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Clarification of the mechanism of pulmonary arteriopathy associated with congenital heart diseases and development of new treatment using lung biopsy speciments

Research Project

Project/Area Number 16K15627
Research Category

Grant-in-Aid for Challenging Exploratory Research

Allocation TypeMulti-year Fund
Research Field Cardiovascular surgery
Research InstitutionTohoku University

Principal Investigator

Saiki Yoshikatsu  東北大学, 医学系研究科, 教授 (50372298)

Co-Investigator(Kenkyū-buntansha) 川本 俊輔  東北大学, 医学系研究科, 非常勤講師 (20400244)
堀井 明  東北大学, 医学系研究科, 教授 (40249983)
遠藤 雅人  東北大学, 医学系研究科, 非常勤講師 (90282128)
齋木 由利子  東北大学, 医学系研究科, 准教授 (80311223)
Project Period (FY) 2016-04-01 – 2019-03-31
Project Status Completed (Fiscal Year 2018)
Budget Amount *help
¥3,380,000 (Direct Cost: ¥2,600,000、Indirect Cost: ¥780,000)
Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2017: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2016: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Keywords先天性心疾患 / 肺動脈性肺高血圧症 / 肺生検 / 肺高血圧症 / 肺血管病変 / 肺静脈狭窄症 / 肺高血圧 / 肺動脈性肺高血圧 / PPAR-γ / アポトーシス
Outline of Final Research Achievements

We demonstrated the following histopathological findings in the patients with pulmonary arterial hypertension (PAH) associated with congenital heart diseases (CHD) using lung biopsy specimens. Pulmonary artery banding can induce pulmonary vascular reverse remodeling as demonstrated by significant pulmonary artery medial thinning and improvement in intimal lesions. In addition, early progression of pulmonary arteriopathy in patients with trisomy 21 was not proved compared with patients without trisomy 21. Moreover, microthrombotic lesions were detected in 7% of patients with CHD and these lesions would be associated with the progression of PAH.
We could not demonstrate the mechanisms of the PAH progression by the molecular biological methods using laser microdissection method and DNA microarray. We will perform further investigation and clarify novel mechanisms of the progression of PAH with CHD.

Academic Significance and Societal Importance of the Research Achievements

先天性心疾患に伴う肺動脈性肺高血圧症における肺血管病変の組織学的特徴が示されたことにより、各症例に応じより良い治療選択が可能になる可能性が示された。加えて肺血管拡張薬のみならず、呼吸器やその他に対するアプローチの必要性や、これまでにそれほど重要視されていなかった血栓性病変に対する新たなアプローチの可能性が示唆された。今後、免疫組織化学的手法等より肺血管病変進行のさらなるメカニズム解明が進めば、新たな治療標的として新薬開発にもつながることが期待できると考えている。

Report

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

    (3 results)

All 2018 2016

All Journal Article (2 results) (of which Peer Reviewed: 1 results,  Open Access: 1 results) Presentation (1 results) (of which Int'l Joint Research: 1 results)

  • [Journal Article] Is Trisomy 21 a Risk Factor for Rapid Progression of Pulmonary Arteriopathy? ― Revisiting Histopathological Characteristics Using 282 Lung Biopsy Specimens ―2018

    • Author(s)
      Masaki Naoki、Saiki Yuriko、Endo Masato、Maeda Kay、Adachi Osamu、Akiyama Masatoshi、Kawamoto Shunsuke、Saiki Yoshikatsu
    • Journal Title

      Circulation Journal

      Volume: 82 Issue: 6 Pages: 1682-1687

    • DOI

      10.1253/circj.CJ-17-0754

    • NAID

      130006744320

    • ISSN
      1346-9843, 1347-4820
    • Year and Date
      2018-05-25
    • Related Report
      2018 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Evidence of Pulmonary Vascular Reverse Remodeling After Pulmonary Artery Banding Performed in Early Infancy in Patients With Congenital Heart Defects2018

    • Author(s)
      Masaki Naoki、Saiki Yuriko、Endo Masato、Maeda Kay、Adachi Osamu、Akiyama Masatoshi、Kawamoto Shunsuke、Saiki Yoshikatsu
    • Journal Title

      Circulation Journal

      Volume: 82 Issue: 3 Pages: 684-690

    • DOI

      10.1253/circj.CJ-17-0379

    • NAID

      130006394538

    • ISSN
      1346-9843, 1347-4820
    • Related Report
      2018 Annual Research Report
  • [Presentation] Is trisomy 21 a risk factor for rapid progression of pulmonary arteriopathy? -revisit histopathological characteristics based on 282 lung biopsy specimens2016

    • Author(s)
      正木 直樹
    • Organizer
      American Heart Association Scientific Session 2016
    • Place of Presentation
      Convention Center(アメリカ・ニューオーリンズ)
    • Year and Date
      2016-11-11
    • Related Report
      2016 Research-status Report
    • Int'l Joint Research

URL: 

Published: 2016-04-21   Modified: 2020-03-30  

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