Faculty Profiles - TAKAKI Akinobu

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Clinical features of Japanese elderly patients with type 1 autoimmune hepatitis

Yasuhiro Miyake, Yoshiaki Iwasaki, Akinobu Takaki, Haruhiko Kobashi, Kohsaku Sakaguchi, Yasushi Shiratori

INTERNAL MEDICINE 46 ( 24 ) 1945 - 1949 2007

Language：English Publisher：JAPAN SOC INTERNAL MEDICINE

Objective In Caucasian type 1 autoimmune hepatitis patients with a main susceptibility of human leukocyte antigen DR3 and DR4, elderly patients have a higher frequency of concurrent autoimmune disease and cirrhosis at presentation. However, in Japanese patients, the disease is dominantly associated with DR4, and their clinical features may be different from those of previous reports. In this study, we assessed the clinical features of Japanese elderly patients with type 1 autoimmune hepatitis.
Methods We investigated 160 consecutive patients with type 1 autoimmune hepatitis, consisting of 34 elderly patients (65 years) and 126 younger patients (< 65 years).
Results There were no differences in form of clinical onset, frequencies of concurrent autoimmune disease, positive proportions of anti-nuclear antibody and/or anti-smooth muscle antibody, and human leukocyte antigen DR status between the two groups. However, the elderly patients had lower serum levels of albumin (p= 0.0049), and higher frequencies of cirrhosis (F4) and pre-cirrhosis (F3) (p= 0.014) compared with the younger patients. In contrast, in elderly patients, the cumulative incidental rate of the normalization of serum alanine aminotransferase levels within 6 months after the introduction of initial treatment was higher in those treated with prednisolone >= 20 mg/day than those treated only with ursodeoxycholic acid (p= 0.001).
Conclusion We speculate that more years may pass between the occurrence of the disease and the presentation in Japanese elderly patients than in younger patients, and we considered that, even in elderly patients, those with advanced fibrosis should be treated with prednisolone in order to prevent progress of the disease into liver failure.

DOI： 10.2169/internalmedicine.46.0420

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Combination of 5-FU and IFN alpha enhances IFN signaling pathway and caspase-8 activity, resulting in marked apoptosis in hepatoma cell lines

Kazuko Koike, Akinobu Takaki, Masashi Tatsukawa, Mayumi Suzuki, Hidenori Shiraha, Yoshiaki Iwasaki, Kohsaku Sakaguchi, Yasushi Shiratori

INTERNATIONAL JOURNAL OF ONCOLOGY 29 ( 5 ) 1253 - 1261 2006.11

Language：English Publisher：PROFESSOR D A SPANDIDOS

Interferon (IFN) combined with 5-Fluorouracil (5-FU) treatment has recently been reported to show beneficial effects in patients with advanced hepatocellular carcinoma. IFNa is usually provided for this combination therapy. In this study, we investigated the molecular mechanisms of apoptosis induction in hepatoma cell lines with IFNa and 5-FU combination therapy from the view point of 5-FU's additive effect on interferon-related signaling pathways. Five hepatoma cell lines (Hep3B, Huh7, HLE, PLC/PRF/5, and HepG2) were tested for apoptosis inducibility by IFN alpha in the absence or presence of 5-FU. Hep3B was the most apoptosis sensitive to IFN plus 5-FU treatment. The JAK/STAT pathway transcriptional factor ISRE was activated more synergistically when 5-FU was added to IFN alpha treatments. Caspase-3, -9, and especially caspase-8 activity was higher with IFN a plus 5-FU than IFN or 5-FU alone. Inhibition of caspase-8, -9, c-Jun N-terminal kinase (INK), phosphatidylinositide 3-kinase (PI3K), and p38 mitogen-activated protein kinase (p38 MAPK) revealed that caspase-8 inhibition was the most effective at decreasing the apoptotic effects of IFN and/or 5-FU. In JAK1 and ISGF3y-silenced Hep3B cells, the apoptosis induction and caspase-8 activation levels by IFN, even in combination with 5-FU, were abrogated. In conclusion, caspase-8 is the most important factor that controls IFN and 5-FU-induced apoptosis in hepatoma cell lines.

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Endoscopic therapy for bleeding esophageal varices improves the outcome of Child C cirrhotic patients

Shinichiro Hori, Akinobu Takaki, Hiroyuki Okada, Akiko Fujiwara, Ryuta Takenaka, Chiho Makidono, Yasushi Shiratori

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 21 ( 11 ) 1704 - 1709 2006.11

Language：English Publisher：BLACKWELL PUBLISHING

Background and Aims: Bleeding from esophageal varices is one of the frequent severe complications arising in patients with liver cirrhosis. The management of esophageal varices is therefore important for patient survival. The purpose of this study was to clarify the predictive factors for mortality in patients with Child C cirrhosis presenting with variceal bleeding.
Methods: A retrospective analysis of 77 Child C cirrhotic patients with bleeding from esophageal varices was conducted. All patients received endoscopic therapy. Twenty-nine patients received endoscopic variceal ligation, and 48 patients received endoscopic injection sclerotherapy or endoscopic injection sclerotherapy with ligation. Univariate and multivariate analyses of clinical data were performed to identify the prognostic factors for survival for these 77 patients.
Results: Fifty-seven of 77 patients received endoscopic therapy within 24 h after variceal bleeding, and bleeding was controlled in 55 (96.5%). The remaining 20 patients received endoscopic therapy more than 24 h after bleeding. Higher bilirubin level and rebleeding were the predictive parameters for 6-week survival in the 77 patients, according to univariate and multivariate analysis. Higher bilirubin level, refractory ascites, and the presence of hepatocellular carcinoma were the predictive parameters for mortality in 77 patients as determined by multivariate analysis.
Conclusion: Endoscopic therapy was effective in controlling acute variceal bleeding of Child C cirrhotic patients. The prognosis of Child C stage patients presenting with variceal bleeding depended on the severity of liver damage and the presence of hepatocellular carcinoma.

DOI： 10.1111/1440-1746.2006.04267.x

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Hepatitis C virus non-structural protein 4 downregulates differentiation and CD4 T cell stimulatory function of dendritic cells

Akinobu Takaki, Yoshiaki Iwasaki, Kazuko Koike, Masashi Tatsukawa, Hidenori Shiraha, Kohsaku Sakaguchi, Eiichi Nakayama, Yasushi Shiratori

HEPATOLOGY 44 ( 4 ) 308A - 309A 2006.10

Gamma-glutamyl carboxylase inhibits cell migration in hepatocellular carcinoma cell lines

Nobuyuki Takaoka, Hidenori Shiraha, Naoki Ueda, Shin-ichi Nishina, Tatsuya Fujikawa, Noriyuki Matsuo, Shigetomi Tanaka, Akinobu Takaki, Kohsaku Sakaguchi, Yasushi Shiratori

HEPATOLOGY 44 ( 4 ) 488A - 489A 2006.10

B型肝炎ウイルス関連肝疾患における生体部分肝移植前後の抗ウイルス療法ラミブジン併用低容量HBIG治療

高木章乃夫, 八木孝仁, 岩崎良章, 貞森裕, 松川啓義, 松田浩明, 篠浦先, 楳田祐二, 坂口孝作, 田中紀章, 白鳥康史

移植 41 ( 5 ) 489 - 489 2006.10

B型慢性肝炎の血清中HBV-DNA全長塩基配列の検討肝線維化の進展とゲノム変異

辰川匡史, 高木章乃夫, 白羽英則, 小池和子, 岩崎良章, 小橋春彦, 坂口孝作, 白鳥康史

肝臓 47 ( Suppl.2 ) A391 - A391 2006.9

Gamma-glutamyl carboxylase活性低下による肝細胞癌悪性化

高岡伸行, 白羽英則, 藤川達也, 上田直樹, 中西豊, 松尾則行, 田中盛富, 仁科慎一, 高木章乃夫, 坂口孝作, 白鳥康史

日本癌学会総会記事 65回 296 - 296 2006.9

腫瘍マーカーの分子機能はどこまで解っているのか異常プロトロンビンの肝細胞癌進展における役割

白羽英則, 藤川達也, 上田直樹, 鈴木真由美, 高岡伸行, 高木章乃夫, 坂口孝作, 白鳥康史

日本臨床検査自動化学会会誌 31 ( 4 ) 352 - 352 2006.9

自己免疫性肝炎患者における肝発癌と危険因子の解析

三宅康広, 岩崎良章, 庄司凡, 寺田亮, 高木章乃夫, 小橋春彦, 坂口孝作, 白鳥康史

日本消化器病学会雑誌 103 ( 臨増大会 ) A956 - A956 2006.9

非アルコール性脂肪性肝炎(NASH)の進行は性別・年齢に依存する

庄司凡, 岩崎良章, 寺田亮, 三宅康広, 高木章乃夫, 小橋春彦, 坂口孝作, 白鳥康史, 岡本良一

日本消化器病学会雑誌 103 ( 臨増大会 ) A934 - A934 2006.9

Early detection and quantification of lamivudine-resistant hepatitis B virus mutants by fluorescent biprobe hybridization assay in lamivudine-treated patients

Fumi Umeoka, Yoshiaki Iwasaki, Masayuki Matsumura, Akinobu Takaki, Haruhiko Kobashi, Masashi Tatsukawa, Hidenori Shiraha, Shin-ichi Fujioka, Kohsaku Sakaguchi, Yasushi Shiratori

JOURNAL OF GASTROENTEROLOGY 41 ( 7 ) 693 - 701 2006.6

Language：English Publisher：SPRINGER JAPAN KK

Background. Long-term lamivudine treatment induces the emergence of lamivudine-resistant hepatitis B virus (HBV). The objective of this study was to develop a fluorescent biprobe hybridization (FBH) assay for the detection and quantification of HBV mutants in the clinical course of lamivudine-treated patients and to evaluate its clinical usefulness. Methods. We developed an FBH assay to detect mutations in the HBV DNA polymerase gene. The assay's detection sensitivity was determined using a dilution series of wild-type/mutant plasmid DNA. Blood samples obtained from 27 lamivudine-treated patients were analyzed. Results. Mutant DNA levels as low as 10% of total HBV DNA were detected (sensitivity = 100%, specificity = 80%). HBV mutants were detected in five of the 27 patients during an average follow-up of 20 months after lamivudine administration. In one of the five patients, the YIDD mutant was detected at the initiation of lamivudine treatment, while the remaining four patients were identified as having YIDD mutants within 3 months after beginning lamivudine administration. Of the five patients with an HBV mutant, four developed breakthrough hepatitis more than 10 months after the detection of HBV mutants, following the reappearance or a re-increase of HBV DNA, characterized by a predominance of the mutant. The YIDD mutant was detected in one patient, even when the titer of the serum HBV DNA was below the detection limit of commercially available quantitative polymerase chain reaction. Conclusions. The FBH assay is an efficient method for detecting and quantifying HBV mutants, as early as 3 months after lamivudine administration.

DOI： 10.1007/s00535-006-1834-x

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Addition of 5-FU enhances the IFN alpha induced signaling pathway and caspase-8 activities, resulting in marked apoptosis in hepatoma cell lines

Kazuko Koike, Akinobu Takaki, Masashi Tatsukawa, Hidenori Shiraha, Yoshiaki Iwasaki, Haruhiko Kobashi, Kohsaku Sakaguchi, Yasushi Shiratori

GASTROENTEROLOGY 130 ( 4 ) A832 - A832 2006.4

Short-term high-dose followed by long-term low-dose hepatitis B immune globulin and long-term lamivudine therapy prevented recurrent hepatitis B after living donor liver transplantation

Akinobu Takaki, Takahito Yagi, Yoshiaki Iwasaki, Hiroshi Sadamori, Hiroyoshi Matsukawa, Hiroaki Matsuda, Susumu Shinoura, Yuuzou Umeda, Haruhiko Kobashi, Kohsaku Sakaguchi, Noriaki Tanaka, Yasushi Shiratori

GASTROENTEROLOGY 130 ( 4 ) A790 - A790 2006.4

肝移植臨床の最前線生体部分肝移植後のC型ウイルス肝炎の再燃・再発時におけるHCV特異的免疫応答変化の検討

高木章乃夫, 八木孝仁, 岩崎良章, 小池和子, 辰川匡史, 白羽英則, 貞森裕, 松川啓義, 松田浩明, 篠浦先, 楳田祐三, 田中紀章, 白鳥康史

肝臓 47 ( Suppl.1 ) A53 - A53 2006.4

B型慢性肝炎発癌例と非発癌例の血清中HBV-DNA全長塩基配列の相違

辰川匡史, 高木章乃夫, 小池和子, 白羽英則, 小橋春彦, 岩崎良章, 坂口孝作, 白鳥康史

肝臓 47 ( Suppl.1 ) A150 - A150 2006.4

肝移植臨床の最前線 B型肝炎ウイルス関連肝疾患における生体部分肝移植前後の抗ウイルス療法ラミブジン併用低用量HBIG治療

高木章乃夫, 八木孝仁, 岩崎良章, 貞森裕, 松川啓義, 松田浩明, 篠浦先, 楳田祐三, 小橋春彦, 寺田亮, 三宅康広, 坂口孝作, 田中紀章, 白鳥康史

肝臓 47 ( Suppl.1 ) A52 - A52 2006.4

Response to steroid therapy in patients with sclerosing cholangitis associated with elevated IgG4 level

Ryo Terada, Hirofumi Kawamoto, Yasuhiro Miyake, Kohsaku Sakaguchi, Yoshiaki Iwasaki, Akinobu Takaki, Haruhiko Kobashi, Yoshiaki Kobayashi, Shin-Ichiro Nakamura, Kazuhide Yamamoto, Yasushi Shiratori

GASTROENTEROLOGY 130 ( 4 ) A721 - A721 2006.4

Double mutation in core promoter region of hepatitis B virus genotype C is associated with an increased risk of hepatocellular carcinoma

Masashi Tatsukawa, Akinobu Takaki, Kazuko Koike, Hidenori Shiraha, Haruhiko Kobashi, Yoshiaki Iwasaki, Yasushi Shiratori

GASTROENTEROLOGY 130 ( 4 ) A751 - A751 2006.4

B型慢性肝炎・肝硬変384例に対するラミブジン療法の長期成績特に耐性化予測,アデホビル併用,肝発癌について

小橋春彦, 西田知弘, 白鳥康史, 池田弘, 岡本良一, 荒木康之, 牧野泰裕, 岡本毅, 坂田達朗, 橋本訓招, 安東正晴, 奥新浩晃, 辰川匡史, 高木章乃夫, 岩崎良章, 高畠弘行, 坂口孝作

肝臓 47 ( Suppl.1 ) A232 - A232 2006.4

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