2021 Fiscal Year Final Research Report
Development of life-saving treatment for amniotic fluid embolism by intratracheal adrenalin administration
| Project/Area Number |
19K09799
|
|---|
| Research Category |
Grant-in-Aid for Scientific Research (C)
|
| Allocation Type | Multi-year Fund |
|---|
| Section | 一般 |
|---|
| Review Section |
Basic Section 56040:Obstetrics and gynecology-related
|
|---|
| Research Institution | Hamamatsu University School of Medicine |
|---|
Principal Investigator |
|
|---|
| Co-Investigator(Kenkyū-buntansha) |
金山 尚裕 浜松医科大学, 医学部, 副学長 (70204550)
伊東 宏晃 浜松医科大学, 医学部, 教授 (70263085)
田村 直顕 浜松医科大学, 医学部, 助教 (90402370)
|
|---|
| Project Period (FY) |
2019-04-01 – 2022-03-31
|
| Keywords | 羊水塞栓症 / 臓器特異的アナフィラクトイド反応 / 肥満細胞 / トリプターゼ / 血液凝固障害 |
|---|
| Outline of Final Research Achievements |
Fatal amniotic fluid embolism (AFE) cases had the low arterial blood gas pH and high serum tryptase at the onset, as well as a large number of cases with twice or more cardiac arrests, compared with survival cases. We stained a series of tissues from lung, myocardium, uterus, liver, kidney, and adrenal glands of 13 autopsy cases diagnosed as AFE with tryptase, in which lung, myocardium, and uterus showed a wider degranulation reaction than other organs. Thrombin-activatable fibrinolysis inhibitor (TAFI), which inactivates the complement system product C3a/C5a, was decreased in AFE plasma, suggesting that it may be involved in mast cell degranulation. We established a culture system of the mast cell line LAD2 and evaluated the total intracellular tryptase concentration. As described above, we investigated the distribution, activation, and relevant factors of mast cells as targets of adrenaline.
|
| Free Research Field |
羊水塞栓症、胎盤生理と病理
|
| Academic Significance and Societal Importance of the Research Achievements |
羊水塞栓症は日本における妊産婦死亡の最大の原因であり、医学的、医療社会的にみても影響力が大きい産科救急疾患である。本研究では肥満細胞に焦点を当て、臨床的、基礎的な検討を通して、ターゲットである肥満細胞が羊水塞栓症でどのように病態に関わっているのか詳細を解明することができた。具体的に、今まで関連が不明であったアナフィラクトイド反応と血液凝固障害について、候補因子を見出すことができた。さらに、肺、心筋、子宮に特異的な肥満細胞活性化を明らかにしたことは病態上重要である。アドレナリンの気管内投与あるいはアナフィラキシーに準じた早期投与などによる活性化肥満細胞を抑制する治療が有効と推測される。
|
