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Trauma-specific memory-like regulatory T-cell responses and fundamental research for clinical translation

Research Project

Project/Area Number 19H03759
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeSingle-year Grants
Section一般
Review Section Basic Section 55060:Emergency medicine-related
Research InstitutionOsaka Medical and Pharmaceutical University (2020-2021)
Osaka University (2019)

Principal Investigator

Yamakawa Kazuma  大阪医科薬科大学, 医学部, 准教授 (50597507)

Co-Investigator(Kenkyū-buntansha) 小倉 裕司  大阪大学, 医学系研究科, 准教授 (70301265)
藤見 聡  地方独立行政法人大阪府立病院機構大阪急性期・総合医療センター(臨床研究支援センター), 救急診療科, 主任部長 (70362720)
谷口 高平  大阪医科薬科大学, 医学部, 講師 (70779686)
嶋津 岳士  大阪大学, 医学系研究科, 教授 (50196474)
吉村 旬平  地方独立行政法人大阪府立病院機構大阪急性期・総合医療センター(臨床研究支援センター), 救急診療科, 医師 (30835202)
松原 庸博  大阪大学, 医学部附属病院, 医員 (70747154)
Project Period (FY) 2019-04-01 – 2022-03-31
Project Status Completed (Fiscal Year 2021)
Budget Amount *help
¥17,420,000 (Direct Cost: ¥13,400,000、Indirect Cost: ¥4,020,000)
Fiscal Year 2021: ¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2020: ¥5,330,000 (Direct Cost: ¥4,100,000、Indirect Cost: ¥1,230,000)
Fiscal Year 2019: ¥7,670,000 (Direct Cost: ¥5,900,000、Indirect Cost: ¥1,770,000)
Keywords制御性T細胞 / 外傷 / マスサイトメトリー / CyTOF / COVID-19 / 免疫応答
Outline of Research at the Start

外傷や大手術など高度な生体侵襲を受けた患者では、複雑な生体反応が惹起され免疫系
の恒常性が破綻する。それら過大侵襲を受けた際に重要な働きをするのが、免疫寛容の中心をなす制御性T細胞である。本研究は、制御性T細胞がいかにして外傷後の免疫恒常性の維持に寄与するか、その動態制御機序を解明することを目的とする。CyTOFマスサイトメトリーを用いた網羅的細胞解析を用い、基礎研究・臨床研究の両面から外傷後の免疫恒常性破綻の本質解明にアプローチする。外傷後の遅発死亡の軽減を目指し、制御性T細胞を介入点とし免疫恒常性バランスをターゲットとする新たな治療戦略構築へ向けた方向性を提示する。

Outline of Final Research Achievements

We examined the dynamic regulation of memory regulatory T cells (Treg), which are positioned as one of the fundamental regulatory mechanisms of immune response after severe trauma. In a mouse trauma model using adoptive transfer, Tregs, expanded in response to secondary trauma, strongly expressed memory markers and have a trauma-specific immune memory function as memory Tregs. CyTOF mass cytometry analysis revealed that memory Tregs in response to secondary trauma showed enhanced expression of specific antigens such as GITR, CTLA-4, ICOS, and Helios. These responses were mediated by the T cell receptor signaling pathway via the MHC class II. Clinical investigation using trauma patient samples revealed an increased Treg phenotype similar to the trauma-specific memory Tregs identified in mice and showed persistent expression up to 90 days post-injury.

Academic Significance and Societal Importance of the Research Achievements

本研究では、外傷受傷後の過剰炎症と過剰抗炎症のアンバランスが生じるメカニズムの一端について、動物モデルを用いた基礎研究ならびに臨床サンプルを用いた臨床研究の両面から明らかとした。炎症・抗炎症のバランス最適化を、Tregの活性化および反応性の調節により行うことができれば、これまで克服不可能であった外傷後亜急性期以降の死亡軽減に大きく寄与することが期待できる。今後は、外傷後のメモリーTregに関する更なる動態制御機序の解明と、将来のTregを介入点とする新たな治療戦略構築へ向けた研究を継続する。

Report

(4 results)
  • 2021 Annual Research Report   Final Research Report ( PDF )
  • 2020 Annual Research Report
  • 2019 Annual Research Report
  • Research Products

    (23 results)

All 2021 2020 2019

All Journal Article (20 results) (of which Int'l Joint Research: 3 results,  Peer Reviewed: 20 results,  Open Access: 19 results) Presentation (3 results) (of which Int'l Joint Research: 3 results,  Invited: 3 results)

  • [Journal Article] Prolonged enhancement of cytotoxic T lymphocytes in the post-recovery state of severe COVID-192021

    • Author(s)
      Mitsuyama Yumi、Yamakawa Kazuma、Kayano Katsuhide、Maruyama Miho、Wada Takeshi、Fujimi Satoshi
    • Journal Title

      Journal of Intensive Care

      Volume: 9 Issue: 1 Pages: 76-76

    • DOI

      10.1186/s40560-021-00591-3

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Optimal target blood pressure in critically ill adult patients with vasodilatory shock: a protocol for a systematic review and meta-analysis2021

    • Author(s)
      Fukui Satoshi、Higashio Koki、Murao Shuhei、Endo Akira、Akira Takasu、Yamakawa Kazuma
    • Journal Title

      BMJ Open

      Volume: 11 Issue: 3 Pages: e048512-e048512

    • DOI

      10.1136/bmjopen-2020-048512

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Effect of Earlier Door-to-CT and Door-to-Bleeding Control in Severe Blunt Trauma: A Retrospective Cohort Study2021

    • Author(s)
      Murao Shuhei、Yamakawa Kazuma、Kabata Daijiro、Kinoshita Takahiro、Umemura Yutaka、Shintani Ayumi、Fujimi Satoshi
    • Journal Title

      Journal of Clinical Medicine

      Volume: 10 Issue: 7 Pages: 1522-1522

    • DOI

      10.3390/jcm10071522

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Effect of tranexamic acid on thrombotic events and seizures in bleeding patients: a systematic review and meta-analysis2021

    • Author(s)
      Murao Shuhei、Nakata Hidekazu、Roberts Ian、Yamakawa Kazuma
    • Journal Title

      Critical Care

      Volume: 25 Issue: 1 Pages: 380-380

    • DOI

      10.1186/s13054-021-03799-9

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Seasonal Variation and Severity of Acute Abdomen in Japan: A Nine-Year Retrospective Analysis2021

    • Author(s)
      Yoshimoto Hidero、Yamakawa Kazuma、Umemura Yutaka、Fujii Kensuke、Nakamura Eriko、Taniguchi Kohei、Tanaka Keitaro、Takasu Akira、Uchiyama Kazuhisa
    • Journal Title

      Journal of Personalized Medicine

      Volume: 11 Issue: 12 Pages: 1346-1346

    • DOI

      10.3390/jpm11121346

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Time Trends of the Outcomes and Treatment Options for Disseminated Intravascular Coagulation: A Nationwide Observational Study in Japan2020

    • Author(s)
      Yamakawa K, Ohbe H, Taniguchi K, Matsui H, Fushimi K, Yasunaga H.
    • Journal Title

      JMA Journal

      Volume: 3 Issue: 4 Pages: 313-320

    • DOI

      10.31662/jmaj.2020-0013

    • NAID

      130007937202

    • ISSN
      2433-328X, 2433-3298
    • Year and Date
      2020-10-15
    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Underlying Disorders, Clinical Phenotypes, and Treatment Diversity among Patients with Disseminated Intravascular Coagulation2020

    • Author(s)
      Ohbe H, Yamakawa K, Taniguchi K, Morita K, Matsui H, Fushimi K, Yasunaga H.
    • Journal Title

      JMA Journal

      Volume: 3 Issue: 4 Pages: 321-329

    • DOI

      10.31662/jmaj.2020-0023

    • NAID

      130007937203

    • ISSN
      2433-328X, 2433-3298
    • Year and Date
      2020-10-15
    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Trauma induces expansion and activation of a memory‐like Treg population2020

    • Author(s)
      Yamakawa Kazuma、Tajima Goro、Keegan Joshua W.、Nakahori Yasutaka、Guo Fei、Seshadri Anupamaa J.、Cahill Laura A.、Lederer James A.
    • Journal Title

      Journal of Leukocyte Biology

      Volume: 109 Issue: 3 Pages: 645-656

    • DOI

      10.1002/jlb.4a0520-122r

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Comparative Analysis of Three Machine-Learning Techniques and Conventional Techniques for Predicting Sepsis-Induced Coagulopathy Progression2020

    • Author(s)
      Hasegawa Daisuke、Yamakawa Kazuma、Nishida Kazuki、Okada Naoki、Murao Shuhei、Nishida Osamu
    • Journal Title

      Journal of Clinical Medicine

      Volume: 9 Issue: 7 Pages: 2113-2113

    • DOI

      10.3390/jcm9072113

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Recombinant Thrombomodulin in Disseminated Intravascular Coagulation Associated with Stage IV Solid Tumors: A Nationwide Observational Study in Japan2020

    • Author(s)
      Taniguchi Kohei、Ohbe Hiroyuki、Yamakawa Kazuma、Matsui Hiroki、Fushimi Kiyohide、Yasunaga Hideo
    • Journal Title

      Thrombosis and Haemostasis

      Volume: 121 Issue: 01 Pages: 036-045

    • DOI

      10.1055/s-0040-1715840

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Antithrombin use and mortality in patients with stage IV solid tumor-associated disseminated intravascular coagulation: a nationwide observational study in Japan2020

    • Author(s)
      Taniguchi Kohei、Ohbe Hiroyuki、Yamakawa Kazuma、Matsui Hiroki、Fushimi Kiyohide、Yasunaga Hideo
    • Journal Title

      BMC Cancer

      Volume: 20 Issue: 1 Pages: 867-867

    • DOI

      10.1186/s12885-020-07375-2

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Galapagosization of sepsis management in Japan: a nationwide survey of current practices2020

    • Author(s)
      Yamakawa Kazuma、Hasegawa Daisuke、Yasuda Hideto、Sakamoto So、Nishida Kazuki、Yatabe Tomoaki、Egi Moritoki、Ogura Hiroshi、Nishida Osamu、the committee of Japanese Clinical Practice Guidelines for Management of Sepsis, Septic Shock 2016 (J‐SSCG 2016)
    • Journal Title

      Acute Medicine & Surgery

      Volume: 7 Issue: 1

    • DOI

      10.1002/ams2.561

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Identifying Septic Shock Populations Benefitting from Polymyxin B Hemoperfusion2020

    • Author(s)
      Nakata Hidekazu、Yamakawa Kazuma、Kabata Daijiro、et al.
    • Journal Title

      SHOCK

      Volume: in press Issue: 5 Pages: 667-674

    • DOI

      10.1097/shk.0000000000001533

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Potential impacts of a novel integrated extracorporeal-CPR workflow using an interventional radiology and immediate whole-body computed tomography system in the emergency department2020

    • Author(s)
      Hayashida Kei、Kinoshita Takahiro、Yamakawa Kazuma、Miyara Santiago J.、Becker Lance B.、Fujimi Satoshi
    • Journal Title

      BMC Cardiovascular Disorders

      Volume: 20 Issue: 1 Pages: 23-23

    • DOI

      10.1186/s12872-020-01332-4

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Clinical Significance of MicroRNAs in Patients with Sepsis: Protocol for a Systematic Review and Meta-Analysis2019

    • Author(s)
      Hasegawa Daisuke、Yamakawa Kazuma、Taniguchi Kohei、Murao Shuhei、Nishida Osamu
    • Journal Title

      Diagnostics

      Volume: 9 Issue: 4 Pages: 211-211

    • DOI

      10.3390/diagnostics9040211

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] A Systematic Summary of Systematic Reviews on Anticoagulant Therapy in Sepsis2019

    • Author(s)
      Murao Shuhei、Yamakawa Kazuma
    • Journal Title

      Journal of Clinical Medicine

      Volume: 8 Issue: 11 Pages: 1869-1869

    • DOI

      10.3390/jcm8111869

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Recombinant human soluble thrombomodulin in patients with sepsis-associated coagulopathy (SCARLET): an updated meta-analysis2019

    • Author(s)
      Yamakawa Kazuma、Levy Jerrold H.、Iba Toshiaki
    • Journal Title

      Critical Care

      Volume: 23 Issue: 1 Pages: 302-302

    • DOI

      10.1186/s13054-019-2587-2

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Identifying Sepsis Populations Benefitting from Anticoagulant Therapy: A Prospective Cohort Study Incorporating a Restricted Cubic Spline Regression Model2019

    • Author(s)
      Yamakawa Kazuma、Gando Satoshi、Ogura Hiroshi、et al.
    • Journal Title

      Thrombosis and Haemostasis

      Volume: 119 Issue: 11 Pages: 1740-1751

    • DOI

      10.1055/s-0039-1693740

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Interventional radiology versus operative management for splenic injuries: a study protocol for a systematic review and meta-analysis2019

    • Author(s)
      Kashiura Masahiro、Yada Noritaka、Yamakawa Kazuma
    • Journal Title

      BMJ Open

      Volume: 9 Issue: 8 Pages: e028172-e028172

    • DOI

      10.1136/bmjopen-2018-028172

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Significance of plasma fibrinogen level and antithrombin activity in sepsis: A multicenter cohort study using a cubic spline model2019

    • Author(s)
      Matsubara Tsunehiro、Yamakawa Kazuma、Umemura Yutaka、Gando Satoshi、Ogura Hiroshi、Shiraishi Atsushi、Kushimoto Shigeki、Abe Toshikazu、Tarui Takehiko、Hagiwara Akiyoshi、Otomo Yasuhiro、Fujimi Satoshi
    • Journal Title

      Thrombosis Research

      Volume: 181 Pages: 17-23

    • DOI

      10.1016/j.thromres.2019.07.002

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access
  • [Presentation] Recombinant Thrombomodulin for Sepsis-Induced Coagulopathy2019

    • Author(s)
      Kazuma YAMAKAWA
    • Organizer
      The International Society on Thrombosis and Haemostasis
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] Disseminated Intravascular Coagulation now and future…2019

    • Author(s)
      Kazuma YAMAKAWA
    • Organizer
      The 38th KSCCM Annual Congress and Acute Critical Care Conference
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] Optimal patient selectionfor anticoagulant therapy in sepsis2019

    • Author(s)
      Kazuma YAMAKAWA
    • Organizer
      IXth Congress of the Int'l Federation of Shock Societies
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research / Invited

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Published: 2019-04-18   Modified: 2023-01-30  

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