Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.7759/cureus.61470

Web of Science

PubMed

Language：English  

DOI： 10.7554/eLife.87288

Web of Science

PubMed

Language：English   Publisher：The Japan Society for Respiratory Endoscopy  

<p>Among various types of aspergillosis, the clinical features of patients with obstructive bronchial aspergillosis remain unclear. Originally, it was reported to occur only in severely immunocompromised patients, such as acquired immunodeficiency syndrome (AIDS) or post-organ transplantation; however, recent reports have suggested that this disease could also affect patients seen in daily practice of pulmonary medicine. We describe a case of a 76-year-old woman with obstructing bronchial aspergillosis. This patient presented to the hospital with a productive cough during asthma and advanced lung cancer treatment. Chest CT showed stenosis of the bronchial lumen. Bronchoscopy showed no recurrence of lung cancer, and aspergillus was found in the granulation tissue. The cough improved with debridement of the lesion by bronchoscopy and oral antifungal medication treatment. Our review of previous case reports, including this case, revealed that obstructing bronchial aspergillosis might occur when patients have several factors inducing immunosuppression, such as solid tumors under anticancer treatment, inhaled corticosteroids, and aging. Since patients may be at risk of progressing to invasive aspergillosis, physicians must properly diagnose obstructing bronchial aspergillosis to deliver appropriate treatment.</p>

DOI： 10.58585/respend.2023-0020

CiNii Research

Language：English   Publisher：The Japan Society for Respiratory Endoscopy  

<p>The case involves a 57-year-old man with a history of laryngeal and lung cancers. He underwent a laryngectomy and right upper lobectomy and developed tracheal methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) colonization. He also underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) to diagnose right mediastinal lymph node adenopathy. His recovery was complicated by a mediastinal infection caused by MRSA five days post-procedure. Combining triple antibiotics comprising MEPM, DAP, and VCM for three weeks gradually improved the mediastinal infection. To our knowledge, this is the first report of mediastinal infection caused by MRSA after EBUS-TBNA. Our successful treatment of EBUS-TBNA-related infectious complications gives us information regarding rare complications management caused by EBUS-TBNA.</p>

DOI： 10.58585/respend.2023-0007

CiNii Research

Web of Science

Language：English   Publisher：(一社)日本呼吸器内視鏡学会  

症例は57歳男性。11年前に右喉頭癌を放射線療法と化学療法で治療されていた。4年前には右肺腺癌に対し切除術と地固め化学療法を受けていた。さらに1年前には左喉頭癌と診断され喉頭全摘出術と永久気管切開術が行われたが、その術後10日目にメチシリン耐性黄色ブドウ球菌(MRSA)による手術部位感染が発生し、洗浄とデブリードマンで治癒していた。喉頭全摘出術から1年が経過した今回の経過観察受診時に縦隔リンパ節が1個腫大していることが判明した。そのリンパ節は16mm大で右傍気管領域に位置しており、FDG-PET所見でも陽性(SUVmax 3.97)が示されたことから癌の再発が疑われた。FDG-PET画像上、他の領域には癌再発を疑わせる所見は示されなかった。気管瘻孔を利用して超音波気管支鏡ガイド下経気管支吸引針生検(EBUS-TBNA)を行い、合併症なく、また予防的抗生物質投与も行われずに同日退院していた。その5日後に高熱を訴え当院を受診した。白血球数とC反応性蛋白の高値が示され、造影CTでは縦隔感染を示唆する所見が示された。EBUS-TBNA処置に関連した縦隔リンパ節および縦隔の感染症と診断し、抗生物質3剤併用療法(MEPM、VCM、DAP)を3週間行ったところ同感染症は徐々に改善していった。生検結果からは右喉頭癌の再発と最終診断し、ペムブロリズマブの投与を開始した。

Language：English   Publisher：(一社)日本呼吸器内視鏡学会  

症例は77歳女性。喘息の持病があった。約5年前、慢性咳嗽の症状で当院を受診し、左肺下葉の肺腺癌(cT2aN1M0、病期IIA)と診断された。根治的放射線療法を受けたが、約2年前には肺癌が再発したため標準的な免疫化学療法(シスプラチン、ペメトレキセド、ペムブロリズマブ)と維持化学療法(ペメトレキセド+ペムブロリズマブ)が1年間行われた。本年になってから咳嗽が悪化しており、聴診所見から気管支喘息の増悪を疑って吸入皮質ステロイド療法を強化したが症状はさらに悪化した。血液検査ではアスペルギルスの抗原と特異的IgEはいずれも陰性所見であった。胸部CT画像では気管支腔の狭窄が示され、肺癌の気管支内への進行が疑われた。しかし、気管支鏡検査では肺癌の再発は認められず、代わりに左気管支の上葉支の内部に1個の白色病変が発見された。その病変の検体を採取したが、その際には抵抗を感じることなく採取することができた。その病理学的診断は閉塞性気管支アスペルギルス症とされた。白色病変のデブリードマン処置を行い、経口ボリコナゾールを開始したところ咳嗽は徐々に改善し、上昇していた白血球数とC反応性蛋白値も正常化した。6ヵ月後の気管支鏡評価では左上葉支にわずかな白色苔癬が観察されたが、生検ではアスペルギルスの菌糸は発見されなかった。そのためボリコナゾールを終了する判断をした。

Language：English   Publisher：Annals of Hematology  

DOI： 10.1007/s00277-023-05391-3

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Scopus

PubMed

Language：English   Publisher：ERJ Open Research  

DOI： 10.1183/23120541.00500-2023

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Scopus

PubMed

Publisher：Nature Microbiology  

Morbilliviruses are among the most contagious viral pathogens of mammals. Although previous metagenomic surveys have identified morbillivirus sequences in bats, full-length morbilliviruses from bats are limited. Here we characterize the myotis bat morbillivirus (MBaMV) from a bat surveillance programme in Brazil, whose full genome was recently published. We demonstrate that the fusion and receptor binding protein of MBaMV utilize bat CD150 and not human CD150, as an entry receptor in a mammalian cell line. Using reverse genetics, we produced a clone of MBaMV that infected Vero cells expressing bat CD150. Electron microscopy of MBaMV-infected cells revealed budding of pleomorphic virions, a characteristic morbillivirus feature. MBaMV replication reached 103–105 plaque-forming units ml−1 in human epithelial cell lines and was dependent on nectin-4. Infection of human macrophages also occurred, albeit 2–10-fold less efficiently than measles virus. Importantly, MBaMV is restricted by cross-neutralizing human sera elicited by measles, mumps and rubella vaccination and is inhibited by orally bioavailable polymerase inhibitors in vitro. MBaMV-encoded P/V genes did not antagonize human interferon induction. Finally, we show that MBaMV does not cause disease in Jamaican fruit bats. We conclude that, while zoonotic spillover into humans may theoretically be plausible, MBaMV replication would probably be controlled by the human immune system.

DOI： 10.1038/s41564-023-01380-4

Scopus

Language：English   Publisher：ERJ Open Research  

DOI： 10.1183/23120541.00033-2023

Web of Science

Scopus

PubMed

Language：English   Publisher：Microbiology Spectrum  

Under the strict quarantine policy imposed to combat the COVID-19 (coronavirus disease 2019) pandemic in Japan, the prevalence of respiratory infections by viruses other than SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has been largely unknown. However, such information on viral circulation is important in order to develop better management policies that are based on scientific data. Here, we retrospectively investigated respiratory virus infections in individuals who visited a community hospital with respiratory symptoms between June of 2020 and September of 2021 with the use of the BioFire FilmArray Respiratory Panel 2.1. Virus was detected in 65 out of a total of 328 subjects, with SARS-CoV-2 (67.7%), rhino/enterovirus (18.5%), and parainfluenza virus 3 (7.7%) accounting for most of the infections. No influenza virus or respiratory syncytial virus (RSV) infections were detected. The monthly cases of rhino/enterovirus infection were highest from winter to spring, with this temporal pattern differing from that of SARS-CoV-2. SARS-CoV-2 was detected more frequently (P , 0.001) in subjects with cough (31/104 cases, 29.8%) than in those without cough (13/ 224 cases, 5.8%), suggesting that cough might contribute to the prediction of COVID-19. Our findings also suggest that testing for rhino/enterovirus and parainfluenza virus 3, in addition to SARS-CoV-2, may be important for the rigorous diagnosis of respiratory virus infections. IMPORTANCE Influenza virus, RSV, adenovirus, and rhino/enterovirus were the major respiratory viruses before COVID-19 pandemic. Circulating respiratory viruses may have been affected by our strong quarantine policy during the COVID-19 pandemic. We checked the circulating respiratory viruses from our outpatients by using a multiplex PCR kit that had recently been released. SARS-CoV-2 was the most frequently detected virus, and it was followed by rhino/enterovirus and parainfluenza virus 3. No influenza virus or RSV infections were detected during our study period, suggesting that influenza virus and RSV became almost extinct. COVID-19 cases frequently experienced cough, and this frequency was statistically significantly higher than that observed in the cases without SARS-CoV-2 detection. The cough can be an indicator of COVID-19.

DOI： 10.1128/spectrum.04162-22

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PubMed

Language：English   Publisher：Frontiers in Immunology  

Immune cells have been implicated in interstitial lung diseases (ILDs), although their phenotypes and effector mechanisms remain poorly understood. To better understand these cells, we conducted an exploratory mass cytometry analysis of immune cell subsets in bronchoalveolar lavage fluid (BALF) from patients with idiopathic pulmonary fibrosis (IPF), connective-tissue disease (CTD)-related ILD, and sarcoidosis, using two panels including 64 markers. Among myeloid cells, we observed the expansion of CD14+ CD36hi CD84hiCCR2– monocyte populations in IPF. These CD14+ CD36hi CD84hi CCR2– subsets were also increased in ILDs with a progressive phenotype, particularly in a case of acute exacerbation (AEx) of IPF. Analysis of B cells revealed the presence of cells at various stages of differentiation in BALF, with a higher percentage of IgG memory B cells in CTD-ILDs and a trend toward more FCRL5+ B cells. These FCRL5+ B cells were also present in the patient with AEx-IPF and sarcoidosis with advanced lung lesions. Among T cells, we found increased levels of IL-2R+ TIGIT+ LAG3+ CD4+ T cells in IPF, increased levels of CXCR3+ CD226+ CD4+ T cells in sarcoidosis, and increased levels of PD1+ TIGIT+ CD57+ CD8+ T cells in CTD-ILDs. Together, these findings underscore the diverse immunopathogenesis of ILDs.

DOI： 10.3389/fimmu.2023.1145814

Web of Science

Scopus

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

Event date： 2022.10

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：佐賀市   Country：Japan  

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Language：Japanese