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Mechanism of mTOR inhibitor-associated stomatitis

Research Project

Project/Area Number 15K11309
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field Surgical dentistry
Research InstitutionNiigata University

Principal Investigator

Kitamura Nobutaka  新潟大学, 医歯学総合病院, 特任教授 (90224972)

Co-Investigator(Kenkyū-buntansha) 芳澤 享子  松本歯科大学, 歯学部, 教授 (60303137)
中田 光  新潟大学, 医歯学総合病院, 教授 (80207802)
武井 延之  新潟大学, 脳研究所, 准教授 (70221372)
Research Collaborator IZUMI Kenzi  
ITO Yuko  
YAMAMOTO Youka  
OHHASHI Riuko  
HUJIMOTO Yoko  
WATANABE Mari  
Project Period (FY) 2015-04-01 – 2019-03-31
Project Status Completed (Fiscal Year 2018)
Budget Amount *help
¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000)
Fiscal Year 2017: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2016: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
Fiscal Year 2015: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
KeywordsmTOR阻害剤 / 口内炎 / 口腔粘膜細胞培養 / シロリムス / 有害事象 / 発症機序 / ヒト口腔粘膜上皮細胞培養 / リンパ脈管筋腫症
Outline of Final Research Achievements

As a basic experiment in vitro for sirolimus stomatitis, oral mucosal cells were cultured from 7 passages to 8 passages. Sirolimus was added onto the cultured cells, and the reaction of the cultured cells was observed. As a result, the doubling time of cell proliferation was prolonged by 5 times at 10 nM compared to 0 nM. The DNA synthesis ability decreased by about 20%. The morphology was spindle-shaped and many large cells at 0 nM, and small spherical cells increased at 1 nM or more. The area of the nuclei was significantly smaller at 10 nM compared to sirolimus 0 nM. The area of the cells was significantly smaller at 0.1 nM, 1 nM and 10 nM compared to sirolimus 0 nM. Furthermore, the expression of E-Cadherin was suppressed, and cell-cell adhesion was weakened.

Academic Significance and Societal Importance of the Research Achievements

申請者らは、リンパ脈管筋腫症に対するmTOR阻害剤の日米加共同MILES試験の日本側代表として試験の成功に貢献し、ついで安全性確立を目的とした医師主導治験を実施し、LAMに対する世界初の薬事承認に繋げた。その後、結節性硬化症の血管線維腫に対する外用が承認された。現在、難治性リンパ管疾患、限局性皮質異形成II型のてんかん発作、進行性骨化性線維異形成症に対する医師主導治験が進行中であり、益々適応拡大が予想される。mTOR阻害剤により高頻度に発症する有害事象の一つに口内炎があり、患者のQOLを著しく低下させている。mTOR阻害剤による口内炎の発症機序の解明と治療・予防法の確立は喫緊の課題である。

Report

(5 results)
  • 2018 Annual Research Report   Final Research Report ( PDF )
  • 2017 Research-status Report
  • 2016 Research-status Report
  • 2015 Research-status Report
  • Research Products

    (18 results)

All 2019 2018 2017 2016 2015 Other

All Journal Article (4 results) (of which Int'l Joint Research: 2 results,  Peer Reviewed: 3 results,  Open Access: 3 results) Presentation (10 results) (of which Int'l Joint Research: 3 results,  Invited: 2 results) Remarks (4 results)

  • [Journal Article] Risk factors for stomatitis in patients with lymphangioleiomyomatosis during treatment with sirolimus: A multicenter investigator-initiated prospective study.2017

    • Author(s)
      Kitamura N, Seyama K, Inoue Y, Nagai K, Suzuki M, Moriyama H, Takada T, Tazawa R, Hirai T, Mishima M, Hayashida M, Hirose M, Arai T, Sugimoto C, Hattori N, Watanabe K, Tamada T, Akazawa K, Tanaka T, Nakata K.
    • Journal Title

      Pharmacoepidemiol Drug Saf.

      Volume: 26 Issue: 10 Pages: 1182-1189

    • DOI

      10.1002/pds.4259

    • Related Report
      2017 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Efficacy and Safety of Long-Term Sirolimus Therapy for Asian Patients with Lymphangioleiomyomatosis2016

    • Author(s)
      Takada T, Mikami A, Kitamura N, Seyama K, Inoue Y, Nagai K, Suzuki M, Moriyama H, Akasaka K, Tazawa R, Hirai T, Mishima M, Hayashida M, Hirose M, Sugimoto C, Arai T, Hattori N, Watanabe K, Tamada T, Yoshizawa H, Akazawa K, Tanaka T, Yagi K, Young LR, McCormack FX, Nakata K
    • Journal Title

      AnnalsATS

      Volume: 13 Issue: 11 Pages: 1912-1922

    • DOI

      10.1513/annalsats.201605-335oc

    • Related Report
      2016 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Megalin-Mediated Tubuloglomerular Alterations in High-Fat Diet-Induced Kidney Disease2016

    • Author(s)
      Kuwahara S, Hosojima M, Kaneko R, Aoki H, Nakano D, Sasagawa T, Kabasawa H, Kaseda R, Yasukawa R, Ishikawa T, Suzuki A, Sato H, Kageyama S, Tanaka T, Kitamura N, Narita I, Komatsu M, Nishiyama A, Saito A
    • Journal Title

      J Am Soc Nephro

      Volume: in press Issue: 7 Pages: 1996-2008

    • DOI

      10.1681/asn.2015020190

    • Related Report
      2016 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Prevention and Care Management of Stomatitis in Patients Treated with Sirolimus2015

    • Author(s)
      北村信隆、森山寛史、高田俊範、芳澤享子、中田光
    • Journal Title

      呼吸と循環

      Volume: 63 Issue: 12 Pages: 1167-1175

    • DOI

      10.11477/mf.1404205860

    • ISSN
      0452-3458, 1882-1200
    • Year and Date
      2015-12-15
    • Related Report
      2015 Research-status Report
  • [Presentation] シロリムスが口腔粘膜細胞の増殖と分化に与える影響に関する研究2019

    • Author(s)
      山本陽香
    • Organizer
      第18回日本再生医療学会総会
    • Related Report
      2018 Annual Research Report
  • [Presentation] 口腔粘膜細胞に及ぼすシロリムスの影響2019

    • Author(s)
      伊藤祐子
    • Organizer
      第18回日本再生医療学会総会
    • Related Report
      2018 Annual Research Report
  • [Presentation] シロリムス口内炎の発症機序に関する研究2018

    • Author(s)
      中田光、山本陽香、伊藤裕子、北村信隆、武井延之
    • Organizer
      第3回LAM研究会
    • Related Report
      2018 Annual Research Report
  • [Presentation] Risk Factors for Stomatitis in Patients with Lymphangioleiomyomatosis During Treatment with Sirolimus: A Multicenter Investigator-Initiated Prospective Study2017

    • Author(s)
      Koh Nakata,Kuniaki Seyama,Yoshikazu Inoue,Toshinori Takada,Masaru Suzuki,Tsutomu Tamada,Toru Arai,Toyohiro Hirai,Tomohiro Handa,Chikatoshi Sugimoto,Nobutaka Kitamura,Ryushi Tazawa
    • Organizer
      American Thoracic Society 2017 International Conference
    • Related Report
      2017 Research-status Report
    • Int'l Joint Research
  • [Presentation] シロリムスによる副作用対策 口内炎の管理について2016

    • Author(s)
      北村信隆
    • Organizer
      リンパ脈管筋腫症Web 講演会
    • Place of Presentation
      Jストリーム 六本木スタジオ(東京都港区)
    • Year and Date
      2016-07-21
    • Related Report
      2016 Research-status Report
    • Invited
  • [Presentation] Early and Late Onset Adverse Events in LAM Patients Treated with Sirolimus for Two Years2016

    • Author(s)
      Nakata K, Inoue Y, Seyama K, Tazawa R, Tamada T, Mikami A, Nakayama H, Suzuki M, Ebina M, Hanaoka M , Hattori N, Hirai T, Arai T, Sugimoto C, Kitamura N, Tanaka T, Akazawa K, Mishima M
    • Organizer
      ATS 2016
    • Place of Presentation
      San Francisco(USA)
    • Year and Date
      2016-05-17
    • Related Report
      2016 Research-status Report
    • Int'l Joint Research
  • [Presentation] Early Intervention with Sirolimus Benefits Mild Lymphangioleiomyomatosis-Related Lung Disease2016

    • Author(s)
      Takada T, Seyama K, Inoue Y, Nagai K, Suzuki M, Moriyama H, Akasaka K, Tazawa R, Hirai T, Mishima M, Hayashida M, Hirose M, Sugimoto C, Arai T, Hattori N, Watanabe K, Mikami A, Tamada T, Yoshizawa H, Akazawa K, Tanaka T, Kitamura N, Nakata K
    • Organizer
      ATS 2016
    • Place of Presentation
      San Francisco(USA)
    • Year and Date
      2016-05-17
    • Related Report
      2016 Research-status Report
    • Int'l Joint Research
  • [Presentation] リンパ脈管筋腫症(LAM)に対するシロリムスによる口内炎について2015

    • Author(s)
      北村信隆、芳澤享子、中田光
    • Organizer
      第60回日本口腔外科学会
    • Place of Presentation
      名古屋国際会議場(愛知県名古屋市)
    • Year and Date
      2015-10-16
    • Related Report
      2015 Research-status Report
  • [Presentation] 口内炎の評価2015

    • Author(s)
      北村信隆
    • Organizer
      平成27年度日本医療研究開発機構研究費第1回班会議
    • Place of Presentation
      千里中央ライフサイエンスセンター(大阪府豊中市)
    • Year and Date
      2015-10-12
    • Related Report
      2015 Research-status Report
  • [Presentation] 口内炎に対する予防と治療について2015

    • Author(s)
      北村信隆
    • Organizer
      第55回日本呼吸器学会学術大会
    • Place of Presentation
      東京国際フォーラム(東京都千代田区)
    • Year and Date
      2015-04-17
    • Related Report
      2015 Research-status Report
    • Invited
  • [Remarks] リンパ脈管筋腫症患者に対するシロリムス投与による口内炎発症のリスクファクター

    • URL

      http://www.bmrctr.jp/lam/data/research02.html

    • Related Report
      2018 Annual Research Report
  • [Remarks] シロリムス口内炎の予防

    • URL

      http://www.bmrctr.jp/lam/

    • Related Report
      2018 Annual Research Report
  • [Remarks] アジア人リンパ脈管筋腫症患者に対するシロリムス長期投与の効果と安全性

    • URL

      http://www.bmrctr.jp/lam/data/research01.html

    • Related Report
      2018 Annual Research Report
  • [Remarks] リンパ脈管筋腫症Web講演会 シロリムスによる副作用対策 口内炎の管理について

    • URL

      https://nobelpark.jp/member/Rapalimus/guide/

    • Related Report
      2016 Research-status Report

URL: 

Published: 2015-04-16   Modified: 2020-03-30  

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