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Study on the difference of severity and treatment response of pulmonary hypertension

Research Project

Project/Area Number 20K08428
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 53020:Cardiology-related
Research InstitutionFukushima Medical University

Principal Investigator

Nakazato Kazuhiko  福島県立医科大学, 医学部, 教授 (90363762)

Co-Investigator(Kenkyū-buntansha) 杉本 浩一  福島県立医科大学, 医学部, 准教授 (30404867)
三阪 智史  福島県立医科大学, 医学部, 助教 (50793080)
横川 哲朗  福島県立医科大学, 医学部, 助教 (80748773)
Project Period (FY) 2020-04-01 – 2023-03-31
Project Status Completed (Fiscal Year 2022)
Budget Amount *help
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2022: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2021: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2020: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Keywords肺高血圧症 / 重症度 / 治療反応性 / 遺伝子変異 / 遺伝子
Outline of Research at the Start

肺高動脈性肺高血圧症(PAH)に対する治療薬の開発や、慢性血栓塞栓性肺高血圧症(CTEPH)に対する手術あるいはカテーテル治療の進歩により、肺高血圧症の予後は非常に改善しているが、治療への反応が個々の患者により異なることも認識されるようになってきた。従来、治療の方法が大きな要因と考えられていたが、患者側の体質的な要因も寄与している可能性がある。その点が明らかになれば、より詳細な病型分類と治療選択が可能となり、肺高血圧症診療の進歩に寄与すると考える。
本研究ではPAHとCTEPH患者に、現在の標準的な治療介入を行なった際の治療反応性と患者個人の特性を比較することにより、その関連性を検討する。

Outline of Final Research Achievements

Mutant clonal hematopoiesis of JAK2, a Janus kinase, is frequently observed in patients with myeloproliferative disorders. Since myeloproliferative disorders are listed in group V of the WHO pulmonary hypertension classification, we focused on the JAK2-V617F mutation in hematopoietic stem cells.
We identified this mutation in 7.1% (5/70) of pulmonary hypertensive patients without hematologic disease, which is significantly more frequent than the 0% (0/83) in the symmetric group in the clinical practice.
In basic research, JAK2-V617F mutant (gain-of-function) mice, neutrophils from the mutant clone infiltrate the peri-pulmonary artery and promote pulmonary artery remodeling from activation of ALK1-Smad1/5/8 signaling via phosphorylation of STAT3, which is downstream of JAK2.

Academic Significance and Societal Importance of the Research Achievements

肺高血圧症は希少疾患ではあるが、その中においても病状の進行や治療反応性には個人差がある。肺高血圧症の病態メカニズムの多様性について、ヤヌスキナーゼであるJAK (Janus Activating Kinase) 2の変異クローン性造血の視点から検討した。
マウスを用いた基礎k的検討では、JAK2-V617F変異クローンの好中球が肺動脈周囲に浸潤し、JAK2-STAT3のリン酸化からALK1-Smad1/5/8シグナリングの活性化を介して肺動脈のリモデリング、さらには肺高血圧症の進展に関与することを突き止めた。さらにALK1の抑制が肺動脈リモデリングや肺高血圧発症の予防になること示した。

Report

(4 results)
  • 2022 Annual Research Report   Final Research Report ( PDF )
  • 2021 Research-status Report
  • 2020 Research-status Report
  • Research Products

    (15 results)

All 2022 2021 2020

All Journal Article (6 results) (of which Int'l Joint Research: 3 results,  Peer Reviewed: 6 results,  Open Access: 6 results) Presentation (7 results) (of which Int'l Joint Research: 3 results,  Invited: 2 results) Book (2 results)

  • [Journal Article] Prognostic Effects of Changes in Right Ventricular Fractional Area Change in Patients With Heart Failure2022

    • Author(s)
      Yukiko Sugawara, Akiomi Yoshihisa, Ryohei Takeishi, Himika Ohara, Fumiya Anzai, Yu Hotsuki, Koichiro Watanabe, Yu Sato, Satoshi Abe, Tomofumi Misaka, Takamasa Sato, Masayoshi Oikawa, Atushi Kobayashi, Kazuhiko Nakazato, Yasuhicka Takeishi
    • Journal Title

      Circulation Journal

      Volume: 86 Issue: 12 Pages: 1982-1989

    • DOI

      10.1253/circj.CJ-22-0212

    • ISSN
      1346-9843, 1347-4820
    • Year and Date
      2022-11-25
    • Related Report
      2022 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Clonal hematopoiesis and cardiovascular diseases: role of JAK2V617F2022

    • Author(s)
      Misaka Tomofumi、Kimishima Yusuke、Yokokawa Tetsuro、Ikeda Kazuhiko、Takeishi Yasuchika
    • Journal Title

      Journal of Cardiology

      Volume: - Issue: 1 Pages: 3-9

    • DOI

      10.1016/j.jjcc.2022.02.001

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Clonal Hematopoiesis and JAK2V617F Mutations in Patients With Cardiovascular Disease2021

    • Author(s)
      Yokokawa Tetsuro、Misaka Tomofumi、Kimishima Yusuke、Wada Kento、Minakawa Keiji、Kaneshiro Takashi、Yoshihisa Akiomi、Ikeda Kazuhiko、Takeishi Yasuchika
    • Journal Title

      JACC: CardioOncology

      Volume: 3 Issue: 1 Pages: 134-136

    • DOI

      10.1016/j.jaccao.2021.01.001

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Clonal hematopoiesis with JAK2V617F promotes pulmonary hypertension with ALK1 upregulation in lung neutrophils2021

    • Author(s)
      Kimishima Yusuke、Misaka Tomofumi、Yokokawa Tetsuro、Wada Kento、Ueda Koki、Sugimoto Koichi、Minakawa Keiji、Nakazato Kazuhiko、Ishida Takafumi、Oshima Motohiko、Koide Shuhei、Shide Kotaro、Shimoda Kazuya、Iwama Atsushi、Ikeda Kazuhiko、Takeishi Yasuchika
    • Journal Title

      Nature Communications

      Volume: 12 Issue: 1 Pages: 6177-6177

    • DOI

      10.1038/s41467-021-26435-0

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Significance of Pulmonary Vascular Resistance and Diastolic Pressure Gradient on the New Definition of Combined Post-Capillary Pulmonary Hypertension2020

    • Author(s)
      Sugimoto K, Yoshihisa A, Nakazato K, Yokokawa T, Misaka T, Oikawa M, Kobayashi A, Yamaki T, Kunii H, Ishida T, Takeishi Y.
    • Journal Title

      International Heart Journal

      Volume: 61 Issue: 2 Pages: 301-307

    • DOI

      10.1536/ihj.19-476

    • NAID

      130007821526

    • ISSN
      1349-2365, 1349-3299
    • Year and Date
      2020-03-28
    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Pulmonary Hypertension and Hereditary Hemorrhagic Telangiectasia Related to an <i>ACVRL1</i> Mutation2020

    • Author(s)
      Yokokawa T, Sugimoto K, Kimishima Y, Misaka T, Yoshihisa A, Morisaki H, Yamada O, Nakazato K, Ishida T, Takeishi Y.
    • Journal Title

      Internal Medicine

      Volume: 59 Issue: 2 Pages: 221-227

    • DOI

      10.2169/internalmedicine.3625-19

    • NAID

      130007785091

    • ISSN
      0918-2918, 1349-7235
    • Year and Date
      2020-01-15
    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] クローン性造血と肺高血圧症~新たな個別化医療のターゲット~2022

    • Author(s)
      Tomofumi Misaka
    • Organizer
      第7回日本肺高血圧・肺循環学会学術集会
    • Related Report
      2022 Annual Research Report
    • Invited
  • [Presentation] Clonal hematopoiesis and pulmonary hypertension -A novel target for precision medicine-2022

    • Author(s)
      Tomofumi Misaka
    • Organizer
      第87回日本循環器学会学術集会
    • Related Report
      2022 Annual Research Report
  • [Presentation] DNA-PKcs -A novel therapeutic target in pulmonary arterial hypertension2022

    • Author(s)
      Tetsuro Yokokawa
    • Organizer
      第87回日本循環器学会学術集会
    • Related Report
      2022 Annual Research Report
  • [Presentation] Clonal hematopoiesis and cardiovascular disease: hematopoietic JAK2V617F mutations in cardiovascular remodeling2021

    • Author(s)
      Misaka Tomofumi
    • Organizer
      The 38th Annual Scientific Meeting of the Japanese Section of the International Society for Heart Research (ISHR)
    • Related Report
      2021 Research-status Report
    • Invited
  • [Presentation] Hematopoietic CALR frameshift mutation exacerbates hypoxia-induced pulmonary hypertension in mice2021

    • Author(s)
      Yokokawa Tetsuro
    • Organizer
      American Heart Association Scientific Sessions 2021
    • Related Report
      2021 Research-status Report
    • Int'l Joint Research
  • [Presentation] Serum level of membrane type 1-matrix metalloproteinase inversely co-relates with right ventricular systolic pressure and mean pulmonary artery pressure in pulmonary hypertension2021

    • Author(s)
      Sugimoto Koichi
    • Organizer
      American Heart Association Scientific Sessions 2021
    • Related Report
      2021 Research-status Report
    • Int'l Joint Research
  • [Presentation] Small hematopoietic clones with JAK2V617F causally lead to pulmonary hypertension through neutrophil selective migration and maturation from the precursors in the lungs2021

    • Author(s)
      Kimishima Yusuke
    • Organizer
      American Heart Association Scientific Sessions 2021
    • Related Report
      2021 Research-status Report
    • Int'l Joint Research
  • [Book] Precision Medicine2022

    • Author(s)
      中里和彦
    • Total Pages
      5
    • Publisher
      北隆館
    • Related Report
      2022 Annual Research Report
  • [Book] 呼吸器内科2022

    • Author(s)
      中里和彦
    • Total Pages
      8
    • Publisher
      科学評論社
    • Related Report
      2022 Annual Research Report

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Published: 2020-04-28   Modified: 2024-01-30  

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