[13C]-naproxen breath test can predict the gastric mucosal injury induced by naproxen

2016 Fiscal Year Annual Research Report

• Project/Area Number: 26460935
• Research Institution: Hamamatsu University School of Medicine
• Principal Investigator: 古田 隆久 浜松医科大学, 医学部附属病院, 准教授 (10303546)
• Co-Investigator(Kenkyū-buntansha): 大澤 恵 浜松医科大学, 医学部附属病院, 講師 (10397391) ; 松山 幸弘 浜松医科大学, 医学部, 教授 (20312316) ; 杉本 健 浜松医科大学, 医学部, 准教授 (20529507) ; 渡邉 裕司 浜松医科大学, 医学部, 教授 (50262803) ; 難波 宏樹 浜松医科大学, 医学部, 教授 (60198405) ; 小川 法良 浜松医科大学, 医学部附属病院, 講師 (80308618) ; 杉本 光繁 浜松医科大学, 医学部附属病院, 助教 (80397398) [Withdrawn]
• Project Period (FY): 2014-04-01 – 2017-03-31
• Keywords: ナプロキセン / NSAID / 13C / 呼気テスト

Outline of Annual Research Achievements

ナプロキセンによる急性期の胃粘膜傷害におけるナプロキセン呼気試験の有用性を検討する試験を行った。健常ボランティアに45名を３群にわけ、1：ナプロキセン　100mg　1日3回投与群、2：ナプロキセン　100mg　1日3回+lannsoprazale　15　mg併用群、そして、3：前年度の基準でナプロキセン呼気試験によってリスクのあると判断された者のみにlansopraole　15mgを併用する個別化療法群での比較試験を行った。即ち、個別化療法群のみナプロキセン呼気試験を行い、AUC0-2 ≧5.8では低リスク群としてナプロキセン単独、
AUC0-2 <5.8では高リスク群としてlansopraole　15mgを併用することとした。そして、ナプロキセン内服期間は2日間として、各群で内視鏡検査をおこない、胃軟膜傷害の程度を比較検討した。
すると、胃粘膜傷害は、ナプロキセン単独群のLANZAスコアのメジアンは3 であったのに対し、lansoprazaole併用群では１と有意に抑制されたが、個別化療法群の粘膜傷害スコアはも１で、ナプロキセン単独群より有意に低く、かつ、Lansoprazole併用群と同等であった。以上よりナプロキセン呼気試験は、NSAID潰瘍の予防を効率的に行う事に貢献することが示唆された。
本試験の結果を実臨床に生かすべく、NSAIDを継続的に内服中の患者において、ナプロキセン呼気試験を行い、上部消化管内視鏡検査所見との比較を行い、本試験が実臨床におけるNSAIDによる胃粘膜傷害の予測マーカーとなるか、そして、PPI等の予防的な内服が必要である症例の絞り込みに有効であるかを検討すべく、プロトコールの立案中である。本試験の結果を将来的には臨床におうようする予定である。

Research Products

• [Journal Article] Influence of low-dose proton pump inhibitors administered concomitantly or separately on the anti-platelet function of clopidogrel. (2017)
  • Author(s): Furuta T, Sugimoto M, Kodaira C, Nishino M, Yamade M, Uotani T, Sahara S, Ichikawa H, Kagami T, Iwaizumi M, Hamaya Y, Osawa S, Sugimoto K, Umemura K.
  • Journal Title: J Thromb Thrombolysis. Volume: 43 Pages: 333-342
  • DOI: 10.1007/s11239-016-1460-2.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Digoxin Attenuates Murine Experimental Colitis by Downregulating Th17-related Cytokines. (2017)
  • Author(s): Tani S, Takano R, Tamura S, Oishi S, Iwaizumi M, Hamaya Y, Takagaki K, Nagata T, Seto S, Horii T, Kosugi I, Iwashita T, Osawa S, Furuta T, Miyajima H, Sugimoto K.
  • Journal Title: Inflamm Bowel Dis. Volume: 23 Pages: 728-738.
  • DOI: 10.1097/MIB.0000000000001096.
  • Peer Reviewed
• [Journal Article] Efficacy of the Kyoto Classification of Gastritis in Identifying Patients at High Risk for Gastric Cancer (2017)
  • Author(s): 114.Sugimoto M, Ban H, Ichikawa H, Sahara S, Otsuka T, Inatomi O, Bamba S, Furuta T, Andoh A.
  • Journal Title: Intern Med Volume: 56 Pages: 579-586
  • DOI: 10.2169/internalmedicine.56.7775
  • Peer Reviewed
• [Journal Article] Natural Course of Helicobacter pylori Infection in Japanese Hemodialysis Patients. (2017)
  • Author(s): Sugimoto M, Sahara S, Ichikawa H, Sakao Y, Ohashi N, Sugimoto K, Yasuda H, Furuta T, Andoh A.
  • Journal Title: Digestion. Volume: 95 Pages: 302-309
  • DOI: 10.1159/000475659.
  • Peer Reviewed
• [Journal Article] Four-times-daily Dosing of Rabeprazole with Sitafloxacin, High-Dose Amoxicillin, or Both for Metronidazole-Resistant Infection with Helicobacter pylori in Japan. (2017)
  • Author(s): Sugimoto M, Sahara S, Ichikawa H, Kagami T, Ban H, Otsuka T, Andoh A, Furuta T.
  • Journal Title: Helicobacter. Volume: 22 Pages: 1-8
  • DOI: 10.1111/hel.12319.
  • Peer Reviewed
• [Journal Article] Relationship between ghrelin, Helicobacter pylori and gastric mucosal atrophy in hemodialysis patients. (2016)
  • Author(s): Ichikawa H, Sugimoto M, Sakao Y, Sahara S, Ohashi N, Kato A, Sugimoto K, Furuta T, Andoh A, Sakao T, Yasuda H.
  • Journal Title: World J Gastroenterol. Volume: 22 Pages: 10440-10449
  • DOI: 10.3748/wjg.v22.i47.10440.
  • Peer Reviewed
• [Journal Article] Severity of Gastric Mucosal Atrophy Is the Major Determinant of Plasma Ghrelin Level in Hemodialysis Patients. (2016)
  • Author(s): Sakao Y, Sugimoto M, Ichikawa H, Sahara S, Tsuji T, Ohashi N, Kato A, Fujigaki Y, Sugimoto K, Furuta T, Sakao T, Yasuda H.
  • Journal Title: Am J Nephrol Volume: 44 Pages: 224-233
  • DOI: 10.1159/000449019.
  • Peer Reviewed
• [Journal Article] M2 polarization of murine peritoneal macrophages induces regulatory cytokine production and suppresses T-cell proliferation. (2016)
  • Author(s): Oishi S, Takano R, Tamura S, Tani S, Iwaizumi M, Hamaya Y, Takagaki K, Nagata T, Seto S, Horii T, Osawa S, Furuta T, Miyajima H, Sugimoto K.
  • Journal Title: Immunology Volume: 149 Pages: 320-328
  • DOI: 10.1111/imm.12647.
  • Peer Reviewed
• [Journal Article] Inverted Meckel's diverticulum preoperatively diagnosed using double-balloon enteroscopy. (2016)
  • Author(s): Takagaki K, Osawa S, Ito T, Iwaizumi M, Hamaya Y, Tsukui H, Furuta T, Wada H, Baba S, Sugimoto K.
  • Journal Title: World J Gastroenterol. Volume: 22 Pages: 4416-4420
  • DOI: 10.3748/wjg.v22.i17.4416.
  • Peer Reviewed
• [Journal Article] Potent acid inhibition by vonoprazan in comparison with esomeprazole, with reference to CYP2C19 genotype. (2016)
  • Author(s): Kagami T, Sahara S, Ichikawa H, Uotani T, Yamade M, Sugimoto M, Hamaya Y, Iwaizumi M, Osawa S, Sugimoto K, Miyajima H, Furuta T.
  • Journal Title: Aliment Pharmacol Ther Volume: 43 Pages: 1048-1059
  • DOI: 10.1111/apt.13588.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Gastroesophageal Reflux Disease in Time Covering Eradication for All Patients Infected with Helicobacter pylori in Japan. (2016)
  • Author(s): Sugimoto M, Uotani T, Ichikawa H, Andoh A, Furuta T.
  • Journal Title: Digestion Volume: 93 Pages: 24-31
  • DOI: 10.1159/000441741.
  • Peer Reviewed
• [Journal Article] Rapid metabolizer genotype of CYP2C19 is a risk factor of being refractory to proton pump inhibitor therapy for reflux esophagitis. (2016)
  • Author(s): Ichikawa H, Sugimoto M, Sugimoto K, Andoh A, Furuta T.
  • Journal Title: J Gastroenterol Hepatol Volume: 31 Pages: 716-26
  • DOI: 10.1111/jgh.13233.
  • Peer Reviewed
• [Presentation] VONOPRAZAN-BASED DUAL THERAPY WITH AMOXICILLIN IS AS EFFECTVE AS THE TRIPLE THERAPY FOR THE ERADICATION OF H. PYLORI (2017)
  • Author(s): Furuta T,Kagami T, Suzuki T, Ichikawa H, Suzuki T, Umemura K.
  • Organizer: ASCPT 2017
  • Place of Presentation: Washington D.C. USA
  • Year and Date: 2017-03-15 – 2017-03-18
  • Int'l Joint Research
• [Presentation] 胃酸分泌抑制薬の薬物間相互作用 (2017)
  • Author(s): 古田隆久
  • Organizer: 第13回日本消化管学会
  • Place of Presentation: 名古屋
  • Year and Date: 2017-02-17 – 2017-02-17
  • Invited
• [Presentation] Vonoprazan-based eradication therapy for H. pylori infection in patients allergic to penicillin. (2016)
  • Author(s): Furuta T, Yamade M, Kagami T, Ichikawa H, Suzuki T, Hamaya Y, Iwaizumi M, Osawa S, Sugimoto K
  • Organizer: ACG 2016
  • Place of Presentation: Lasvegas, USA
  • Year and Date: 2016-10-14 – 2016-10-19
  • Int'l Joint Research
• [Presentation] Vonoprazan-based rescue eradication therapy for patients who failed in the eradication of H. pylori. (2016)
  • Author(s): Furuta T
  • Organizer: XXIXth International Workshop on Helicobacter &Microbiota in Inflammation and Cancer
  • Place of Presentation: Magdeburg, Germany
  • Year and Date: 2016-09-15 – 2016-09-17
  • Int'l Joint Research
• [Presentation] ガイドライン改正のポイント ー 除菌療法 ー (2016)
  • Author(s): 古田隆久
  • Organizer: 第22回日本ヘリコバクター学会
  • Place of Presentation: 別府
  • Year and Date: 2016-06-24 – 2016-06-25
  • Invited
• [Presentation] Evaluation of the Accuracy of DK14-HP-001, a Novel H. pylori Stool Antigen Test, for the Diagnosis of H. pylori Infection (2016)
  • Author(s): Furuta T, Sugimoto M, Sahara S, Ichikawa H, Kagami T, Uotani T, Yamade M, Hamaya Y, Iwaizumi M, Osawa S, Ken Sugimoto K
  • Organizer: DDW 2016
  • Place of Presentation: San Diego, CA, USA
  • Year and Date: 2016-05-21 – 2016-05-24