Basic research for using MRI evaluating cartilage damage in rheumatoid arthritis

• Project/Area Number: 15K09530
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Collagenous pathology/Allergology
• Research Institution: Nagasaki University
• Principal Investigator: TAMAI Mami 長崎大学, 医歯薬学総合研究科(医学系), 准教授 (60380862)
• Co-Investigator(Kenkyū-buntansha): 上谷 雅孝 長崎大学, 医歯薬学総合研究科(医学系), 教授 (40176582) ; 青柳 潔 長崎大学, 医歯薬学総合研究科(医学系), 教授 (80295071) ; 岩本 直樹 長崎大学, 医歯薬学総合研究科(医学系), 助教 (80437897) ; 川上 純 長崎大学, 医歯薬学総合研究科(医学系), 教授 (90325639) ; 古賀 智裕 長崎大学, 医歯薬学総合研究科(医学系), 助教 (90537284)
• Project Period (FY): 2015-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000); Fiscal Year 2017: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2016: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000); Fiscal Year 2015: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
• Keywords: 関節リウマチ / 軟骨傷害 / MRI / 関節裂隙狭小化 / 関節軟骨

Outline of Final Research Achievements

Early adequate treatment induced the better outcome in patients with rheumatoid arthritis (RA) and the cases who achieved remission is increasing. In addition, recently, the repairment of bone erosion in X ray were frequently observed. However, joint space narrowing (JSN) which interferes with quality of life more than bone erosion, is still unsolved. This is the prospective study evaluating JSN using MRI in patients with RA and to clarify the mechanism of JSN. We evaluated JSN in 17 patients with rheumatoid arthritis using MRI. Disease activities were moderate at baseline, after 1 year all patients achieved remission. After 1 year, 9 patients (52.9 %) showed radiographic progression, and out of 5 patients showed JSN progression. In the group with JSN progression, every MRI scores, such as synovitis, bone edema, bone erosion, JSN, were higher than another group. In addition, MRI JSN score did not corelated with radiographic JSN score.

Academic Significance and Societal Importance of the Research Achievements

関節リウマチ（RA）は関節・骨破壊をきたすことにより寝たきりの原因となりうる疾患である。近年、治療の進歩によりRAでは寛解症例が増え、特に早期RAでは日常生活に全く支障のない症例も増えた。またX線にて骨びらん修復がしばしば観察されるようになった。一方、RAで早期から認められる関節裂隙の狭小化は、骨びらんよりも日常生活に支障をきたす要因とされており、次に克服すべき課題である。本研究はMRIを用いて関節裂隙狭小化（＝軟骨傷害）を評価することにより、その機序を解明し、あわよくば再生医療につなげようとする、時代のニーズに応えた研究である。

Research Products

• [Int'l Joint Research] ライデン大学(オランダ)
• [Journal Article] 関節リウマチとMRI (2018)
  • Author(s): 玉井慎美
  • Journal Title: Clinical Calcium Volume: 28 Pages: 642-648
• [Journal Article] Baseline MRI bone erosion predicts the subsequent radiographic progression in early rheumatoid arthritis patients who achieve d sustained good clinical response (2017)
  • Author(s): Tamai M, Arima K, Nakashima Y, Kita J, Umeda M, Fukui S, Nishino A, Suzuki T, Horai Y, Okada A, Koga T, Kawashiri S-Y, Iwamoto N, Ichinose K, Yamasaki S, Nakamura H, Origuchi T, Aoyagi K, Uetani M, Eguchi K, Kawakami A
  • Journal Title: Modern Rheumatology Volume: 印刷中
  • Peer Reviewed
• [Journal Article] MRI bone oedema at enrollment predicts rapid radiographic progression over 1 year in early rheumatoid arthritis patients: results from the Nagasaki University Early Arthritis Cohort (2016)
  • Author(s): Nakashima Y, Tamai M, Kita J, Michitsuji T, Shimizu T, Fukui S, Umeda M, Nishino A, Suzuki S, Yoshiro Horai, Akitomo Okada, Takayuki Nishimura, Tomohiro Koga, Shin-ya Kawashiri, Naoki Iwamoto, Kunihiro Ichinose, Yasuko Hirai, Arima K, Yamasaki S, Nakamura H, Origuchi T, Takao S, Uetani M, Aoyagi K, Eguchi K, Kawakami A
  • Journal Title: Journal of Rheumatology Volume: 43 Issue: 7 Pages: 7-13
  • DOI: 10.3899/jrheum.150988
  • Peer Reviewed / Int'l Joint Research
• [Presentation] Risk factors of radiographic progression in patients with rheumatoid arthritis by using magnetic resonance imaging and ultrasound (2018)
  • Author(s): Ayuko Takatani, Mami Tamai, Nozomi Ohki, Yoshikazu Nakashima, Masataka Uetani, Atsushi Kawakami, et al.
  • Organizer: EULAR2018
  • Int'l Joint Research
• [Presentation] Evaluation of diagnostic performance of magnetic resonance imaging and ultrasound toward early rheumatoid arthritis from Nagasaki Early Arthritis Cohort (2018)
  • Author(s): Ayuko Takatani, Mami Tamai, Nozomi Ohki, Yoshikazu Nakashima, Masataka Uetani Atsushi Kawakami, et al.
  • Organizer: EULAR2018
  • Int'l Joint Research
• [Presentation] MRI対称性MCP関節腱鞘滑膜炎は分類不能関節炎のRA進展を予測する (2018)
  • Author(s): 玉井 慎美, Vincent Grundeken, 有馬 和彦, Robin ten Brinck, Annette H.M. van der Helm-van Mil, 大木 望, 上谷雅孝, 川上 純
  • Organizer: 第33回日本臨床リウマチ学会
• [Presentation] 関節リウマチと歯周疾患 (2017)
  • Author(s): 玉井慎美、清水俊匡、高谷亜由子、梅田雅孝、福井翔一、西野文子、古賀智裕、川尻;真也、岩本直樹、一瀬邦弘、中村英樹、折口智樹、川下由美子、梅田正博、上谷雅孝、佐藤俊太朗、川上純
  • Organizer: 第45回日本臨床免疫学会
• [Presentation] 関節リウマチにおけるMRIと超音波検査(US)を用いたX線進行のリスク因子の検討 (2017)
  • Author(s): 髙谷亜由子、玉井慎美、大木望、遠藤友志郎、辻創介、井川敬、清水俊匡、梅田雅孝、福井翔一、西野文子、古賀智裕、川尻真也、岩本直樹、一瀬邦弘、中村英樹、折口智樹、上谷雅孝、川上純
  • Organizer: 第32回日本臨床リウマチ学会
• [Presentation] MRI bone erosion at baseline predicts the subsequent radiographic progression in early-stage RA patients who achieved in sustained clinical good response: Sub-analysis from Nagasaki University Early Arthritis Cohort. (2015)
  • Author(s): Tamai M, Nakashima Y, Arima K, Kita J, Umeda M, Fukui S, Nishino A, Suzuki T, Horai Y, Okada A, Koga T, Kawashiri S-Y, Iwamoto N, Ichinose K, Yamasaki S, Nakamura H, Origuchi T, Aoyagi K, Uetani M, Eguchi K, Kawakami A
  • Organizer: American College of Rheumatology 2015
  • Place of Presentation: San Francisco, USA
  • Year and Date: 2015-11-07
  • Int'l Joint Research
• [Presentation] MRI bone oedma at enrollment predicts the development of rapid radiographic progression at 1 year toward patients with early-stage rheumatoid arthritis: Results from Nagasaki University Early Arthritis Cohort (2015)
  • Author(s): Nakashima Y, Tamai M, Kita J, Fukui S, Umeda M, Nishino A, Suzuki T, Horai Y, Okada A, Koga T, Kawashiri S-Y, Iwamoto N, Ichinose K, Hirai Y, Arima K, Nakamura H, Origuchi T, Uetani M, Aoyagi K, Eguchi K, Kawakami A
  • Organizer: European League Against Rheumatism 2015
  • Place of Presentation: Rome, Italy
  • Year and Date: 2015-06-11
  • Int'l Joint Research