九州大学 研究者情報
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基本情報 研究活動 教育活動 社会活動 病院臨床活動
的場 哲哉(まとば てつや) データ更新日:2018.06.18

講師 /  九州大学病院 循環器内科 九州大学大学院医学研究院循環器内科学


主な研究テーマ
細胞外微粒子の心血管病態における役割の解明と新規治療法の開発
キーワード:エクソソーム、動脈硬化、心筋梗塞
2017.10~2022.03.
動脈硬化性心血管病の病態形成における酸化脂質の役割
キーワード:動脈硬化、酸化コレステロール、血管内皮機能
2011.04~2020.03.
炎症性単球/マクロファージの心血管病における役割の解明と新規治療法の開発
キーワード:炎症 単球 マクロファージ 動脈硬化 急性冠症候群
2012.04~2019.03.
単球選択性ナノ粒子による新規動脈硬化プラーク破綻予防治療の開発
キーワード:動脈硬化 マクロファージ ナノ粒子
2008.04~2011.03.
研究業績
主要原著論文
1. 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, 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..
2. Tetsuya Matoba, Susumu Takase, Soichi Nakashiro, Yasushi Mukai, Inoue Shujiro, Keiji Oi, Taiki Higo, Shunsuke Katsuki, Masao Takemoto, Nobuhiro Suematsu, Kenichi Eshima, Kenji Miyata, SHinji Satoh, Toshiaki Kadokami, Kiyoshi Hironaga, Ikuyo Ichi, Koji Todaka, Junji Kishimoto, Egashira kensuke, 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, [URL], 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..
3. 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..
4. 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..
主要総説, 論評, 解説, 書評, 報告書等
主要学会発表等
1. 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.
2. Tetsuya Matoba, Kaku Nakano, Kenji Sunagawa, Kensuke Egashira, Nanoparticle-Mediated Monocyte-Selective Drug Delivery System for Treatment of Atherosclerotic Cardiovascular Disease, Cardiovascular System Dynamics Society 2010, 2010.09.
学会活動
所属学会名
日本動脈硬化学会
日本不整脈学会
日本血管生物医学会
米国心臓協会
日本心血管インターベンション学会
日本循環器学会
日本内科学会
学協会役員等への就任
2014.04~2020.03, 国際心血管薬物療法学会日本部会, 評議員.
2014.04~2022.03, 日本心血管インターベンション治療学会, 評議員.
2013.07~2020.07, 日本動脈硬化学会, 評議員.
2013.05~2023.05, American Heart Associatioin, International Fellow of AHA.
2010.04~2020.03, 日本循環器学会九州地方会, 評議員.
2010.04~2020.03, 日本血管生物医学会, 評議員.
学会大会・会議・シンポジウム等における役割
2017.04.14~2017.04.14, Bifurcation symposium, 座長(Chairmanship).
2017.03.04~2017.03.04, 日本老年医学会九州地方会, 座長(Chairmanship).
2016.08.19~2016.08.20, 日本心血管インターベンション学会九州沖縄地方会, 座長(Chairmanship).
2016.06.25~2016.06.25, 日本循環器学会九州地方会, 座長(Chairmanship).
2017.03.17~2017.03.19, 日本循環器学会総会, 座長(Chairmanship).
2015.04.23~2015.04.26, 日本循環器学会, 座長(Chairmanship).
2014.10.24~2014.10.24, QcVIC Research, 座長(Chairmanship).
2014.07.10~2014.07.11, 日本動脈硬化学会, 座長(Chairmanship).
2014.06.28~2014.06.28, 日本循環器学会九州地方会, 座長(Chairmanship).
2014.06.27~2014.06.27, QcVIC Research, 座長(Chairmanship).
2013.07.18~2013.07.20, 日本動脈硬化学会, 座長(Chairmanship).
2013.02.23~2013.02.23, 第7回QcVIC, 座長(Chairmanship).
2012.09.29~2012.09.29, 第6回QcVIC, 座長(Chairmanship).
2012.09.07~2012.09.09, Molecular Cardiovascular Conference II, 座長(Chairmanship).
2012.07.19~2012.07.20, 日本動脈硬化学会, 座長(Chairmanship).
2010.09.04~2010.09.05, Molecular Cardiovascular Conference II, 座長(Chairmanship).
2014.11.29~2014.11.29, QcVIC, 世話人.
2014.09.05~2014.09.06, Molecular Cardiovascular Conference II, 世話人.
2011.09.02~2011.09.04, Molecular Cardiovascular Conference II, 世話人、座長.
2009.09~2015.09, Molecular Cardiovascular Conference II, 世話人.
学会誌・雑誌・著書の編集への参加状況
2015.04~2017.04, International Heart Journal, 国際, 編集委員.
学術論文等の審査
年度 外国語雑誌査読論文数 日本語雑誌査読論文数 国際会議録査読論文数 国内会議録査読論文数 合計
2017年度 20  20 
2016年度 25        25 
2015年度 29        29 
2014年度 10        10 
2013年度    
2012年度      
2011年度      
2010年度      
その他の研究活動
海外渡航状況, 海外での教育研究歴
Cardiovascular Research Institute, University of Rochester Medical Center, UnitedStatesofAmerica, 2003.09~2006.03.
受賞
Circulation Journal Best Reviewers Award, 日本循環器学会, 2017.03.
Young Investigator Award, 日本循環器学会, 2003.03.
研究資金
科学研究費補助金の採択状況(文部科学省、日本学術振興会)
2017年度~2017年度, 基盤研究(C), 代表, 急性心筋梗塞後の心臓修復を促進する革新的PPARγナノ医薬の研究開発.
2007年度~2008年度, 若手研究(B), 代表, 動脈硬化プラーク破綻におけるマクロファージ・アポトーシスの役割解明と治療法.
2009年度~2010年度, 若手研究(B), 代表, マクロファージ分化スイッチ制御による粥状動脈硬化プラーク破綻予防療法の研究開発.
科学研究費補助金の採択状況(文部科学省、日本学術振興会以外)
2017年度~2019年度, AMED: JROAD・J-ASPECT・脳卒中データバンクによる全国規模レジストリーによる脳卒中および循環器疾 患の実態把握の確立と両疾患合併例に関する包括的診療実態解明, 分担, JROAD・J-ASPECT・脳卒中データバンクによる全国規模レジストリーによる脳卒中および循環器疾 患の実態把握の確立と両疾患合併例に関する包括的診療実態解明.
2017年度~2019年度, 厚生労働科学研究費補助金 (厚生労働省), 分担, 研究項目:SS-MIX2データ抽出システム実装とテストおよびアウトカムテンプレート仕様検討
.
2014年度~2014年度, 厚生労働科学研究費補助金 (厚生労働省), 分担, 重症肺高血圧症の予後と生活の質を改善するための安心安全のナノ医療製剤(希 少疾病用医薬品)の実用化臨床試験.
日本学術振興会への採択状況(科学研究費補助金以外)
2017年度~2020年度, 戦略的創造研究推進事業・CREST, 分担, 分化再生と生体恒常性を制御するエクソソームの新しい細胞同調機能の解 明とナノ粒子による生体機能制御への応用.
競争的資金(受託研究を含む)の採択状況
2008年度~2009年度, ストラゼネカ・リサーチ・グラント, 代表, New therapeutic approach to control atherosclerotic cardiovascular disease.

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