2019 Fiscal Year Final Research Report

Elucidation of the mechanism of polymyxin B column therapy for rapidly progressive interstitial lung disease

Research Project

PDF

Project/Area Number	17K09605
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Respiratory organ internal medicine
Research Institution	Niigata University
Principal Investigator	Ohashi Kazumasa 新潟大学, 医歯学総合病院, 特任助教 (50463998)
Co-Investigator(Kenkyū-buntansha)	坂上拓郎熊本大学, 大学院生命科学研究部(医), 教授 (00444159) 高田俊範新潟大学, 医歯学総合病院, 特任教授 (40361919) 林正周新潟大学, 医歯学総合病院, 助教 (40463997) 朝川勝明新潟大学, 医歯学総合病院, その他 (60599158)
Project Period (FY)	2017-04-01 – 2020-03-31
Keywords	PMX / ILD
Outline of Final Research Achievements	Some patients with rapid progressive interstitial lung disease (ILD) are resistant and fatal to steroids as well as immunosuppressants. We found that rapid progressive ILD treated with polymyxin B column therapy (PMX-DHP) on the first day of steroid pulse therapy had a significantly better prognosis than the other patients. The purpose of this study was to clarify the exacerbating factors of rapidly progressive ILD by comprehensively measuring the serum concentrations of 38 cytokines before PMX-DHP, after PMX-DHP, and after steroid pulse therapy. 14 patients treated with PMX-DHP and steroid pulse therapy for rapidly progressive ILD at our hospital were enrolled. Five cytokines were significantly decreased after PMX-DHP, and more decreased after steroid pulse therapy. However, only eotaxin was decreased after PMX-DHP (p<0.05), but increased after steroid pulse therapy (p<0.05).
Free Research Field	呼吸器
Academic Significance and Societal Importance of the Research Achievements	急速進行性間質性肺疾患（ILD）は難治性で致死的となる症例が多いが、PMX-DHP療法を併用することにより急速進行性ILDの予後が改善する報告があった。そこでPMX-DHP療法とステロイド治療を施行した14例を対象にPMX前後、ステロイドパルス療法後の3時点で、38種類の血清サイトカイン濃度を測定し急速進行性ILDの増悪因子を明らかにすることが目的とした。その中で血清Eotaxin濃度はPMX療法後に有意に低下したがステロイドパルス療法後は再び増加していたことが判明した。上記よりEotaxinがPMX-DHP治療によっても増悪する急速進行性ILDの病態に関与している可能性が示唆された。