Continuous monitoring and analysis of patients’ medication status and laboratory data are believed to enhance the effectiveness and safety of drug therapy, while also allowing early detection of adverse drug reactions. In 2011, pharmacies began to print laboratory data on outpatient prescriptions nationwide, and in February 2017, Asahikawa Medical University Hospital began printing 2D codes for laboratory data. In the present study, we retrospectively examined the extent to which laboratory data-related inquiries in pharmacies during the first six years after the introduction of laboratory data printing led to prescriptions changes and subsequent improvements in patient outcomes, as assessed by laboratory data. The results showed that the rate of questionable referrals based on laboratory data after the start of laboratory data printing was 36.5 times higher than that before printing. When prescriptions were changed due to a questionable referral, laboratory data after the referral were significantly improved compared to those at the time of questionable referral in cases related to renal function and hyperkalemia. When only drugs for renal impairment were included in the study, laboratory data showed significantly greater improvement in the group with a change in prescription following pharmacy inquiries compared to the group without such changes. The results of this study suggested that the use of laboratory data contributes to improved patient outcomes, at least regarding renal function, when pharmacists make question-and-answer referrals.

Rachel Carson’s “Silent Spring” (1962) raised global awareness of the persistence of pesticides and their ecological impacts. Forty years later, the Hokkaido Study on Environment and Children’s Health was initiated in 2002 as a large-scale, birth cohort study. Its primary aim is to investigate the health effects of environmental chemical exposure and to provide scientific evidence for environmental policy. Between 2002 and 2012, approximately 20,000 pregnant women from Hokkaido were recruited for the study. Their children, aged 13–23 years, were followed up. Maternal health and lifestyle data and blood samples were collected during the pregnancy. Medical records and umbilical cord blood samples were collected at the time of birth. Follow-up questionnaires were administered to children of various ages to collect information on child development, allergies, infections, and other health indicators. Face-to-face surveys conducted at school and during pubertal age selected a subset of participants living in the Sapporo area to collect detailed data, including cognitive and respiratory function tests, pubertal development evaluations, and biological sampling. Internal exposure to environmental chemicals was assessed using chemical analyses of blood and urine samples collected from mothers and children. This study provides important insights into the health effects of prenatal and postnatal chemical exposure. This presentation highlights the key findings of the Hokkaido Study, including exposure trends in the general Japanese population, associated health outcomes, and future research directions.

Chemical substances are an indispensable part of the development of civilization; however, there are many known cases of health hazards induced by exposure to chemicals and their byproducts. In particular, the effects of exposure on the developing cerebral nervous system, even after a single exposure, may have lifelong effects; therefore, careful evaluation is required. In this paper, we provide examples of assessments conducted by our research group regarding the effects of exposure to chemicals in the environment during development, as well as the endpoints at which we were able to assess these effects. This will ultimately deepen our understanding of developmental neurotoxicity. Here, we demonstrate a case of late-onset abnormalities in female behavior and reproductive physiology due to developmental exposure to tris(2,6-dimethylphenyl)phosphate (TDMPP), a phosphorus-based flame retardant that exhibits typical estrogen-like effects. Also, we used IntelliCage, a fully automated behavioral measurement system for group-reared mice, to assess basal activity and adaptation to the social environment. An example of how IntelliCage can be used to assess behavior is dioxins, which are chemicals that are unintentionally produced. We focused on brominated dioxins and reported a case of abnormal exploratory behavior in a novel environment. Currently, there is growing public concern regarding substances and particle bodies that have not been adequately evaluated for use in the developing brain, such as PFAS and micro/nanoplastics. We believe that the establishment of more sophisticated evaluation methods and endpoints, including those introduced here, will continue to be necessary for building a foundation for a safe and secure society.

Although supernumerary ribs have been examined in regulatory developmental toxicity studies, their toxicological significance remains controversial because of the unclear etiology and strain-dependent background incidence of this condition. In the current study, we established a rat model of drug-induced supernumerary ribs by administering flucytosine to pregnant Sprague–Dawley rats, a strain with low natural occurrence of this skeletal anomaly. The results revealed that flucytosine exposure induced supernumerary ribs in a dose- and timing-dependent manner, accompanied by dysregulated expression of specific Hox genes. Altered expression was correlated with axial patterning defects and, in some cases, limb abnormalities. Comparative genetic analysis between Sprague–Dawley rats and BrlHan:WIST@GALAS rats, which exhibit high spontaneous incidence (~50%) of supernumerary ribs, revealed sequence variation in the upstream regulatory region of Hoxa9, particularly affecting miR-196b. These findings demonstrate that temporal dysregulation of Hox gene networks and micro RNA (miRNA)-mediated modulation are key factors in the pathogenesis of supernumerary ribs. Moreover, our results suggest that genetic background should be considered when interpreting skeletal variations in developmental toxicity studies. Mechanistic understanding of these findings may improve the relevance of endpoints in risk assessment and regulatory decision-making.

Nanomaterials have unique functions due to their increased specific surface area compared to conventional materials. Various nanomaterials are already used in the production of many pharmaceuticals, cosmetics, and foods; however, this also means that, regardless of age or gender, it is now impossible to avoid exposure to these unique materials. Currently, there are concerns that nanomaterials may induce unexpected toxicities due to their small size. In addition, safety evaluations related to the exposure of pregnant women and fetuses, who are particularly vulnerable to the toxic effects of chemicals, are lacking globally; therefore, our understanding of the reproductive and developmental effects of nanomaterials is insufficient. Our group expects that understanding more about how the toxic effects of nanomaterials manifest not just in the mother and fetus but also in the placenta, an essential organ for maintaining pregnancy and fetal development, will be crucial for improving our understanding of the mechanisms that underly the reproductive and developmental toxicities of nanomaterials. Based on this, we have conducted a correlation analysis of the physicochemical properties, kinetics, and toxicities of nanomaterials, focusing on the placenta. In this review, we introduce the results of our research about effects of silica nanoparticles on trophoblast syncytial formation and placental kinetics of silica nanoparticles.

Suicide prevention efforts in Japan have gradually improved through the combined work of emergency and psychiatric medical staff, along with government services such as ambulances. In this situation, the community pharmacists are required to learn about suicide attempters, engage in supportive conversations at the pharmacy counter, and serve as frontline gatekeepers. To achieve this purpose, active involvement and educational support from the academic organizations of pharmacists are essential.

Suicide remains a critical public health challenge in Japan, with the interaction between physical illness and psychiatric comorbidity emerging as a major determinant of risk. Patients with serious medical conditions face markedly elevated rates of suicidal behavior, particularly when depression or alcohol use disorders are present. Conventional preventive strategies, including screening and provider education, have yielded only modest effects. In contrast, collaborative care models that integrate psychiatrists, primary care physicians, and pharmacists demonstrate superior efficacy, significantly reducing suicidal ideation and attempts. Case management further enhances treatment adherence and clinical outcomes. Internationally, pharmacists play a pivotal role in medication management and suicide risk monitoring; however, in Japan their involvement remains limited by insufficient psychiatric training, institutional constraints, and inadequate reimbursement systems. Addressing these barriers through enhanced education, supportive policy reforms, and structured collaborative care frameworks could expand their role in suicide prevention. A comprehensive, multidisciplinary approach that strengthens pharmacist engagement may contribute substantially to reducing suicide risk among physically ill patients in Japan.

The incidence of overdoses is increasing, especially among young people, and patients with a history of overdoses are more likely to engage in subsequent suicidal behavior, even if their initial goal was self-harm. Drugs used in overdose cases include not only over-the-counter drugs but also prescription drugs, and, in many instances, the pharmacist dispenses the drug to the patient immediately before it is taken. Pharmacists working in insurance-affiliated pharmacies and drugstores should serve as gatekeepers to prevent overdose and suicide. This review aimed to generate concrete evidence to support pharmacists in preventing medication overdose and, ultimately, suicide. Specifically, we sought to (1) identify psychotropic drugs that may lead to tracheal intubation following an overdose, based on GC-MS analysis of samples of patients with drug overdose transported to emergency care facilities; (2) determine measures adopted by pharmacies to enable pharmacists and registered sales representatives to act as gatekeepers for medication overdose prevention; and (3) establish an OD score to rapidly identify overdose cases among patients transported to emergency care facilities and to characterize such patients based on the collected data. The abovementioned information may serve as concrete evidence to support the role of pharmacists as gatekeepers in overdose and suicide prevention.

My research has focused on optimizing drug delivery system (DDS) related gene and cell therapies. In my gene therapy research, I first developed a polyethylene glycol (PEG)-conjugated adenovirus vector (PEG-Ad) to allow modulation of adenovirus pharmacokinetics and achieve tumor targeting. Evaluating correlations between PEG-Ad blood retention, tumor tissue delivery, liver accumulation, and gene expression is an important step toward creating tumor-targeting PEG-Ad, demonstrating that a 90% PEGylation rate optimally reduced liver accumulation and improved tumor targeting via enhanced permeability and retention. To enhance tumor targeting specificity, we designed Cys-Gly-Lys-Arg-Lys (CGKRK)-PEG-Ad, in which the tumor-targeting peptide CGKRK was attached to the end of the PEG chain. Although CGKRK-PEG-Ad exhibited similarly reduced liver accumulation to that of PEG-Ad, its tumor delivery was higher than that of PEG-Ad, demonstrating its potent therapeutic efficacy against metastatic tumors. Next, I worked to optimize tumor immunotherapy by controlling immune cells in vivo dynamics. In this study, cytokines were used to activate antitumor immune cells, and chemokines were used to induce intratumoral infiltration by antitumor immune cells. While intratumoral administration of Arg-Gly-Asp (RGD)-Ad-C–C motif chemokine ligand 27 (CCL27) alone did not produce an antitumor effect against OV-HM tumors; however, co-administration with RGD-Ad-interleukin-12 (IL-12) demonstrated a stronger antitumor effect than administration of RGD-Ad-IL-12 alone. Infiltration of cluster of differentiation 3 (CD3)- and perforin-positive cells into tumor tissues was increased by combined administration of RGD-Ad-CCL27 and RGD-Ad-IL-12 compared with administration of RGD-Ad-IL-12 alone. These results demonstrate the importance of controlling the in vivo dynamics of antitumor immune cells.

In Japan, amrubicin hydrochloride (AMR) is occasionally administered to patients with recurrent small cell lung cancer (SCLC). AMR therapy can induce febrile neutropenia (FN), a complication that may be fatal or compromise therapeutic efficacy due to treatment interruption or dose reduction. Identifying risk factors for FN is therefore critical to ensuring safe and effective AMR administration. Current evidence on this issue remains limited to small case series, underscoring the need for more robust studies. We conducted a multicenter retrospective analysis to examine predictors of FN during AMR treatment for recurrent SCLC. Patients who received AMR between April 1, 2013, and March 31, 2023, were included. The cohort comprised 256 patients, divided into 192 without FN and 64 with FN. Multivariate analysis demonstrated that performance status (PS) >2 (odds ratio: 5.8, 95% confidence interval: 1.70–19.80, p=0.005) and hematocrit (HCT) (odds ratio: 0.93, 95% confidence interval: 0.877–0.994, p=0.033) were significantly associated with FN development. These findings suggest that PS and HCT may serve as key indicators for predicting FN during AMR therapy in patients with recurrent SCLC.

Although still controversial in some aspects, the human papillomavirus (HPV) vaccine is widely recognized as a tool for preventing cervical cancer. However, Japan has historically struggled with vaccine hesitancy due to misinformation and public concerns about side effects. This cross-sectional preliminary study investigated an emerging social media trend, the “praise movement,” in which users on X (formerly Twitter) commend individuals for receiving the HPV vaccine. Although the data collection period was short in 17 d and limited volume of posts were included in the analysis (n=70), we identified the movement when the term “HPV vaccination” appeared on Japan’s trending list on X. Through sentiment analysis and content categorization of posts, we found that the majority of posts (91.4%) exhibited positive sentiment, whereas 5.7% were negative. While previous studies have documented negative reactions to HPV vaccination on social media, this study highlights a shift toward positive reinforcement. The praise movement may reflect a broader shift in public attitudes toward HPV vaccination, influenced by both grassroots advocacy and official efforts, including the catch-up vaccination program. Given this study is just a snapshot of a short period and a small volume of trend, a further in-depth study should be warranted. Nevertheless, our findings suggest that online communities can play a meaningful role in influencing public health behaviors, providing insights into potential strategies for improving vaccine uptake. This study offers valuable perspectives on digital health communication and its implications for addressing vaccine hesitancy in Japan and beyond.

This study utilized real-world data from the “Setsuyaku-Bag Campaign” conducted by the Hokkaido Pharmaceutical Association to investigate the actual status of leftover medications among patients with diabetes and identify factors associated with pharmacists’ pharmaceutical care interventions aimed at addressing this issue. The primary analysis focused on patients who brought their antidiabetic medications,a examining factors related to the implementation of pharmaceutical care. In addition, a supplementary analysis including all patients was performed. The implementation rate of pharmaceutical care activities in the Setsuyaku-Bag Campaign (3.5–67.0%) substantially exceeded national statistics. Patients who brought antidiabetic medications had a significantly greater number of medications (p=0.015) and higher dosing frequency (p<0.001). Multivariate analysis revealed that, in addition to hypoglycemia-risk drugs such as sulfonylureas and glinides, the use of biguanides and α-glucosidase inhibitors was associated with pharmaceutical care activities. These findings suggest that pharmacists provide support and assess medication adherence based on the pharmacological characteristics of drugs. Furthermore, regarding the pharmaceutical care of patients with diabetes, interventions tend to depend on factors such as collaboration with related medical institutions and the establishment of information-sharing systems as opposed to the outcomes of prescription inquiries. Through these frameworks, pharmacies notify prescribing physicians of patients’ leftover medications, and under such collaboration, measures against polypharmacy and adjustments of medication regimens are carried out. To realize more effective pharmaceutical care in the future, a comprehensive management system that includes collaboration between physicians and pharmacists needs to be constructed.

We developed a symptom monitoring system that facilitates collaborations among physicians, hospital pharmacists, and community pharmacists using an electronic Patient-Reported Outcome (ePRO) application. The present study investigated the feasibility and acceptability of this system. Before and after the introduction of the system, participants completed a questionnaire assessing the burden, anxiety, and satisfaction using a 0–10 numeric rating scale. The rate of application input implementation, the number of times alert and free messages sent by patients, adherence, the incidence of adverse events (AEs), and admission due to AEs were assessed as secondary endpoints. Twenty-one patients with breast cancer initiating abemaciclib (300 mg/d), 10 community pharmacists, and 5 physicians participated in this study. Patients reported a reduced burden in both explaining their symptoms and having their symptoms confirmed (p<0.005), as well as a decrease in anxiety related to treatment (p<0.001). Healthcare professionals reported a reduced burden in symptom monitoring (p<0.05), and also experienced reduced anxiety about not knowing the status of patients (p<0.05). The rate of application input implementation was 94.3%. The total numbers of alert and free messages sent were 316 and 426, respectively. The median medication adherence rate based on pill counts and the medication possession ratio were 94.7% and 0.97, respectively. The rate of grade ≥2 diarrhea was 80.9%, with no emergency admissions due to AEs. The implementation of application input was well accepted and participants actively engaged with it. These results warrant further confirmation in large-scale studies.