| Project/Area Number |
15K09697
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Pediatrics
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| Research Institution | Jichi Medical University |
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Principal Investigator |
MINAMI TAKAOMI 自治医科大学, 医学部, 非常勤講師 (60423951)
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| Co-Investigator(Kenkyū-buntansha) |
佐藤 智幸 自治医科大学, 医学部, 講師 (20567995)
森本 哲 自治医科大学, 医学部, 教授 (30326227)
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| Project Period (FY) |
2015-04-01 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥3,510,000 (Direct Cost: ¥2,700,000、Indirect Cost: ¥810,000)
Fiscal Year 2017: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2016: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2015: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
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| Keywords | 川崎病 / 免疫グロブリン / シクロスポリン持続静注療法 / シクロスポリン / バイオマーカー |
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| Outline of Final Research Achievements |
The involvement of platelet activating factor (PAF) has been reported in refractory cases of Kawasaki disease (patients who are resistant to intravenous immunoglobulin [IVIG]). Continuous intravenous injection of cyclosporin (CsA), which inhibits the transcription factor NFAT in the inflammatory response pathway of PAF at a dose of 3 mg/kg/day was administered in 50 patients with IVIG resistance. Consequently, symptoms subsided within 7 days in all patients (72% of all patients within 24 hours). The proportion of patients with coronary artery aneurysm was very small (only 1 [2%] patient with middle aneurysm) compared to the previous reported 10.1% (after 30 days of disease). In addition, levels of soluble IL-2 receptor, which is a marker of T cell activation, were also significantly decreased before and after CsA administration, suggesting the involvement of T-cell activation in refractory cases of Kawasaki disease.
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| Academic Significance and Societal Importance of the Research Achievements |
川崎病は、乳幼児に特に多い全身性血管炎で、現在も原因不明である。研究開始当時、約5％に冠動脈瘤を残していた。免疫グロブリン療法（IVIG）に反応しない不応例は、冠動脈瘤のリスクが約8－10倍で、その対応が課題であった。本研究は、学術的には、川崎病IVIG不応例の免疫学的機序の一端を明らかにするとともに、シクロスポリン持続静注療法という治療法の選択肢を示した点で、社会的にも意義があると考えられる。
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