超拡大内視鏡によるリアルタイム炎症性腸疾患診断への挑戦

2010 Fiscal Year Annual Research Report

• Project/Area Number: 22590763
• Research Institution: Keio University
• Principal Investigator: 緒方 晴彦 慶應義塾大学, 医学部, 教授 (30177117)
• Co-Investigator(Kenkyū-buntansha): 金井 隆典 慶應義塾大学, 医学部, 准教授 (40245478)
• Keywords: 超拡大内視鏡 / 炎症性腸疾患 / 迅速病理診断 / 潰瘍性大腸炎 / リアルタイム

Research Abstract

急性消化管感染症の病原体観察と診断の確立
急性腸炎の症例において、臨床的かつ内視鏡観察によって、アメーバ性大腸炎と疑診に至った症例を前向きに、a)便汁顕微鏡観察、b)血中アメーバ抗体、c)病理検体による病理診断に加え、d)ECS観察によってアメーバ虫体検索を実施し、ECS観察によるアメーバ虫体の同定は最も簡便で迅速なモダリティーであることを明らかとし、迅速な治療介入の可能性を示唆した。
生体腸管微細構造の運動性生理学の確立
通常の病理診断では不可能で、超拡大生体動的観察が可能なECS観察の特徴に着目し、現代社会で患者数の激増中であり機能性胃腸疾患(過敏性大腸症候群[IBS]、機能性胃腸症[FD])の病態解明に挑戦すした。臨床上、IBS、IBDと診断する過程で実施する内視鏡検査時、通常の観察に加え、IBS,IBDにおいてはS状結腸でECS観察による腺管構造の動的観察をおこなった。結果、IBSでは腸管運動の不規則性(亢進と低下)を認めること、IBDにおいては血流の亢進をリアルタイムで観察することに成功した。平成23年度では得られたビデオ記録された腺管構造の動的観察映像をコンピューター解析化し、病態よる腺管運動異常を明らかとする予定である。

Research Products

• [Journal Article] Successful treatment of a large hyperplastic polyp in the jejunum by using single-balloon enteroscopy. (2011)
  • Author(s): Nakamura S, Imaeda H, Sujino T, Hosoe N, Naganuma M, Ebinuma H, Okamoto S, Nishizawa T, Takahashi M, Iwao Y, Kameyama K, Mukai M, Ogata H, Hibi T.
  • Journal Title: Gastrointest Endosc. Volume: (Epub ahead of print)
  • Peer Reviewed
• [Journal Article] Upregulated IL-7 receptor (alpha) expression on colitogenic memory CD4+ T cells may participate in the development and persistence of chronic colitis. (2011)
  • Author(s): Shinohara T, Nemoto Y, Kanai T, Kameyama K, Okamoto R, Tsuchiya K, Nakamura T, Totsuka T, Ikuta K, Watanabe M
  • Journal Title: J Immunol Volume: 186 Pages: 2623-2632
  • Peer Reviewed
• [Journal Article] Partial regression of duodenal lesions of intestinal follicular lymphoma after antibiotic treatment. (2010)
  • Author(s): Yaguchi T, Imaeda H, Kizaki M, Hosoe N, Suzuki H, Ogata H, Iwao Y, Kameyama K, Ikeda Y, Hibi T.
  • Journal Title: Dig Endosc. Volume: 22 Pages: 316-318
  • Peer Reviewed
• [Journal Article] Clinical results of observation of the upper gastrointestinal tract by transgastrostomic endoscopy using an ultrathin endoscope. (2010)
  • Author(s): Imaeda H, Hosoe N, Nakamizo H, Kashiwagi K, Suzuki H, Saito Y, Suganuma K, Ida Y, Matsuzaki J, Iwasaki E, Iwao Y, Ogata H, Hibi T.
  • Journal Title: J Gastroenterol Hepatol. Volume: 25 Pages: 1850-1854
  • Peer Reviewed
• [Journal Article] Competition between colitogenic Th1 and Th17 cells contributes to the amelioration of colitis. (2010)
  • Author(s): Mikami Y, Kanai T, Sujino T, Ono Y, Hayashi A, Okazawa A, Kamada N, Matsuoka K, Hisamatsu T, Okamoto S, Takaishi H, Inoue N, Ogata H, Hibi T.
  • Journal Title: Eur J Immunol. Volume: 40 Pages: 2409-2422
  • Peer Reviewed
• [Journal Article] Imbalance of NKp44(+)NKp46(-) and NKp44(-)NKp46(+) natural killer cells in the intestinal mucosa of patients with Crohn's disease. (2010)
  • Author(s): Takayama T, Kamada N, Chinen H, Okamoto S, Kitazume MT, Chang J, Matuzaki Y, Suzuki S, Sugita A, Koganei K, Hisamatsu T, Kanai T, Hibi T.
  • Journal Title: Gastroenterology Volume: 139 Pages: 882-892
  • Peer Reviewed
• [Journal Article] Monocyte chemoattractant protein-1 contributes to gut homeostasis and intestinal inflammation by composition of IL-10-producing regulatory macrophage subset. (2010)
  • Author(s): Takada Y, Hisamatsu T, Kamada N, Kitazume MT, Honda H, Oshima Y, Saito R, Takayama T, Kobayashi T, Chinen H, Mikami Y, Kanai T, Okamoto S, Hibi T.
  • Journal Title: J Immunol. Volume: 184 Pages: 2671-2676
  • Peer Reviewed
• [Journal Article] MyD88-dependent pathway accelerates the liver damage of Concanavalin A-induced hepatitis. (2010)
  • Author(s): Ojiro K, Ebinuma H, Nakamoto N, Wakabayashi K, Mikami Y, Ono Y, Po-Sung C, Usui S, Umeda R, Takaishi H, Yamagishi Y, Saito H, Kanai T, Hibi T.
  • Journal Title: Biochem Biophys Res Commun. Volume: 399 Pages: 744-749
  • Peer Reviewed
• [Presentation] Treatment of Ulcerative Colitis in Japan (2011)
  • Author(s): Haruhiko Ogata
  • Organizer: UC Expert Meeting in Tokyo
  • Place of Presentation: 東京
  • Year and Date: 2011-01-25
• [Presentation] In vivo visualization and evaluation of colorectal inflammation in ulcerative colitis by a newly integrated endocytoscopy (2010)
  • Author(s): Haruhiko Ogata
  • Organizer: 18^<th> United European Gastroenterology Week
  • Place of Presentation: Centre Conventions International Barcelona (Spain)
  • Year and Date: 2010-10-26
• [Presentation] Proposal for the Asian Organization for the Study of IBD (2010)
  • Author(s): Haruhiko Ogata
  • Organizer: 5^<th> Japan-Korea IBD Symposium
  • Place of Presentation: Sheraton Grande Walkerhill Hotel (Korea)
  • Year and Date: 2010-10-02
• [Presentation] IBD診断・治療の新時代 (2010)
  • Author(s): 緒方晴彦
  • Organizer: 第79回日本消化器内視鏡学会総会
  • Place of Presentation: 東京
  • Year and Date: 2010-05-15
• [Presentation] In vivo visualization and evaluation of colorectal inflammation in ulcerative colitis by a newly integrated endocytoscopy-correlation analysis with conventional histology (2010)
  • Author(s): Haruhiko Ogata
  • Organizer: 第96回日本消化器病学会総会
  • Place of Presentation: 新潟
  • Year and Date: 2010-04-23