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Tetsuya Matoba Last modified date:2019.08.06

Lecturer / Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
Angiocardiology
Kyushu University Hospital


Graduate School
Undergraduate School
Administration Post
Other


E-Mail
Phone
092-642-5360
Fax
092-642-5374
Academic Degree
MD, PhD
Field of Specialization
Cardiovascular Medicine, Vascular biology
Outline Activities
Research in vascular biology, clinical cardiology and resuscitation science
Education in basic vascular biology, clinical cardiology and resuscitation
Clinical practice in interventional cardiology
Research
Research Interests
  • Role of extracellular vesicles in cardiovascular diseases; Development of new therapeutic strategy
    keyword : exosome, atherosclerosis, myocardial infarction
    2017.10~2022.03.
  • Roles of oxidized lipids including oxysterols in the development of atherosclerotic cardiovascular disease
    keyword : atherosclerosis, oxysterol, endothelial function
    2011.04~2020.03.
  • Development of new therapeutic modality targeting inflammatory monocyte/macrophage in cardiovascular disease
    keyword : inflammation, monocyte, macrophage, atherosclerosis, acute coronary syndrome
    2012.04~2019.03.
  • Monocyte-selective nanoparticle-mediated drug delivery system for treatment of atherosclerotic plaque rupture
    keyword : atherosclerosis macrophage nanoparticle
    2008.04~2011.03.
Academic Activities
Papers
1. Tetsuya Matoba, Takahide Kohro, Hideo Fujita, Masaharu Nakayama, Arihiro Kiyosue, Yoshihiro Miyamoto, Kunihiro Nishimura, Hideki Hashimoto, Yasuaki Antoku, Naoki Nakashima, Kazuhiko Ohe, Hisao Ogawa, Hiroyuki Tsutsui, Ryozo Nagai, Architecture of the Japan Ischemic Heart Disease Multimodal Prospective Data Acquisition for Precision Treatment (J-IMPACT) System, International heart journal, 10.1536/ihj.18-113, 60, 2, 264-270, 2019.03, The utilization of electronic medical records and multimodal medical data is an ideal approach to build a real-time and precision registry type study with a smaller effort and cost, which may fill a gap between evidence-based medicine and the real-world clinical practice. The Japan Ischemic heart disease Multimodal Prospective data Acquisition for preCision Treatment (J-IMPACT) project aimed to build an clinical data registry system that electronically collects not only medical records, but also multimodal data, including coronary angiography and percutaneous coronary intervention (PCI) report, in standardized data formats for clinical studies.The J-IMPACT system comprises the standardized structured medical information exchange (SS-MIX), coronary angiography and intervention reporting system (CAIRS), and multi-purpose clinical data repository system (MCDRS) interconnected within the institutional network. In order to prove the concept, we acquired multimodal medical data of 6 consecutive cases that underwent PCI through the J-IMPACT system in a single center. Data items regarding patient background, laboratory data, prescriptions, and PCI/cardiac catheterization report were correctly acquired through the J-IMPACT system, and the accuracy of the multimodal data of the 4 categories was 100% in all 6 cases.The application of J-IMPACT system to clinical studies not only fills the gaps between randomized clinical trials and real-world medicine, but may also provide real-time big data that reinforces precision treatment for each patient..
2. Masaki Tokutome, Tetsuya Matoba, Yasuhiro Nakano, Arihide Okahara, Masaki Fujiwara, Jun Ichiro Koga, Kaku Nakano, Hiroyuki Tsutsui, Kensuke Egashira, Peroxisome proliferator-activated receptor-gamma targeting nanomedicine promotes cardiac healing after acute myocardial infarction by skewing monocyte/macrophage polarization in preclinical animal models, Cardiovascular research, 10.1093/cvr/cvy200, 115, 2, 419-431, 2019.02, Aims Monocyte-mediated inflammation is a major mechanism underlying myocardial ischaemia-reperfusion (IR) injury and the healing process after acute myocardial infarction (AMI). However, no definitive anti-inflammatory therapies have been developed for clinical use. Pioglitazone, a peroxisome proliferator-activated receptor-gamma (PPARγ) agonist, has unique anti-inflammatory effects on monocytes/macrophages. Here, we tested the hypothesis that nanoparticle (NP)-mediated targeting of pioglitazone to monocytes/macrophages ameliorates IR injury and cardiac remodelling in preclinical animal models. Methods and results We formulated poly (lactic acid/glycolic acid) NPs containing pioglitazone (pioglitazone-NPs). In a mouse IR model, these NPs were delivered predominantly to circulating monocytes and macrophages in the IR heart. Intravenous treatment with pioglitazone-NPs at the time of reperfusion attenuated IR injury. This effect was abrogated by pre-treatment with the PPARγ antagonist GW9662. In contrast, treatment with a pioglitazone solution had no therapeutic effects on IR injury. Pioglitazone-NPs inhibited Ly6C high inflammatory monocyte recruitment as well as inflammatory gene expression in the IR hearts. In a mouse myocardial infarction model, intravenous treatment with pioglitazone-NPs for three consecutive days, starting 6 h after left anterior descending artery ligation, attenuated cardiac remodelling by reducing macrophage recruitment and polarizing macrophages towards the pro-healing M2 phenotype. Furthermore, pioglitazone-NPs significantly decreased mortality after MI. Finally, in a conscious porcine model of myocardial IR, pioglitazone-NPs induced cardioprotection from reperfused infarction, thus providing pre-clinical proof of concept. Conclusion NP-mediated targeting of pioglitazone to inflammatory monocytes protected the heart from IR injury and cardiac remodelling by antagonizing monocyte/macrophage-mediated acute inflammation and promoting cardiac healing after AMI..
3. Kazuo Sakamoto, Tetsuya Matoba, Masahiro Mohri, Yasushi Ueki, Yasuyuki Tsujita, Masao Yamasaki, Nobuhiro Tanaka, Yohei Hokama, Motoki Fukutomi, Katsutaka Hashiba, Rei Fukuhara, Satoru Suwa, Hirohide Matsuura, Eizo Tachibana, Naohiro Yonemoto, Ken Nagao, Clinical characteristics and prognostic factors in acute coronary syndrome patients complicated with cardiogenic shock in Japan
analysis from the Japanese Circulation Society Cardiovascular Shock Registry, Heart and Vessels, 10.1007/s00380-019-01354-9, 2019.01, Cardiogenic shock frequently leads to death even with intensive treatment. Although the leading cause of cardiogenic shock is acute coronary syndrome (ACS), the clinical characteristics and the prognosis of ACS with cardiogenic shock in the present era still remain to be elucidated. We analyzed clinical characteristics and predictors of 30-day mortality in ACS with cardiogenic shock in Japan. The Japanese Circulation Society Cardiovascular Shock registry was a prospective, observational, multicenter, cohort study. Between May 2012 and June 2014, 495 ACS patients with cardiogenic shock were analyzed. The primary endpoint was 30-day all-cause mortality. The median [interquartile range; IQR] age was 71.0 [63.0, 80.0] years. The median [IQR] value of systolic blood pressure (SBP) and heart rate were 75.0 [50.0, 86.5] mm Hg and 65.0 [38.0, 98.0] bpm, respectively. Multivariable analysis showed an odds ratio (OR) of 4.76 (confidence intervals; CI 1.97–11.5, p < 0.001) in the lowest SBP category (< 50 mm Hg) for SBP ≥ 90 mm Hg. Moreover, age per 10 years increase (OR 1.38, CI 1.18–1.61, p = 0.002), deep coma (OR 3.49, CI 1.94–6.34, p < 0.001), congestive heart failure (OR 3.81, CI 2.04–7.59, p < 0.001) and left main trunk disease (LMTD) (OR 2.81, CI 1.55–5.10, p < 0.001) were independent predictors. Severe hypotension, older age, deep coma, congestive heart failure, and LMTD were independent unfavorable factors in ACS complicated by cardiogenic shock in Japan. A prompt assessment of high-risk patients referring to those predictors in emergency room could lead to appropriate treatment without delay..
4. Honda, Katsuya; Matoba, Tetsuya; Antoku, Yoshibumi; Koga, Jun-ichiro; Ichi, Ikuyo; Nakano, Kaku; Tsutsui, Hiroyuki; Egashira, Kensuke, Lipid-Lowering Therapy With Ezetimibe Decreases Spontaneous Atherothrombotic Occlusions in a Rabbit Model of Plaque Erosion: A Role of Serum Oxysterols, ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 10.1161/ATVBAHA.117.310244, 38, 4, 757-771, 2018.04, [URL], OBJECTIVE:Plaque erosion is increasing its importance as one of the mechanisms of acute coronary syndromes in this statin era. However, the clinical efficacy of currently used lipid-lowering agents in the prevention of thrombotic complications associated with plaque erosion has not been clarified. Therefore, we examined the therapeutic effects of ezetimibe or rosuvastatin monotherapy on spontaneous atherothrombotic occlusion.

APPROACH AND RESULTS:Femoral arteries of Japanese white rabbits, fed a high-cholesterol diet, were injured by balloon catheter, and then angiotensin II was continuously administrated. In 94% of these arteries, spontaneous thrombotic occlusions were observed after 5 weeks (median) of balloon injury. Histochemical analyses indicated that the injured arteries had similar pathological features to human plaque erosions; (1) spontaneous thrombotic occlusion, (2) lack of endothelial cells, and (3) tissue factor expression in vascular smooth muscle cells. Ezetimibe (1.0 mg/kg per day), but not rosuvastatin (0.6 mg/kg per day), significantly decreased thrombotic occlusion of arteries accompanied with accelerated re-endothelialization and the decreases of serum oxysterols despite the comparable on-treatment serum cholesterol levels. The 7-ketocholesterol inhibited the migration of human umbilical vein endothelial cells. Both 7-ketocholesterol and 27-hydroxycholesterol increased tissue factor expression in cultured rat vascular smooth muscle cells. Tissue factor expression was also induced by serum from vehicle- or rosuvastatin-treated rabbits, but the induction was attenuated with serum from ezetimibe-treated rabbits.

CONCLUSIONS:We have established a novel rabbit model of spontaneous atherothromobotic occlusion without plaque rupture that is feasible to test the therapeutic effects of various pharmacotherapies. Ezetimibe may decrease atherothrombotic complications after superficial plaque erosion by reducing serum oxysterols..
5. Susumu Takase, Tetsuya Matoba, Soichi Nakashiro, Yasushi Mukai, Shuujirou Inoue, Keiji Oi, Taiki Higo, Shunsuke Katsuki, Masao Takemoto, Nobuhiro Suematsu, Kenichi Eshima, Kenji Miyata, Mitsutaka Yamamoto, Makoto Usui, Kenji Sadamatsu, Shinji Satoh, Toshiaki Kadokami, Kiyoshi Hironaga, Ikuyo Ichi, Koji Todaka, Junji Kishimoto, Kensuke Egashira, Kenji Sunagawa, Ezetimibe in combination with statins ameliorates endothelial dysfunction in coronary arteries after stenting
the CuVIC trial (effect of cholesterol absorption inhibitor usage on target vessel dysfunction after coronary stenting), a multicenter randomized controlled trial, Arteriosclerosis, thrombosis, and vascular biology, 10.1161/ATVBAHA.116.308388, 37, 2, 350-358, 2017.02, Objectives - We sought to investigate whether treatment with ezetimibe in combination with statins improves coronary endothelial function in target vessels in coronary artery disease patients after coronary stenting. Approach and Results - We conducted a multicenter, prospective, randomized, open-label, blinded-end point trial among 11 cardiovascular treatment centers. From 2011 to 2013, 260 coronary artery disease patients who underwent coronary stenting were randomly allocated to 2 arms (statin monotherapy, S versus ezetimibe [10 mg/d]+statin combinational therapy, E+S). We defined target vessel dysfunction as the primary composite outcome, which comprised target vessel failure during treatment and at the 6- to 8-month follow-up coronary angiography and coronary endothelial dysfunction determined via intracoronary acetylcholine testing performed in cases without target vessel failure at the follow-up coronary angiography. Coadministration of ezetimibe with statins further lowered low-density lipoprotein cholesterol levels (83±23 mg/dL in S versus 67±23 mg/dL in E+S; P<0.0001), with significant decreases in oxidized low-density lipoprotein and oxysterol levels. Among patients without target vessel failure, 46 out of 89 patients (52%) in the S arm and 34 out of 96 patients (35%) in the E+S arm were found to have coronary endothelial dysfunction (P=0.0256), and the incidence of target vessel dysfunction at follow-up was significantly decreased in the E+S arm (69/112 (62%) in S versus 47/109 (43%) in E+S; P=0.0059). A post hoc analysis of post-treatment low-density lipoprotein cholesterol-matched subgroups revealed that the incidence of both target vessel dysfunction and coronary endothelial dysfunction significantly decreased in the E+S arm, with significant reductions in oxysterol levels. Conclusions - The CuVIC trial (Effect of Cholesterol Absorption Inhibitor Usage on Target Vessel Dysfunction after Coronary Stenting) has shown that ezetimibe with statins, compared with statin monotherapy, improves functional prognoses, ameliorating endothelial dysfunction in stented coronary arteries, and was associated with larger decreases in oxysterol levels..
6. Shunsuke Katsuki, Tetsuya Matoba, Kenji Sunagawa, Kensuke Egashira, Nanoparticle-Mediated Delivery of Pitavastatin Inhibits Atherosclerotic Plaque Destabilization/Rupture in Mice by Regulating the Recruitment of Inflammatory Monocytes, CIRCULATION, 10.1161/CIRCULATIONAHA.113.002870, 129, 8, 896-906, 2014.02, Preventing atherosclerotic plaque destabilization and rupture is the most reasonable therapeutic strategy for acute myocardial infarction. Therefore, we tested the hypotheses that (1) inflammatory monocytes play a causative role in plaque destabilization and rupture and (2) the nanoparticle-mediated delivery of pitavastatin into circulating inflammatory monocytes inhibits plaque destabilization and rupture.
We used a model of plaque destabilization and rupture in the brachiocephalic arteries of apolipoprotein E-deficient (ApoE(-/-)) mice fed a high-fat diet and infused with angiotensin II. The adoptive transfer of CCR2(+/+)Ly-6C(high) inflammatory macrophages, but not CCR2(-/-) leukocytes, accelerated plaque destabilization associated with increased serum monocyte chemoattractant protein-1 (MCP-1), monocyte-colony stimulating factor, and matrix metalloproteinase-9. We prepared poly(lactic-co-glycolic) acid nanoparticles that were incorporated by Ly-6G(-)CD11b(+) monocytes and delivered into atherosclerotic plaques after intravenous administration. Intravenous treatment with pitavastatin-incorporated nanoparticles, but not with control nanoparticles or pitavastatin alone, inhibited plaque destabilization and rupture associated with decreased monocyte infiltration and gelatinase activity in the plaque. Pitavastatin-incorporated nanoparticles inhibited MCP-1-induced monocyte chemotaxis and the secretion of MCP-1 and matrix metalloproteinase-9 from cultured macrophages. Furthermore, the nanoparticle-mediated anti-MCP-1 gene therapy reduced the incidence of plaque destabilization and rupture.
The recruitment of inflammatory monocytes is critical in the pathogenesis of plaque destabilization and rupture, and nanoparticle-mediated pitavastatin delivery is a promising therapeutic strategy to inhibit plaque destabilization and rupture by regulating MCP-1/CCR2-dependent monocyte recruitment in this model..
7. Tetsuya Matoba, Kensuke Egashira, Anti-inflammatory gene therapy for cardiovascular disease., Curr Gene Ther, 11, 6, 442-446, 2011.12, [URL], Inflammation in the vascular wall is an essential hallmark during the development of atherosclerosis, for which major leukocytes infiltrated in the lesions are monocytes/macrophages. Therefore, monocyte chemoattractant protein-1 (MCP-1) and its primary receptor CC chemokine receptor 2 (CCR2) are feasible molecular targets for gene therapy to inhibit monocyte/macrophage-mediated inflammation in atherogenesis. A mutant MCP-1 that lacks N-terminal 7 amino acids (7ND) has been shown to heterodimerize with native MCP-1, bind to CCR2 and block MCP-1-mediated monocyte chemotaxis by a dominant-negative manner. Gene therapy using intramuscular transfection with plasmid DNA encoding 7ND showed inhibitory effects on atherosclerosis in hypercholesterolemic mice, and neointima formation after vascular injury in animal models. Bare metal stents for coronary intervention were coated with multiple thin layers of biocompatible polymer with 7ND plasmid. The 7ND gene-eluting stent inhibited macrophage infiltration surrounding stent struts and in-stent neointima formation in rabbit femoral arteries and cynomolgus monkey iliac arteries. Finally, the authors describe new application of 7ND plasmid encapsulated in polymer nanoparticle (NP) that functions as gene delivery system with unique in vivo kinetics. NP-mediated 7ND gene delivery inhibited MCP-1-induced chemotaxis of mouse peritoneal macrophage ex vivo, which may be applicable for the treatment of atherosclerotic cardiovascular disease. In conclusion, anti-inflammatory gene therapy targeting MCP-1/CCR2 signal, with a novel NP-mediated gene delivery system, is a potent therapeutic strategy for the treatment of cardiovascular diseases..
Presentations
1. Tetsuya Matoba, Gentaro Ikeda, Jun-ichiro Koga, Hiroyuki Tsutsui, Kensuke Egashira, Targeting Cyclophilin D and Inflammation with Nano-medicines in Myocardial Ischemia-Reperfusion Injury, 3rd Annual 2019 International Hawaii Cardiovascular Symposium, 2019.02, Aims: The opening of mitochondrial permeability transition pore (mPTP) and inflammation may cooperatively progress myocardial ischemia-reperfusion (IR) injury; however, clinical trials of cardioprotection with cyclosporine A (CsA) or anti-inflammatory agents ended with neutral results. In this pre-clinical study, we examined the ischemic time-dependent contribution of the 2 mechanisms, and tested the therapeutic effects of nanoparticle-mediated medicine that targets mPTP opening and inflammation in the mouse model of myocardial IR injury.
Methods and Results: We employed mice lacking cyclophilin D (CypD, a key molecule for mPTP opening) and CCR2 (a receptor for monocyte chemoattractant protein-1) and found that CypD contributed to progression of myocardial IR injury caused by shorter durations of ischemia (30-45 minutes), whereas CCR2 contributed to IR injury caused by longer durations of ischemia (60-90 minutes). Double deficiency of CypD and CCR2 showed larger cardioprotection over single deficiency regardless of the durations of ischemia. CypD deficiency induced production of interleukin-1β proteins and recruitment of Ly6Chigh inflammatory monocytes in the IR-injured myocardium despite the reduction in the infarction, whereas CCR2-deficiency markedly inhibited these inflammations. Anti-interleukin-1β treatment reduced the recruitment of monocytes to the myocardium, resulted in smaller infarct size in CypD-deficient mice. Then we engineered poly (lactic-co-glycolic acid) nanoparticle containing CsA (CsA-NP) that inhibits mPTP opening and pitavastatin (Pitava-NP) that reduces monocyte-mediated inflammation. Simultaneous treatment with CsA-NP and Pitava-NP at the time of reperfusion presented a remarkable reduction in infarct size after IR injury with 30 or 60 minutes of ischemia.
Conclusions: The mechanism of myocardial IR injury differs depending on the durations of ischemia. Simultaneous targeting to mitochondrial injury and inflammation with nano-medicines is a promising strategy that provides a solution for myocardial IR injury. .
2. Tetsuya Matoba, Kazuo Sakamoto, Masahiro Mohri, Yasuyuki Tsujita, Masao Yamasaki, Yasushi Ueki, Nobuhiro Tanaka, Yohei Hokama, Motoki Fukutomi, Katsutaka Hashiba, Rei Fukuhara, Yasushi Ueki, Satoru Suwa, Hirohide Matsuura, Eizo Tachibana, Takahiro Nakashima, Hayato Hosoda, Yoshio Tahara, Michikazu Nakai, Kunihiro Nishimura, Naohiro Yonemoto, Ken Nagao, The Impact of Institutional Characteristics on the Prognosis of Acute Myocardial Infarction with Cardiogenic Shock: Analysis from the JROAD/JROAD-DPC, 日本循環器学会学術集会, 2018.06.
Membership in Academic Society
  • Japanese Atherosclerosis Society
  • Japanese Heart Rhythm Society
  • The Japanese Vascular and Medicine Organization
  • American Heart Association
  • Japanese Association of Cardiovascular Intervention and Therapeutics
  • The Japanese Circulation Sciety
  • The Japanese Society of Internal Medicine
Awards
  • Identification of Hydrogen Peroxide as an Endothelium-Derived Hyperpolarizing Factor in Animals and Humans
Educational
Educational Activities
Education for medical students: Bedside teaching for grade 5, Clinical clerkship for grade 6
Education for graduate students: Basic and clinical research on cardiology and vascular biology
Education for medical staff in the university hospital on resuscitation and cardiovascular care
Social
Professional and Outreach Activities
Certified Instructor for American Heart Association BLS and ACLS Provider Course.