| Project/Area Number |
26460449
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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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| Research Field |
Human pathology
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| Research Institution | Tohoku University |
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Principal Investigator |
Joh Kensuke 東北大学, 医学系研究科, 客員教授 (10057086)
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| Co-Investigator(Kenkyū-buntansha) |
中村 保宏 東北大学, 医学系研究科, 大学院非常勤講師 (80396499)
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| Research Collaborator |
Muto Masahiro 順天堂大学, 腎臓内科
Meng M 山形大学, 病理診断学講座
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| Project Period (FY) |
2014-04-01 – 2017-03-31
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| Project Status |
Completed (Fiscal Year 2016)
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| Budget Amount *help |
¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000)
Fiscal Year 2016: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2015: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
Fiscal Year 2014: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
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| Keywords | IgA腎症 / 寛解 / 扁桃摘出 / 扁桃炎 / 樹状細胞 / 腎生検 / 定量RTーPCR / T細胞 / B細胞 / 扁桃摘出術 / ステロイドパルス療法 / 治療効果 / 寛解予後 / ＩｇＡ腎症 / 糸球体腎炎 / フローサイトメトリー |
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| Outline of Final Research Achievements |
Tonsillectomy (TL) combined with steroid pulse therapy (SPT) has become a major choice against IgA nephropathy (IgAN) in Japan. The purpose was to figure out the factors preventing proteinuric remission（PUR）at 1 yr after the therapy and to contribute the indication of TL with SPT. PUR was found in 119 pts out of 194 pts (81%) at 1 year after. ROC analysis showed that cut off points, which were critical for a dichotomous classification of proteinuric remission, were 25% of interstitial fibrosis and 0.43 g/day of a grade of proteinuria, respectively. With these 2 parameters, PUR was predicted with 78% of probability.
Tonsil is an unique organ causing initial and progressive events to generate IgAN. Comparing the features of the IgAN tonsilitis with chronic tonsillitis, the number of T lymphocyte nodules with assembly of CD208-positive dendritic cells and the grade of lymphoepithelial involution correlated with frequency of crescent and segmental sclerosis in the kidney, respectively.
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