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Comparison in the indication for endotoxin adsorption therapy diagnosed by new endotoxin detection methods

Research Project

Project/Area Number 20K09285
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 55060:Emergency medicine-related
Research InstitutionShiga University of Medical Science

Principal Investigator

Nomi Kitamura  滋賀医科大学, 医学部, 講師 (30572474)

Co-Investigator(Kenkyū-buntansha) 谷 眞至  滋賀医科大学, 医学部, 教授 (60236677)
清水 智治  滋賀医科大学, 医学部, 教授 (70402708)
藤野 和典  滋賀医科大学, 医学部, 講師 (70402716)
三宅 亨  滋賀医科大学, 医学部, 講師 (70581924)
小幡 徹  滋賀医科大学, 医学部, 客員准教授 (80119776)
田畑 貴久  滋賀医科大学, 医学部, 非常勤講師 (90278200)
Project Period (FY) 2020-04-01 – 2023-03-31
Project Status Completed (Fiscal Year 2022)
Budget Amount *help
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2022: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2021: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2020: ¥2,730,000 (Direct Cost: ¥2,100,000、Indirect Cost: ¥630,000)
Keywordsエンドトキシン / 敗血症性ショック / エンドトキシン吸着療法 / トレミキシン / 血液浄化療法 / EAA / ESP / エンドトキシンショック / Endotoxin Activity Assay / PMX / 敗血症 / Septic shock
Outline of Research at the Start

国内で利用できるエンドトキシン測定法は感度が低く『エンドトキシン血症』を正確に測定することができない。我々が開発したEndotoxin Scattering Photometry(ESP)は従来法より高感度・迅速にエンドトキシンを測定できる。
本研究では、
1)ESPにて『エンドトキシン血症』を正確に評価することにより重症病態形成へのエンドトキシンの関与を解明すること
2)PMXの適応判断が可能かどうか検討することを目的としている。
正確なエンドトキシンの評価により救命率の向上、適切な医療材料使用により医療費の削減にもつながると考える。

Outline of Final Research Achievements

PMX therapy was effective for patients with septic shock diagnosed by Sepsis-2, MODS score>9 and 0.6≦EAA<0.9 in the EUPHRATES trial. In this study, the effectiveness of PMX therapy was evaluated in patients with septic shock diagnosed by Sepsis-3, exploring optimal EAA range to receive this therapy. We observed that the 30 days-survival rate was improved after PMX therapy in patients with septic shock (Sepsis-3) who revealed 0.57≦EAA<0.9. We found that favorable and optimal EAA range for this therapy in patients with septic shock (Sepsis-3) was almost same as previous EUPHRATES trial. We also observed circulating endotoxin value measurede by ESP method was lowered before and after PMX column 1hr after the starting of PMX therapy. This finding suggested that endotoxin was certainly adsorbed by PMX column.

Academic Significance and Societal Importance of the Research Achievements

本研究の成果から、Sepsis-3の診断基準でSeptic shockと診断された症例でもEAAにて『エンドトキシン血症』を正確に評価することにより、PMX治療の有効性を発揮できる症例を選別できる可能性が示唆された。現在の本邦のPMXの保険適応はSepsis-3の診断基準が用いられているが、EAAなどの適切なコンパニオン診断を用いることが有効である事が判明した。EAAの本邦への導入を促進させる機会になると考えられ、学術的意義も高いと考えられる。さらに、本研究の成果は、敗血症患者の救命率の向上や適切な医療材料使用判断ができることにより医療費の削減にも貢献でき、社会的意義も高い研究であると考える。

Report

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

    (18 results)

All 2023 2022 2021 2020

All Journal Article (13 results) (of which Int'l Joint Research: 2 results,  Peer Reviewed: 13 results,  Open Access: 12 results) Presentation (5 results) (of which Invited: 1 results)

  • [Journal Article] Adverse impact of postoperative intra-abdominal infectious complications on cancer recurrence-related survival after curative gastric cancer surgery2022

    • Author(s)
      Katsushi Takebayashi, Satoshi Murata, Sachiko Kaida, et al.
    • Journal Title

      The American Journal of Surgery

      Volume: 224 Issue: 3 Pages: 949-954

    • DOI

      10.1016/j.amjsurg.2022.05.009

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Rare monomorphic epithelial intestinal T-cell lymphoma of the stomach with a giant gastric perforation rescued by liver-covering sutures followed by a total gastrectomy and lateral hepatectomy: a case report2022

    • Author(s)
      Muramoto Keiji、Kaida Sachiko、Miyake Toru、Nishimura Rie、Kito Katsuyuki、Shiohara Masanori、Kushima Ryoji、Shimizu Tomoharu、Tani Masaji
    • Journal Title

      Surgical Case Reports

      Volume: 8 Issue: 1

    • DOI

      10.1186/s40792-022-01381-1

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Long-term prognosis of patients with cancer-related genes detected in postoperative peritoneal washings obtained during curative gastrectomy2022

    • Author(s)
      Takebayashi Katsushi、Murata Satoshi、Kodama Hirokazu、Kaida Sachiko、Yamaguchi Tsuyoshi、Ishikawa Ken、Shimoji Miyuki、Miyake Toru、Ueki Tomoyuki、Kojima Masatsugu、Iida Hiroya、Maehira Hiromitsu、Shimizu Tomoharu、Tani Masaji
    • Journal Title

      European Journal of Surgical Oncology

      Volume: 48 Issue: 1 Pages: 177-182

    • DOI

      10.1016/j.ejso.2021.05.012

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Predictors and clinical impact of postoperative diarrhea after colorectal cancer surgery: a prospective, multicenter, observational study (SHISA-1602)2022

    • Author(s)
      Ohta Hiroyuki、Miyake Toru、Ueki Tomoyuki、Kojima Masatsugu、Kawasaki Masayasu、Tatsuta Takeshi、Iuchi Takekazu、Kamitani Sumihiro、Shimizu Tomoharu、Mekata Eiji、Tani Masaji
    • Journal Title

      International Journal of Colorectal Disease

      Volume: 37 Issue: 3 Pages: 657-664

    • DOI

      10.1007/s00384-022-04097-8

    • NAID

      120007190901

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Postoperative analgesic effect of ultrasound‐guided rectus sheath block and local anesthetic infiltration after laparoscopic cholecystectomy: Results of a prospective randomized controlled trial2021

    • Author(s)
      Kitamura Naomi、Iida Hiroya、Maehira Hiromitsu、Mori Haruki、Sada Yoko、Shimizu Tomoharu、Kitagawa Hirotoshi、Tani Masaji
    • Journal Title

      Asian Journal of Endoscopic Surgery

      Volume: 15 Issue: 1 Pages: 29-35

    • DOI

      10.1111/ases.12957

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Involvement of TRPV1-containing peripheral sensory efferents in hemodynamic responses in a rat hemorrhagic shock model2021

    • Author(s)
      Akabori Hiroya、Yamamoto Hiroshi、Shimizu Tomoharu、Endo Yoshihiro、Tani Tohru、Tani Masaji
    • Journal Title

      Surgery

      Volume: 169 Issue: 4 Pages: 879-884

    • DOI

      10.1016/j.surg.2020.09.007

    • Related Report
      2021 Research-status Report 2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Incidence of surgical site infections with triclosan-coated monofilament versus multifilament sutures in elective colorectal surgery2021

    • Author(s)
      Terada Yoshitaka、Miyake Toru、Ueki Tomoyuki、Shimizu Tomoharu、Kojima Masatsugu、Takebayashi Katsushi、Maehira Hiromitsu、Kaida Sachiko、Yamaguchi Tsuyoshi、Iida Hiroya、Tani Masaji
    • Journal Title

      Surgery Today

      Volume: 52 Issue: 4 Pages: 652-659

    • DOI

      10.1007/s00595-021-02383-6

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] A Prospective Multicenter Observational Study of Venous Thromboembolism after Gastric Cancer Surgery (SHISA-1601)2021

    • Author(s)
      Kaida Sachiko、Miyake Toru、Murata Satoshi、Yamaguchi Tsuyoshi、Tatsuta Takeshi、Murakami Koichiro、Okauchi Hiroshi、Nishimura Shoichi、Ohta Hiroyuki、Tsuchihashi Hiroshi、Kawasaki Masayasu、Takebayashi Katsushi、Shimizu Tomoharu、Tani Masaji
    • Journal Title

      European Surgical Research

      Volume: 62 Issue: 1 Pages: 10-17

    • DOI

      10.1159/000514309

    • NAID

      120007000434

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Experience and technique of simultaneous robotic resection for synchronous advanced gastric and rectal cancers: a case report2020

    • Author(s)
      Kaida Sachiko、Miyake Toru、Shimizu Tomoharu、Takebayashi Katsushi、Yamaguchi Tsuyoshi、Ishikawa Ken、Tani Masaji
    • Journal Title

      Surgical Case Reports

      Volume: 6 Issue: 1 Pages: 169-169

    • DOI

      10.1186/s40792-020-00911-z

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Infiltration of CD4, CD8, CD56, and Fox-P3-positive lymphocytes in breast carcinoma tissue after neoadjuvant chemotherapy with or without trastuzumab2020

    • Author(s)
      Itoi Naoko、Umeda Tomoko、Ishida Mitsuaki、Murata Satoshi、Mori Tsuyoshi、Kawai Yuki、Tomida Kaori、Shimizu Tomoharu、Kushima Ryoji、Tani Masaji
    • Journal Title

      Breast Disease

      Volume: 39 Issue: 1 Pages: 47-49

    • DOI

      10.3233/bd-190429

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Cerebellar hemorrhage in patients treated with edoxaban for portal vein thrombosis after hepatobiliary surgery: a report of two cases2020

    • Author(s)
      Iida Hiroya、Miyake Toru、Tani Masaji、Tanaka Takuya、Kawakami Kayo、Ikuno Yoshihiro、Mandai Ryoichi、Shimizu Tomoharu
    • Journal Title

      Surgical Case Reports

      Volume: 6 Issue: 1 Pages: 319-319

    • DOI

      10.1186/s40792-020-01086-3

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Perioperative tight glycemic control using artificial pancreas decreases infectious complications via suppression of inflammatory cytokines in patients who underwent pancreaticoduodenectomy: A prospective, non-randomized clinical trial2020

    • Author(s)
      Akabori Hiroya、Tani Masaji、Kitamura Naomi、Maehira Hiromitsu、Imashuku Yasuhiko、Tsujita Yasuyuki、Shimizu Tomoharu、Kitagawa Hirotoshi、Eguchi Yutaka
    • Journal Title

      The American Journal of Surgery

      Volume: 220 Issue: 2 Pages: 365-371

    • DOI

      10.1016/j.amjsurg.2019.12.008

    • NAID

      120006776242

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] A Novel Technique to Predict Liver Damage After Laparoscopic Gastrectomy From the Stomach Volume Overlapping the Liver by Preoperative Computed Tomography2020

    • Author(s)
      Kaida Sachiko、Murakami Yoko、Ohta Shinichi、Yamaguchi Tsuyoshi、Takebayashi Katsushi、Murata Satoshi、Nitta Norihisa、Shimizu Tomoharu、Tani Masaji
    • Journal Title

      World Journal of Surgery

      Volume: 44 Issue: 9 Pages: 3052-3060

    • DOI

      10.1007/s00268-020-05584-1

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] 腹腔鏡下低位前方切除術後3日目に左肝動脈瘤破裂をきたした1例2023

    • Author(s)
      太田 裕之, 永井 望, 寺田 好孝, 北村 直美, 赤堀 浩也, 目片 英治
    • Organizer
      第59回日本腹部救急医学会総会
    • Related Report
      2022 Annual Research Report
  • [Presentation] 総胆管結石による肝内胆管圧上昇に伴う左肝内胆管穿通、胆汁瘻を認めた1例2023

    • Author(s)
      永井 望, 太田 裕之, 寺田 好孝, 北村 直美, 赤堀 浩也, 目片 英治
    • Organizer
      第59回日本腹部救急医学会総会
    • Related Report
      2022 Annual Research Report
  • [Presentation] 北村 直美, 仁科 勇佑, 寺田 好孝, 赤堀 浩也, 太田 裕之, 目片 英治, 任 聿煕, 加藤 裕美, 藤野 能久2022

    • Author(s)
      腹腔鏡下胆嚢摘出術における硬膜外麻酔法の効果
    • Organizer
      第122回日本外科学会定期学術集会
    • Related Report
      2022 Annual Research Report
  • [Presentation] PMX-DHP施行時間とタイミングを考える 敗血症性ショックに対するPMX-DHPの試行時間の検討2020

    • Author(s)
      江口 豊, 田中 智基, 田畑 貴久, 清水 智治, 谷 眞至
    • Organizer
      2020年 エンドトキシン血症救命治療研究会
    • Related Report
      2020 Research-status Report
  • [Presentation] 敗血症の治療戦略の一つとしてのエンドトキシン吸着療法(PMX)の再考2020

    • Author(s)
      清水 智治, 三宅 亨, 植木 智之, 小島 正継, 貝田 佐知子, 飯田 洋也, 前平 博充, 竹林 克士, 目片 英治, 遠藤 善裕, 谷 眞至
    • Organizer
      第120回 日本外科学会定期学術集会
    • Related Report
      2020 Research-status Report
    • Invited

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

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