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  • 1
    Online Resource
    Online Resource
    American Society of Hematology ; 2018
    In:  Blood Vol. 132, No. Supplement 1 ( 2018-11-29), p. 5499-5499
    In: Blood, American Society of Hematology, Vol. 132, No. Supplement 1 ( 2018-11-29), p. 5499-5499
    Abstract: Myelodysplastic syndromes (MDS) is a clonal disorder caused by mutation in hematopoietic stem cells (HSCs), including several somatic mutations and aberrant DNA hypermethylation, which can induce silence of tumor-suppressor genes and lead to the pathogenesis and/or progression of MDS. Thus, reducing methylation with the aim of genes reestablishing the expression of silenced tumor-suppressor genes represents one promising approach for the treatment of MDS. Azacytidine (AZA) and/or decitabine (DAC), two DNA methyltransferase (DNMT) inhibitors currently available for the treatment of MDS, have dramatically improved the prognosis of MDS. However, these DNMT inhibitors must be administered intravenously or subcutaneously, necessitating that patients must visit a hospital every day for treatment. Thus, oral DNMT inhibitors are desired. OR21 is a novel and potentially oral-absorbable DAC prodrug with an oral absorbability of +2.14 (Log P value). In this study, we investigated the efficacy of OR21 in MDS (MDS-L) and AML cell lines (HL60, THP1 and KG1a). OR21 inhibited cell growth and induced cell apoptosis in a dose dependent manner in MDS and AML cell lines. Its effects were similar to those of DAC, but not to those of AZA. Western blotting and pyrosequencing revealed that OR21 and DAC were more effective in reducing the DNMT protein level and LINE-1 methylation levels, respectively (Control, 88.9%; OR21, 74.2%; DAC 71.2%; AZA, 88.8%) in MDS-L (100 nM, 96 hr) than AZA. Next, we investigated changes in gene expression after DAC treatment (100 nM, 96 hr) in the MDS-L cell line using RNA microarray analysis. Out of a total of approximately 20000 sequenced genes, 188 genes were up-regulated and 238 genes were down-regulated. DAC dramatically changed gene expression in the MDS-L cell line via hypomethylation. Because MDS is also associated with impairment of cell differentiation in hematopoietic progenitor cells, developing agents that reestablish. Cell differentiation is also promising approach for the treatment of MDS. We assessed the effects of OR21 on the expression of the surface differentiation marker CD11b and stem cell marker HLA-DR in MDS-L cells. CD11b expression was upregulated while HLA-DR expression was downregulated, indicating that OR21 can induce cell differentiation. CEBPE, a key late differentiation driver, is silencing via hypermethylation in MDS. CEBPE mRNA level was up-regulated after OR21 treatment (100 nM, 96hr). Finally, we used a mouse xenograft model to evaluate the anti-tumor effect of OR21 in vivo. BALB/c Rag-2/JAK3 double-deficient (BRJ) mice were injected intravenously via their tail veins with 5 × 106 HL60 cells. OR21 (2.7 mg/kg), DAC (1.0 mg/kg), or vehicle (1% DMSO) was administered by intraperitoneal injection twice weekly. The AUCs of OR21 and DAC were equal. We evaluated in vivo model using intraperitoneal injection because oral intake of capsule coated OR 21 successfully absorbed in cynomolgus monkey model. OR21 significantly prolonged survival (median survival 49 days and 44 days, P=0.005), whereas DAC did not prolong survival (median 46.5 days and 44 days, P=0.164) in the xenograft mouse model. OR21 significantly lowered LINE-1 methylation levels in mouse bone marrow cells (Vehicle, 83.7%; OR21, 62.8%; P 〈 0.0001). Furthermore, OR21-treated mice tended to show less in anemia than DAC-treated mice (Hb: Vehicle, 17.5 g/dL; OR21, 17.1 g/dL; DAC, 15.8 g/dL). OR21 has a stronger anti-tumor effect with lower toxicity than DAC. Taken together, these results suggest OR21 could be used as an alternative drug to decitabine for the treatment of MDS. Disclosures Ureshino: OHARA Pharmaceutical Co., Ltd.: Research Funding. Watanabe:OHARA Pharmaceutical Co., Ltd.: Research Funding. Kurahashi:OHARA Pharmaceutical Co., Ltd.: Employment. Kurahashi:OHARA Pharmaceutical Co., Ltd.: Employment. Ureshino:OHARA Pharmaceutical Co., Ltd.: Research Funding.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2018
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  • 2
    In: Journal of Intensive Care, Springer Science and Business Media LLC, Vol. 9, No. 1 ( 2021-08-25)
    Abstract: The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high-quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J-SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU-acquired weakness [ICU-AW], post-intensive care syndrome [PICS] , and body temperature management). The J-SSCG 2020 covered a total of 22 areas with four additional new areas (patient- and family-centered care, sepsis treatment system, neuro-intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large-scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members. As a result, 79 GRADE-based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, 27 answers to background questions (BQs), and summaries of definitions and diagnosis of sepsis were created as responses to 118 CQs. We also incorporated visual information for each CQ according to the time course of treatment, and we will also distribute this as an app. The J-SSCG 2020 is expected to be widely used as a useful bedside guideline in the field of sepsis treatment both in Japan and overseas involving multiple disciplines.
    Type of Medium: Online Resource
    ISSN: 2052-0492
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2739853-5
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  • 3
    In: Acute Medicine & Surgery, Wiley, Vol. 8, No. 1 ( 2021-01)
    Abstract: The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J‐SSCG 2020), a Japanese‐specific set of clinical practice guidelines for sepsis and septic shock created as revised from J‐SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high‐quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J‐SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU‐acquired weakness [ICU‐AW], post‐intensive care syndrome [PICS] , and body temperature management). The J‐SSCG 2020 covered a total of 22 areas with four additional new areas (patient‐ and family‐centered care, sepsis treatment system, neuro‐intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large‐scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members. As a result, 79 GRADE‐based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, 27 answers to background questions (BQs), and summaries of definitions and diagnosis of sepsis were created as responses to 118 CQs. We also incorporated visual information for each CQ according to the time course of treatment, and we will also distribute this as an app. The J‐SSCG 2020 is expected to be widely used as a useful bedside guideline in the field of sepsis treatment both in Japan and overseas involving multiple disciplines.
    Type of Medium: Online Resource
    ISSN: 2052-8817 , 2052-8817
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2751184-4
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  • 4
    Online Resource
    Online Resource
    Japan Society of Histochemistry & Cytochemistry ; 1969
    In:  ACTA HISTOCHEMICA ET CYTOCHEMICA Vol. 2, No. 4 ( 1969), p. 176-203
    In: ACTA HISTOCHEMICA ET CYTOCHEMICA, Japan Society of Histochemistry & Cytochemistry, Vol. 2, No. 4 ( 1969), p. 176-203
    Type of Medium: Online Resource
    ISSN: 0044-5991 , 1347-5800
    Language: English
    Publisher: Japan Society of Histochemistry & Cytochemistry
    Publication Date: 1969
    detail.hit.zdb_id: 2106630-9
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  • 5
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 12, No. 1 ( 2022-05-31)
    Abstract: This study compared hand function and the cost-effectiveness of treatment between collagenase Clostridium histolyticum (CCH) injection and limited fasciectomy for patients with Dupuytren’s contracture (DC). The CeCORD-J study is a prospective, multicenter, non-randomized controlled, observational study of two parallel groups. Participants were DC patients with multiple affected fingers, including flexion contracture of the proximal interphalangeal (PIP) joint. The primary outcome was the Hand10 score, as a patient-reported outcome measure (PROM). We set secondary outcomes of EQ-5D-5L (QOL) score, degree of extension deficit, and direct cost. Propensity score adjustment was used to balance differences in patient characteristics between groups. Participants comprised 52 patients in the Collagenase group and 26 patients in the Surgery group. There were no significant differences in the Hand10 and QOL scores between the two groups at 26 weeks. Mean direct cost was 248,000 yen higher in the Surgery group than in the Collagenase group. Extension deficit angle of the PIP joint was significantly larger in the Collagenase group at 26 weeks. Although the Collagenase group showed dominance in cost-effectiveness, there was no significant difference between the two groups in hand function at 26 weeks.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2615211-3
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  • 6
    In: The Lancet Respiratory Medicine, Elsevier BV, Vol. 5, No. 8 ( 2017-08), p. 627-638
    Type of Medium: Online Resource
    ISSN: 2213-2600
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2017
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  • 7
    In: Blood, American Society of Hematology, Vol. 132, No. Supplement 1 ( 2018-11-29), p. 4175-4175
    Abstract: Aberrant DNA methylation profiles in various types of cancer have highlighted the importance of DNA methylation in human carcinogenesis and opened the prospect of targeting aberrant DNA methylation with demethylating agents as a therapy for cancer. Adult T-cell leukemia-lymphoma (ATL) is an aggressive hematological malignancy derived from CD4 (+) T-cells transformed by human T-cell lymphotropic virus-1 (HTLV-1). Although it has been estimated that 20 million people are infected with HTLV-1 worldwide, most HTLV-1 infected individuals have no symptoms and only 3-7% of HTLV-1 positive carriers develop ATL in their life time. HTLV-1 infected cells undergo multistep leukemogenesis and there are four clinical subtypes of ATL, smoldering type, chronic type, acute type, and lymphoma type. It takes several decades to acquire aggressive phenotypes through the accumulation of genetic and epigenetic abnormalities. In this study, we aimed to elucidate the contribution of aberrant DNA methylation to ATL leukemogenesis and the anti-ATL effects of DNA demethylating agents. Since the expression profiles of CADM1 and CD7 in CD4 (+) T-cells reflect ATL disease progression, fractions of HTLV-1 infected cells and normal T-cells were isolated from ATL patients, HTLV-1 carriers, and healthy volunteers using the expression statuses of CADM1 and CD7. Comprehensive genome-wide profiling of DNA methylation was performed by quantitative array-based methylation analysis at the single-CpG-site level using the Infinium HumanMethylation450 BeadChip array. Anti-ATL effects of four DNA demethylating agents were investigated in in vitro experiments using ATL-related cell lines and a xenograft mouse model. Unsupervised hierarchical clustering analysis was first conducted using the DNA methylation profiles of 20,000 CpG probes, which were randomly picked from 470,870 probes. Global DNA hypomethylation was detected in HTLV-1 infected cells at the asymptomatic carrier stage. To identify differentially methylated positions (DMPs) that specifically reflect ATL disease status, the DNA methylation profiles of a normal cell subpopulation were compared with those of a HTLV-1 infected subpopulation. We identified 12,025 hypermethylated and 33,581 hypomethylated DMPs that were specific to the HTLV-1 infected subpopulation. Importantly, the methylation profiles of hypermethylated DMPs, but not those of hypomethylated DMPs, were different between the aggressive and indolent types of ATL and could be used to distinguish them. Therefore, we next extracted and analyzed 1,207 hypermethylated CpG sites located in TSS200 CpG islands (CGIs) in hypermethylated DMPs, since TSS200 CGIs are widely recognized to regulate gene expression in a methylation dependent manner. We found the DNA methylation profiles of 1,207 probes tended to correlate with ATL disease status. Since regional DNA hypermethylation appears to be associated with ATL disease progression, we tested the anti-leukemia activities of two novel decitabine prodrugs, OR-21 and OR-12, and compared their efficacies with those of clinically available AZA and DAC. OR-21 and OR-12 showed enhanced oral bioavailability and sustained release of decitabine and decitabine 5'-monophosphate, respectively. In ATL-related T-cell lines cultured in the presence of each DNA demethylating compound, DAC and OR-21 significantly suppressed cell growth and decreased DNA methylation at LINE-1 repeat regions, which are used as a biomarker for the monitoring of global changes in DNA methylation. To establish a xenograft mouse model, cells of the HTLV-1-transformed T-cell line, MT-2, were inoculated into the subcutaneous tissue of immunodeficient Balb/c Rag-2-/- Jak3-/- mice, which lack mature T and B lymphocytes and NK cells. A visible tumor appeared 10 days after inoculation and DAC or OR-21 was injected intraperitoneally twice a week, because they were rapidly degraded in the stomach acidic environment and could not be administered orally. The AUC-guided dosing of OR21 (3.39mg/kg) suppressed tumor growth, which was comparable with that obtained with 1.25 mg/kg DAC, while OR21 showed less hematotoxicity than DAC. Disclosures Watanabe: OHARA Pharmaceutical Co., Ltd.: Research Funding. Ureshino:OHARA Pharmaceutical Co., Ltd.: Research Funding. Kurahashi:OHARA Pharmaceutical Co., Ltd.: Employment. Fukuda-Kurahashi:OHARA Pharmaceutical Co., Ltd.: Employment. Kimura:OHARA Pharmaceutical Co., Ltd.: Research Funding.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2018
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 8
    In: Blood Advances, American Society of Hematology, Vol. 7, No. 8 ( 2023-04-25), p. 1545-1559
    Abstract: Adult T-cell leukemia/lymphoma (ATL) is a malignancy of mature CD4+ T cells caused by human T-cell lymphotropic virus type 1 (HTLV-1)–induced T-cell transformation. After infection with HTLV-1, it takes several decades for HTLV-1 carriers to develop ATL. The prognosis of ATL remains poor despite several new agents being approved in the last few years. Recently, it has been noted that epigenetic abnormalities, both DNA methylation and trimethylation at histone H3Lys27 (H3K27me3), contribute to ATL leukemogenesis. Here, we investigated the effect of combination treatment with DNA demethylating agents (azacitidine [AZA], decitabine (DAC), and OR-2100 (OR21), which is a silylated derivative of DAC) and inhibitors of enhancer of zeste homolog 2 (EZH2) (EPZ-6438 and DS-3201b), which catalyze trimethylation of H3K27, in ATL. The combination of DAC and OR21 but not AZA with EZH inhibitors exhibited synergistic anti-ATL effects in vitro and in vivo, concomitant with DNA demethylation and reduction of H3K27me3. The combination induced gene expression reprogramming. Dual-specificity phosphatase 5 (DUSP5), an extracellular signal-regulated kinase (ERK)–specific phosphatase, was identified as a key molecule that mediated the inhibitory effect of combination treatment by inactivating the ERK signaling pathway. DUSP5 was downregulated by DNA methylation and H3K27me3 accumulation in the promoter region in HTLV-1–infected cells from patients with ATL during ATL leukemogenesis. The present results demonstrate that dual targeting of aberrant DNA and histone methylation synergistically suppresses tumor cell growth by restoring DUSP5, and that dual targeting of aberrant DNA and histone methylation is a feasible therapeutic approach for ATL.
    Type of Medium: Online Resource
    ISSN: 2473-9529 , 2473-9537
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2023
    detail.hit.zdb_id: 2876449-3
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  • 9
    In: International Journal of Cancer, Wiley, Vol. 150, No. 7 ( 2022-04), p. 1184-1197
    Abstract: Adult T‐cell leukemia‐lymphoma (ATL) is an aggressive neoplasm derived from T‐cells transformed by human T‐cell lymphotropic virus‐1 (HTLV‐1). Recently, we reported that regional DNA hypermethylation in HTLV‐1‐infected T‐cells reflects the disease status of ATL and the anti‐ATL effects of DNA demethylating agents, including azacitidine (AZA), decitabine (DAC) and a new DAC prodrug, OR‐2100 (OR21), which we developed. Here, to better understand the mechanisms underlying drug resistance, we generated AZA‐, DAC‐ and OR21‐resistant (AZA‐R, DAC‐R and OR21‐R, respectively) cells from the ATL cell line TL‐Om1 and the HTLV‐1‐infected cell line MT‐2 via long‐term drug exposure. The efficacy of OR21 was almost the same as that of DAC, indicating that the pharmacodynamics of OR21 were due to release of DAC from OR21. Resistant cells did not show cellular responses observed in parental cells induced by treatment with drugs, including growth suppression, depletion of DNA methyltransferase DNMT1 and DNA hypomethylation. We also found that reduced expression of deoxycytidine kinase (DCK) correlated with lower susceptibility to DAC/OR21 and that reduced expression of uridine cytidine kinase2 (UCK2) correlated with reduced susceptibility to AZA. DCK and UCK2 catalyze phosphorylation of DAC and AZA, respectively; reconstitution of expression reversed the resistant phenotypes. A large homozygous deletion in DCK and a homozygous splice donor site mutation in UCK2 were identified in DAC‐R TL‐Om1 and AZA‐R TL‐Om1, respectively. Both genomic mutations might lead to loss of protein expression. Thus, inactivation of UCK2 and DCK might be a putative cause of phenotypes that are resistant to AZA and DAC/OR21, respectively.
    Type of Medium: Online Resource
    ISSN: 0020-7136 , 1097-0215
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 218257-9
    detail.hit.zdb_id: 1474822-8
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  • 10
    In: HemaSphere, Ovid Technologies (Wolters Kluwer Health), Vol. 7, No. S3 ( 2023-08), p. e73633b7-
    Type of Medium: Online Resource
    ISSN: 2572-9241
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2922183-3
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