| Project/Area Number |
17K17044
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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 |
Emergency medicine
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| Research Institution | Tokyo Medical and Dental University |
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Principal Investigator |
Shiota Nobuhiro 東京医科歯科大学, 医学部附属病院, 特任助教 (30771779)
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| Project Period (FY) |
2017-04-01 – 2021-03-31
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| Project Status |
Completed (Fiscal Year 2020)
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| Budget Amount *help |
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2018: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2017: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
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| Keywords | 集中治療医学 / 補助循環 / ECMO / 生理学 / 免疫学 / トランスレーショナルリサーチ / 細胞・組織 / 細胞外小胞 |
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| Outline of Final Research Achievements |
Extracorporeal membrane oxygenation (ECMO) is an indispensable tool in the ICU to rescue critically ill patients. Whereas ECMO provides an ultimate cardiorespiratory support for critically ill patients, this also incurs number of fatal complications including systemic inflammation resulting in multiple organ failure (MOF).
Microvesicles (MV) carry a variety molecular cargo providing an alternative pathway for intercellular communications thus could cause systemic inflammation. In this study, we developed an experimental ECMO model and investigated MV numbers and their subtypes in human blood plasma during an experimental ECMO run.
We demonstrated that blood cell-derived MV increased in plasma in proportion to pump speed. In addition, MV was increased earlier than free hemoglobin, a conventional cell damage marker. Our findings suggest that blood cell-derived MV may serve as a useful early biomarker of MOF in ECMO patients, which warrants further investigation.
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| Academic Significance and Societal Importance of the Research Achievements |
ECMOは最重症の呼吸・循環不全患者に用いられる長期使用型人工心肺装置であるが、依然としてECMO 症例の致死率は50%程度と高値であり、その合併症の軽減及び予後の改善は社会経済にも大きな影響を与える。本研究では、実験モデルを用いて、細胞外小胞の一種であるMicrovesicles(MV)がECMO管理中に血中で増加することを示した。本研究は、血球細胞由来のMVの多臓器不全の新規バイオマーカーとしての有用性及び、血球細胞由来のMVが多臓器不全の発症において重要な役割を果たしている可能性を示した。
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