Investigation of the pathophysiology and the treatment for pulmonary fibrosis associated with bronchopulmonary dysplasia

• Project/Area Number: 19K08315
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 52050:Embryonic medicine and pediatrics-related
• Research Institution: Tohoku University
• Principal Investigator: Ota Chiharu 東北大学, 医学系研究科, 教授 (00733106)
• Co-Investigator(Kenkyū-buntansha): 山田 充啓 東北大学, 大学病院, 講師 (00396483) ; 埴田 卓志 東北大学, 大学病院, 講師 (30400360) ; 菊池 敦生 東北大学, 大学病院, 助教 (30447156) ; 小山 涼子 (齋藤涼子 / 齊藤 涼子) 東北大学, 医学系研究科, 非常勤講師 (30733349) ; 大田 英揮 東北大学, 医学系研究科, 准教授 (40586905) ; 木村 正人 東北大学, 大学病院, 助教 (80646894)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Project Status: Completed (Fiscal Year 2022)
• Budget Amount: ¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000); Fiscal Year 2021: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2020: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2019: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
• Keywords: 未熟児慢性肺疾患 / 肺高血圧症 / 肺胞上皮細胞 / 肺発生 / 肺volumetry / 肺高血圧 / 肺ボリュメトリ / 気腫 / 線維化 / 肺発達 / 慢性肺疾患 / 肺胞上皮幹細胞 / サーファクタント / 早産低出生体重児 / 間質性肺炎 / 肺血管拡張薬 / 抗線維化薬 / 肺血管内皮細胞 / 肺胞傷害

Outline of Research at the Start

周産期医療の発達に伴い，超低出生体重児の救命率は上昇している一方，少ない週数で
出生した児は気管支肺異形成症（BPD）を発症しやすく，20％程度に肺高血圧（PH）を合併する．このようなBPD-PH症例では呼吸不全と右心不全を合併し，PHを伴わない症例に比して生命予後が悪いが，発症メカニズムは解明されておらず，確立された治療法はない．
本研究ではBPD-PHの発症メカニズムを肺胞構成細胞レベルで解明し，薬物による治療介入の可能性を検討する．所属機関に保存してあるヒト胎児／新生児肺組織を用いた免疫染色・RNAseq，マウス肺胞構成細胞を用いたスフェロイドアッセイ，マウスBPD-PHモデルを構築する．

Outline of Final Research Achievements

The purpose of this study was to clarify the pathogenesis of pulmonary hypertension associated with chronic lung disease in premature infants (BPD-PH).
Immunostaining with alveolar epithelial cell markers and vascular endothelial cell markers was performed using BPD-PH patient lungs (transplant donor lungs), and the distribution in BPD-PH patient lungs was investigated. We analyzed the CT findings of a BPD-PH patient who had been treated with pulmonary vasodilators for 10 years, performed volumetry using analysis software, and reported the results in a paper together with the case. Using commercially available isolated alveolar epithelial cells and pulmonary fibroblasts, we seeded them on Matrigel and performed alveolar-like organoid/spheroid formation experiments under the conditions of adding various growth factors.

Academic Significance and Societal Importance of the Research Achievements

世界で初のBPD-PH小児移植肺の検討から，肺発生段階の途上で出生した児の肺の状態が明らかになったことによって，出生週数が年々早くなっている超低出生体重児の治療法について再考する契機となる．また，小児肺CTを用いたvolumetryはまだ一般的ではなかったが，本研究でvolumetryをindexとして算出したことにより，今後の肺発達段階の評価法の一つとなる可能性がある．さらに，本研究によって，未熟児慢性肺疾患に伴う肺高血圧症の治療法開発が進展する可能性がある．

Research Products

• [Journal Article] Two Distinct Cases of Adult-onset Kawasaki Disease (2022)
  • Author(s): Onoki Takehiko、Metoki Takaya、Iwasawa Shinya、Kawano Kengo、Kimura Masato、Kure Shigeo、Ota Chiharu
  • Journal Title: Internal Medicine Volume: 61 Issue: 23 Pages: 3525-3529
  • DOI: 10.2169/internalmedicine.9044-21
  • ISSN: 0918-2918, 1349-7235
  • Year and Date: 2022-12-01
  • Peer Reviewed / Open Access
• [Journal Article] Male infant with Noonan syndrome with RAF-1 gene mutation who survived hypertrophic cardiomyopathy-induced fatal heart failure and uncontrollable arrhythmias (2022)
  • Author(s): Hagino Mao、Ota Chiharu、Onoki Takehiko、Iwasawa Shinya
  • Journal Title: BMJ Case Reports Volume: 15 Issue: 9 Pages: e250342-e250342
  • DOI: 10.1136/bcr-2022-250342
  • Peer Reviewed / Open Access
• [Journal Article] Bilateral lung transplantation in a 9-year-old girl with bronchopulmonary dysplasia with pulmonary hypertension. (2021)
  • Author(s): Chiharu Ota, Ryoko Saito, Junya Tominaga, Shinya Iwasawa, Takashi Hirama, Yasushi Matsuda, Katsunori Ono, Takehiko Onoki, Masato Kimura, Yoshinori Kawabata, Yoshinori Okada
  • Journal Title: Pediatric Pulmonology Volume: 56 Issue: 10 Pages: 3417-3421
  • DOI: 10.1002/ppul.25597
  • Peer Reviewed / Open Access
• [Journal Article] Thoracic Empyema Secondary to Congenital Chylothorax in a 14-Month-Old Boy with Noonan Syndrome. (2021)
  • Author(s): Takeru Oikawa, Chiharu Ota, Shinya Iwasawa, Takehiko Onoki, Hideyuki Ikeda, Takushi Hanita
  • Journal Title: Case Rep Pediatr Volume: 6620353 Pages: 1-5
  • DOI: 10.1155/2021/6620353
  • Peer Reviewed / Open Access
• [Journal Article] Thoracic Empyema Secondary to Congenital Chylothorax in a 14-Month-Old Boy with Noonan syndrome (2021)
  • Author(s): Takeru Oikawa, Chiharu Ota, Shinya Iwasawa, Takehiko Onoki, Hideyuki Ikeda, and Takushi Hanita
  • Journal Title: Casae report in Pediatrics Volume: -
  • Peer Reviewed / Open Access
• [Journal Article] Extracellular‐Matrix‐Reinforced Bioinks for 3D Bioprinting Human Tissue (2020)
  • Author(s): De Santis Martina M, Alsafadi Hani N, Tas Sinem, Ota Chiharu, Wagner Darcy E, et al..
  • Journal Title: Advanced Materials Volume: 33 Issue: 3 Pages: 2005476-2005476
  • DOI: 10.1002/adma.202005476
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Wnt/β-catenin signaling is critical for regenerative potential of distal lung epithelial progenitor cells in homeostasis and emphysema (2020)
  • Author(s): Hu Yan、Ng-Blichfeldt John-Poul、Ota Chiharu、Ciminieri Chiara、Ren Wenhua、Hiemstra Pieter S.、Stolk Jan、Gosens Reinoud、K?nigshoff Melanie
  • Journal Title: STEM CELLS Volume: 38 Issue: 11 Pages: 1467-1478
  • DOI: 10.1002/stem.3241
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Preoperative administration of propranolol reduced the surgical risks of PHACES syndrome in a 14-month-old girl (2019)
  • Author(s): Rokugo Yuka、Ota Chiharu、Kimura Masato、Sasahara Yoji
  • Journal Title: BMJ Case Reports Volume: 12 Issue: 4 Pages: e228117-e228117
  • DOI: 10.1136/bcr-2018-228117
• [Journal Article] Improving the viability of tissue‐resident stem cells using an organ‐preservation solution (2019)
  • Author(s): Suzuki Takaya、Ota Chiharu、Fujino Naoya、Tando Yukiko、Suzuki Satoshi、Yamada Mitsuhiro、Kondo Takashi、Okada Yoshinori、Kubo Hiroshi
  • Journal Title: FEBS Open Bio Volume: 9 Issue: 12 Pages: 2093-2104
  • DOI: 10.1002/2211-5463.12748
  • Peer Reviewed / Open Access
• [Presentation] 当院小児科および循環器内科でフォロー中の異なる年齢層の成人期Eisenmenger症候群症例の検討 (2020)
  • Author(s): 大田千晴，岩澤伸哉，大軒健彦，木村正人，六郷由佳，建部俊介
  • Organizer: 小児循環器学会
• [Presentation] Bilateral lung transplantation (BLTx) in a 9-year-old girl with pulmonary hypertension associated with severe bronchopulmonary dysplasia (BPD) (2019)
  • Author(s): Chiharu Ota, Masato Kimura, Yasushi Matsuda, Shinya Iwasawa, Ryoko Saito, Yoshinori Kawabata, Shigeo Kure, Yoshinori Okada
  • Organizer: American Thoracic Society
  • Int'l Joint Research