Journal of Nihon University Medical Association
Online ISSN : 1884-0779
Print ISSN : 0029-0424
ISSN-L : 0029-0424
Volume 79 , Issue 2
Journal of Nihon University Medical Association
Showing 1-11 articles out of 11 articles from the selected issue
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  • Yoshimichi Okayama
    2020 Volume 79 Issue 2 Pages 63-64
    Published: April 01, 2020
    Released: August 14, 2020
    JOURNALS FREE ACCESS
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  • Yutaka Kozu
    2020 Volume 79 Issue 2 Pages 65-69
    Published: April 01, 2020
    Released: August 14, 2020
    JOURNALS FREE ACCESS
    Anaphylaxis is a serious disease that can be encountered in all medical departments. Although the onset may occur in unforeseen circumstances, it is necessary that the initial response be as efficient as possible. This article outlines the initial response and preventive measures based on the guidelines published by the Allergy Society in 2014. In the future, with the development of new drugs such as anti-tumor drugs, monoclonal antibodies, and biologics, dealing with atypical symptoms will become an issue. In order to deepen the understanding of anaphylaxis, it is important to understand the disease state, including the phenotype, end type, and biomarkers.
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  • Koji Hashimoto
    2020 Volume 79 Issue 2 Pages 71-76
    Published: April 01, 2020
    Released: August 14, 2020
    JOURNALS FREE ACCESS
    In recent years, the morbidity prevalence rate of asthma among elementary school children in Japan and the number of hospitalized patients has been declining. In 2017, the number of asthma deaths in children was zero. Japanese pediatric guidelines for the treatment and management of asthma (JPGL) are considered to have contributed to the success of pediatric asthma treatment in Japan. This article explains the latest information on bronchial asthma treatment in children, such as the new findings of pathology, transition of long-term management drugs for children, characteristics of the latest GINA (Global Initiative for Asthma), drug therapy for long-term management, response to acute exacerbation, allergen-specific immunotherapy, patient education, partnership with patients and their family, pediatric transitional care, pediatric asthma and chronic obstructive pulmonary disease (COPD).
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  • Reiko Ito
    2020 Volume 79 Issue 2 Pages 77-80
    Published: April 01, 2020
    Released: August 14, 2020
    JOURNALS FREE ACCESS
    Asthma is characterized by chronic inflammation and reversibility of the airways. The disease is characterized by inflammation of eosinophils. Recently, a new disease related to innate immunity has been proposed, and it has been found that there are several subtypes of refractory asthma. Biomarkers are also being explored to identify therapeutic targets during diagnosis. New treatments for asthma include an increase in inhaled drug types and antibody therapy with biologics targeting refractory asthma. In addition, we can choose to treat asthma by respiratory intervention using bronchoscopy. Asthma treatment, like that of other diseases, benefits from personalization.
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  • Japanese Pediatric Guidelines for Food Allergy
    Motoko Iwama
    2020 Volume 79 Issue 2 Pages 81-86
    Published: April 01, 2020
    Released: August 14, 2020
    JOURNALS FREE ACCESS
    The goal of the treatment of food allergies is to determine exactly which foods cause allergic symptoms and remove minimal food that induce symptoms from the diet. Oral food challenge is the gold standard for definitive diagnosis; detailed interviews are essential, and immunological tests are helpful. Nutritional guidance for food allergy patients should be given safely after understanding the amount of the food that induces symptoms. It is also necessary to prescribe medications for allergic symptoms and to find an emergency outpatient clinic to consult. Control of bronchial asthma and atopic dermatitis is also very important for preventing severe allergic symptoms and blocking the sensitization pathway
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  • Yoshiyuki Nagata, Yasuyuki Nomura
    2020 Volume 79 Issue 2 Pages 87-92
    Published: April 01, 2020
    Released: August 14, 2020
    JOURNALS FREE ACCESS
    Research on the pathophysiology of airway mucosal disease has been dramatically advanced by recent progress in immunology in the past few decades. In ARIA (Allergic Rhinitis and its Impact on Asthma), the similarity and relevance of the mucosal pathology of the upper and lower respiratory tracts has been pointed out. Even otolaryngologists, who often treat upper respiratory diseases, need to understand and treat lower respiratory diseases, which have a similar pathophysiology. Allergic rhinitis and eosinophilic chronic rhinosinusitis are noted allergic diseases in the field of otorhinolaryngology, and both are associated with lower respiratory tract diseases (particularly bronchial asthma). In this article, we describe the pathologies and treatments of allergic rhinitis and eosinophilic chronic rhinosinusitis.
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  • Koremasa Hayama
    2020 Volume 79 Issue 2 Pages 93-97
    Published: April 01, 2020
    Released: August 14, 2020
    JOURNALS FREE ACCESS
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  • Jun Shoji
    2020 Volume 79 Issue 2 Pages 99-105
    Published: April 01, 2020
    Released: August 14, 2020
    JOURNALS FREE ACCESS
    Allergic conjunctival diseases (ACDs) are inflammatory diseases of the conjunctiva caused predominantly by the IgE-mediated immediate hypersensitivity response and accompanied by conjunctival eosinophilic inflammation. ACDs comprise five different clinical forms: seasonal allergic conjunctivitis, perennial allergic conjunctivitis, atopic keratoconjunctivitis (AKC), vernal keratoconjunctivitis (VKC), and giant papillary conjunctivitis. In the diagnosis of ACDs, clinical scores, clinical tests for atopic diathesis (including total IgE in tears and antigen specific-IgE antibody in serum), and ocular allergic tests are crucial diagnostic tools. In the ocular allergic tests for ACDs, allergy-associated factors in tear samples and cytology specimens are usually investigated in the laboratory to assess the severity of allergic inflammation in the conjunctiva. Eosinophil cationic protein and eotaxin-2 are suitable biomarkers in the ocular surface test. Topical immunosuppressants, including cyclosporine ophthalmic solution and tacrolimus ophthalmic suspension, have been shown to be effective nonsteroidal therapies for treating VKC. It is important that the efficacy and safety of topical immunosuppressant therapy for VKC should be evaluated objectively. Recent findings related to ocular surface biomarkers and topical immunosuppressant therapy provide a novel approach for allergy treatment of the ocular surface of patients with ACDs.
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  • Noboru Kitamura, Masami Takei
    2020 Volume 79 Issue 2 Pages 107-112
    Published: April 01, 2020
    Released: August 14, 2020
    JOURNALS FREE ACCESS
    Systemic vasculitis is a general term for the disease that causes various organ failure with inflammatory vasculitis. At present, systemic vasculitis is classified by the size of the blood vessel as described by the Chapel Hill Consensus Conference (CHCC) criteria. Small size vasculitis is classified as ANCA-associated vasculitis and immune-complex associated vasculitis. Various symptoms occur with systemic vasculitis because various sizes of vessels cause injury. The pathological etiology of systemic vasculitis is giant cell arteritis, necrotizing vasculitis or leukocyteclastic vasculitis. Glucocorticoids were the main treatment for systemic vasculitis, but today, combination therapy with glucocorticoids and some immunosuppressive drugs is the mainstream treatment for systemic vasculitis. Recently, some biological drugs have been used in the treatment of systemic vasculitis. Tocilizumab, an IL-6 receptor antagonist, is used to treat rheumatoid arthritis and Castleman’s disease. In 2017, tocilizumab was used to treat Takayasu arteritis and giant cell arteritis, which it is able to improve with glucocorticoid monotherapy. Infliximab, an anti-TNFα monoclonal antibody, is used as a treatment for rheumatoid arthritis and other autoimmune diseases. In 2015, infliximab was used as a treatment for Kawasaki disease, which it improves, by intravenous immunoglobulin treatment. Rituximab, an anti-CD20 monoclonal antibody, is usually used as a treatment for CD20+ B cell lymphoma. While rituximab is usually used to treat RA and SLE in the United States and Europe, it cannot be used to treat RA and SLE in Japan. In 2017, rituximab was used as a treatment for MPA and GPA when there is improvement caused by glucocorticoids. Mepolizumab, an IL-5 monoclonal antibody, is used as treatment for severe bronchial asthma. Since 2017, mepolizumab has been used as a treatment for EGPA when there is improvement caused by glucocorticoids. It is expected that more new treatments for systemic vasculitis will be developed.
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