Proteoglycans (PGs) consist of a core protein and glycosaminoglycans (GAGs). They are components of the extracellular matrices of the central nervous system (CNS) and also are present in the peripheral nervous system. They have been reported to be axon regenerating inhibitors in the CNS. They may therefore affect the pathogenetic mechanisms of the neurological diseases, but their roles have rarely been studied so far. Recently we investigated experimental autoimmune encephalomyelitis (EAE) induced in the mice deficient in glycosyltransferases involved in the synthesis of GAGs and found that modification of the carbohydrate residue of PGs have major effects on the pathogenesis of EAE. About half of the patients with IgM paraproteinemic neuropathy (IgM–N), IgM M–proteins are known to recognize HNK–1 epitope of myelin–associated glycoprotein (MAG). Phosphacan is a proteoglycan, which also has HNK–1 epitope. We studied binding specificities of such IgM M–proteins and found that they were heterogeneous. The ratio of the binding activity to phosphacan divided by that to MAG (P/M ratio) was related with the clinical severity of IgM–N. Further investigation on the roles of PGs in the neurological diseases may lead to the understanding of the pathogenesis and the development of novel therapies of neurological diseases.
身体疾患で入院した認知症患者に対する認知症ケアサポートチーム（以下ケアチーム）の役割について検討を行った．対象は，ケアチームが介入した65歳以上で，かつ認知症生活自立度III以上の130例（平均年齢86±6歳）とした．入院の原因は肺炎，骨折が多く，行動・心理症状（behavioral and psychological symptoms of dementia：BPSD）が67%の症例で認められた．ケアチームによる介入は入院後平均9.1日で開始され，介入期間は平均34.0日間であり，その内訳は看護ケア単独57%，看護ケア＋薬剤調整40%，前者＋家族指導3%であった．介入終了時，BPSDは改善64%，不変35%，悪化1%の割合であった．自宅から入院した症例のうち，退院後自宅へ戻ったのは46%で，54%は転院もしくは施設に入所した．BPSDを伴う認知症の入院患者に対しては，認知症の専門知識を持った多職種からなるケアチームのサポートが有用と思われる．