Searching a novel pathogenetic mechanism of pruritus in hemodialysis patients for developing a new treatment -intracranial pressure and B-type natriuretic peptide in cerebrospinal fluid-
| Project/Area Number |
17K09039
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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 |
Pain science
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| Research Institution | Juntendo University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
遠藤 未来美 順天堂大学, 医学(系)研究科(研究院), 博士研究員 (70625855)
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| Project Period (FY) |
2017-04-01 – 2023-03-31
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| Project Status |
Completed (Fiscal Year 2022)
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| Budget Amount *help |
¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000)
Fiscal Year 2019: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2018: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2017: ¥3,120,000 (Direct Cost: ¥2,400,000、Indirect Cost: ¥720,000)
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| Keywords | 血液透析 / 痒み / 頭蓋内圧 / BNP / B型ナトリウム利尿ペプチド / 光干渉断層計 / 髄液 / 非侵襲測定 / 医療・福祉 / 痒みの発生 / 痒みの増強機序 |
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| Outline of Final Research Achievements |
We made a hypothesis that elevated concentration of B-type natriuretic peptide (BNP) in cerebrospinal fluid is a novel pruritic cause in hemodialysis patients. Since we could not ethically obtain cerebrospinal fluid, we measured intracranial pressure using an optical coherence tomography (OCT) as a surrogate marker of cerebrospinal BNP. The OCT clearly revealed the morphological changes around optic disc which is affected by intracranial pressure. We found that there are statistically significant correlation between pruritic VAS score and Rim area, and between dermatology life quality index (DLQI) and Rim area、Cup volume、average Cup/Disc (C/D) ratio and vertical C/D ratio. Each parameter derived OCT consistently moved in parallel with intracranial pressure. The correlation between VAS and intracranial pressure and between DLQI and intracranial pressure suited as our prediction. These findings suggest that elevated intracranial pressure worsen pruritus in hemodialysis patients.
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| Academic Significance and Societal Importance of the Research Achievements |
透析患者では透析方法の改良やステロイドや中枢性に作用する薬剤によっても痒みの改善がみられない患者が存在するため、未知の発痒機序の存在が示唆される。本研究は髄液中のBNPが上昇すると痒みが増悪するとの仮説にて開始した。倫理的な問題を解決するためサロゲートマーカーの頭蓋内圧と痒み・QOLスコアとの相関を検討したところ、頭蓋内圧亢進と痒み・QOLスコアには有意な相関が認められた。この知見は頭蓋内圧亢進が透析患者の痒みを誘発する新規の機序であることが示唆する。髄液中BNPを測定するというさらに進んだ研究の端緒となるとともに、一般的な頭蓋内圧亢進に対する治療が痒みに対する新規治療法であることを示唆する。
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Report
(7 results)
Research Products
(53 results)
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[Journal Article] Immunotactoid glomerulopathy (ITG) with nontuberculous mycobacterial infection (NTM); A novel association-2021
Author(s)
Shimizu Y, Wakabayashi K, Iwasaki H, Kishida C, Seki S, Okuma T, Iwakami N, Iwasawa T, Maekawa H, Tomino Y, Wada R, Suzuki Y.
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Journal Title
Case Rep Nephrol Dialysis
Volume: 11
Related Report
Peer Reviewed / Open Access
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[Book] IgA腎症の病態と治療2019
Author(s)
富野 康日己、川村 哲也、鈴木 祐介
Total Pages
315
Publisher
中外医学社
ISBN
9784498224469
Related Report
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[Book] 内科外来診断navi2017
Author(s)
富野 康日己、長谷部 直幸、高橋 和久
Total Pages
358
Publisher
中外医学社
ISBN
9784498020740
Related Report
