analyzed by using the KEGG Pathway database.
    Hierarchical clustering analysis showed that the gene-expression profiles of each cell group constituted clear clusters of na < ve, HCV replicon-expressed, and cured cell lines. The pathway process analysis between the replicon-expressing and the cured cell lines identified significantly altered pathways, including MAPK, steroid biosynthesis and TGF-beta signaling pathways, suggesting that these pathways were affected directly by HCV replication. Comparison of cured and na < ve Huh7 cells identified pathways, including steroid biosynthesis and sphingolipid metabolism, suggesting that these pathways were required for efficient HCV replication. Cytoplasmic lipid droplets were obviously increased in replicon-expressing and cured cells as compared to na < ve cells. HCV replication was significantly suppressed by peroxisome proliferator-activated receptor (PPAR)-alpha agonists but augmented by PPAR-gamma agonists.
    Comprehensive gene expression and pathway analyses show that lipid biosynthesis pathways are crucial to support proficient virus replication. These metabolic pathways could constitute novel antiviral targets against HCV.
  • A-5 ゴルフスイングにおける下肢の動作特性(ゴルフ)
    野澤 むつこ, 吉田 康行, 丸山 剛生, 須田 和裕
    ジョイント・シンポジウム講演論文集:スポーツ工学シンポジウム:シンポジウム:ヒューマン・ダイナミックス, 2009, 23, 27, 一般社団法人 日本機械学会, 2009年
    日本語, The purpose of this study was to understand characteristic of lower limb in golf swing by relationship between movements of knee and hip, and hip joints' torque. Four right-handed professional golfers used their own drivers to hit standard golf balls in our laboratory. The swing motions were recorded using a 3D optical motion capturing system with a 200Hz frame rate, and three-dimensional ground reaction forces were captured by two force plates operating at 1000Hz on the ground. The hip joints' torque was calculated using these sets of data. Also the rotational angle of hips and the knees and the angular velocity of the hips and knees were calculated as kinematic data. In this study, the golf swing time was divided into two phases on the basis of the hips' rotational angle. As for the results, the rotational angle of hips and the knees became parallel to the X-axis at the approximately same time, and the angular velocity of hips coincidentally reached a maximum value in the middle of forward swing. Particularly the two torques of the left hip joint were continuously exerted in the beginning of the forward swing, and then these torques started to decrease after the peak. This suggested that left hip joints were effective at promoting the rotational movement of the pelvis during the golf swing.
  • Antiviral effects of the interferon-induced protein guanylate binding protein 1 and its interaction with the hepatitis C virus NS5B protein
    Yasuhiro Itsui, Naoya Sakamoto, Sei Kakinuma, Mina Nakagawa, Yuko Sekine-Osajima, Megumi Tasaka-Fujita, Yuki Nishimura-Sakurai, Gouki Suda, Yuko Karakama, Kako Mishima, Machi Yamamoto, Takako Watanabe, Mayumi Ueyama, Yusuke Funaoka, Seishin Azuma, Mamoru Watanabe
    Hepatology, 50, 6, 1727, 1737, 2009年
    英語, 研究論文(学術雑誌), Interferons (IFNs) and the interferon-stimulated genes (ISGs) play a central role in antiviral responses against hepatitis C virus (HCV) infection. We have reported previously that ISGs, including guanylate binding protein 1 (GBP-1), interferon alpha inducible protein (IFI)-6-16, and IFI-27, inhibitHCVsubgenomic replication. In this study we investigated the effects of these ISGs against HCV in cell culture and their direct molecular interaction with viral proteins. HCV replication and virus production were suppressed significantly by overexpression of GBP-1, IFI-6-16, or IFI-27. Knockdown of the individual ISGs enhanced HCV RNA replication markedly. A two-hybrid panel of molecular interaction of the ISGs with HCV proteins showed that GBP-1 bound HCV-NS5B directly. A protein truncation assay showed that the guanine binding domain of GBP-1 and the finger domain of NS5B were involved in the interaction. Binding of NS5B with GBP-1 inhibited its guanosine triphosphatase GTPase activity, which is essential for its antiviral effect. Taken together, interferoninduced GBP-1 showed antiviral activity against HCV replication. Conclusion: Binding of the HCV-NS5B protein to GBP-1 countered the antiviral effect by inhibition of its GTPase activity. These mechanisms may contribute to resistance to innate, IFN-mediated antiviral defense and to the clinical persistence of HCV infection. Copyright © 2009 by the American Association for the Study of Liver Diseases.
  • Two flavonoids extracts from Glycyrrhizae radix inhibit in vitro hepatitis C virus replication
    Yuko Sekine-Osajima, Naoya Sakamoto, Mina Nakagawa, Yasuhiro Itsui, Megumi Tasaka, Yuki Nishimura-Sakurai, Cheng-Hsin Chen, Goki Suda, Kako Mishima, Yuko Onuki, Machi Yamamoto, Shinya Maekawa, Nobuyuki Enomoto, Takanori Kanai, Kiichiro Tsuchiya, Mamoru Watanabe
    HEPATOLOGY RESEARCH, 39, 1, 60, 69, WILEY-BLACKWELL PUBLISHING, INC, 2009年01月, [査読有り]
    英語, 研究論文(学術雑誌), Traditional herbal medicines have been used for several thousand years in China and other Asian countries. In this study we screened herbal drugs and their purified compounds, using the Feo replicon system, to determine their effects on in vitro HCV replication.
    We screened herbal drugs and their purified extracts for the activities to suppress hepatitis C virus (HCV) replication using an HCV replicon system that expressed chimeric firefly luciferase reporter and neomycin phosphotransferase (Feo) genes. We tested extracts and 13 purified compounds from the following herbs: Glycyrrhizae radix; Rehmanniae radix; Paeoniae radix; Artemisiae capillari spica; and Rhei rhizoma.
    The HCV replication was significantly and dose-dependently suppressed by two purified compounds, isoliquiritigenin and glycycoumarin, which were from Glycyrrhizae radix. Dose-effect analyses showed that 50% effective concentrations were 6.2 +/- 1.0 mu g/mL and 15.5 +/- 0.8 mu g/mL for isoliquiritigenin and glycycoumarin, respectively. The MTS assay did not show any effect on cell growth and viability at these effective concentrations, indicating that the effects of the two compounds were specific to HCV replication. These two compounds did not affect the HCV IRES-dependent translation nor did they show synergistic action with interferon-alpha.
    Two purified herbal extracts, isoliquiritigenin and glycycoumarin, specifically suppressed in vitro HCV replication. Further elucidation of their mechanisms of action and evaluation of in vivo effects and safety might constitute a new anti-HCV therapeutics.
  • A case of acute portal and mesenteric venous thrombosis treated with urokinase via superior mesenteric artery
    Daisuke Kubota, Kazuo Tajiri, Shunsuke Mimura, Goki Suda, Kaoru Yui, Junichi Satoh, Chikara Yamamoto, Mamoru Watanabe
    Japanese Journal of Gastroenterology, 102, 2, 183, 189, 2005年02月, [査読有り]
    日本語, 研究論文(学術雑誌)
  • 4088 重量負荷運動が血清酵素活性値及び血清尿酸値に及ぼす影響
    三上 俊夫, 丹 信介, 鈴井 正敏, 後藤 浩史, 佐藤 貴樹, 丸山 剛生, 伊藤 朗, 栗林 徹, 須田 直之
    日本体育学会大会号, 34, 289, 一般社団法人 日本体育学会, 1983年
    日本語

その他活動・業績

講演・口頭発表等

共同研究・競争的資金等の研究課題

  • 肝線維化治療標的同定とそれに基づく新規抗肝線維化治療法開発
    科学研究費助成事業
    2022年04月01日 - 2025年03月31日
    須田 剛生, 坂本 直哉
    日本学術振興会, 基盤研究(C), 北海道大学, 22K08046
  • 肝癌幹細胞におけるPARP阻害剤耐性メカニズムの解明およびその克服
    科学研究費助成事業
    2022年04月01日 - 2025年03月31日
    小松 嘉人, 川久保 和道, 須田 剛生
    日本学術振興会, 基盤研究(C), 北海道大学, 22K08023
  • 食道扁平上皮癌がん幹細胞における免疫逃避機構の解明
    科学研究費助成事業
    2022年04月01日 - 2025年03月31日
    夏井坂 光輝, 須田 剛生, 前原 経
    日本学術振興会, 基盤研究(C), 北海道大学, 22K08000
  • 肝線維化機構に関連する宿主因子の網羅的探索と新規治療法の開発
    科学研究費助成事業
    2022年04月01日 - 2025年03月31日
    坂本 直哉, 大西 俊介, 須田 剛生
    日本学術振興会, 基盤研究(B), 北海道大学, 22H03050
  • 肝癌幹細胞の維持・免疫寛容機構の解明と治療最適化の検討
    科学研究費助成事業
    2021年04月01日 - 2024年03月31日
    荘 拓也, 坂本 直哉, 須田 剛生
    肝癌の難治性の原因の一旦に肝癌幹細胞(CSCs)が関与するとの仮説ものもと、肝癌幹細胞の研究を行った。その中で、肝癌幹細胞維持に重要なファクターとしてKLF5が強く関与する可能性をRNA-sequence data をもとに明らかにした。続いてその恒常発現細胞を樹立、同細胞株を用いて検討を行い肝癌CSCs維持についての検討をFGFシグナルに着目して行った。siRNA, receptor 特異的な阻害剤を用いる事によりFGFR4でなくFGFR1-3シグナルがCSCs維持に重要である事を見出した。更に、現在までに、sorafenib と殺細胞性抗がん剤との併用療法の実臨床での相乗効果は明らかにされていない為にその原因を検索する為に肝癌細胞にsofafenib, sorafenib+5FUを添加して検討するとSorafenib +5FU 群ではCSCs populationが増加する事が明らかとなった。一方で、FGFR1-3阻害活性を有するlenvatinib と殺細胞性抗がん剤5FUを添加して検討するとlenvatinib +5FU 群ではCSCs populationが減少させながら相乗的な抗腫瘍効果を発揮する事が明らかとなった。同知見に基づきKLF5KR細胞マウスXenograft modelに、lenvatinib または、sorafenib +5FU併用療法 が行われた腫瘍を摘出し、サイズの比較、腫瘍細胞のFACS解析にてCSCsポピュレーションの変化を観察を行った。FGFR1-3 阻害によるCSCs減少により殺細胞性に対する感受性が上昇し、殺細胞性抗がん剤との併用が相乗効果を示すことがin vivoにても明らかになれば、現在までその有効性が十分に示されていない、経動脈的な肝癌治療とmultikinase 阻害剤併用療法の有効性を示された
    日本学術振興会, 基盤研究(C), 北海道大学, 21K07953
  • B型肝炎ウイルス宿主制限因子を標的とした新規抗ウイルス治療の開発
    科学研究費助成事業
    2020年04月01日 - 2023年03月31日
    森川 賢一, 坂本 直哉, 須田 剛生
    B型肝炎ウイルス(hepatitis B virus: HBV)の感染肝細胞核内には、完全閉鎖型二本鎖cccDNA(covalently closed circular DNA: cccDNA)が形成される。慢性B型肝炎・肝硬変に対する治療として、インターフェロン(IFN)および核酸アナログ製剤が使用され、肝炎重症化阻止、肝線維化進展抑制に一定の効果を上げているが、いずれもcccDNAに直接抑制作用を有せず、免疫抑制療法および化学療法でのHBV再活性化や発がんのリスクは残存したままとなっている。近年、抗HBV効果を有する宿主制限因子がHBVにより制御されている事が報告されているが、ウイルス側戦略の全容解明にはほど遠く、分子機序解明に向けた取り組みは急務である。本研究は、抗HBV作用を有する新規宿主制限因子の同定および機能解析を目的とする。本研究により、将来的に抗HBV宿主制限因子をターゲットにした新規治療法の開発と、HBV再活性化予防への貢献、肝臓癌発生・進展および再発阻止に寄与する癌予防医学への貢献が期待される。
    2021年度は、2020年度に作成したU2OS細胞を起源とし、薬剤誘導性にHBxにMycタグを付与
    した蛋白を発現制御できる細胞株U2OS-Myc-linker-HBx-27細胞を用いて、HBxにより影響を受ける新規宿主因子の探索を目指して、SILAC法を用いたProteome解析を行った。
    HBx蛋白により影響を受ける宿主因子を検討することにより、本研究の結果は基礎的解析にとどまらず、HBV cccDNAの排除に関与する宿主因子を増強する新規化合物の探索に重要な役割を果たすと考えられており、非常に特色のある研究になると思われる。
    日本学術振興会, 基盤研究(C), 北海道大学, 20K08371
  • 非アルコール性脂肪肝炎、新規診断マーカー・治療標的としての糖鎖修飾解析
    科学研究費助成事業
    2020年04月01日 - 2023年03月31日
    小川 浩司, 坂本 直哉, 須田 剛生
    脂肪性肝疾患は、世界的な、肥満人口の増加に伴いその有病率は上昇し、世界的な公衆衛生上の大きな問題の1つとなり、本邦においても高い有病率である事、経年的に増加傾向である事が報告されている。すなわち、本邦ではEguchiらは 診受診者の 約30%がNAFLDと診断されたと報告されている。NAFLDは、非 アルコール性脂肪肝(Non-alcoholic fatty liver; NAFL)と非アルコール性脂肪性肝炎(Non alcoholic steatohepatitis; NASH)に分類されるが、その過半 は予後良好なNAFLにとどまることが想定されている。一方で、NASHは肝に脂肪が蓄積することに加えて炎症性細胞の浸潤を合併し、炎症を引き起こす疾患群として知られ、肝硬変、肝細胞癌へと進展する予後不良な 病態であり早期の疾患の囲い込みが必須となが、肝生検以外の方法が現時点存在しない。我々は、独自に開発した網羅的な複合糖質糖鎖解析(総合グライコミクス)にて、早期NASHを診断可能で、肝炎症を鋭敏に反映する可能をもった糖鎖マーカーを見出した(特許公開番号 WO2017126514A1)。すなわち、中央病理判定にて診断されたmatteoni分類1-2 のNAFL患者とmatteoni分類3-4のNASH患者血清中のα1 アンチトリプシン(AAT)結合フコシル化糖鎖A3F(AAT-A3F)濃度 は、基質蛋白は変化を認めないにもかかわらずNASH患者において、NAFL患者と比較して有意に 上昇し特に、matteoni分類1-2の症例と線維化の進展していない matteoni分類3の症例においても差を認める事を明らかにした。
    日本学術振興会, 基盤研究(C), 北海道大学, 20K08298
  • 肝組織間質蛋白の糖鎖修飾構造を標的とした肝線維化に対する糖鎖創薬の基盤形成
    科学研究費助成事業
    2020年07月30日 - 2022年03月31日
    坂本 直哉, 須田 剛生, 古川 潤一
    我々は、肝星細胞を標的とした細胞・薬物療法による肝線維化の組織修復を促進する治療法を開発するため、血清・細胞内の包括的糖鎖修飾解析を行い、下記の成果を得た。1.血清糖タンパク質糖鎖の包括的解析をおこない、組織障害のステージに有意に関連する修飾糖鎖構造およびそのキャリアタンパク質として、IgA、Fibronectinをはじめとする複数の蛋白を同定した。2.培養肝星細胞活性化に関連するmicro RNAの包括的解析を施行し、miR-29a、miR-449a、その他特定のmiRNAが関連することを示した。3.培養肝星細胞の活性化に関連する。
    日本学術振興会, 挑戦的研究(萌芽), 北海道大学, 20K21592
  • レポーターアッセイによる新規・大規模抗HBV薬スクリーニング系を用いた薬剤開発
    科学研究費助成事業
    2019年04月01日 - 2022年03月31日
    須田 剛生, 坂本 直哉, 森川 賢一
    我々は、HBVのウイルス蛋白の一つであるHBx蛋白が、自然免疫によるウイルス排除機構のkey player であるIFNシグナル を阻害する事を明らかにした。更に、他グループより他HBV蛋白も同様にIFNシグナル阻害を行う事が明らかになった。我々はこのHBV蛋白のIFNシグナル阻害 作用に着目した新規の抗HBV のレポーターアッセイを構築した。このスクリーニング系と北海道大学薬学部にて独 自に合成された化合物ライブラリーを用いて、新規の抗HBV 候補の大規模スクリーニングを行い、複数の抗HBV活性を細胞毒性のない レンジで発揮する化合物を複数同定した。
    日本学術振興会, 基盤研究(C), 北海道大学, 19K08458
  • 肝硬変の組織学的進展・軽快を担う間質微小環境因子の包括的解析
    科学研究費助成事業
    2019年04月01日 - 2022年03月31日
    坂本 直哉, 須田 剛生, 古川 潤一, 森川 賢一, 大西 俊介
    1. 血清糖鎖修飾構造の網羅的解析を行い、NASHの肝線維化進展例でA2F bisect 糖鎖の発現が上昇することを見いだした。2. A2F bisect糖鎖のキャリア蛋白としてIgAをはじめとする複数の蛋白を同定した。3. 培養肝星細胞活性化に関連するmicro RNAの包括的解析を施行し、miR-29a、miR-449a、その他特定のmiRNAが活性化星細胞で高発現しており、Pathway解析で細胞骨格、細胞外マトリックス、chemotaxis関連経路の蛋白の発現を調節していた。4. C型肝炎SVR後発癌症例では血清中のAng2が有意に高値であった。
    日本学術振興会, 基盤研究(B), 北海道大学, 19H03630
  • 肝硬変の組織学的展を抑制する糖鎖修飾構造を標的とした薬剤開発系の構築
    科学研究費助成事業
    2018年06月29日 - 2020年03月31日
    坂本 直哉, 須田 剛生, 古川 潤一
    本研究では、肝線維化を標的とした新規治療標的を探索するため、肝硬変症例の肝組織および血清、さらに培養肝星細胞の表面蛋白の複合糖鎖構造の変化とその関連機構の解析を目的として遂行し、下記の結果を得た。1. 培養肝星細胞由来および初代ヒト肝星細胞を用いて、LPS刺激、TGF-β添加培養などにより活性化状態構築のための条件設定を行った。2. 培養肝星細胞活性化に関連し、4種の分泌型micro RNAの発現が上昇した。当該micro RNAの培養星細胞への遺伝子導入により、線維化に関連するαSMA、I型コラーゲン、ケモカイン遺伝子の発現増強が認められた。
    日本学術振興会, 挑戦的研究(萌芽), 北海道大学, 18K19530
  • B型肝炎ウイルスcccDNA排除を目指した新規抗ウイルス治療の開発
    科学研究費助成事業
    2017年04月01日 - 2020年03月31日
    森川 賢一, 坂本 直哉, 須田 剛生
    HBxはDDB1と結合することにより、E3ユビキチンライゲース機構をハイジャックし、cccDNAに抑制的に働く宿主制限因子を除去している。各遺伝子型(Ae、Bj、C、D)のHBxをクローンニングし、DDB1と共遺伝子導入実験を行ったところ、汎遺伝子型でHBxはDDB1と結合し、Smc5/6を分解していることが判明した。DDB1の領域を分割したクローンを作成し、HBxとの結合を免疫沈降法を用いて検討した結果、DDB1内で既知のHBxと結合する領域ではなく、これまで既報にない領域に強い結合を示すことが判明した。現在、DDB1内新規結合領域の同定と、その領域を標的とした新規創薬を目指している。
    日本学術振興会, 基盤研究(C), 北海道大学, 17K09400
  • C末端欠損HBx遺伝子インテグレーションによる肝発癌・悪性化機構の検討
    科学研究費助成事業
    2016年04月01日 - 2019年03月31日
    須田 剛生, 坂本 直哉, 森川 賢一
    C末端欠損HBX蛋白のインテグレーションを肝細胞癌cell lineに導入しCSCsに与える影響を検討した。C末端欠損HBX蛋白のインテグレーションを導入する事により殺細胞性抗癌剤に対して有意に、耐性となり、更に非足場依存性の腫瘍形成能が有意に上昇していた。これらのC末端欠損HBX蛋白のインテグレーションのCSCsマーカーの発現を検討するとCD44、CD133の発現上昇が確認されLTBP-1の発現が関与する事を明らかにした。C末端欠損HBX蛋白のインテグレーションを介した肝癌悪性化機構の一部に、このLTBP-1が関与している可能性があり、新たな治療ターゲットとなりうる可能性が示唆された。
    日本学術振興会, 基盤研究(C), 北海道大学, 16K09334
  • 肝硬変の組織病態を修復する新規細胞薬物治療法の探索
    科学研究費助成事業
    2016年04月01日 - 2019年03月31日
    坂本 直哉, 大西 俊介, 須田 剛生, 森川 賢一
    本研究は,肝線維化の組織修復を促進する候補分子の探索とその作用機構を解析することを目的として遂行した。(1)ヒト羊膜膜由来間葉系幹細胞(AM-MSC)培養上清由来エクソソームの肝線維化抑制,炎症抑制を確認した。(2)palmitoylethanolamide (PEA)の、PPAR非依存的な星細胞活性化抑制作用を示した。(3)血清蛋白の網羅的糖鎖修飾構造解析により、血清蛋白のフコシル化修飾がNAFLからNASH、肝線維化の進展と密接に関連することを見いだした。(4)培養肝星細胞活性化に関連するmicro RNAの包括的解析を施行し、活性化星細胞で発現上昇・低下するmiRNAを抽出した。
    日本学術振興会, 基盤研究(B), 北海道大学, 16H05282
  • 生体高分子シミュレーションによる抗ウイルス薬耐性化仮想アッセイシステムの構築
    科学研究費助成事業
    2016年04月01日 - 2018年03月31日
    坂本 直哉, 須田 剛生, 森川 賢一
    我々は、分子動力学解析法により、DAAの標的蛋白との結合モデルを構築し、ウイルス薬剤耐性変異が標的結合性、複合体安定性に与える影響を解析し、HCV replicon細胞を用いたデータとの関連解析をおこなった。シミュレーションにより、NS5A2量体が安定して小胞体膜上に局在するための最適構造を確定した。分子動力学シミュレーションで得られた仮説(モデル)を検証するためにNS5A阻害薬に対する耐性変異を有するHCV repliconおよびHCV genotype 1b培養系を構築し、増殖能および薬剤感受性を解析し、シミュレーションでの結合安定性と薬剤感受性が逆相関することが確認した。
    日本学術振興会, 挑戦的萌芽研究, 北海道大学, 16K15420
  • HCVに対するカルニチンの抗ウイルス/抗脂肪化/抗酸化効果の基礎的・臨床的検討
    科学研究費助成事業
    2015年04月01日 - 2018年03月31日
    小川 浩司, 坂本 直哉, 須田 剛生
    我々は、HCVにより誘導される肝脂肪化とHCV増殖作用におけるカルニチンの効果を検討した。我々は、in vitro の解析にてカルニチンの抗HCV作用について1)HCVレプリコンに対しては抗ウイルス作用を有しなかった事 2)HCV全長のウイルスJFH-1株に対しては抗ウイルス作用を有していた3)カルニチンは、HCVエントリーには影響しなかった4)カルニチン投与によりLDの形成低下が確認される5)肝脂肪化改善の機序の一つとしてCPT-1の発現上昇が関与する。6)カルニチンはHCVが惹起する酸化ストレスに対し、抗酸化作用がある事を明らかにした
    日本学術振興会, 基盤研究(C), 北海道大学, 15K08980
  • 高速分子動力学法によるHCV抗ウイルス薬耐性化予測仮想アッセイシステムの構築
    科学研究費助成事業
    2014年04月01日 - 2016年03月31日
    坂本 直哉, 遠藤 俊徳, 須田 剛生
    ・NS5A蛋白とNS5A阻害薬分子、小胞体核酸、DAA分子のモデリングと分子動力学シミュレーションを実施し、NS5Aが安定して小胞体膜上に局在する最適構造を確定した。
    ・NS5A阻害薬とNS5A二量体の結合構造をシミュレーションし、薬剤耐性変異の近傍に安定結合することを確認した。
    ・分子動力学シミュレーションで得られた仮説を検証するためにNS5A阻害薬に対する耐性変異を有するHCV replicon増殖能および薬剤感受性を検証した。
    日本学術振興会, 挑戦的萌芽研究, 北海道大学, 26670375
  • HCVキメラウイルス感染培養系を用いた薬剤耐性機序の解析
    科学研究費助成事業
    2013年04月01日 - 2015年03月31日
    須田 剛生, 坂本 直哉
    C型肝炎のIFNに対する抵抗性の詳細な機序は不明である。我々は新規にgenotyep2bのHCVをクローニングしJFH1株とのキメラウイルスを構築し長期培養が可能であることを明らかにした。IFNとともに長期培養する事によりIFN抵抗性のHCV株を抽出しえた。シークエンスによる解析にて、構造遺伝子部分に2カ所の変異が入っていることが明らかとなった。この変異を有するウイルスを構築しIFN抵抗性となる事を確認した。このウイルスを用いる事によりHCVのIFN抵抗性の機序の解明に役立つ事が期待される。更に患者血清から次世代シークエンサーを用いて治療前の耐性ウイルスの存在と治療成績の関連を明らかにした。
    日本学術振興会, 若手研究(B), 北海道大学, 25860513

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