| Project/Area Number |
17K15892
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Multi-year Fund |
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| Research Field |
General internal medicine(including psychosomatic medicine)
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| Research Institution | Shinshu University |
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Principal Investigator |
Kishida Dai 信州大学, 学術研究院医学系(医学部附属病院), 助教 (50467180)
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2018: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2017: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
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| Keywords | 家族性地中海熱 / 発熱発作 / 月経 / 誘発因子 / コルヒチン / 女性患者 / MEFV遺伝子 / 遺伝型 / 子宮内膜症 / 自己炎症疾患 / ホルモン療法 |
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| Outline of Final Research Achievements |
The clinical characteristics of the female patients whose attacks were triggered by menstruation (menstrual-related patients) was shown below. The age at onset and the age at diagnosis in these patients was significantly lower than that in non-menstrual-related patients. Moreover, the percentage of patients with peritonitis was significantly higher in menstrual-related patients. The frequency of attacks, the percentage of symptoms other than peritonitis, and the response to colchicine treatment were not significantly different between the two groups. The proportion of patients complicating endometriosis was significantly higher in the menstrual-related group. With regard to the genetic features, the frequency of p.M694I mutation was higher in menstrual-related patients, but this was not statistically significant.
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| Academic Significance and Societal Importance of the Research Achievements |
女性FMF患者において月経は最大の発作誘発因子となることが示された。月経の度に熱が出る患者に遭遇した際、FMFを想起することの重要性が示されたと言える。子宮内膜症の合併率は高く、子宮内膜症そのものも炎症が関与しているとする研究もあり、両者の関連は興味深い。その他の発作誘発因子と異なり、月経は分かっていても回避することが難しいものではあるが、コルヒチン不応例、不耐例に対し、ホルモン療法が代替治療の一つになる可能性が示唆された。
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