Elucidation of pathophysiology of gastrointestinal motility abnormalities in patients with systemic sclerosis

• Project/Area Number: 18K15772
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53010:Gastroenterology-related
• Research Institution: Gunma University
• Principal Investigator: 栗林 志行 群馬大学, 医学部附属病院, 助教 (60726173)
• Project Period (FY): 2018-04-01 – 2024-03-31
• Project Status: Completed (Fiscal Year 2023)
• Budget Amount: ¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000); Fiscal Year 2020: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000); Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2018: ¥2,600,000 (Direct Cost: ¥2,000,000、Indirect Cost: ¥600,000)
• Keywords: 全身性強皮症 / 食道運動障害 / 逆流性食道炎 / 間質性肺炎 / 消化管運動障害

Outline of Annual Research Achievements

全身性強皮症患者において胃排出能測定を行い、胃排出遅延と食道運動障害との関連性及び胃排出遅延と他臓器疾患との関連性を検討する研究を計画した。胃排出検査で国内未承認の13C標識化合物を使用することから、特定臨床研究として認定IRBの承認を得て、研究実施体制は整え、登録・実施を開始した。
COVID-19感染拡大の影響で、上記の呼気試験を用いた研究は感染リスクが高く、研究を完遂することができなかったため、全身性強皮症患者における食道運動障害と皮膚硬化および間質性肺炎との関連性を明らかにした（Kuribayashi S, et al. J Gastroenterol 2019 Nov;54(11):950-962.）。また、全身性強皮症患者における薬物治療抵抗性の逆流性食道炎の頻度とリスク因子を検討する研究を行い、UEGW2022で発表し、論文として発表した（Kuribayashis, et al. J Gastroenterol 2024 Mar;59(3):179-186.）。
また、全身性強皮症患者では食道の固有筋層の萎縮が認められることから、内視鏡治療を行う際には注意が必要であることを発表した（Kuribayashi S, et al. Gastrointest Endosc 2020; 91(2):441-442、Kuribayashi S, et al. Dig Endosc 2020; 32(7): 1116）。
なお、本研究に関係する食道運動障害を上部消化管内視鏡検査を用いて評価する方法についてまとめ、発表した（Kuribayashi S, et al. Dig Endosc 2021 Jul;33(5):744-745.）。また、本研究に関係する食道運動障害を来たす疾患として好酸球性食道炎に注目し、Red dichromatic imagingを用いた内視鏡評価に関して発表した（Kuribayashi S, et al. Gastrointest Endosc in press）。

Research Products

• [Journal Article] How to diagnose esophageal motility disorders? (2024)
  • Author(s): 栗林 志行、保坂 浩子、浦岡 俊夫
  • Journal Title: Nippon Shokakibyo Gakkai Zasshi Volume: 121 Issue: 2 Pages: 84-95
  • DOI: 10.11405/nisshoshi.121.84
  • ISSN: 0446-6586, 1349-7693
  • Year and Date: 2024-02-10
• [Journal Article] Prevalence and risk factors for medication-refractory reflux esophagitis in patients with systemic sclerosis in Japan (2024)
  • Author(s): Kuribayashi Shiko、Nakamura Fumihiko、Motegi Sei-Ichiro、Hara Kenichiro、Hosaka Hiroko、Sekiguchi Akiko、Ishikawa Mai、Endo Yukie、Harada Tomonari、Sorimachi Hidemi、Obokata Masaru、Uchida Mitsuo、Yamaguchi Koichi、Uraoka Toshio
  • Journal Title: Journal of Gastroenterology Volume: 59 Issue: 3 Pages: 179-186
  • DOI: 10.1007/s00535-024-02076-0
  • Peer Reviewed / Open Access
• [Journal Article] A new grading assessment of eosinophilic esophagitis using red dichromatic imaging: A pilot study (2024)
  • Author(s): Kuribayashi Shiko、Hosaka Hiroko、Tomaru Shota、Sato Keigo、Itoi Yuki、Hashimoto Yu、Kasuga Kengo、Tanaka Hirohio、Takeuchi Yoji、Uraoka Toshio
  • Journal Title: Gastrointestinal Endoscopy Volume: - Issue: 2 Pages: 300-304
  • DOI: 10.1016/j.gie.2024.02.007
  • Peer Reviewed / Open Access
• [Journal Article] Usefulness of Endoscopy for the Detection and Diagnosis of Primary Esophageal Motility Disorders and Diseases Relating to Abnormal Esophageal Motility (2023)
  • Author(s): Kuribayashi S, Hosaka H, Uraoka T.
  • Journal Title: Diagnostics (Basel) Volume: 13 (4) Issue: 4 Pages: 695-695
  • DOI: 10.3390/diagnostics13040695
  • Peer Reviewed / Open Access
• [Journal Article] Utility of a new automated diagnostic program in high-resolution esophageal manometry. (2021)
  • Author(s): Kuribayashi S, Akiyama J, Ikeda H, Nagai K, Hosaka H, Hamada M, Onimaru M, Kawami N, Hayashi K, Iwakiri K, Inoue H, Kusano M, Uraoka T.
  • Journal Title: Journal of Gastroenterology Volume: 56 (7) Issue: 7 Pages: 633-639
  • DOI: 10.1007/s00535-021-01794-z
  • Peer Reviewed / Open Access
• [Journal Article] Impact of improvement of sleep disturbance on symptoms and quality of life in patients with functional dyspepsia. (2021)
  • Author(s): Nakamura F, Kuribayashi S, Tanaka F, Kawami N, Iwakiri K, Fujiwara Y, Kusano M, Uraoka T.
  • Journal Title: BMC Gastroenterology Volume: 21 (1) Issue: 1 Pages: 78-78
  • DOI: 10.1186/s12876-021-01659-y
  • Peer Reviewed
• [Journal Article] The role of endoscopy in the management of gastroesophageal reflux disease. (2021)
  • Author(s): Kuribayashi S, Hosaka H, Nakamura F, Nakata K, Sato K, Itoi Y, Hashimoto Y, Kasuga K, Tanaka H, Uraoka T.
  • Journal Title: DEN Open Volume: 2 (1) Issue: 1
  • DOI: 10.1002/deo2.86
  • Peer Reviewed / Open Access
• [Journal Article] Response to the letter by Dr. Costa-Moreira, Dr. Peixoto, Dr. Ramalho, and Dr. Macedo regarding our manuscript: "Relationship between esophageal motility abnormalities and skin or lung involvements in patients with systemic sclerosis" (2020)
  • Author(s): Kuribayashi S, Motegi SI, Hara K, Sekiguchi A, Hosaka H, Kusano M, Uraoka T.
  • Journal Title: Journal of Gastroenterology Volume: 55 Issue: 2 Pages: 246-247
  • DOI: 10.1007/s00535-019-01630-5
  • Peer Reviewed
• [Journal Article] Possible causes of a focal esophageal muscle defect (2020)
  • Author(s): Kuribayashi S, Kuwano H, Uraoka T.
  • Journal Title: Digestive Endoscopy Volume: 32 Issue: 7 Pages: 1116-1116
  • DOI: 10.1111/den.13818
  • Peer Reviewed
• [Journal Article] Can esophageal motility disorders be detected by esophagogastroduodenoscopy? (2020)
  • Author(s): Kuribayashi S, Uraoka T.
  • Journal Title: Digestive Endoscopy Volume: N/A Issue: 5 Pages: 744-745
  • DOI: 10.1111/den.13909
  • Peer Reviewed
• [Journal Article] Risk of perforation during endoscopic resection of esophageal lesions in patients with systemic sclerosis (2020)
  • Author(s): Kuribayashi S, Matsumura N, Sohda M, Kuwano H, Uraoka T
  • Journal Title: Gastrointestinal Endoscopy Volume: 91 Issue: 2 Pages: 441-442
  • DOI: 10.1016/j.gie.2019.08.016
  • Peer Reviewed
• [Journal Article] Relationship between esophageal motility abnormalities and skin or lung involvements in patients with systemic sclerosis (2019)
  • Author(s): Kuribayashi S, Motegi S, Hara K, Shinomaya Y, Hosaka H, Sekiguchi A, Yamaguchi K, Kawamura O, Hisada T, Ishikawa O, Kusano M, Uraoka T.
  • Journal Title: Journal of Gastroenterology Volume: in press Issue: 11 Pages: 950-962
  • DOI: 10.1007/s00535-019-01578-6
  • Peer Reviewed / Int'l Joint Research
• [Presentation] 全身性強皮症患者におけるmultiple rapid swallowsによる食道運動の評価 (2024)
  • Author(s): 本多夏穂、栗林志行、保坂浩子、都丸翔太、佐藤圭吾、糸井祐貴、橋本悠、田中寛人、竹内洋司、浦岡俊夫
  • Organizer: 第20回日本消化管学会総会学術集会（GI Week 2024）
• [Presentation] A NEW ENDOSCOPIC GRADING ASSESSMENT USING RED DICHROMATIC IMAGING IN PATIENTS WITH EOSINOPHILIC ESOPHAGITIS (2023)
  • Author(s): Kuribayashi S, Hosaka H, Itoi Y, Sato K, Hashimoto Y, Kasuga K, Tanaka H, Uraoka T.
  • Organizer: DDW2023
  • Int'l Joint Research
• [Presentation] Red dichromatic imagingを用いた好酸球性食道炎の内視鏡評価 (2023)
  • Author(s): 栗林志行、保坂浩子、浦岡俊夫
  • Organizer: 第105回日本消化器内視鏡学会総会
• [Presentation] 全身性強皮症患者における胃食道逆流症状とディスペプシア症状との関連性 (2023)
  • Author(s): 栗林志行、保坂浩子、都丸翔太、佐藤圭吾、糸井祐貴、橋本悠、田中寛人、竹内洋司、浦岡俊夫
  • Organizer: 第25回日本神経消化器病学会
• [Presentation] Red dichromatic imagingを併用した好酸球性食道炎の内視鏡評価 (2023)
  • Author(s): 栗林志行、保坂浩子、浦岡俊夫
  • Organizer: JDDW2023
• [Presentation] Vonoprazan or more than double-dose proton pump inhibitor maintenance therapy should be performed in patients with systemic sclerosis with absent contractility (2022)
  • Author(s): Kuribayashi S, Nakamura F, Motegi S, Hara K, Hosaka H, Ishikawa M, Endo Y, Obokata M, Harada T, Uchida M, Uraoka T.
  • Organizer: UEGW2022
  • Int'l Joint Research
• [Presentation] High-resolution manometry自動診断ソフトの有用性 (2021)
  • Author(s): 栗林志行、秋山純一、池田晴夫、長井万恵、保坂浩子、濱田麻梨子、鬼丸学、井上晴洋、浦岡俊夫
  • Organizer: 第17回日本消化管学会総会学術集会
• [Presentation] 睡眠障害の改善が便秘症状の与える影響 (2021)
  • Author(s): 中村文彦、栗林志行、根本夕夏子、田中史生、川見典之、藤原靖弘、岩切勝彦、草野元康、浦岡俊夫
  • Organizer: 第17回日本消化管学会総会学術集会
• [Presentation] High-resolution manometry を用いた食道運動評価 (2021)
  • Author(s): 栗林志行
  • Organizer: 第75回日本食道学会学術集会
  • Invited
• [Presentation] 全身性強皮症患者における食道運動障害と食道胃接合部バリア機能の関連について (2021)
  • Author(s): 栗林志行、保坂浩子、田中寛人、浦岡俊夫
  • Organizer: 第113回日本消化器内視鏡学会関東支部例会
• [Presentation] Vonoprazan maintenance therapy is more effective than standard dose proton pump inhibitor maintenance therapy in patients with systemic sclerosis (2020)
  • Author(s): Kuribayashi S, Hosaka H, Motegi S, Hara K, Sekiguchi A, Shimoyama Y, Kawamura O, Kusano M, Uraoka T.
  • Organizer: DDW2020
  • Int'l Joint Research
• [Presentation] Efficacy of proton pump inhibitors and vonoprazan for reflux esophagitis in patients with systemic sclerosis (2020)
  • Author(s): Kuribayashi S, Hosaka H, Uraoka T.
  • Organizer: 第99回日本消化器内視鏡学会総会
  • Int'l Joint Research
• [Presentation] 逆流性食道炎患者における食道胃接合部形態とGastroesophageal flap valveを組み合わせた新規胃食道逆流症のリスク評価の可能性 (2020)
  • Author(s): 栗林志行、保坂浩子、茂木精一郎、関口明子、下山康之、石川治、浦岡俊夫
  • Organizer: 第16回日本消化管学会学術集会
• [Presentation] 全身性強皮症患者における食道運動障害と逆流性食道炎コントロール及び酸分泌抑制薬選択の違い (2019)
  • Author(s): 栗林志行、保坂浩子、浦岡俊夫
  • Organizer: 第97回日本消化器内視鏡学会総会
• [Presentation] Gastroesophageal reflux disease in patients with systemic sclerosis (2019)
  • Author(s): Kuribayashi S, Hosaka H, Motegi S, Hara K, Sekiguchi A, Yamaguchi K, Shimoyama Y, Kusano M, Uraoka T
  • Organizer: OESO2019
  • Int'l Joint Research
• [Presentation] Relationship between dyspeptic symptoms and esophageal motility in patients with systemic sclerosis (2019)
  • Author(s): Kuribayashi S, Hosaka H, Uraoka T
  • Organizer: JDDW2019
• [Presentation] STANDARD DOSE OF PROTON PUMP INHIBITORS CANNOT CONTROL REFLUX ESOPHAGITIS ENOUGH IN PATIENTS WITH SYSTEMIC SCLEROSIS WHO HAVE ABSENT PERISTALSIS AND WEAK ESOPHAGO-GASTRIC JUNCTION BARRIER FUNCTION (2018)
  • Author(s): Kuribayashi S, Shinomaya Y, Hosaka H, S, Hara K, Sekiguchi A, Yamaguchi K, Kawamura O, Kusano M.
  • Organizer: DDW2018
  • Int'l Joint Research
• [Presentation] Relationship between esophageal motility abnormalities and skin involvements in patients with systemic sclerosis: Multivariate analysis (2018)
  • Author(s): Kuribayashi S, Shinomaya Y, Hosaka H, S, Hara K, Sekiguchi A, Yamaguchi K, Kawamura O, Kusano M, Uraoka T.
  • Organizer: UEGW2018
  • Int'l Joint Research