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136 巻, 2 号
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長野 一也, 東阪 和馬2016 年 136 巻 2 号 p. 143-144
発行日: 2016/02/01
公開日: 2016/02/01
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長野 一也2016 年 136 巻 2 号 p. 145-149
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーDisease proteomics that systemically analyzes and identifies differentially expressed proteins between healthy and diseased samples is a potentially useful approach for obtaining target proteins for drug development. To date, however, very few target proteins have been identified from this field. A key issue that remains to be resolved is how to correctly identify target proteins from a number of potential candidates. To circumvent this problem, we have developed “antibody proteomics technology” in which a single chain Fv phage antibody library is utilized for proteome analysis. Here, we describe the application of this technology by primarily focusing on Eph receptor A10 (EphA10), a novel breast cancer-related protein that is a promising target for antibody drugs. To establish an effective and safe targeted cancer therapy, it is important that the target is specifically expressed in cancer tissues. Therefore, we attempted to analyze the EphA10 expression profiles. Tissue microarray analysis showed that EphA10 was expressed in all subtypes of breast cancer containing triple negative breast cancer cases. On the other hand, EphA10 was only expressed in testis tissue among 36 kinds of normal tissues. Thus, EphA10 could be a highly cancer-specific protein, making it a promising target for female breast cancer patients. Finally, we examined the anti-tumor effect by anti-EphA10 antibody, aiming for the development of a novel EphA10 targeting therapy. Administration of the antibody showed that tumor volumes were significantly inhibited. Our results suggest that targeting EphA10 in breast cancer cases might be a promising new form of therapy.
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砂川 陽一, 刀坂 泰史, 和田 啓道, 長谷川 浩二, 森本 達也2016 年 136 巻 2 号 p. 151-156
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーVarious stresses on the heart, such as myocardial infarction and hemodynamic overload, activate the sympathetic nervous system and the renin-angiotensin system, ultimately reach the nuclei of cardiomyocytes, and change the pattern of gene expression associated with cardiac hypertrophy. Although present pharmacological therapy for heart failure targets such extracellular molecules, mortality due to heart failure is still high. A zinc finger protein, GATA4, is one of the hypertrophy-responsive transcription factors, forms a functional protein complex with an intrinsic histone acetyltransferase, p300, and regulates pathological cardiac hypertrophy. Disruption of this complex results in the inhibition of cardiac hypertrophy and heart failure in vivo. To establish a more effective therapy for heart failure, we have been analyzing a common nuclear pathway within cardiomyocytes. We identified 73 GATA4 binding proteins by tandem-affinity purification and mass spectrometric analysis. Noble GATA4 binding partners, such as cyclin-dependent kinase-9 (Cdk9: the core factor of positive transcription elongation factor b) and retinoblastoma-association protein 48/46 (RbAp48/46: the co-repressor complexes containing HDAC1/2), regulate the p300/GATA4-mediated signaling pathway and hypertrophic responses. Further analysis of p300/GATA4 complex is expected to identify target molecules for heart failure therapy.
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大山 要2016 年 136 巻 2 号 p. 157-161
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーOur immune system resembles an intelligent security system, which continually monitors for foreign invaders (infectious diseases); however, in some cases, this system recognizes healthy parts as something harmful or foreign and then attacks them (autoimmune diseases). The defining characteristics of an autoimmune disease are the existence of T- and B-cell autoreactivity against self proteins (autoantigens). In addition to autoimmune diseases, aberrant host proteins that occur during a certain state of diseases (e.g., cancer) can be recognized as an autoantigen. Immune complexes (ICs) are produced during an immune response and may reflect some aspects of an ongoing immune response. Therefore, the identity of antigens incorporated into ICs provides the information that in the future may aid in the development of diagnosis and treatment strategies for autoimmune diseases, infection, cancer, and transplantation therapy, and this information might be more relevant than information on free antigens. We developed a novel proteomic strategy (immune complexome analysis) in which ICs are separated from serum, followed by direct tryptic digestion and nano-liquid chromatography-tandem mass spectrometry for the identification and profiling of antigens in circulating ICs. We applied this strategy to the analysis of circulating ICs in autoimmune diseases (rheumatoid arthritis, anti-neutrophil cytoplasmic antibody-associated vasculitis, Takayasu's arteritis, mixed connective tissue disease, dermatomyositis, Sjögren's syndrome, systemic scleroderma, and systemic lupus erythematosus), infectious diseases and cancers. In this review, we mainly discuss the results for autoimmune diseases.
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早坂 孝宏2016 年 136 巻 2 号 p. 163-170
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーImaging mass spectrometry (IMS) can reveal the distribution of biomolecules on tissue sections. In this process, the biomolecules are directly ionized within tissue sections using matrix-assisted laser desorption/ionization, and then their distribution is visualized by pseudo-color based on the relative signal intensity. The biomolecules, such as fatty acids, phospholipids, glycolipids, peptides, proteins, and neurotransmitters, have been analyzed at a spatial resolution of 5 μm. A special instrument for IMS analysis was developed by Shimadzu. The IMS analysis does not require the labeling of biomolecules and is capable of analyzing all the ionized biomolecules. Interest in this method has expanded to many research fields, including biology, agriculture, medicine, and pharmacology. The technique is especially relevant to the drug discovery process. As practiced currently, drug discovery is expensive and time consuming, requiring the preparation of probes for each drug and its metabolites, followed by systematic probe tracking in animal models. The IMS technique is expected to overcome these drawbacks by revealing the distribution of drugs and their metabolites using only a single analysis. In this symposium, I introduced the methodology and applications of IMS and discussed the feasibility of its application to drug discovery in the near future.
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清水 敏之, 加藤 博章2016 年 136 巻 2 号 p. 171-172
発行日: 2016/02/01
公開日: 2016/02/01
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清水 敏之2016 年 136 巻 2 号 p. 173-178
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーToll-like receptors (TLRs) are a family of pattern-recognition receptors that recognize microbial components and initiate subsequent immune responses. TLR7 and TLR8 recognize single-stranded (ss)RNA and initiate innate immune responses. Moreover, several small-molecule compounds have been identified as TLR7 and TLR8 activators. We determined the crystal structures of unliganded and ligand-induced activated human TLR8 dimers. Upon ligand stimulation, the TLR8 dimer was reorganized such that the two C-termini were brought into proximity. Ligand binding induces reorganization of the TLR8 dimer, which enables downstream signaling processes. To elucidate how TLR8 recognizes its natural ligand, ssRNA, as well as how the receptor can be activated by ssRNA that is structurally and chemically very different from the chemical ligands, we performed crystallographic studies of TLR8 in complex with ssRNA. TLR8 recognizes, at distinct sites, uridine and small oligonucleotides derived from the degradation of ssRNA. Uridine bound the site on the dimerization interface where small chemical ligands are recognized, whereas short oligonucleotides bound a newly identified site. Based on structural information, new compounds have been developed. We describe the crystal structure of a newly developed agonist, C2-butyl furo[2,3-c]quinolone.
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小林 拓也2016 年 136 巻 2 号 p. 179-184
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーG protein-coupled receptors (GPCRs) are the largest family of receptors in the human genome. They are involved in many diseases and also the target of approximately 30% of all modern medicinal drugs. GPCRs respond to a broad spectrum of chemical entities, ranging from photons, protons, and calcium ions to small organic molecules (including odorants and neurotransmitters), peptides, and glycoproteins. Many GPCRs are members of closely related subfamilies that respond to the same hormone or neurotransmitter. However, they have different physiologic functions based on the cells in which they are expressed and the different signaling pathways that they exploit (e.g., coupling through heterotrimeric G-proteins such as Gs, Gi, and Gq, as well as β-arrestins). Antibody fragments including Fab and Fv can effectively stabilize and crystallize membrane proteins. However, using the mouse hybridoma technology it has been difficult to develop monoclonal antibodies that can recognize conformational epitopes of native GPCRs. We have recently succeeded in developing antibodies against native GPCRs using this technology in combination with our improved immunization and screening methods. In this symposium review, I present a successful example of prostaglandin E2 receptor (one of the GPCRs) crystallization using antibody fragments. To avoid several adverse effects of current therapeutics, it is essential to understand the molecular mechanism of GPCR signaling in a monomeric, dimeric, or oligomeric state. Also, we are interested in selectively regulating GPCR signaling via functional antibodies developed using our methods and/or the designed small organic molecules depending on the GPCR structure.
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須藤 雄気2016 年 136 巻 2 号 p. 185-189
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーRetinal proteins possess vitamin A aldehyde (retinal) as a chromophore within seven transmembrane α-helices. Visible light absorption of them triggers trans-cis photoisomerization of the retinal chromophore and induces structural changes in the protein moiety, resulting in a variety of biological functions such as vision, ion transportation, and photosensing. Environmental genomics revealed that retinal proteins are widely distributed through all three biological kingdoms, eukarya, bacteria, and archaea, indicating the biological significance of their light energy conversion. In addition to their biological aspect, retinal proteins have become a focus of interest in part because of applications for optogenetics. On the basis of our results and other findings, we highlight the recent progress in structural and functional studies on retinal proteins.
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Christopher John Hipolito, 西尾 洸祐, 菅 裕明2016 年 136 巻 2 号 p. 191-196
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーMembrane proteins allow a cell to communicate with its environment by relaying a signal or transporting a molecule through the cell membrane. Elucidation of the three-dimensional structure of a membrane protein provides a greater understanding of its function and mechanisms. Ultimately, this knowledge will enlighten researchers on how these proteins can be regulated to elicit a desired cellular response, which could lead to novel therapeutic medicine. Unfortunately, the determination of the high-resolution crystal structures of transmembrane proteins remains a challenge due to their poor solubility and high conformational flexibility. Additives and cocrystallization ligands are being used to address these problems. In vitro selected macrocyclic peptides have recently been successfully employed as cocrystallization ligands. Although originally intended as inhibitors and drug lead molecules, in vitro selected macrocyclic peptides are now showing that their pharmacodynamic properties also allow them to serve as excellent cocrystallization ligands. Structures for macrocyclic peptide-bound transporters, the multidrug and toxic compound extrusion family transporter from Pyrococcus furiosus (PfMATE) and the ABC transporter subfamily B member 1 from Cyanidioschyzon meraloe (CmABCB1), have been elucidated using X-ray crystallography. The cocrystal structures reveal that the macrocyclic peptides improve crystallization by binding in a similar manner as a small molecule or a biologic. The PfMATE-binding macrocyclic peptides MaD3S and MaD5 bind to the surfaces buried in the center channel of the transporters. Although both transporters possess a center channel and substrate-binding pocket, the CmABCB1-binding macrocyclic peptide, aCAP, binds to the outer surface of the transporter in a similar manner to a biologic.
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山口 知宏2016 年 136 巻 2 号 p. 197-202
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーA drug's effectiveness against a disease depends not only on its interaction with receptors but also its pharmacokinetics (absorption, distribution, metabolism, and extrusion; ADME). ATP binding cassette (ABC) multidrug transporters are important proteins that influence the ADME properties of a drug, especially the ABC transporter subfamily B member 1 (ABCB1). Elucidation of the molecular mechanisms of ABCB1 will contribute to our understanding of the molecular basis of ADME. Human ABCB1 is expressed in many organelles, and exports various substrates from cells using energy generated by its ATP hydrolase (ATPase) activity. The ATPase activity depends on the concentration of the transport substrates, and the characteristic behavior of the substrate-dependent ATPase activity can be related to the molecular mechanism of ABCB1. Recently, we have revealed the molecular mechanisms of a eukaryotic ABCB1 homolog, CmABCB1, based on structural and functional studies. In this review, I discuss the relationship between key structural features and the behavior of transport substrate-dependent ATPase activity of CmABCB1, including its role in determining the molecular basis of ADME.
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北 潔, 山田 陽城2016 年 136 巻 2 号 p. 203-204
発行日: 2016/02/01
公開日: 2016/02/01
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北 潔2016 年 136 巻 2 号 p. 205-211
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーEBOLA hemorrhagic fever, a typical emerging infectious disease, began in December 2013 in the southern part of Guinea, and killed more than 11000 people by the end of June, 2015. In addition to emerging/re-emerging diseases and the 3 major infectious diseases i.e. HIV/AIDS, tuberculosis and malaria, neglected tropical diseases (NTDs) have recently become important tropical diseases of the poor. It is remarkable that Japan succeeded in the eradication of malaria and other tropical diseases, which include lymphatic filariasis and schistosomiasis. However, despite these achievements, it is important to sustain our efforts when we consider global health. This review highlights the significance of elimination and/or control of NTDs, and then introduces the current situation of drug development activities in Japan, which are aimed towards combating tropical infectious diseases. They include studies on a novel drug target, the “mitochondrial NADH-fumarate reductase system (Fumarate respiration)” composed of complex I, rhodoquinone and complex II, which plays an important role in the anaerobic energy metabolism of many helminths such as Ascaris suum. An additional interesting finding highlighted herein is that ascofuranone, a recently developed anti-African trypanosome drug, shows specific inhibition of fumarate respiration in Echinococcus multilocularis mitochondria.
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山田 陽城, 平林 史子, Chris Brünger2016 年 136 巻 2 号 p. 213-222
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーThe Drugs for Neglected Diseases initiative (DNDi), with headquarters in Geneva, is a non-profit drug research and development (R&D) organization and Product Development Partnership (PDP) which was established in 2003 by 7 founding organizations such as Médecins Sans Frontières (MSF), the Pasteur Institute, The Specific Programme for Research and Training in Tropical Diseases (WHO-TDR), etc. DNDi has worked mainly on the development of new treatments for neglected tropical diseases (NTDs), which is difficult to achieve under market economy conditions. DNDi has promoted overall drug discovery research including the screening of drug candidates, hit to lead, lead optimization, pre-clinical and clinical studies in the area of infectious diseases with a focus on malaria, sleeping sickness (human African trypanosomiasis; HAT), Chagas disease, leishmaniasis, filarial diseases and pediatric formulations for HIV treatment. DNDi's achievements include the development of novel therapies based on patient needs through innovative partnerships with over 130 organizations in industry, government, academia, and public institutions around the world. To date, DNDi has registered 6 novel treatments adapted to the needs of patients in poor countries, and has another 12 novel entities in development. DNDi Japan is a Japanese non-profit organization (NPO) based on the global principles of DNDi and, as the only PDP in Japan, is supporting NTD drug discovery projects in collaboration with Japanese pharmaceutical companies, academic institutions and government agencies by utilizing Japan's excellent R&D capabilities to develop new treatments for NTDs in order to contribute to global health.
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浅田 誠2016 年 136 巻 2 号 p. 223-230
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーThe Pharmaceutical Industry is expected to play a proactive global role in combatting neglected tropical diseases (NTDs) and other tropical diseases affecting low-income countries. Such a role would include novel medicine R&D, manufacturing and distribution. In order to succeed in this role, several challenges need to be overcome: a) the economic challenge or cost benefit balance for the development of these medicines, and b) sparse in-house experience with these diseases within the Industry. During the last decade, the Product Development Partnership (PDP) model has become an effective strategy to address such challenges. Organizations such as the Medicines for Malaria Venture (MMV), Drugs for Neglected Diseases initiative (DNDi), TB alliance, PATH (formerly the Program for Appropriate Technology in Health), and others have linked pharmaceutical companies, funding organizations, academic researchers and others, and have thus been able to successfully populate treatment pipelines directed at NTDs, Malaria, tuberculosis (TB), and human immunodeficiency virus (HIV)/AIDS. In this paper, our experience working with one of these organizations, DNDi, is described. We have been collaborating with DNDi in evaluating the actions of Eisai's antifungal compound, E1224, in a clinical study for treating Chagas Disease. In addition, other Eisai initiatives directed at NTDs and improving patients' access to medicines are introduced.
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生田目 一寿2016 年 136 巻 2 号 p. 231-236
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーNeglected tropical diseases (NTDs) are an extremely important issue facing global health care. To improve “access to health” where people are unable to access adequate medical care due to poverty and weak healthcare systems, we have established two consortiums: the NTD drug discovery research consortium, and the pediatric praziquantel consortium. The NTD drug discovery research consortium, which involves six institutions from industry, government, and academia, as well as an international non-profit organization, is committed to developing anti-protozoan active compounds for three NTDs (Leishmaniasis, Chagas disease, and African sleeping sickness). Each participating institute will contribute their efforts to accomplish the following: selection of drug targets based on information technology, and drug discovery by three different approaches (in silico drug discovery, “fragment evolution” which is a unique drug designing method of Astellas Pharma, and phenotypic screening with Astellas' compound library). The consortium has established a brand new database (Integrated Neglected Tropical Disease Database; iNTRODB), and has selected target proteins for the in silico and fragment evolution drug discovery approaches. Thus far, we have identified a number of promising compounds that inhibit the target protein, and we are currently trying to improve the anti-protozoan activity of these compounds. The pediatric praziquantel consortium was founded in July 2012 to develop and register a new praziquantel pediatric formulation for the treatment of schistosomiasis. Astellas Pharma has been a core member in this consortium since its establishment, and has provided expertise and technology in the area of pediatric formulation development and clinical development.
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日下 英司2016 年 136 巻 2 号 p. 237-242
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーIn developing countries, many people are unable to access basic healthcare services, resulting in many avoidable deaths and/or disabilities. The United Nations adopted the Millennium Development Goals in order to resolve this problem, and Japan has been contributing greatly to the achievement of these goals. In this context, in 2013 the Government of Japan proposed its Strategy on Global Health Diplomacy, and since then has been promoting Universal Health Coverage. Since the beginning of the 21st century, the particular importance of addressing neglected tropical diseases (NTDs) has been stressed by the international community. Nevertheless, of the 1 billion people world-wide who are currently living with NTDs, about three-fourths of these are living in poverty, and of these, nearly 65% are unable to acquire or access drugs for the prevention and treatment of these diseases. Under these circumstances, Japan decided to support the Global Health Innovative Technology (GHIT) Fund in order to support the research and development of drugs for people in developing countries, as well as the manufacture, supply and administration of these drugs. Over the last two years, the GHIT Fund has been supporting the research and development of five new candidate drugs for three NTDs (Chagas disease, leishmaniasis and malaria). Japan also hopes to stimulate domestic pharmaceutical industries in developing countries, as well as to increase international cooperation through various activities such the utilization of our capacity to research and develop new drugs.
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齋藤 充生, 山本 美智子2016 年 136 巻 2 号 p. 243-244
発行日: 2016/02/01
公開日: 2016/02/01
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齋藤 充生2016 年 136 巻 2 号 p. 245-249
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーAccording to the “Japan Revitalization Strategy” established in June 2013, “the government will promote better contributions of local pharmacies and pharmacists in encouraging self-medication of citizens by making pharmacies the community-based hub for providing information, giving advice on the proper use of non-prescription drugs, etc. and offering consultation and information service concerning health”. In addition, the “Demanded Function and Ideal Form of Pharmacy,” published in January 2014, requested a change, from pharmacies that specialized in dispensing medicines to pharmacies that serve as whole healthcare stations, providing pharmaceutical care based on patients' medical history, including the intake of dietary supplements. The medication fee was revised in April 2014 to enhance family pharmacy services and the management of pharmaceutical care. At that time, blood testing at a registered pharmacy was officially allowed under strict regulation. Revision of the “Pharmacist Law” in June 2014 included a request to pharmacists to provide pharmaceutical advice in addition to information. For the mitigation of drug-induced tragedies, the “Pharmaceutical Affairs Law” was amended to the “Pharmaceutical and Medical Device Act (PMD Act)” in November 2014, and proper use of medicines was imposed on healthcare professionals and other stakeholders. Patients were also requested to learn and understand the safety and harmful effects of medicines, and were requested to use medicines appropriately. As mentioned above, the status of pharmacies and pharmacists has dramatically changed in the past 2 years, and such changes over time are required.
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古川 綾, 浅田 美子, 森 貴幸, 井上 岳, 厚田 幸一郎2016 年 136 巻 2 号 p. 251-258
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーThe Asheville Project® began in 1996 in Asheville, North Carolina, where community pharmacists, in collaboration with physicians, provide health coaching to patients with lifestyle diseases to accomplish their improved self-management of the disease. The project has now widely expanded across the United States. With periodical coaching by pharmacists, according to the reports of these programs, patients have been reported to show improvements in self-management and laboratory data, including the number of doctor visits, medication adherence and the number of foot examinations. Economically, the total medical costs for this disease have decreased 34% over a 5-year period by complying with the Asheville Project. In implementing this model in Japan, various questions, such as the feasibility for busy pharmacists to expend 30-60 min for meeting individually with patients, effective collaboration between pharmacy and physician, patients' acceptance of support by pharmacists to modify their behavior, etc. had to be answered. Thus, we developed a program entitled, “A Health Coaching Program by Community Pharmacists in a Collaborative Practice,” aimed at preventing the aggravation of lifestyle diseases; we evaluated its feasibility for the above mentioned concerns. The content of this coaching program has been prepared with reference to the Asheville Project® and with the support of Kitasato University School of Pharmacy and the Iowa Pharmacy Association, USA. We herein introduce this coaching program, as well as what the pharmacists have learned through this program.
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藤井 仁美, 森 貴幸, 古川 綾, 井上 岳, 厚田 幸一郎2016 年 136 巻 2 号 p. 259-263
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーFor prevention of the aggravation of diabetic nephropathy, a treatment method that combines self-care with medical guidance is becoming increasingly important, leading to the development of programs for lifestyle modification for the patients. To assess the effectiveness of such programs, we have conducted a feasibility study of a patient self-care support program with medical collaboration by registered pharmacists in community pharmacies involving patients with diabetic nephropathy who are under treatment at medical institutions, including our hospital. This study evaluated the two primary measurements, which are A) the actual execution rate versus planned programs, and B) the patient satisfaction rate. In addition, the achievement rate of behavioral objectives, satisfaction rate of diabetes treatment, degree of concerns (Diabetes Treatment Satisfaction Questionnaire; DTSQ, Problem Areas in Diabetes; PAID) and other physiological indicators have been evaluated. With the approval of the IRB at Kitasato University, sixteen out of 18 patients have continued to participate in the support program, and the study has shown high patient satisfaction with pharmacist coaching support. Patients have gained interest in managing their lifestyles, thereby increasing self-efficacy. Also, information shared between the pharmacists and the physicians has clarified patients' issues and concerns pertaining to their lifestyles, which were effectively utilized in the coaching program. Through meetings with pharmacists, patients have been reassured of the expertise of the pharmacist and thus gained mutual trust, which leads to the patient's behavioral change. We believe that the collaboration of patients, pharmacists and physicians has resulted in effective team-based patient care.
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林 譲, 齋藤 充生, 矢島 毅彦2016 年 136 巻 2 号 p. 265-271
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーThe purpose of this study was to propose a method for visualizing the patterns of the geographical propagation of influenza infection, and to elaborate parameters for the characterization of these patterns. First, a motion picture was prepared for the quotidian propagation of influenza infection in the Greater Tokyo Metropolitan area, which is considered a typical epidemic area for the 2012/2013 flu season. Second, hebdomadal recordings of patients with influenza infection in the 47 prefectures of Japan were grouped into 3 categories (1-peak, 2-peak, or multi-peak). The prefectures were arranged according to the weeks with the maximum number of patients, to examine variations in the temporal infection order of the districts among the flu seasons. These characteristics were analyzed using Cramer's coefficient of association and Spearman's rank correlation coefficient. Finally, the propagation of influenza infection was compared between urban and remote areas: the Greater Tokyo Metropolitan area and Tochigi prefecture. Regarding influenza virus infection, differences in population density, public transportation systems, and lifestyles between the urban and rural areas were found to lead to distinct endemic patterns of infection. Emphasis was placed on the so-called big data hubris.
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大室 弘美, 中嶋 弥生, 齋藤 充生, 湯田 康勝2016 年 136 巻 2 号 p. 273-279
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーKampo medicines must be used according to an individual's physical characteristics and symptoms to avoid lack of efficacy, adverse reactions or interactions with other drugs. As category-2 over-the-counter drugs (OTCs), Kampo OTCs are not targets of active explanations by pharmacists, and consumers usually decide to use OTCs by themselves on the basis of drug label information. However, information on the label is occasionally brief. To promote the proper use of Kampo OTCs, we herein propose an informative tool based on the Australian Shelf-Talker (information on the proper use of OTCs with a self-check questionnaire for consumers), the Self-Check Card (SCC). We also prepared the informative material, Information to the Pharmacist (IP), directed at pharmacists regarding these Kampo OTCs. We created SCCs and IPs for 16 prescriptions in the 5 most demanded categories (cold, cough/sore throat, urination problems, women's diseases, and shoulder stiffness or joint/nerve pain). The SCC with questions in a simplified language specifies individuals who should avoid the drug, or those who should consult a pharmacist before purchase, according to the safety information on the respective drug labels. The IP provides information to pharmacists on safety issues and those concerning recognition of the consumer's symptoms and physical characteristics needed for the selection of appropriate Kampo OTCs. Such SCCs and IPs are now in use in 2 pharmacies to know pharmacists' suggestions about improvements and consumer's opinions and degree of satisfaction. We believe these risk-benefit communication tools, SCC and IP, will contribute to improve the proper use of Kampo OTCs.
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山本 美智子, 土肥 弘久, 渡部 一宏2016 年 136 巻 2 号 p. 281-286
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーAccording to the Japanese revitalization strategy endorsed by the government in June, 2013, pharmacies are expected to play an active role as the hub of health information. But this is not sufficiently organized: an infrastructure for providing neutral information which becomes the basis of such health information is not yet established for healthcare professionals, patients and consumers. As for drug information available subsequent to the marketing of pharmaceutical products, information from the pharmaceutical companies including Package Inserts and Interview-forms are often found. However, though such information from companies is important, it is necessary for healthcare professionals and patients to have access to the information evaluated by a trustworthy third party. With overseas distribution, the dissemination of drug information is provided by third parties, which are independent of regulatory agencies. For example, National Health Service (NHS) Evidence in the UK offers wide-ranging information based on evidence from a disease to pharmaceutical products, and is a widely available information source for healthcare professionals, patients and consumers. With regard to therapeutic medications, drug information and health foods in the Japanese community, it is necessary for patients and healthcare professionals that we establish neutral and common systematic information based on the research evidence. By providing information on the Internet, which enables people to access the information easily and to assess a product's usefulness objectively, we hope to eventually develop a system that ensures a patient's safety in the use of drugs.
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総説
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田口 恭治2016 年 136 巻 2 号 p. 287-296
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーPeripheral neuropathy is a common adverse effect of paclitaxel and oxaliplatin treatment. The major dose-limiting side effect of these drugs is peripheral sensory neuropathy. The symptoms of paclitaxel-induced neuropathy are mostly sensory and peripheral in nature, consisting of mechanical allodynia/hyperalgesia, tingling, and numbness. Oxaliplatin-induced neurotoxicity manifests as rapid-onset neuropathic symptoms that are exacerbated by cold exposure and as chronic neuropathy that develops after several treatment cycles. Although many basic and clinical researchers have studied anticancer drug-induced peripheral neuropathy, the mechanism is not well understood. In this review, we focus on (1) analysis of transient receptor potential vanilloid 1 (TRPV1) channel expression in the rat dorsal root ganglion (DRG) after paclitaxel treatment and (2) analysis of transient receptor potential ankyrin 1 (TRPA1) channel in the DRG after oxaliplatin treatment. This review describes that (1) paclitaxel-induced neuropathic pain may be the result of up-regulation of TRPV1 in small- and medium-diameter DRG neurons. In addition, paclitaxel treatment increases the release of substance P, but not calcitonin gene-related peptide, in the superficial layers of the spinal dorsal horn. (2) TRPA1 expression via activation of p38 mitogen-activated protein kinase in small-diameter DRG neurons, at least in part, contributes to the development of oxaliplatin-induced acute cold hyperalgesia. We suggest that TRPV1 or TRPA1 antagonists may be potential therapeutic lead compounds for treating anticancer drug-induced peripheral neuropathy.
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井上 義雄2016 年 136 巻 2 号 p. 297-308
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーAnimal defense mechanisms against both endogenous and exogenous toxic compounds function mainly through receptor-type transcription factors, including the constitutive androstane receptor (CAR). Following xenobiotic stimulation, CAR translocates into the nucleus and transactivates its target genes including oxygenic and conjugative enzymes and transporters in hepatocytes. We identified subcellular localization signals in the rat CAR: two nuclear localization signals (NLS1 and 2); two nuclear export signals (NES1 and 2); and a cytoplasmic retention region. The nuclear import of CAR is regulated by the importin-Ran system and microtubule network. Five splice variants (SV1-5) were identified in rat liver in addition to wild-type CAR. When expressed in immortalized cells, their artificial transcripts were inactive as transcription factors. A CAR mutant with three consecutive alanine residues inserted into the ligand-binding domain of CAR showed ligand-dependent activation of target genes in immortalized cells, which is in marked contrast to the constitutive transactivating nature of wild-type CAR. Using this assay system, androstenol and clotrimazole, both of which are inverse agonists of CAR, were classified as an antagonist and weak agonist, respectively. A member of the DEAD box DNA/RNA helicase family (DP97) and protein arginine methyltransferase 5 (PRMT5) were found to be gene (or promotor)-specific coactivators of CAR. The expression of the CAR gene might be under the control of clock genes mediated by the nuclear receptor Rev-erb-α.
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通 元夫2016 年 136 巻 2 号 p. 309-327
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーThe terpenoid constituents of Ligularia virgaurea (30 samples), Ligularia pleurocaulis (8 samples), Ligularia dictyoneura (8 samples), Ligularia brassicoides (5 samples), Ligularia lingiana (1 sample), and Ligularia liatroides (1 sample)(all belonging to section Senecillis of Ligularia, Asteraceae and collected in Yunnan, Sichuan, Qinghai, and Gansu provinces, China), from which 220 compounds were isolated, including 113 novel ones, are reviewed. Five chemotypes were identified in L. virgaurea based on their chemical constituents, while three clades were detected from the base sequences. Although intra-specific diversity was found in L. virgaurea, more samples were needed of other species in order to reach a definite conclusion. Inter-specific diversity was also examined in section Senecillis but was restricted due to the scarcity of samples. Synthetic studies on chiral natural products to determine their absolute configurations, especially those of riccardiphenols A and B as well as crispatanolide, which were all isolated from the liverwort, are briefly reviewed.
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小松 生明2016 年 136 巻 2 号 p. 329-335
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーMorphine with its potent analgesic property has been widely used for the treatment of various types of pain. However, the intrathecal (i.t.) administration of morphine at doses far higher than those required for antinociception exhibited nociceptive-related behaviors consisting of scratching, biting and licking, hyperalgesia, and allodynia in mice. Morphine-3-glucuronide (M3G), one of the major metabolites of morphine, has been found to evoke nociceptive behaviors similar to those after high-dose i.t. morphine. It is plausible that M3G may be responsible for nociception seen after high-dose i.t. morphine treatment. This article reviews the potential mechanism of spinally mediated nociceptive behaviors evoked by i.t. M3G in mice. We discuss the possible presynaptic release of nociceptive neurotransmitters/neuromodulators such as substance P, glutamate, dynorphin, and Leu-enkephalin in the primary afferent fibers following i.t. M3G administration. It is possible to speculate that i.t. M3G could indirectly activate NK1, NMDA, and δ2-opioid receptors that lead to the release of nitric oxide (NO) in the dorsal spinal cord. The major function of NO is the production of cGMP and the activation of protein kinase G (PKG). The NO-cGMP-PKG pathway plays an important role in M3G-induced nociceptive behavior. The phosphorylation of extracellular signal-related kinase (ERK) in the dorsal spinal cord was also evoked via the NO-cGMP-PKG pathway through the activation of δ2-opioid, NK1, and NMDA receptors, contributing to M3G-induced nociceptive behaviors. The demonstration of a neural mechanism underlying M3G-induced nociception provides a pharmacological basis for improved pain management with morphine at high doses.
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一般論文
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池田 佳代, 細井 徹, 吉井 美智子, 杉山 政則, 小澤 光一郎2016 年 136 巻 2 号 p. 337-350
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーThe field of pharmacotherapy has advanced to use molecular targeted agents, and pharmacists are now encouraged to focus on pharmacogenomics. A seminar titled “Implementation and evaluation of genetic testing of lifestyle-related disease genes” was presented to students at the Faculty of Pharmaceutical Sciences, Hiroshima University, describing the pharmacogenomic role of single nucleotide polymorphisms in obesity-related genes and alcohol metabolism-related genes. The seminar topic was selected first because pharmaceutical students were already familiar with some of the content, and secondly because we believe that pharmacists should be informed about the prevention of lifestyle-related diseases using genetic testing. We evaluated the usefulness of this seminar by administering a questionnaire before and after the seminar to participating students. Several points requiring improvement were identified, although 82% of students stated that the seminar was “very useful” or “useful”. We conclude that this educational seminar was useful to students of pharmaceutical sciences.
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ノート
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中田 亜希子, 赤川 圭子, 山本 仁美, 加藤 裕久, 山元 俊憲2016 年 136 巻 2 号 p. 351-358
発行日: 2016/02/01
公開日: 2016/02/01
ジャーナル フリーA questionnaire survey was performed to obtain pharmacy students' impressions of pharmacists' behavior, to classify these based on professionalism, and to analyze the relationship between these experiences and students' satisfaction with their clinical practice in Japan. The questionnaire was answered by 327 5th-year pharmacy school students upon completing clinical practice at community pharmacies from 2011 to 2012. They rated their satisfaction with their clinical practice using a 6-point Likert scale, and provided descriptions of their experience such as, “This health provider is professional”, or “What a great person he/she is as a health provider”. We counted the words and then categorized the responses into 10 traits, as defined by the American Pharmaceutical Association Academy of Students of Pharmacy—American Association of Colleges of Pharmacy, Council of Deans Task Force on Professionalism 1999, using text mining. We analyzed the relationship between their experiences with respectful persons, and satisfaction, using the Mann-Whitney U-test (significance level<0.05). Most students (337 of 364, 92.6%) reported experiences with respectful health providers. These students experienced significantly more satisfaction than did other students (p<0.001). We analyzed 343 sentences written by 261 students, using text mining analysis after excluding unsuitable responses. The word most used was “patient” (121 times). Many students noted their impression that the pharmacists had answered patients' questions. Of the 10 trait categories, “professional knowledge and skills” was mentioned most often (151 students).
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