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Development of selective immunosuppressive therapy preserving natural immunity for treating chronic rejection after lung transplantation

Research Project

Project/Area Number 18H02893
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeSingle-year Grants
Section一般
Review Section Basic Section 55040:Respiratory surgery-related
Research InstitutionNagoya University (2019-2020)
Kyoto University (2018)

Principal Investigator

Yoshikawa Toyofumi  名古屋大学, 医学系研究科, 教授 (00452334)

Co-Investigator(Kenkyū-buntansha) 進藤 岳郎  京都大学, 医学研究科, 助教 (10646706)
伊達 洋至  京都大学, 医学研究科, 教授 (60252962)
祝迫 惠子  同志社大学, 生命医科学部, 教授 (70625300)
吉澤 明彦  京都大学, 医学研究科, 准教授 (80378645)
Project Period (FY) 2018-04-01 – 2021-03-31
Project Status Completed (Fiscal Year 2020)
Budget Amount *help
¥16,770,000 (Direct Cost: ¥12,900,000、Indirect Cost: ¥3,870,000)
Fiscal Year 2020: ¥5,200,000 (Direct Cost: ¥4,000,000、Indirect Cost: ¥1,200,000)
Fiscal Year 2019: ¥5,330,000 (Direct Cost: ¥4,100,000、Indirect Cost: ¥1,230,000)
Fiscal Year 2018: ¥6,240,000 (Direct Cost: ¥4,800,000、Indirect Cost: ¥1,440,000)
Keywords肺移植 / 慢性拒絶 / 免疫抑制自然免疫 / 免疫抑制剤 / 自然免疫 / 免疫抑制 / 画像解析 / 新規治療 / MEK阻害剤 / 慢性移植肺機能不全
Outline of Final Research Achievements

The greatest cause to prevent long-term survival after lung transplantation is chronic allograft dysfunction (CLAD), which is mainly due to chronic rejection. The etiology of CLAD remains unknown and there is no proper therapy for progressive CLAD. Since lungs communicate with the outer world, immunity in lungs is developed, while lungs are susceptible to infection. Thus, in lung transplantation, it is crucial to develop a selective immune suppression which does not decrease immunity against infection. Herein, we focused on a MEK inhibitor (trametinib), which has a new mechanism for immunosuppression, as an immunosuppressant which does not decrease immunity against infection. We performed several studies to prove that a MEK inhibitor alleviated chronic rejection in a rat lung transplantation model.

Academic Significance and Societal Importance of the Research Achievements

世界だけでなく本邦においても、肺移植は年々増加しており、慢性呼吸不全に対する最後の砦としての医療として確立した。しかしながら長期予後は満足が行くものではない。現在、肺移植において最も克服すべき課題は、慢性期死亡の最大の原因である、「慢性拒絶」が主体の慢性期移植肺機能不全(CLAD)である。今回、我々は、感染に対する免疫力を低下させない「選択的な免疫抑制」に着眼し、免疫抑制剤としては新規のメカニズムを有する、MEK阻害剤(Trametinib)が、肺の慢性拒絶を軽減することを世界で初めて証明した。本研究の学術的的意義は大きく、今後、臨床応用を含めた展開が期待され、社会的意義も大きい。

Report

(4 results)
  • 2020 Annual Research Report   Final Research Report ( PDF )
  • 2019 Annual Research Report
  • 2018 Annual Research Report
  • Research Products

    (23 results)

All 2021 2020 2019 2018

All Journal Article (8 results) (of which Int'l Joint Research: 5 results,  Peer Reviewed: 7 results,  Open Access: 2 results) Presentation (14 results) (of which Int'l Joint Research: 4 results,  Invited: 6 results) Book (1 results)

  • [Journal Article] Native lung complications after living-donor lobar lung transplantation2021

    • Author(s)
      Mineura Katsutaka、Chen-Yoshikawa Toyofumi F.、Tanaka Satona、Yamada Yoshito、Yutaka Yojiro、Nakajima Daisuke、Ohsumi Akihiro、Hamaji Masatsugu、Menju Toshi、Date Hiroshi
    • Journal Title

      The Journal of Heart and Lung Transplantation

      Volume: - Issue: 5 Pages: 343-350

    • DOI

      10.1016/j.healun.2021.01.1562

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Protective effect of necrosulfonamide on rat pulmonary ischemia-reperfusion injury via inhibition of necroptosis2021

    • Author(s)
      Ueda Satoshi、Chen-Yoshikawa Toyofumi F.、Tanaka Satona、Yamada Yoshito、Nakajima Daisuke、Ohsumi Akihiro、Date Hiroshi
    • Journal Title

      The Journal of Thoracic and Cardiovascular Surgery

      Volume: - Issue: 2 Pages: e113-e122

    • DOI

      10.1016/j.jtcvs.2021.01.037

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Protective Effects of a Hydrogen-Rich Preservation Solution in a Canine Lung Transplantation Model2021

    • Author(s)
      Kayawake Hidenao、Chen-Yoshikawa Toyofumi F.、Saito Masao、Yamagishi Hiroya、Yoshizawa Akihiko、Hirano Shin-ich、Kurokawa Ryosuke、Date Hiroshi
    • Journal Title

      The Annals of Thoracic Surgery

      Volume: 111 Issue: 1 Pages: 246-252

    • DOI

      10.1016/j.athoracsur.2020.05.076

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Expanded indications for lung transplantation for pulmonary complications after hematopoietic stem cell transplantation2020

    • Author(s)
      Noguchi Misa、Chen-Yoshikawa Toyofumi F.、Arai Yasuyuki、Kondo Tadakazu、Ohsumi Akihiro、Nakajima Daisuke、Hamaji Masatsugu、Takita Junko、Takaori-Kondo Akifumi、Date Hiroshi
    • Journal Title

      The Journal of Thoracic and Cardiovascular Surgery

      Volume: - Issue: 4 Pages: 1549-1557.e4

    • DOI

      10.1016/j.jtcvs.2020.10.065

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] LPS-induced airway-centered inflammation leading to BOS-like airway remodeling distinct from RAS-like fibrosis in rat lung transplantation2020

    • Author(s)
      Takahagi Akihiro、Sato Masaaki、Chen-Yoshikawa Toyofumi F、Miyamoto Ei、Saito Masao、Gochi Fumiaki、Hamaji Masatsugu、Yoshizawa Akihiko、Terasaki Yasuhiro、Urushiyama Hirokazu、Aoyama Akihiro、Sonobe Makoto、Date Hiroshi
    • Journal Title

      Transplantation

      Volume: - Issue: 6 Pages: 1-1

    • DOI

      10.1097/tp.0000000000003097

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Trametinib attenuates delayed rejection and preserves thymic function following rat lung transplantation2019

    • Author(s)
      150.Takahagi A, Shindo T, Chen-Yoshikawa TF, Yoshizawa A, Gochi F, Miyamoto E, Saito M, Tanaka S, MotoyamaH, Date H
    • Journal Title

      Am J Respir Cell Mol Biol.

      Volume: 印刷中 Issue: 3 Pages: 3550366-3550366

    • DOI

      10.1165/rcmb.2018-0188oc

    • Related Report
      2019 Annual Research Report 2018 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Commentary: Promising future solution for unmet needs in lung transplantation.2019

    • Author(s)
      Chen-Yoshikawa TF
    • Journal Title

      J Thorac Cardiovasc Surg

      Volume: 157 Issue: 5 Pages: 2107-2108

    • DOI

      10.1016/j.jtcvs.2018.12.064

    • Related Report
      2019 Annual Research Report
  • [Journal Article] Intermediate outcomes of right-to-left inverted living-donor lobar lung transplantation.2019

    • Author(s)
      Chen-Yoshikawa TF, Tanaka S, Yamada Y, Yutaka Y, Nakajima D, Ohsumi A, Hamaji M, Menju T, Date H.
    • Journal Title

      Eur J Cardiothorac Surg

      Volume: 56 Issue: 6 Pages: 1046-1053

    • DOI

      10.1093/ejcts/ezz244

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed
  • [Presentation] 肺移植における抗体陽性診療のUpdate。Beyond臓器移植抗体陽性診療ガイドライン20182020

    • Author(s)
      芳川豊史
    • Organizer
      第54回日本移植学会総会
    • Related Report
      2020 Annual Research Report
    • Invited
  • [Presentation] 外科から内科にお願いしたいこと。2020

    • Author(s)
      芳川豊史、伊藤俊成、門松由佳、坪内秀樹、上野陽史、杉山燈人、後藤真輝、森俊輔、尾関直樹、羽切周平、中村彰太、福井高幸、川口晃司
    • Organizer
      第60回日本呼吸器学会学術講演会
    • Related Report
      2020 Annual Research Report
    • Invited
  • [Presentation] Ex vivo lung perfusionを用いたマージナルドナー肺の移植前治療2020

    • Author(s)
      中島大輔、芳川豊史、伊達洋至、Shaf Keshavjee
    • Organizer
      第54回日本移植学会総会
    • Related Report
      2020 Annual Research Report
  • [Presentation] FCγ受容体IIAの一塩基多型と肺移植後の感染性合併症との相関2020

    • Author(s)
      栢分秀直、芳川豊史、田中里奈、田中友加、大段秀樹、豊洋次郎、山田義人、大角明宏、中島大輔、濱路政嗣、江川裕人、伊達洋至
    • Organizer
      第54回日本移植学会総会
    • Related Report
      2020 Annual Research Report
  • [Presentation] Living lung transplantation2019

    • Author(s)
      Chen-Yoshikawa TF
    • Organizer
      7th Shenzhen International Conference on Thoracic Surgery Shenzhen (China)
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] 肺移植における悪性疾患2019

    • Author(s)
      陳 豊史、田中里奈、山田義人、豊洋次郎、中島大輔、大角明宏、濱路政嗣、伊達洋至
    • Organizer
      第57回日本癌治療学会学術集会
    • Related Report
      2019 Annual Research Report
  • [Presentation] 肺移植におけるドナー特異的抗体の検討2019

    • Author(s)
      陳 豊史、合地史明、大角明宏、田中里奈、山田義人、豊洋次郎、中島大輔、濱路政嗣、伊達洋至
    • Organizer
      第28回日本組織適合性学会大会
    • Related Report
      2019 Annual Research Report
  • [Presentation] 生体肺移植術後de novo DSAとHLA eplet ミスマッチの検討2019

    • Author(s)
      合地史明、陳 豊史、尾田博美、横山雄平、池田政樹、上田聡司、栢分秀直、徳野純子、山岸弘哉、田中里奈、山田義人、大角明宏、豊洋次郎、中島大輔、濱路政嗣、万木紀美子、菱田理恵、前川平、伊達洋至
    • Organizer
      第28回日本組織適合性学会大会
    • Related Report
      2019 Annual Research Report
  • [Presentation] Intermediate outcomes of right-to-left inverted living-dnor lobar lung transplantation2019

    • Author(s)
      Chen-Yoshikawa TF, Yamada Y, Yutaka Y, Nakajima D, Ohsumi A, Hamaji M, Date H
    • Organizer
      27th ESTS meeting (European Conference on General Thoracic Suergery)
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Comparison of De Novo Donor-Specific Anti-HLA Antibodies (DSAs) between Living-Donor Lobar Lung Transplantation and Cadaveric Lung Transplantation2019

    • Author(s)
      Chen-Yoshikawa TF, Gochi F, Ohsumi A Yamada Y, Yutaka Y, Nakajima D, Hamaji M, Date H
    • Organizer
      SHLT 39th Annual Meeting and Scientific Sessions
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Presentation] 肺移植における抗HLA 抗体診療の現状2018

    • Author(s)
      陳 豊史
    • Organizer
      第27回日本組織適合性学会大会
    • Related Report
      2018 Annual Research Report
    • Invited
  • [Presentation] 本邦の肺移植における組織適合性検査の現状と課題2018

    • Author(s)
      陳 豊史
    • Organizer
      第54回日本移植学会総会
    • Related Report
      2018 Annual Research Report
    • Invited
  • [Presentation] 肺移植におけるDSAの現状と今後2018

    • Author(s)
      陳 豊史
    • Organizer
      第5回日本移植学会スプリングセミナー
    • Related Report
      2018 Annual Research Report
    • Invited
  • [Presentation] Characteristics of de novo donor-specific anti-HLA antibodies (DSAs) in living-donor lobar and cadaveric lung transplantation.2018

    • Author(s)
      合地史明、陳豊史
    • Organizer
      ISHLT 38th Annual Meeting and Scientific Sessions
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research
  • [Book] 最新呼吸器内科・外科学2019

    • Author(s)
      伊達 洋至、平井 豊博
    • Total Pages
      9
    • Publisher
      メディカルレビュー社
    • ISBN
      9784779223150
    • Related Report
      2019 Annual Research Report

URL: 

Published: 2018-04-23   Modified: 2022-01-27  

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