記述言語：日本語   出版者・発行元：耳鼻と臨床会  

高安動脈炎は大血管での炎症を主体とした血管炎疾患であるが初発症状は多岐にわたる。頭頸部症状として難聴、めまい、耳鳴も見逃されやすい症状とされており、中耳炎を伴う例も少ないながら報告されている。難聴の臨床像はさまざまであり、診断が遅れたことで難聴が進行し、その他の症状が出現して初めて診断に至ることもある。この度、当初ANCA関連血管炎性中耳炎(Otitis Media with ANCA-Associated Vasculitis;OMAAV)などの難治性中耳炎を疑うも、精査の結果、高安動脈炎の診断となり、副腎皮質ステロイドと免疫抑制剤の投与により中耳炎と難聴が改善した例を経験したため報告する。難治性中耳炎症例ではOMAAV以外の血管炎の可能性もあるため、早期に診断し膠原病内科とも連携して診療することが必要と考える。(著者抄録)

記述言語：英語   出版者・発行元：Oxford University Press  

記述言語：英語   出版者・発行元：Modern Rheumatology  

Objectives: This study aimed to describe the treatment selection for systemic lupus erythematosus (SLE) using data from the Kyushu Collagen Disease Network for SLE (KCDN-SLE) registry, a multicentre prospective registry in Japan. Methods: This study used data from patients registered between August 2022 and November 2023. Clinical characteristics, purpose of agent initiation, other candidate agents, and short-term efficacy and safety were evaluated. Results: We analysed 69 previously treated patients with SLE (mean age 43.7 years; 62 females, 7 males). Hydroxychloroquine, biological agents, and immunosuppressive agents were initiated during the maintenance phase in 12, 41, and 16 patients, respectively. In patients with active organ involvement, hydroxychloroquine and biological agents were widely used for initiation. In those who already achieved treatment goals, biological agents alone were predominantly selected. The SLE Disease Activity Index 2000 score and prednisolone dose declined significantly over a 6-month follow-up period. Among 48 patients with active disease, 22 achieved a lupus low disease activity state, but this had no evident association with the initiation of a biological agent. In total, 14 adverse events, predominantly infections, were observed. Conclusions: Biological agents were used preferentially, and the therapeutic agents were appropriately effective and mostly achieved the purpose of agent initiation.

DOI： 10.1093/mr/roae058

Web of Science

Scopus

PubMed

記述言語：英語   出版者・発行元：Tuberculosis  

Mycobacteria often cause chronic infection. To establish persistence in the host, mycobacteria need to evade host immune responses. However, the molecular mechanisms underlying the evasion strategy are not fully understood. Here, we demonstrate that mycobacterial cell wall lipids trigger an inhibitory receptor to suppress host immune responses. Mycolic acids are major cell wall components and are essential for survival of mycobacteria. By screening inhibitory receptors that react with mycobacterial lipids, we found that mycolic acids from various mycobacterial species bind to mouse Clec12A, and more potently to human Clec12A. Clec12A is a conserved inhibitory C-type lectin receptor containing immunoreceptor tyrosine-based inhibitory motif (ITIM). Innate immune responses, such as MCP-1 production, and PPD-specific recall T cell responses were augmented in Clec12A-deficient mice after infection. In contrast, human Clec12A transgenic mice were susceptible to infection with M. tuberculosis. These results suggest that mycobacteria dampen host immune responses by hijacking an inhibitory host receptor through their specific and essential lipids, mycolic acids. The blockade of this interaction might provide a therapeutic option for the treatment or prevention of mycobacterial infection.

DOI： 10.1016/j.tube.2022.102294

Scopus

PubMed

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語