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Studies on molecular pathology of hemophilia A and gain-of-function of FVIII

Research Project

Project/Area Number 17H04231
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeSingle-year Grants
Section一般
Research Field Pediatrics
Research InstitutionNara Medical University

Principal Investigator

Midori Shima  奈良県立医科大学, 医学部, 教授 (30162663)

Co-Investigator(Kenkyū-buntansha) 武山 雅博  奈良県立医科大学, 医学部, 講師 (30572010)
矢田 弘史  奈良県立医科大学, 医学部, 助教 (30635785)
野上 恵嗣  奈良県立医科大学, 医学部, 准教授 (50326328)
松本 智子  天理医療大学, 医療学部, 助教 (80642678)
Project Period (FY) 2017-04-01 – 2020-03-31
Project Status Completed (Fiscal Year 2019)
Budget Amount *help
¥13,650,000 (Direct Cost: ¥10,500,000、Indirect Cost: ¥3,150,000)
Fiscal Year 2019: ¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000)
Fiscal Year 2018: ¥5,590,000 (Direct Cost: ¥4,300,000、Indirect Cost: ¥1,290,000)
Fiscal Year 2017: ¥3,250,000 (Direct Cost: ¥2,500,000、Indirect Cost: ¥750,000)
Keywords血友病 / 血友病A / 第VIII因子 / 第IX因子 / 第X因子 / 高機能型 / 遺伝子治療 / トロンビン / 活性型第IX因子 / 活性型第X因子 / リン脂質 / 内科 / 小児科 / 血液 / 血栓止血
Outline of Final Research Achievements

The experimental objective of this study is to design the hyper-functional FVIII for improving the current hemophilia A treatment. We attempted to identify essential amino acid residues though the binding experiments to FIXa, FX and phospholipid, which are crucial components in the FX activating complex (Xase), and FXa generation assay and expression of recombinant FVIII with amino acid substitutions. We found that the FVIII cofactor function is heavily dependent on the binding to FIXa. FVIII mutant, K1813A, has high affinity to FIXa and resistant to FIXa mdediated inactivation. These results suggested that K1813A would be a promising model for hyper-functional FVIII.

Academic Significance and Societal Importance of the Research Achievements

現在、次世代の血友病A治療として遺伝子治療の臨床研究も進みつつあるが、出血予防に必要な凝固因子機能を長期間維持することは困難である。したがって、現状の遺伝子治療の方法には限界がある。本研究は止血レベルを長期期間維持できる遺伝子/細胞治療を実現するために、より高機能な第VIII因子を創製することである。これは、出血抑制のみならず、関節機能を正常に維持し、高い活動性を可能になる。さらに、遺伝子治療においてもベクター投与量を減少させることで副作用の軽減にもつながる。また、本研究の成果により第VIII因子の補因子機能の本態を解明することにもなり、学術的意義も高い。

Report

(4 results)
  • 2019 Annual Research Report   Final Research Report ( PDF )
  • 2018 Annual Research Report
  • 2017 Annual Research Report
  • Research Products

    (42 results)

All 2020 2019 2018 2017

All Journal Article (15 results) (of which Int'l Joint Research: 2 results,  Peer Reviewed: 15 results,  Open Access: 14 results) Presentation (27 results) (of which Int'l Joint Research: 16 results,  Invited: 4 results)

  • [Journal Article] Emicizumab improves ex vivo clotting function in patients with mild/moderate hemophilia A2020

    • Author(s)
      Nakajima Yuto、Nogami Keiji、Yada Koji、Furukawa Shoko、Noguchi-Sasaki Mariko、Hirata Michinori、Shima Midori
    • Journal Title

      Thrombosis and Haemostasis

      Volume: オンライン Issue: 06 Pages: 968-976

    • DOI

      10.1055/s-0040-1710315

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Emicizumab improves the stability and structure of fibrin clot derived from factor VIII‐deficient plasma, similar to the addition of factor VIII2020

    • Author(s)
      Shimonishi Naruto、Nogami Keiji、Ogiwara Kenichi、Matsumoto Tomoko、Nakazawa Fumie、Soeda Tetsuhiro、Hirata Michinori、Arai Nobuo、Shima Midori
    • Journal Title

      Haemophilia

      Volume: オンライン Issue: 3

    • DOI

      10.1111/hae.13961

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Assessment of self‐/parent‐reported quality of life in Japanese children with haemophilia using the Japanese version of KIDSCREEN‐522020

    • Author(s)
      Furuichi Yasuko、Nogami Keiji、Yada Koji、Nezu Satoko、Obayashi Kenji、Saeki Keigo、Kurumatani Norio、Nakajima Mitsuru、Kinoshita Seiji、Shima Midori
    • Journal Title

      Haemophilia

      Volume: 26 Issue: 2 Pages: 243-250

    • DOI

      10.1111/hae.13945

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] An anti-factor IXa/factor X bispecific antibody, emicizumab, improves ex vivo coagulant potentials in plasma from patients with acquired hemophilia A.2020

    • Author(s)
      Takeyama M, Nogami K, Matsumoto T, Noguchi-Sasaki M, Kitazawa T, Shima M.
    • Journal Title

      J Thromb Haemost.

      Volume: 18 Issue: 4 Pages: 825-833

    • DOI

      10.1111/jth.14746

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Potential role of activated factor VIII (FVIIIa) in FVIIa/tissue factor-dependent FXa generation in initiation phase of blood coagulation.2019

    • Author(s)
      Furukawa S, Nogami K, Ogiwara K, Shima M.
    • Journal Title

      Int J Hematol.

      Volume: 109 Issue: 4 Pages: 390-401

    • DOI

      10.1007/s12185-019-02611-3

    • Related Report
      2019 Annual Research Report 2018 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] A novel simultaneous clot-fibrinolysis waveform analysis for assessing fibrin formation and clot lysis in haemorrhagic disorders.2019

    • Author(s)
      Nogami K, Matsumoto T, Sasai K, Ogiwara K, Arai N, Shima M.
    • Journal Title

      Br J Haematol.

      Volume: 187 Issue: 4 Pages: 518-529

    • DOI

      10.1111/bjh.16111

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Efficacy, safety, and pharmacokinetics of emicizumab prophylaxis given every 4 weeks in people with haemophilia A (HAVEN 4): a multicentre, open-label, non-randomised phase 3 study.2019

    • Author(s)
      Pipe SW, Shima M, Lehle M, Shapiro A, Chebon S, Fukutake K, Key NS, Portron A, Schmitt C, Podolak-Dawidziak M, Selak Bienz N, Hermans C, Campinha-Bacote A, Kiialainen A, Peerlinck K, Levy GG, Jiménez-Yuste V.
    • Journal Title

      Lancet Haematol

      Volume: 30054 Issue: 6 Pages: 30057-30057

    • DOI

      10.1016/s2352-3026(19)30054-7

    • Related Report
      2018 Annual Research Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] New therapies using nonfactor products for patients with hemophilia and inhibitors2018

    • Author(s)
      Nogami Keiji、Shima Midori
    • Journal Title

      Blood

      Volume: 133 Issue: 5 Pages: 399-406

    • DOI

      10.1182/blood-2018-07-820712

    • Related Report
      2018 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Emicizumab, a humanized bispecific antibody to coagulation factors IXa and X with a factor VIIIa-cofactor activity2018

    • Author(s)
      Kitazawa Takehisa、Shima Midori
    • Journal Title

      International Journal of Hematology

      Volume: on line Issue: 1 Pages: 20-30

    • DOI

      10.1007/s12185-018-2545-9

    • Related Report
      2018 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Emicizumab-mediated haemostatic function in patients with haemophilia A is down-regulated by activated protein C through inactivation of activated factor V2018

    • Author(s)
      Yada Koji、Nogami Keiji、Shinozawa Keiko、Kitazawa Takehisa、Hattori Kunihiro、Amano Kagehiro、Fukutake Katsuyuki、Shima Midori
    • Journal Title

      British Journal of Haematology

      Volume: 183 Issue: 2 Pages: 257-266

    • DOI

      10.1111/bjh.15525

    • Related Report
      2018 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Factor (F)VIII/VIIa enhances global haemostatic function in the co-presence of bypassing agents and FVIII among patients with haemophilia A with inhibitor2018

    • Author(s)
      Nogami K, Matsumoto T, Yada K, Ogiwara K, Furukawa S, Shida Y, Takeyama M, Shima M
    • Journal Title

      Br J Haematol

      Volume: ahead of printing Issue: 4 Pages: 528-536

    • DOI

      10.1111/bjh.15209

    • Related Report
      2018 Annual Research Report 2017 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Modified clot waveform analysis to measure plasma coagulation potential in the presence of the anti-factor IXa/factor X bispecific antibody, emicizumab2018

    • Author(s)
      Nogami K, Matsumoto T, Tabuchi Y, Soeda T, Arai N, Kitazawa T, Shima M
    • Journal Title

      Journal of Thrombosis and Haemostasis

      Volume: 未定 Issue: 6 Pages: 1078-1088

    • DOI

      10.1111/jth.14022

    • Related Report
      2017 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Long-term safety and efficacy of emicizumab in a phase 1/2 study in patients with hemophilia A with or without inhibitors.2017

    • Author(s)
      Shima M, Hanabusa H, Taki M, Matsushita T, Sato T, Fukutake K, Kasai R, Yoneyama K, Yoshida H, Nogami K.
    • Journal Title

      Blood Adv.

      Volume: 1(22) Issue: 22 Pages: 1891-1899

    • DOI

      10.1182/bloodadvances.2017006684

    • Related Report
      2017 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] A combined approach using global coagulation assays quickly differentiates coagulation disorders with prolonged aPTT and low levels of FVIII activity.2017

    • Author(s)
      Tomoko Matsumoto, Keiji Nogami, Midori Shima
    • Journal Title

      International Jurnal of Hematology

      Volume: 105(2) Issue: 2 Pages: 174-183

    • DOI

      10.1007/s12185-016-2108-x

    • Related Report
      2017 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Emicizumab Prophylaxis in Hemophilia A with Inhibitors.2017

    • Author(s)
      Wada H, Matsumoto T, Katayama N
    • Journal Title

      N Engl J Med

      Volume: 377 Issue: 22 Pages: 2193-2194

    • DOI

      10.1056/nejmc1712683

    • Related Report
      2017 Annual Research Report
    • Peer Reviewed / Int'l Joint Research
  • [Presentation] Additive effect on the global clotting function in moderate/mild hemophilia A by addition of emicizumab, evaluated by clot waveform analysis2019

    • Author(s)
      Nakajima Y, Nogami K, Yada K, Furukawa S, Noguchi M, Hirata M, Shima M
    • Organizer
      International Society on Thrombosis and Hemostasis
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Novel measurement of factor VIII by template matching method using weighed center on APTT clot waveform2019

    • Author(s)
      Shimonishi N, Ogiwara K, Nogami K, Oda Y, Kawabe T, Okazaki S, Shima M
    • Organizer
      International Society on Thrombosis and Hemostasis
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Quantitative evaluation of fibrin clot strcture formed in the presence of emicizumab using scanning electron microscope2019

    • Author(s)
      Shimonishi N, Nogami K, Ogiwara K, Matsumoto T, Nakazawa F, Noguchi-Sasaki M, Hirata M, Arai N, Shima M
    • Organizer
      International Society on Thrombosis and Hemostasis
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Bispecific antibodies and advances in non-genme therapy options in hemophilia2019

    • Author(s)
      Shima M
    • Organizer
      International Society on Thrombosis and Hemostasis
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] Residues 1680-1684 in the A3 domain of factor VIII contain a novel thrombin-interactive site responsible for proteolysitc clevage at Arg16892019

    • Author(s)
      Nakajima Y, Nogami K, Minami H, Sasai K, Shima M
    • Organizer
      61th American Society of Hematology Annual meeting & Exposition
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Monoclonal antibody-based therapies2018

    • Author(s)
      Midori Shima
    • Organizer
      European Society of hematology
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] Mode of action and interaction of the bispecific antibody emicizumab2018

    • Author(s)
      Midori Shima
    • Organizer
      Annual meeting of the German Society of Thrombosis and Hmeaostais Research
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] Clot waveform analysis , laboratory monitoring of2018

    • Author(s)
      Midori Shima
    • Organizer
      Annual Meeting of Laboratory Medicine Congress and Exhibition
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] 第VIII因子の解明とFVIIIa代替バイスペシフィック抗体製剤の開発への道2018

    • Author(s)
      嶋 緑倫
    • Organizer
      第80回日本血液学会
    • Related Report
      2018 Annual Research Report
  • [Presentation] Utility of converted factor VIII activity by thrombin generation assay for evaluation of clotting function among hemophilia A carriers2018

    • Author(s)
      Nogami K, Kawamura T, Shima M, Yada K
    • Organizer
      World Federation of Hemophilia 2018
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research
  • [Presentation] R2159C 変異FVIII(FVIII-Ise)はC2 ドメインの構造機能変化をきたしている2018

    • Author(s)
      越智 聡史,武山 雅博,野上 恵嗣,嶋  緑倫
    • Organizer
      第40回日本血栓止血学会
    • Related Report
      2018 Annual Research Report
  • [Presentation] 第VIII 因子A3 残基1663-1666 にArg1689開裂を制御するトロンビン結合領域が存在する2018

    • Author(s)
      南  博明,野上 恵嗣,笹井 香那,古川 晶子,武山 雅博,嶋  緑倫
    • Organizer
      第40回日本血栓止血学会
    • Related Report
      2018 Annual Research Report
  • [Presentation] 第VIII因子A3ドメイン上の新規第IXa因子結合部位の同定2018

    • Author(s)
      武山 雅博, 野上 恵嗣, 笹井 香那, 嶋  緑倫
    • Organizer
      第80回日本血液学会
    • Related Report
      2018 Annual Research Report
  • [Presentation] Contribution of Factor VIII A3 Domain Residues 1793-1795 to a Factor IXa-Interactive Site2018

    • Author(s)
      Masahiro Takeyama, Keiji Nogami, Kana Sasai, Midori Shima
    • Organizer
      60thAmerican Society of Hematology Annual Meeting and Exposition
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research
  • [Presentation] A Novel Mechanism of Factor VIIa/Tissue Factor (TF)-Catalyzed Activation and Inactivation of B-Domain-Deleted Factor VIII in the Early Initiation Phases of Coagulation2018

    • Author(s)
      Yuto Nakajima, Koji Yada, Keiji Nogami, Midori Shima
    • Organizer
      60thAmerican Society of Hematology Annual Meeting and Exposition
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research
  • [Presentation] 第VIII因子とインヒビター:どこまで解明されたか?2017

    • Author(s)
      嶋 緑倫
    • Organizer
      第39回 日本血栓止血学会
    • Related Report
      2017 Annual Research Report
  • [Presentation] 包括的ダイナミック解析による血友病の凝固線溶動態の特性2017

    • Author(s)
      松本 智子, 野上 恵嗣, 笹井 香那, 荻原 建一, 竹中亜利沙, 嶋  緑倫
    • Organizer
      第39回 日本血栓止血学会
    • Related Report
      2017 Annual Research Report
  • [Presentation] 凝固初期相におけるFVIII活性化を介したTF依存性内因系tenase促進機序2017

    • Author(s)
      古川 晶子, 野上 恵嗣, 荻原 建一, 嶋  緑倫
    • Organizer
      第39回 日本血栓止血学会
    • Related Report
      2017 Annual Research Report
  • [Presentation] Tenase(Xase) 反応軸に基づく中等症・軽症血友病Aにおける異常FVIIIの多元的機能解析2017

    • Author(s)
      矢田 弘史, 野上 恵嗣, 竹中亜利沙, 河村 武志, 嶋  緑倫
    • Organizer
      第39回 日本血栓止血学会
    • Related Report
      2017 Annual Research Report
  • [Presentation] 凝固波形解析によるFVIII補因子機能代替抗体emicizumabの包括的凝固機能モニタリング法の確立2017

    • Author(s)
      松本 智子, 野上 恵嗣, 田渕 有香, 添田 哲弘, 新井 信夫, 北沢 剛久, 高岡 秀成, 服部 有宏, 嶋  緑倫
    • Organizer
      第39回 日本血栓止血学会
    • Related Report
      2017 Annual Research Report
  • [Presentation] 第IX因子微量存在化におけるemicizumabの凝固能改善効果2017

    • Author(s)
      荻原 建一, 南  博明, 野上 恵嗣, 松本 智子, 北沢 剛久, 服部 有宏, 嶋  緑倫
    • Organizer
      第39回 日本血栓止血学会
    • Related Report
      2017 Annual Research Report
  • [Presentation] Factor VIII A1 Residues 346-349 is a Novel Thrombin-binding Site Responsible for cleavage at Arg372 in the Heavy Chain2017

    • Author(s)
      Minami H, Nogami K, Sasai K, Furukawa S, Takeyama M, Shima M
    • Organizer
      the ISTH 2017 Congress
    • Related Report
      2017 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Anti FIXa/FX Bispecific Antibody (Emicizumab) Enhances Plasma Procoagulant Activity In Hemophilia B in the Presence of Very Low Level of Factor IX2017

    • Author(s)
      Ogiwara K, Minami H, Nogami K, Matsumoto T, Kitazawa T, Hattori K, Shima M
    • Organizer
      the ISTH 2017 Congress
    • Related Report
      2017 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Mode of Enhancement in the Global Hemostatic Potentials with Concomitant Use of Bypassing Agents and Emicizumab in Hemophilia A Patients with Inhibitor Evaluated by ROTEM2017

    • Author(s)
      Yada K, Nogami K, Kitazawa T, Hattori K, Shima M
    • Organizer
      the ISTH 2017 Congress
    • Related Report
      2017 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Clinical and immunological profiles of Mild/Moderate hemophilia A patients with inhibitor2017

    • Author(s)
      Furukawa S, Nogami K, Shima M
    • Organizer
      7th East Asia Hemophilia Forum 2017
    • Related Report
      2017 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Factor VIIIa mimetic bispecific antibody(Emicizumab) improves thrombus formation of von Willebrand disease under high shear flow conditions2017

    • Author(s)
      Shida Y, Nogami K, Yaoi H, Kitazawa T, Shima M
    • Organizer
      7th East Asia Hemophilia Forum 2017
    • Related Report
      2017 Annual Research Report
    • Int'l Joint Research
  • [Presentation] 第VIII因子A1残基346-349はArg372の開裂を制御する新たなトロンビン結合部位である2017

    • Author(s)
      南  博明, 野上 恵嗣, 笹井 香那, 古川 晶子, 武山 雅博, 嶋  緑倫
    • Organizer
      第79回 日本血液学会
    • Related Report
      2017 Annual Research Report

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Published: 2017-04-28   Modified: 2021-02-19  

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