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Immunological and metabolic changes induced by severe insults : insights into its pathophysiology and a development of new therapies

Research Project

Project/Area Number 17390482
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeSingle-year Grants
Section一般
Research Field Emergency medicine
Research InstitutionKeio University

Principal Investigator

AIKAWA Naoki  Keio University, School of Medicine, Professor (40110879)

Co-Investigator(Kenkyū-buntansha) HORI Shingo  Keio University, School of Medicine, Associate Professor (80129650)
FUJISHIMA Seitaro  Keio University, School of Medicine, Assistant Professor (00173419)
SEKINE Kazuhiko  Keio University, School of Medicine, Researcher (90296715)
YOH Kikuo  Keio University, School of Medicine, Instructor (00327644)
MIYAKI Masaru  Keio University, School of Medicine, Instructor (60365400)
Project Period (FY) 2005 – 2007
Project Status Completed (Fiscal Year 2007)
Budget Amount *help
¥16,740,000 (Direct Cost: ¥15,600,000、Indirect Cost: ¥1,140,000)
Fiscal Year 2007: ¥4,940,000 (Direct Cost: ¥3,800,000、Indirect Cost: ¥1,140,000)
Fiscal Year 2006: ¥3,800,000 (Direct Cost: ¥3,800,000)
Fiscal Year 2005: ¥8,000,000 (Direct Cost: ¥8,000,000)
KeywordsSIRS / sepsis / priming / LPS / Sepsis / CCL22 / MDC / 高濃度酸素 / 高温環境 / 高体温 / protein C / TNF
Research Abstract

1. Mouse model of burn-primed endotoxemia We have intended to elucidate the mechanisms of IL-18-derived survival benefit for burn-primed endotoxemia. In IL-18-treated mice, acute lung injury (ALI) was histologically attenuated. Lung contents of TNF-alpha, MIP-2, IFN-gamma, IL-12, IL-4 were lower, whereas those of IL-10 were higher than those of IL-1.8-untreated positive controls. In another set of experiments, we found the increase of lung CCL22/MDC contents after burn injury and showed that treatment with a CCR4 antagonist resulted in the increase in survival. In CCR4 antagonist-treated group, lung contents of TNF-alpha IL-6, MDC, and TARC were increased, suggesting that its effects were not mediated by the inhibition of cytokines production.
2. In vitro culture of endothelial cells and spleen cells: To elucidate the immunomodulatory roles of IL-18, we have examined the change in cytokines production by spleen cell in vitro. In spleen cells obtained from IL-18-treated mice, the product … More ion of TNF-alpha, MIP-2 in response to LPS was attenuated, whereas that of IL-10 was increased. Furthermore, we cultured spleen cells at various IL-18 concentrations and found that the production of MIP-2 was attenuated at IL-18 100 pg/ml as compared with that at 30 pg/ml. The induction of IL-10 production was not observed with the increase in IL-18 concentration.
To examine the direct effect of hyperoxia, we examined morphological changes of human umbilical endothelial cells using an improved microscopic monitoring system and found that TNT-alpha and hyperoxia synergistically induce endothelial cell apoptosis.
3. Effects of hyperthermia in critical patients: We have experienced several cases in which DIC or organ dysfunctions seemed to be induced by hyperthermia. By precisely examining their clinical courses, we speculated the direct immunomodulatory effects of hyperthermia in these patients. In the second set of study, we found that D dimer levels were significantly higher and those of AT III and protein C were significantly lower in patients with sepsis. Furthermore, protein C levels were significantly lower in the group with deteriorating clinical conditions on day 7. In the third set of study, we found that NE-AT and e-XDP levels were significantly higher in the group with deteriorating lung oxygenation, among ALI/ARDS patients Less

Report

(4 results)
  • 2007 Annual Research Report   Final Research Report Summary
  • 2006 Annual Research Report
  • 2005 Annual Research Report
  • Research Products

    (58 results)

All 2008 2007 2006 2005

All Journal Article (46 results) (of which Peer Reviewed: 5 results) Presentation (2 results) Book (8 results) Patent(Industrial Property Rights) (2 results) (of which Overseas: 1 results)

  • [Journal Article] Neutrophil elastase and systemic inflammatory response syndrome in the initiation and development of acute lung injury among critically ill patients2008

    • Author(s)
      S Fujishima, [N Aikawa], et. al.
    • Journal Title

      Biomedicine & Pharmacotherapy (In press)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2007 Annual Research Report 2007 Final Research Report Summary
    • Peer Reviewed
  • [Journal Article] Neutrophil elastase and systemic inflammatory response syndrome in the initiation and development of acute lung injury among critically ill patients2008

    • Author(s)
      S, Fujishima, [N, Aikawa], et. al.
    • Journal Title

      Biomedicine & Pharmacotherapy (in press)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2007 Final Research Report Summary
  • [Journal Article] 救急患者における人工呼吸器関連肺炎の臨床的検討2008

    • Author(s)
      宮木 大、[相川 直樹]
    • Journal Title

      日本外科感染症学会雑誌 5

      Pages: 49-54

    • Related Report
      2007 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Prostaglandin E^2 induces hypertrophic changes and suppresses α-skeletal actin gene expression in rat cardiomyocytes2007

    • Author(s)
      S Miyatake, [N Aikawa]
    • Journal Title

      Journal of Cardiovascular Pharmacology 50

      Pages: 548-554

    • Related Report
      2007 Annual Research Report
    • Peer Reviewed
  • [Journal Article] 細菌性髄膜炎から急激にDIC, Septic shockを呈し心肺停止に至った1剖検例2007

    • Author(s)
      林田敬, [相川直樹]他
    • Journal Title

      日本集中治療医学会雑誌 14

      Pages: 260-260

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 輸液療法に反応した深在性複雑型肝損傷における非手術的治療の限界2007

    • Author(s)
      関根和彦, [相川直樹]他
    • Journal Title

      日本腹部救急医学会雑誌 27

      Pages: 155-155

    • Related Report
      2006 Annual Research Report
  • [Journal Article] The role of the surgeon as intensivist: an international perspective2006

    • Author(s)
      Jeffrey L, [Aikawa N], et. al.
    • Journal Title

      Current Opinion in Critical Care 12

      Pages: 357-369

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2007 Final Research Report Summary
    • Peer Reviewed
  • [Journal Article] The role of the surgeon as intensivist : an international perspective2006

    • Author(s)
      Jeffrey, L, [Aikawa, N], et. al.
    • Journal Title

      Current Opinion in Critical Care 12

      Pages: 357-369

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2007 Final Research Report Summary
  • [Journal Article] 重症肺炎に伴うsepsis関連病態,ALI/ARDSの治療2006

    • Author(s)
      藤島清太郎, 相川直樹
    • Journal Title

      呼吸器科 9

      Pages: 52-59

    • Related Report
      2006 Annual Research Report
  • [Journal Article] The role of the surgeon as intensivist : an intensivist : an international2006

    • Author(s)
      Jefirey L, [Aikawa N], et al.
    • Journal Title

      Current Opinion in Critical Care 12

      Pages: 357-369

    • Related Report
      2006 Annual Research Report
  • [Journal Article] The surgeon in the intensive care unit : a Japanese perspective2006

    • Author(s)
      Aikawa N
    • Journal Title

      Current Opinion in Critical Care 12

      Pages: 364-365

    • Related Report
      2006 Annual Research Report
  • [Journal Article] Sepsis救命ガイドライン 重症sepsisおよびseptic shock患者に対する抗菌薬療法(エビデンスに基づくレビュー)2006

    • Author(s)
      相川直樹
    • Journal Title

      救急・集中治療 別冊

    • Related Report
      2006 Annual Research Report
  • [Journal Article] Orthostatic decrease in cardiac chaos during the head-up tilt test in patients with vasovagal syoncope2006

    • Author(s)
      Suzuki M, [Aikawa N], et al.
    • Journal Title

      Circulation Journal 70

      Pages: 902-908

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 生体侵襲・生体反応と臓器不全2006

    • Author(s)
      藤島清太郎, 関根和彦, 相川直樹
    • Journal Title

      救急医学 30

      Pages: 1025-1031

    • Related Report
      2006 Annual Research Report
  • [Journal Article] Pharmacokinetic-pharmacodynamic relationship of Arbekacin for treatment of patients infected with Methicillin-resistant Staphylococcus aureus2006

    • Author(s)
      Sato R, [Aikawa N], et al.
    • Journal Title

      Antimicrobial Agents and Chemotherapy 50

      Pages: 3763-3769

    • Related Report
      2006 Annual Research Report
  • [Journal Article] Population pharmacokinetics of Arbekacin in patients infected with methicillin-resistant Staphylococcus aureus2006

    • Author(s)
      Tanigawara Y, [Aikawa N], et al.
    • Journal Title

      Antimicrobial Agents and Chemotherapy 50

      Pages: 3754-3762

    • Related Report
      2006 Annual Research Report
  • [Journal Article] Efficacy and safety of recombinant human soluble thrombomodulin (ART-123) in disseminated intravascular coagulation : results of a phase III, randomized, double-blind climical trial2006

    • Author(s)
      Saito H, [Aikawa N], et al.
    • Journal Title

      Journal of Thrombosis and Haemostasis 5

      Pages: 31-41

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 抗MRSA薬の適正使用について2006

    • Author(s)
      砂川慶介, [相川直樹]他
    • Journal Title

      Japanese Journal of Antibiotics 60

      Pages: 1-16

    • NAID

      10018550901

    • Related Report
      2006 Annual Research Report
  • [Journal Article] ステロイド薬-感染症治療におけるステロイド薬の位置づけ-2006

    • Author(s)
      佐々木淳一, [相川直樹]他
    • Journal Title

      日本臨床 65

      Pages: 315-319

    • Related Report
      2006 Annual Research Report
  • [Journal Article] アムビゾーム; Drug delivery systemを応用して開発されたアムホテリシンBリポソーム2006

    • Author(s)
      相川直樹
    • Journal Title

      日本病院薬剤師会雑誌 43

      Pages: 557-560

    • Related Report
      2006 Annual Research Report
  • [Journal Article] Surviving sepsis campaign guidelines に基づく治療が奏功した重症肺炎によるDIC合併感染性ショックの1例2006

    • Author(s)
      林正憲, [相川直樹]他
    • Journal Title

      日本臨床救急医学会雑誌 9

      Pages: 149-149

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 肺血栓塞栓症の主訴と生命予後の検討2006

    • Author(s)
      船曵知弘, [相川直樹]他
    • Journal Title

      日本臨床救急医学会雑誌 9

      Pages: 156-156

    • Related Report
      2006 Annual Research Report
  • [Journal Article] Sepsis患者における凝固線溶系動態と病態への関与2006

    • Author(s)
      藤島清太郎, [相川直樹]他
    • Journal Title

      日本臨床救急医学会雑誌 9

      Pages: 138-138

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 耐性グラム陽性球菌治療の新しい選択肢-リネゾリドを中心に-2006

    • Author(s)
      相川直樹
    • Journal Title

      日本科学療法学会雑誌 54

      Pages: 17-17

    • NAID

      10017426028

    • Related Report
      2006 Annual Research Report
  • [Journal Article] ALI/ARDS患者の気道被覆液および血清エンドセリン-1濃度の検討2006

    • Author(s)
      田坂定智, [相川直樹]他
    • Journal Title

      日本Shock学会雑誌 21

      Pages: 39-39

    • NAID

      10024300193

    • Related Report
      2006 Annual Research Report
  • [Journal Article] ERにおけるSepsis患者に対する抗菌薬投与開始までの時間の検討2006

    • Author(s)
      林田敬, [相川直樹]他
    • Journal Title

      日本救急医学会雑誌 17

      Pages: 384-384

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 高度侵襲下で発症したSepsisに対する早期輸液療法の生存率改善効果2006

    • Author(s)
      葉季久雄, [相川直樹]他
    • Journal Title

      日本救急医学会雑誌 17

      Pages: 385-385

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 救急患者におけるALI/ARDS病態と好中球エラスターゼ(NE)2006

    • Author(s)
      藤島清太郎, [相川直樹]他
    • Journal Title

      日本救急医学会雑誌 17

      Pages: 395-395

    • Related Report
      2006 Annual Research Report
  • [Journal Article] BeadArrayシステムを用いた遺伝子発現変動の網羅的解析 : 高度侵襲下病態解析への応用2006

    • Author(s)
      藤島清太郎, [相川直樹]他
    • Journal Title

      日本救急医学会雑誌 17

      Pages: 344-344

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 急性硬膜下血腫に対する脳圧制御目標型の手術・術後(外減圧・バルビツレート・脳平温・浸透圧利尿薬・軽度過換気による複合治療2006

    • Author(s)
      並木淳, [相川直樹]他
    • Journal Title

      日本救急医学会雑誌 17

      Pages: 464-464

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 外傷性脳損傷の急性期メディエーターの制御と神経再生2006

    • Author(s)
      並木淳, [相川直樹]他
    • Journal Title

      日本救急医学会雑誌 17

      Pages: 543-543

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 基礎傷病に続発したseptic ALI/ARDSに対するsteroidの治療効果 マウス熱傷後sepsisモデルによる検討2006

    • Author(s)
      佐々木淳一, [相川直樹]他
    • Journal Title

      日本外科感染症学会雑誌 3

      Pages: 400-400

    • Related Report
      2006 Annual Research Report
  • [Journal Article] 重症熱傷患者における血流感染の予測因子の検討2006

    • Author(s)
      葉季久雄, [相川直樹]他
    • Journal Title

      日本外科感染症学会雑誌 3

      Pages: 458-458

    • Related Report
      2006 Annual Research Report
  • [Journal Article] Heat stroke with multiple organ failure treated with cold hemodialysis and cold continuous hemodiafiltration:a case report2005

    • Author(s)
      Wakino S, [Aikawa N], et. al.
    • Journal Title

      Ther Apher Dial 9

      Pages: 423-428

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2007 Final Research Report Summary
    • Peer Reviewed
  • [Journal Article] Heat stroke with multiple organ failure treated with cold hemodialysis and cold continuous hemo-diafiltration : a case report2005

    • Author(s)
      Wakin, s, [Aikawa, N], et. al.
    • Journal Title

      Ther Apher Dial 9

      Pages: 423-428

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2007 Final Research Report Summary
  • [Journal Article] Current status of diagnosis and treatment of invasive fungal infections in Japan : the influence of the new Japanese guidelines2005

    • Author(s)
      Aikawa N, Kohno S, et al.
    • Journal Title

      J infect Chemother 11

      Pages: 278-287

    • NAID

      10016911976

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Cost-minimisation analysis of sivelestat for acute lung injury associated with systemic inflammatory response syndrome2005

    • Author(s)
      Aikawa N, Fujishima S, et al.
    • Journal Title

      Pharmacoeconomics 23

      Pages: 169-181

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Heat stroke with multiple organ failure treated with cold hemodialysis and cold continuous hemodiafiltration : a case report2005

    • Author(s)
      Wakino S, [Aikawa N], et al.
    • Journal Title

      Ther Apher Dial 9

      Pages: 423-428

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Multicenter prospective study of procalcitonin as an indicator of sepsis2005

    • Author(s)
      Aikawa N, Fujishima S, et al.
    • Journal Title

      J Infect Chemother 11

      Pages: 152-159

    • NAID

      10016473065

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Epidemiological and outcome characteristics of major burns in Tokyo2005

    • Author(s)
      Kobayashi K, [Aikawa N], et al.
    • Journal Title

      Burns 31 Suppl 1

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Voriconazoleの開発の経緯2005

    • Author(s)
      相川直樹
    • Journal Title

      日本化学療法学会雑誌 53S-2

      Pages: 4-7

    • NAID

      10017083414

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Prognostic implications of inhalation injury in burn patients in Tokyo2005

    • Author(s)
      Suzuki M, Aikawa N, et al.
    • Journal Title

      Burns 31

      Pages: 331-336

    • Related Report
      2005 Annual Research Report
  • [Journal Article] A case of severe heat stroke with abnormal cardiac findings2005

    • Author(s)
      Wakino S, [Aikawa N], et al.
    • Journal Title

      Int Heart J 46

      Pages: 543-550

    • NAID

      130000068508

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Flow-independent myocardial ischemia induced by endothelin-1 : an NADH fluorescence analysis2005

    • Author(s)
      Inoue S, [Aikawa N], et al.
    • Journal Title

      J Cardiovasc Pharmacol 46

      Pages: 810-816

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Emergency medical services in Japan : an opportunity for the rational development of pre-hospital care and research2005

    • Author(s)
      M.R.Lewin, [Aikawa N], et al.
    • Journal Title

      J Emerg Med 28

      Pages: 237-241

    • Related Report
      2005 Annual Research Report
  • [Journal Article] 深在性真菌症に対するvoriconazoleの臨床試験-他施設共同、非対照試験-2005

    • Author(s)
      二木芳人, [相川直樹], 他
    • Journal Title

      日本化学療法学会雑誌 353S-2

      Pages: 32-50

    • Related Report
      2005 Annual Research Report
  • [Presentation] Cytokine and other mediator responses in the phase of fluid shift following burn injury2007

    • Author(s)
      Aikawa N
    • Organizer
      42nd World Congress of the International Society of Surgery ISS/SIC
    • Place of Presentation
      Montreal,Canada
    • Year and Date
      2007-08-28
    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2007 Annual Research Report 2007 Final Research Report Summary
  • [Presentation] Cytokine and other mediator responses in the phase of fluid shift following burn injury2007

    • Author(s)
      Aikawa, N
    • Organizer
      42nd World Congress of the International Society of Surgery ISS/SIC
    • Place of Presentation
      Montreal, Canada
    • Year and Date
      2007-08-28
    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2007 Final Research Report Summary
  • [Book] 救急救命士標準テキスト2007

    • Author(s)
      相川 直樹, 他
    • Publisher
      へるす出版
    • Related Report
      2007 Annual Research Report
  • [Book] 深在性真菌症の診断・治療ガイドライン20072007

    • Author(s)
      相川直樹, 他
    • Total Pages
      127
    • Publisher
      深在性真菌症のガイドライン作成委員会
    • Related Report
      2006 Annual Research Report
  • [Book] MRSA-基礎・臨床・対策-2006

    • Author(s)
      藤島清太郎, [相川直樹]他
    • Total Pages
      300
    • Publisher
      医薬ジャーナル社
    • Related Report
      2006 Annual Research Report
  • [Book] 敗血症の解明と治療戦略2006

    • Author(s)
      藤島清太郎, 相川直樹, 他
    • Total Pages
      382
    • Publisher
      医薬ジャーナル
    • Related Report
      2005 Annual Research Report
  • [Book] 抗菌薬使用のガイドライン2005

    • Author(s)
      相川 直樹, 他
    • Publisher
      日本感染症学会/日本化学療法学会
    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2007 Final Research Report Summary
  • [Book] 抗菌薬使用のガイドライン2005

    • Author(s)
      相川直樹, 他
    • Total Pages
      280
    • Publisher
      日本感染症学会/日本化学療法学会
    • Related Report
      2005 Annual Research Report
  • [Book] 発熱性好中球減少症2005

    • Author(s)
      藤島清太郎, 相川直樹, 他
    • Total Pages
      146
    • Publisher
      医薬ジャーナル
    • Related Report
      2005 Annual Research Report
  • [Book] 臨床に生かす体液管理・輸液マニュアル2005

    • Author(s)
      相川直樹[監修], 他
    • Total Pages
      287
    • Publisher
      照林社
    • Related Report
      2005 Annual Research Report
  • [Patent(Industrial Property Rights)] 医薬組成物及び治療方法2005

    • Inventor(s)
      相川 直樹, 他
    • Industrial Property Rights Holder
      慶應義塾
    • Filing Date
      2005-05-17
    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2007 Final Research Report Summary
    • Overseas
  • [Patent(Industrial Property Rights)] 医薬組成物及び治療方法2005

    • Inventor(s)
      相川 直樹, 他
    • Industrial Property Rights Holder
      慶應義塾
    • Acquisition Date
      2005-11-24
    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2007 Final Research Report Summary

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Published: 2005-04-01   Modified: 2016-04-21  

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