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Verification of microbial involvement in the pathogenesis of ocular complications of SJS/TEN

Research Project

Project/Area Number 23K24503
Project/Area Number (Other) 22H03244 (2022-2023)
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeMulti-year Fund (2024)
Single-year Grants (2022-2023)
Section一般
Review Section Basic Section 56060:Ophthalmology-related
Research InstitutionKyoto Prefectural University of Medicine

Principal Investigator

外園 千恵  京都府立医科大学, 医学(系)研究科(研究院), 教授 (30216585)

Co-Investigator(Kenkyū-buntansha) 木下 茂  京都府立医科大学, 医学(系)研究科(研究院), 教授 (30116024)
上田 真由美  京都府立医科大学, 医学(系)研究科(研究院), 特任准教授 (60398386)
Project Period (FY) 2022-04-01 – 2025-03-31
Project Status Granted (Fiscal Year 2024)
Budget Amount *help
¥17,420,000 (Direct Cost: ¥13,400,000、Indirect Cost: ¥4,020,000)
Fiscal Year 2024: ¥5,460,000 (Direct Cost: ¥4,200,000、Indirect Cost: ¥1,260,000)
Fiscal Year 2023: ¥5,460,000 (Direct Cost: ¥4,200,000、Indirect Cost: ¥1,260,000)
Fiscal Year 2022: ¥6,500,000 (Direct Cost: ¥5,000,000、Indirect Cost: ¥1,500,000)
KeywordsSJS/TEN / 自然免疫 / 遺伝子解析 / 角化 / 眼表面上皮 / マイクロアレイ / TLR3 / ポリジェニック解析 / 眼合併症 / 微生物 / ゲノム解析
Outline of Research at the Start

本研究では、SJS/TENによる失明の回避と予後向上を目的に、眼表面の炎症の病態解析、新規手法によるゲノムデータ解析を行い、自然免疫応答異常と病態の関連を明らかにして、発症予防、発症後の治療、発症予測に役立てる。

Outline of Annual Research Achievements

本研究では、SJS/TENによる失明の回避と予後向上を目的に、眼表面の炎症の病態解析、新規手法によるゲノムデータ解析を行い、自然免疫応答異常と病態の関連を明らかにする。
本年度は、 眼表面(OS)疾患の慢性期における病的角化の分子メカニズムを調べるために、Stevens-Johnson症候群、眼瘢痕性類天疱瘡、前眼部ブドウ球腫の3名の病的角化症患者から得られた眼表面上皮細胞について、オリゴヌクレオチドマイクロアレイを用いて網羅的な遺伝子発現解析を行った。一部の転写産物における発現は、定量的リアルタイムポリメラーゼ連鎖反応を用いて確認した。その結果、コントロールと比較して、病的角化上皮細胞では3118遺伝子が2分の1以上の有意な発現上昇を示した(P < 0.05)。角化、脂質代謝、酸化還元酵素に関与する遺伝子はアップレギュレートされ、細胞応答に関与する遺伝子や転写因子(TF)はダウンレギュレートされた。これらの遺伝子について、さらに遺伝子オントロジー解析と既知の報告により、TFとレチノイン酸(RA)に関する解析を行った。TFであるMYBL2、FOXM1、SREBF2の発現は上昇し、TFであるELF3の発現は有意に低下した。AKR1B15、RDH12、CRABP2、すなわち角化を抑制することが知られているRAに関連する遺伝子の発現は20倍以上増加し、RARB、RARRES3遺伝子の発現は50分の1に減少した。CRABP2、RARB、RARRES3の発現変化はqRT-PCRでも確認された。これらの結果から、病的角化眼表面では、ビタミンA代謝異常を含む共通の転写産物の変化が病的角化のメカニズムに関与していると考えられた。
また、本年度は、自然免疫に着目した眼表面の炎症病態の解析も継続して行っている。さらに、ゲノムデータの新規解析法による疾患発症リスクの解析も継続して解析中である。

Current Status of Research Progress
Current Status of Research Progress

2: Research has progressed on the whole more than it was originally planned.

Reason

自然免疫に着目した眼表面の炎症病態の解析についても、一つ論文を出版しており、重要な成果を得ている。自然免疫および炎症に着目した眼表面における瘢痕化・角化の解析についても大きな成果を得ており、、現在、論文投稿中である。ゲノムデータの新規解析法による疾患発症リスクの解析についても、研究協力者(理化学研究所 生命医科学研究センター 莚田泰誠チームリーダー)と一緒に解析を進めており、全体としても、おおむね順調に進展していると考えらえる。

Strategy for Future Research Activity

自然免疫に着目した眼表面の炎症病態の解析と、ゲノムデータの新規解析法による疾患発症リスクの解析を継続して、SJS/TENによる失明の回避と予後向上を目的に、自然免疫応答異常と病態の関連を明らかにして、発症予防、発症後の治療、発症予測に役立てる。

Report

(2 results)
  • 2023 Annual Research Report
  • 2022 Annual Research Report
  • Research Products

    (22 results)

All 2024 2023 2022 2021

All Journal Article (12 results) (of which Int'l Joint Research: 3 results,  Peer Reviewed: 12 results,  Open Access: 9 results) Presentation (10 results) (of which Int'l Joint Research: 8 results,  Invited: 3 results)

  • [Journal Article] Positive regulation of innate immune response by miRNA-let-7a-5p2023

    • Author(s)
      Ueta Mayumi、Nishigaki Hiromi、Komai Seitaro、Mizushima Katsura、Tamagawa-Mineoka Risa、Naito Yuji、Katoh Norito、Sotozono Chie、Kinoshita Shigeru
    • Journal Title

      Frontiers in Genetics

      Volume: 13 Pages: 1025539-1025539

    • DOI

      10.3389/fgene.2022.1025539

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Post-acute phase and sequelae management of epidermal necrolysis: an international, multidisciplinary DELPHI-based consensus2023

    • Author(s)
      Ingen-Housz-Oro S, Schmidt V, Ameri MM, Abe R, Brassard A, Mostaghimi A, Paller AS, Romano A, Didona B, Kaffenberger BH, Ben Said B, Thong BYH, Ramsay B, Brezinova E, Milpied B, Mortz CG, Chu CY, Sotozono C, Gueudry J, Fortune DG, Dridi SM, Tartar D, Do-Pham G, Gabison E, Phillips EJ, Lewis F
    • Journal Title

      Orphanet J Rare Dis

      Volume: 18(1) Issue: 1 Pages: 33-33

    • DOI

      10.1186/s13023-023-02631-7

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Differences in gene regulation by TLR3 and IPS-1 signaling in murine corneal epithelial cells2023

    • Author(s)
      Komai S, Ueta M, Nishigaki H, Mizushima K, Naito Y, Kinoshita S, Sotozono C
    • Journal Title

      Sci Rep

      Volume: 13(1) Issue: 1 Pages: 7925-7925

    • DOI

      10.1038/s41598-023-35144-1

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Topical Betamethasone Treatment of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis with Ocular Involvement in the Acute Phase2023

    • Author(s)
      MATSUMOTO KAORI、UETA MAYUMI、INATOMI TSUTOMU、FUKUOKA HIDEKI、MIENO HIROKI、TAMAGAWA-MINEOKA RISA、KATOH NORITO、KINOSHITA SHIGERU、SOTOZONO CHIE
    • Journal Title

      American Journal of Ophthalmology

      Volume: 253 Pages: 142-151

    • DOI

      10.1016/j.ajo.2023.05.010

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Long-Term Benefits of Tear Exchangeable Limbal-Rigid Contact Lens Wear Therapy in Stevens?Johnson Syndrome Cases2023

    • Author(s)
      Yoshikawa Yamato、Ueta Mayumi、Kinoshita Shigeru、Kida Teruyo、Sotozono Chie
    • Journal Title

      Eye & Contact Lens: Science & Clinical Practice

      Volume: Publish Ahead of Print Issue: 6 Pages: 247-253

    • DOI

      10.1097/icl.0000000000000989

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Severe ocular complications of SJS/TEN and associations among pre-onset, acute, and chronic factors: a report from the international ophthalmology collaborative group2023

    • Author(s)
      Ueta M, Inoue C, Nakata M, Sotozono C, Kim MK, Wakamatsu T, Jongkhajornpong P, Saeed H, Rauz S, Ma DH, Yoon KC, Puangsricharern V, Bouchard C, Ahmad S, Seo KY, Joo CK, Gomes JAP, Chodosh J, Kinoshita S, Teramukai S
    • Journal Title

      Front Med (Lausanne)

      Volume: 10 Pages: 1189140-1189140

    • DOI

      10.3389/fmed.2023.1189140

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Development and Validation of a Novel Score to Predict Mortality in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: CRISTEN.2023

    • Author(s)
      Hama N, Sunaga Y, French LE, Chen WT, Chung WH, Chu CY, Abe R. et al
    • Journal Title

      J Allergy Clin Immunol Pract.

      Volume: 11(10) Issue: 10 Pages: 3161-3168

    • DOI

      10.1016/j.jaip.2023.07.001

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Strategic combination of cultivated oral mucosal epithelial transplantation and postoperative limbal-rigid contact lens-wear for end-stage ocular surface disease: a retrospective cohort study2023

    • Author(s)
      Aziza Y, Imai K, Itoi M, Yoshioka H, Komai S, Kitazawa K, Sitompul R, Ueta M, Fukuoka H, Inatomi T, Kinoshita S, Sotozono C
    • Journal Title

      Br J Ophthalmol

      Volume: - Issue: 8 Pages: 1177-1183

    • DOI

      10.1136/bjo-2023-323617

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Susceptibility Genes and HLA for Cold Medicine-Related SJS/TEN with SOC2022

    • Author(s)
      Ueta Mayumi
    • Journal Title

      Frontiers in Genetics

      Volume: 13 Pages: 912478-912478

    • DOI

      10.3389/fgene.2022.912478

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Challenges in the management of bilateral eyelid closure in Stevens-Johnson Syndrome2022

    • Author(s)
      Aziza Y, Harada K, Ueta M, Fukuoka H, Kinoshita S, Sotozono C
    • Journal Title

      Am J Ophthalmol Case Rep

      Volume: 26 Pages: 101473-101473

    • DOI

      10.1016/j.ajoc.2022.101473

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Risk factors for sepsis and effects of pretreatment with systemic steroid therapy for underlying condition in SJS/TEN patients: Results of a nationwide cross-sectional survey in 489 Japanese patients.2022

    • Author(s)
      Sunaga Y, Hama N, Ochiai H, Kokaze A, Lee ES, Watanabe H, Kurosawa M, Azukizawa H, Asada H, Watanabe Y, Yamaguchi Y, Aihara M, Mizukawa Y, Ohyamag M, Abe R, Hashizume H, Nakajima S, Nomurai T, Kabashima K, Tohyama M, Takahashi H, Mieno H, Ueta M, Sotozono C, Niiharam H, Morita E, Sueki H.
    • Journal Title

      J Dermatol Sci.

      Volume: 107(2) Issue: 2 Pages: 75-81

    • DOI

      10.1016/j.jdermsci.2022.07.004

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Japanese Research Committee on Severe Cutaneous Adverse Reaction. Multi-state model for predicting ocular progression in acute Stevens-Johnson syndrome/toxic epidermal necrolysis.2021

    • Author(s)
      Kinoshita F, Yokota I, Mieno H, Ueta M, Bush J, Kinoshita S, Sueki H, Asada H, Morita E, Fukushima M, Sotozono C, Teramukai S
    • Journal Title

      PLoS One.

      Volume: 16 Issue: 12 Pages: e0260730-e0260730

    • DOI

      10.1371/journal.pone.0260730

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed / Open Access
  • [Presentation] Stem Cell Recon in SJS2024

    • Author(s)
      Sotozono C
    • Organizer
      The 39th Asia-Pacific Academy of Ophthalmology Congress (APAO)
    • Related Report
      2023 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Long-term Outcomes of Autologous Cultivated Oral Mucosal Epithelial Transplantation for Corneal Reconstruction in Patients With Severe Ocular Surface DisordersB2024

    • Author(s)
      Yoshioka H, Aziza Y, Inatomi T, Kinoshita S, Komai S, Sotozono C
    • Organizer
      The 39th Asia-Pacific Academy of Ophthalmology Congress (APAO)
    • Related Report
      2023 Annual Research Report
    • Int'l Joint Research
  • [Presentation] SJS/TEN全国疫学調査450例に基づく急性期限重症度リスク因子の解明2024

    • Author(s)
      松本晃典, 中田美津子, 手向井聡, 上田真由美, 外園千恵
    • Organizer
      角膜カンファランス2024(第48回日本角膜学会総会・第40回日本角膜移植学会)
    • Related Report
      2023 Annual Research Report
  • [Presentation] Treatment Strategies for Severe Ocular Surface Disorders Using Sacracy2023

    • Author(s)
      Sotozono C
    • Organizer
      The Joint Meeting of Faculty of Medicine, Chulalongkorn University and Faculty of Medicine, Kyoto Prefectural University of Medicine
    • Related Report
      2023 Annual Research Report
    • Int'l Joint Research
  • [Presentation] SJS/TEN眼合併症と発症前, 急性, 慢性期 要因との関連性:国際眼科共同研究の報告. SJS/TEN眼合併症と発症前, 急性, 慢性期 要因との関連性:国際眼科共同研究の報告2023

    • Author(s)
      上田真由美, 井上史嵐, 中田美津子, 外園千恵, 木下 茂, 手良向 聡
    • Organizer
      第77回日本臨床眼科学会
    • Related Report
      2023 Annual Research Report
  • [Presentation] Sub-acute and chronic management of ocular sequele in Stevens-Johnson Syndrome.2022

    • Author(s)
      Sotozono C
    • Organizer
      Scientific meeting schedule comprehensive management in ocular surface problem
    • Related Report
      2022 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] Dramatic Decrease of Ocular Sequelae in SJS/TEN Cases due to Early Treatment2022

    • Author(s)
      Sasaki M, Mieno H, Ueta M, Nakata M, Teramukai S, Kinoshita S, Sotozono C
    • Organizer
      American Academy of Ophthalmology 2022 (AAO)
    • Related Report
      2022 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Limbal-Rigid Contact Lens Wear for the Treatment of Ocular Surface Disorders: A Review.2022

    • Author(s)
      Aziza Y, Itoi M, Ueta M, Inatomi T, Kinoshita S, Sotozono C.
    • Organizer
      American Academy of Ophthalmology 2022 (AAO)
    • Related Report
      2022 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Subspecialty Day: Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis2022

    • Author(s)
      Sotozono C
    • Organizer
      American Academy of Ophthalmology 2022 (AAO)
    • Related Report
      2022 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] Current Benchmarks in the Use of COMET for Severe Ocular Surface Disorders2022

    • Author(s)
      Sotozono C
    • Organizer
      World Cornea Congress Ⅷ
    • Related Report
      2022 Annual Research Report
    • Int'l Joint Research / Invited

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Published: 2022-04-19   Modified: 2024-12-25  

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