| Project/Area Number |
20K09863
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 56070:Plastic and reconstructive surgery-related
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| Research Institution | Juntendo University (2021-2023)
Kobe University (2020) |
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Principal Investigator |
Fujii Miki 順天堂大学, 大学院医学研究科, 准教授 (80444602)
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| Co-Investigator(Kenkyū-buntansha) |
榊原 俊介 神戸大学, 医学研究科, 客員准教授 (50444592)
寺師 浩人 神戸大学, 医学部附属病院, 教授 (80217421)
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| Project Period (FY) |
2020-04-01 – 2024-03-31
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| Project Status |
Completed (Fiscal Year 2023)
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| Budget Amount *help |
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2022: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2021: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2020: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
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| Keywords | 糖尿病性足潰瘍 / 骨髄炎 / AGE / 腱 / 終末糖化産物 |
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| Outline of Research at the Start |
糖尿病患者と非糖尿病患者の足趾において、腱組織内でのAGEの局在と、骨への細菌の感染経路を確認する事で糖尿病性足潰瘍の骨髄炎の発症経路を解明する。
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| Outline of Final Research Achievements |
We retrospectively performed an immunohistochemical examination of 64 tendons from toes of 64 patients (50 males, 14 females, aged 69.7±11.1 years, 48 patients with diabetes) who underwent toe resection due to foot ulcers. Significant AGE stains were identified in vascular endothelial cells. The degree of AGE accumulation in vascular endothelial cells was classified into 4 stages: 0 (negative stain), +1 (weak or partially positive), +2 (clear or whole perimeter positive), and +3 (strong and thick positive). The findings were (diabetes vs non-diabetes): 9 (18.8%) vs 2 (12.5%) in stage 0, 20 (41.7%) vs 10 (62.5%) in stage 1, 16 (33.3%) vs 4 (25%) in stage 2, and 3 (62.5%) vs 0 in stage 3. AGE positivity rates (stages +1, +2, +3) of the patients <69 years with diabetes (n=21) was 80.7%, and those of patients without diabetes (n=2) was 66.7% (p=0.52).Our study indicates that tendon fragility may be caused by microangiopathy due to AGE accumulation in the vascular endothelial cells.
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| Academic Significance and Societal Importance of the Research Achievements |
近年、生活習慣の変化に伴い日本でも糖尿病患者は増加し、それに伴い糖尿病性足潰瘍を発症する患者も増加している。糖尿病性足潰瘍が骨髄炎を合併すると切断になる危険性は非常に高くなり、患者のADLの低下だけでなく医療経済的にも大きな問題となる。骨髄炎発症のメカニズムが解明されれば、骨髄炎を予防する方法の解明やより効果的な抗生剤の投与方法に繋がる可能性があり社会的意義は大きい。AGEによる腱の栄養血管の微小血管障害が骨髄炎発症の一要因であることが判明すれば、AGE形成阻害薬が骨髄炎の新たな治療薬となる可能性がある。
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