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Yanagida N.,NHO Sagamihara National Hospital | Yanagida N.,Sendai Medical Center | Minoura T.,Sendai Medical Center | Kitaoka S.,Sendai Medical Center
IRYO - Japanese Journal of National Medical Services | Year: 2015

[Purpose] The purpose of this study is to examine influences of stepwise oral food challenge test on the avoidance of allergenic food. [Method] Among 357 patients who first visited our hospital from April, 2010 to December, 2011, we investigated items of food that should be avoided to eat about 294 food allergy patients to whom we could continue follow-up survey for a year or more. The survey was performed for each patient at the time of initial medical examination, half a year later and a year later after the first visit. In all cases the first test was performed within 4 months after the initial medical examination. We also investigated the effect and the safety of the oral food challenge test in total number of 1,714 cases. [Results] In above-mentioned 1,714 cases total number of positive patients in the test was 564, this is 32.9 % of total cases. One (0.2 %) patient needed injection of adrenalin. The average number of items of the avoidance of food at the initial medical examination was 3.8. At a year after the examination that number significantly (p<0.001) reduced to 0.8, and the avoidance of food became unnecessary for 55.4 % of patients. [Conclusion]The frequency of serious symptom caused by the oral challenge test was low and the tests could be performed safely. Items of the avoided food were reduced remarkably and those results suggest it is possible that in many cases the avoidance of food became unnecessary after oral food challenge test. Source

Kudo-Tanaka E.,Osaka Minami Medical Center | Shimizu T.,Osaka Minami Medical Center | Nii T.,Osaka Minami Medical Center | Teshigawara S.,Osaka Minami Medical Center | And 18 more authors.
Modern Rheumatology | Year: 2015

Objectives. To examine whether or not earlier therapeutic intervention with methotrexate (MTX) prevents the development of rheumatoid arthritis (RA) in patients with recent-onset undifferentiated arthritis (UA) showing high anti-citrullinated peptide antibody (ACPA) titers.Methods. The patients were divided into two groups, one was treated with MTX (MTX+ group, n = 29), and the other was treated without MTX (MTX- group, n = 19), and other disease-modifying anti-rheumatic drugs were not permitted in the two groups before the primary endpoint was met. The primary endpoint is the occurrence of definite RA, and it was compared in the two groups after 1 year.Results. The percentage of patients who developed definite RA in the MTX+ group (17.2%) was significantly lower than that in the MTX- group (78.9%) (log-rank test, P < 0.001, n = 48); adjusted hazards ratio: 0.028 [95% confidence interval (CI): 0.003-0.250, P = 0.001, n = 39]. Treatment effectiveness was not decreased by major risk factors of RA onset such as smoking habits and human leukocyte antigen-DRB1 shared epitope (SE) (smoking habit, odds ratio [OR]: 0.041 [95% CI: 0.007-0.246] P < 0.001; SE, OR: 0.022 [95% CI: 0.002-0.204] P < 0.001). The safety issues were comparable between the two groups.Conclusions. This suggests that early therapeutic intervention with MTX could safely prevent the development of RA in patients with recent-onset UA showing high ACPA titers. © 2015 Japan College of Rheumatology. Source

Kitamura N.,Clinical Research Center for Allergy and Rheumatology | Mori A.,Clinical Research Center for Allergy and Rheumatology | Tatsumi H.,NHO Sagamihara National Hospital | Nemoto S.,NHO Sagamihara National Hospital | And 2 more authors.
International Archives of Allergy and Immunology | Year: 2011

Background: Among several GATA family transcription factor-associating proteins, zinc finger protein, multitype 1 (ZFPM1), at least that of murine origin, has been shown to modulate the activity of GATA-3. However, the functional role of human ZFPM1 in the immune system has not been elucidated. Therefore, we here investigated the contribution of ZFPM1 to human Th1/Th2 differentiation. Methods: The cDNA of ZFPM1 was cloned and introduced into human cord blood CD4+ T cells by a lentiviral transduction system. Then, the expression of IL-4 and IFN-γ mRNA was determined by quantitative real-time RT-PCR. The effect of ZFPM1 on the promoter activity of IL-4 and IFN-γ in Jurkat cells was also investigated. Results: Stimulation-induced expression of IL-4 and IFN-γ in human CD4+ T cells was suppressed and enhanced, respectively, by the introduction of ZFPM1. The transcriptional activity of IL-4 was also diminished by ZFPM1, whereas that of IFN-γ was not affected. Conclusion: ZFPM1 that facilitates human Th1 differentiation via the downregulation of IL-4 is a potential target for the treatment of allergic diseases. Copyright © 2011 S. Karger AG. Source

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