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Elucidation of the mechanism of joint destruction in rheumatoid arthritis: approach using high-resolution CT

Research Project

Project/Area Number 18K08390
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 54020:Connective tissue disease and allergy-related
Research InstitutionNagasaki University

Principal Investigator

Tamai Mami  長崎大学, 医歯薬学総合研究科(医学系), 准教授 (60380862)

Co-Investigator(Kenkyū-buntansha) 千葉 恒  長崎大学, 医歯薬学総合研究科(医学系), 助教 (00457574)
川尻 真也  長崎大学, 医歯薬学総合研究科(医学系), 講師 (20457576)
有馬 和彦  長崎大学, 医歯薬学総合研究科(医学系), 准教授 (30423635)
上谷 雅孝  長崎大学, 医歯薬学総合研究科(医学系), 教授 (40176582)
大山 要  長崎大学, 医歯薬学総合研究科(薬学系), 准教授 (50437860)
岩本 直樹  長崎大学, 医歯薬学総合研究科(医学系), 助教 (80437897)
川上 純  長崎大学, 医歯薬学総合研究科(医学系), 教授 (90325639)
Project Period (FY) 2018-04-01 – 2022-03-31
Project Status Completed (Fiscal Year 2021)
Budget Amount *help
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2020: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2019: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
Fiscal Year 2018: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
Keywords関節リウマチ / 関節破壊 / 高解像度CT(HRpQCT) / 骨関節破壊 / HR-pQCT / MRI / 関節超音波 / 高解像度CT / 関節裂隙 / 関節傷害 / 関節エコー
Outline of Final Research Achievements

Joints were evaluated using high-resolution peripheral quantitative CT (HR-pQCT) in active rheumatoid arthritis with a high rate of autoantibody positivity, MRI bone marrow edema, and active synovitis on ultrasound. After 1 year, 80% remission was achieved and less radiographic progression was observed. On the other hand, HR-pQCT showed changes, with five new bone erosions, but half of the existing erosions were reduced in size, with a decrease in volume and an increase in bone density. Joint space increased in volume and width. These findings differed between drugs, with 50% of methotrexate-treated patients and 30% of biologic-treated patients showing a decrease in both volume and width.HR-pQCT was able to detect bone and joint changes earlier than radiographs, MRI, or US.

Academic Significance and Societal Importance of the Research Achievements

高い解像度を有するHR-pQCTを用いて、関節リウマチ患者を対象に手指関節を治療経過と共に詳細に評価した。従来の高感度画像とされる超音波やMRIの研究では得られなかった知見を今回観察することができた。すなわち、関節裂隙、骨びらん、骨微細構造(骨粗鬆)の治療による経過が少ない症例ながら明らかになった。薬剤間で所見の違いが認められ、更なる研究の推進が望まれる。今後、日常診療に有用な知見を得られる可能性が高い。

Report

(5 results)
  • 2021 Annual Research Report   Final Research Report ( PDF )
  • 2020 Research-status Report
  • 2019 Research-status Report
  • 2018 Research-status Report
  • Research Products

    (5 results)

All 2021 2020 2019

All Journal Article (2 results) Presentation (3 results) (of which Int'l Joint Research: 1 results,  Invited: 1 results)

  • [Journal Article] 関節リウマチの診断:画像診断の最新知見2021

    • Author(s)
      辻 良香、玉井慎美、川尻真也、川上 純
    • Journal Title

      日本臨牀

      Volume: 79 Pages: 1302-1308

    • Related Report
      2021 Annual Research Report
  • [Journal Article] 関節リウマチの発症リスク因子2020

    • Author(s)
      玉井慎美
    • Journal Title

      リウマチ科

      Volume: 64 Pages: 387-395

    • Related Report
      2020 Research-status Report
  • [Presentation] MRI in Rheumatoid Arthritis2020

    • Author(s)
      Mami Tamai, Masataka Uetani, Kiyoshi Aoyagi, Katsumi Eguchi, Atsushi Kawakami
    • Organizer
      22nd Aisa-Pacific League of Associations for Rheumatology
    • Related Report
      2020 Research-status Report
    • Int'l Joint Research / Invited
  • [Presentation] MRIによる関節リウマチの関節裂隙狭小化の評価2019

    • Author(s)
      玉井慎美, 高谷亜由子, 大木 望, 上谷雅孝 岩本直樹, 古賀智裕, 有馬和彦, 青柳 潔, 川上 純
    • Organizer
      第47回日本臨床免疫学会総会
    • Related Report
      2019 Research-status Report
  • [Presentation] 早期RAにおけるMRI腱鞘炎の有用性の検討2019

    • Author(s)
      玉井慎美,Vincent Grundeken,有馬和彦,Robin ten Brinck, Annette H.M. van der Helm-van Mil,大木 望,上谷雅孝,川上 純
    • Organizer
      第63回日本リウマチ学会総会・学術集会
    • Related Report
      2019 Research-status Report

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Published: 2018-04-23   Modified: 2023-01-30  

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