12 results on '"Kazuhiro Asada"'
Search Results
2. Eosinophilic airway inflammation and eosinophilic chronic rhinosinusitis during nivolumab and ipilimumab
- Author
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Hirofumi Watanabe, Kazuhiro Asada, Toshihiro Shirai, Hiroko Torii, Koji Yoshimura, and Kimihide Kusafuka
- Subjects
Cytotoxic T‐lymphocyte‐associated antigen‐4 ,eosinophilic chronic rhinosinusitis ,immune checkpoint inhibitor ,immune‐related adverse event ,programmed cell death‐1 ,Diseases of the respiratory system ,RC705-779 - Abstract
Abstract Immune‐related adverse events (irAEs) are induced by immune checkpoint inhibitors (ICIs) which are administered for many cancers. There are many irAEs such as endocrine abnormalities, interstitial lung disease, and colitis. However, irAEs associated with type 2 (T2) inflammation are less known. We herein report a 71‐year‐old woman who developed eosinophilic airway inflammation and eosinophilic chronic rhinosinusitis (ECRS) simultaneously during combination therapy with nivolumab and ipilimumab for renal cell carcinoma. After two cycles of therapy, she developed cough and nasal congestion with high level of fractioned exhaled nitric oxide and blood eosinophil count, and nasal polyps with eosinophil infiltration in bilateral nasal cavities. She was diagnosed with eosinophilic airway inflammation and ECRS, and treated with corticosteroid inhalation, steroid nasal spray, and nasal irrigation, resulting in symptom reduction. Although they are relatively rare irAEs of ICIs, clinicians should consider these diseases associated with T2 inflammation and treat appropriately.
- Published
- 2020
- Full Text
- View/download PDF
3. Longitudinal lung involvement of systemic lupus erythematosus‐related vasculitis and alveolar proteinosis‐like reaction
- Author
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Takahito Suzuki, Noriyuki Enomoto, Yasuoki Horiike, Kazuhiro Asada, Toshihiro Shirai, and Takafumi Suda
- Subjects
Pulmonary alveolar proteinosis ,systemic lupus erythematosus ,vasculitis ,Diseases of the respiratory system ,RC705-779 - Abstract
Abstract A 44‐year‐old woman with no symptoms was referred to our hospital for thorough examination of consolidation opacity on her left lung, which was growing for four years. She was diagnosed with systemic lupus erythematosus (SLE) at the age of 35 years and had been treated with prednisolone 10 mg/day. Physical examination and bronchoscopy revealed no abnormality including microbiological tests. She underwent surgical resection of the lung lesion. Lung biopsy specimens showed aggregation of lymphocytes with germinal centres and collagen deposition. Vasculitis and pulmonary alveolar proteinosis (PAP)‐like reaction were also found. We diagnosed this lung opacity as an SLE‐related lung lesion with vasculitis and PAP‐like reaction. Lung involvement of SLE is scarce and long‐term lung vasculitis and PAP‐like reaction are extremely rare in patients with SLE. Clinicians should be aware of such SLE‐related lung consolidation opacity that comprises lung vasculitis and PAP‐like reaction.
- Published
- 2020
- Full Text
- View/download PDF
4. Subacute invasive pulmonary aspergillosis after chemoradiotherapy for lung cancer
- Author
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Hirofumi Watanabe, Toshihiro Shirai, Mika Saigusa, Kazuhiro Asada, and Kazumori Arai
- Subjects
Chemoradiotherapy ,invasive pulmonary aspergillosis ,lung cancer ,subacute ,Diseases of the respiratory system ,RC705-779 - Abstract
Subacute invasive pulmonary aspergillosis (SIPA), a rapidly progressive fungal infection of less than three months arising from pre‐existing lung lesions, generally afflicts moderately immunocompromised patients. We herein report the case of a 69‐year‐old man who developed SIPA following chemoradiotherapy for lung cancer and treated with antifungal therapy. He presented with fever, and computed tomography revealed a cavity with surrounding consolidation. The cavity itself had been considered as the primary tumour treated by chemoradiotherapy. Bronchoalveolar lavage by bronchoscopy performed at admission identified Aspergillus fumigatus; no other pathogens or malignant cells were observed. Owing to the worsening of symptoms and inflammation despite micafungin administration, the treatment was changed to liposomal amphotericin B with voriconazole, which led to clinical improvement. In addition to cancer recurrence and bacterial infection, fungal infection should also be considered in patients undergoing chemoradiotherapy for lung cancer with deteriorating imaging findings and symptoms. In intractable cases, multiple antifungal drugs are effective.
- Published
- 2020
- Full Text
- View/download PDF
5. Propensity score analysis of overall survival between first‐ and second‐generation EGFR‐TKIs using real‐world data
- Author
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Kazuhiro Asada, Joe Shindoh, Kazuyoshi Imaizumi, Masato Karayama, Akihito Kubo, Yuko Oya, Kenta Murotani, Eiji Kunii, Takafumi Suda, Sayako Morikawa, Tatsuya Yoshida, Toyoaki Hida, Takeshi Tsuda, Kentaro Ito, Kosuke Takahashi, Teppei Yamagichi, Tomoki Kimura, Shunsaku Hayai, Osamu Hataji, Hirokazu Taniguchi, Takashi Abe, Naoki Inui, and Motoyasu Okuno
- Subjects
Adult ,Male ,0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,non–small‐cell lung cancer ,Afatinib ,Disease-Free Survival ,Erlotinib Hydrochloride ,03 medical and health sciences ,0302 clinical medicine ,Gefitinib ,Japan ,Clinical Research ,Carcinoma, Non-Small-Cell Lung ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Clinical endpoint ,Humans ,Medicine ,Osimertinib ,Protein Kinase Inhibitors ,EGFR‐TKI ,Aged ,Aged, 80 and over ,Acrylamides ,Aniline Compounds ,business.industry ,Hazard ratio ,General Medicine ,Middle Aged ,propensity scoring analysis ,real‐world data ,respiratory tract diseases ,ErbB Receptors ,Clinical trial ,030104 developmental biology ,030220 oncology & carcinogenesis ,Mutation ,Propensity score matching ,Female ,Original Article ,Erlotinib ,business ,medicine.drug - Abstract
We constructed a data set of EGFR‐mutant non–small‐cell lung carcinoma (NSCLC) patients, and compared the overall survival of first‐generation (1G), and second‐generation (2G) EGFR‐tyrosine kinase inhibitors (TKIs) in clinical practice using a propensity score. We reviewed the clinical data of consecutive EGFR‐mutated NSCLC patients who received EGFR‐TKI therapy between January 2008 and August 2017 at 11 institutions in Japan. The primary endpoint was overall survival (OS). When comparing OS between 1G and 2G EGFR‐TKIs, propensity score analyses were performed using 2 methods: matching and inverse probability of treatment weighting (IPTW). (Clinical Trial information: UMIN000030121) In total, 1400 patients from 11 institutions were enrolled in this study, and the data from the 1366 patients who received only EGFR‐TKI therapy were analyzed (gefitinib [GEF], N = 732; erlotinib [ERL], N = 416; afatinib, N = 218). Median OS times (months [95%CI]) were 29.7 [27.5‐33.5] in the 1G group (gefitinib, 32.0 [28.1‐35.8]; erlotinib, 27.5 [23.9‐31.7]), and 38.6 [32.2‐NR] in the 2G group (afatinib), respectively. The trend of longer OS for afatinib against 1G EGFR‐TKIs remained, even after adjusted by propensity score. (unadjusted, hazard ratio [HR] 0.676, P = .0023; adjusted by IPTW, HR 0.685 P
- Published
- 2020
6. Eosinophilic airway inflammation and eosinophilic chronic rhinosinusitis during nivolumab and ipilimumab
- Author
-
Kimihide Kusafuka, Hirofumi Watanabe, Hiroko Torii, Kazuhiro Asada, Koji Yoshimura, and Toshihiro Shirai
- Subjects
Pulmonary and Respiratory Medicine ,programmed cell death‐1 ,medicine.medical_specialty ,medicine.medical_treatment ,immune checkpoint inhibitor ,Ipilimumab ,Case Report ,Case Reports ,Nasal congestion ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Eosinophilic ,medicine ,Nasal polyps ,Cytotoxic T‐lymphocyte‐associated antigen‐4 ,lcsh:RC705-779 ,business.industry ,lcsh:Diseases of the respiratory system ,Eosinophil ,respiratory system ,medicine.disease ,Nasal irrigation ,medicine.anatomical_structure ,030228 respiratory system ,Nasal spray ,030220 oncology & carcinogenesis ,Nivolumab ,medicine.symptom ,business ,eosinophilic chronic rhinosinusitis ,immune‐related adverse event ,medicine.drug - Abstract
Immune‐related adverse events (irAEs) are induced by immune checkpoint inhibitors (ICIs) which are administered for many cancers. There are many irAEs such as endocrine abnormalities, interstitial lung disease, and colitis. However, irAEs associated with type 2 (T2) inflammation are less known. We herein report a 71‐year‐old woman who developed eosinophilic airway inflammation and eosinophilic chronic rhinosinusitis (ECRS) simultaneously during combination therapy with nivolumab and ipilimumab for renal cell carcinoma. After two cycles of therapy, she developed cough and nasal congestion with high level of fractioned exhaled nitric oxide and blood eosinophil count, and nasal polyps with eosinophil infiltration in bilateral nasal cavities. She was diagnosed with eosinophilic airway inflammation and ECRS, and treated with corticosteroid inhalation, steroid nasal spray, and nasal irrigation, resulting in symptom reduction. Although they are relatively rare irAEs of ICIs, clinicians should consider these diseases associated with T2 inflammation and treat appropriately., There are many immune‐related adverse events (irAEs) induced by immune checkpoint inhibitors; however, irAEs associated with type 2 inflammation are less known. We report a case of eosinophilic airway inflammation and eosinophilic chronic rhinosinusitis simultaneously during combination therapy with nivolumab and ipilimumab for renal cell carcinoma.
- Published
- 2020
7. A clustering approach to identify and characterize the asthma and chronic obstructive pulmonary disease overlap phenotype
- Author
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Kazuyuki Inoue, Takefumi Akita, Akito Yamamoto, Toshihiro Shirai, Takahito Suzuki, Satoru Morita, Keita Hirai, Kazuhiro Asada, Taisuke Akamatsu, Ichiro Hayashi, Kunihiko Itoh, Masayuki Suzuki, and Daiki Tsuji
- Subjects
Male ,medicine.medical_specialty ,Endotype ,Exacerbation ,Immunology ,Comorbidity ,Immunoglobulin E ,Gastroenterology ,Diagnosis, Differential ,Pulmonary Disease, Chronic Obstructive ,03 medical and health sciences ,FEV1/FVC ratio ,0302 clinical medicine ,Risk Factors ,Internal medicine ,medicine ,Cluster Analysis ,Humans ,Immunology and Allergy ,030212 general & internal medicine ,Aged ,Asthma ,COPD ,biology ,business.industry ,Hazard ratio ,Area under the curve ,Middle Aged ,medicine.disease ,Respiratory Function Tests ,respiratory tract diseases ,Phenotype ,Gene Expression Regulation ,ROC Curve ,030228 respiratory system ,Disease Progression ,Quality of Life ,biology.protein ,Female ,Symptom Assessment ,business ,Biomarkers - Abstract
Background Asthma and chronic obstructive pulmonary disease (COPD) are heterogeneous diseases. The phenotypes that have clinical features of both asthma and COPD are still incompletely understood. Objective To clarify the best discriminators of the asthma-COPD overlap phenotype from asthma and COPD subgroups using a clustering approach. Methods This study assessed pathophysiological parameters, including mRNA expression levels of T helper cell-related transcription factors, namely, TBX21 (Th1), GATA3 (Th2), RORC (Th17), and FOXP3 (Treg), in peripheral blood mononuclear cells in asthma patients (n = 152) and in COPD patients (n = 50). Clusters were determined using k-means clustering. Exacerbations of asthma and COPD were recorded during the 1-year follow-up period. Results The cluster analysis revealed four biological clusters: cluster 1, predominantly patients with COPD; cluster 2, patients with an asthma-COPD overlap phenotype; cluster 3, patients with non-atopic and late-onset asthma; and cluster 4, patients with early-onset atopic asthma. Hazard ratios for exacerbation were 2.5 (95% confidence interval [CI], 1.1–5.6) in cluster 1 and 2.3 (95% CI, 1.0–5.0) in cluster 2 compared with patients in other clusters. Cluster 2 was discriminated from other clusters by total serum IgE level ≥ 310 IU/mL, blood eosinophil counts ≥ 280 cells/μL, a higher ratio of TBX21/GATA3, FEV1/FVC ratio < 0.67, and smoking ≥ 10 pack-years with an area under the curve of 0.94 (95% CI, 0.90–0.98) in the receiver operating characteristic analysis. Conclusions & Clinical Relevance The asthma-COPD overlap phenotype was characterized by peripheral blood eosinophilia and higher levels of IgE despite the Th2-low endotype. This article is protected by copyright. All rights reserved.
- Published
- 2017
8. Respiratory mechanics and peripheral airway inflammation and dysfunction in asthma
- Author
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Kingo Chida, Kazuhiro Asada, Toshihiro Shirai, Y. Shishido, Satoru Morita, Takefumi Akita, M. Fujii, Takafumi Suda, M. Mikamo, and Kazutaka Mori
- Subjects
Adult ,Male ,Spirometry ,Immunology ,Respiratory physiology ,Nitric Oxide ,Pulmonary function testing ,Risk Factors ,medicine ,Humans ,Immunology and Allergy ,Respiratory system ,Aged ,Asthma ,Lung ,medicine.diagnostic_test ,business.industry ,Middle Aged ,medicine.disease ,Respiratory Function Tests ,medicine.anatomical_structure ,Exhalation ,Case-Control Studies ,Anesthesia ,Exhaled nitric oxide ,Respiratory Mechanics ,Breathing ,Female ,business - Abstract
SummaryBackground Clinical application of the forced oscillation technique (FOT) has progressed with the spread of commercially available FOT devices. The correlation between respiratory impedance and spirometry has been reported; however, the association with airway inflammation and pulmonary function, in the lung periphery in particular, is unclear. Objective To assess whether respiratory impedance is associated with peripheral airway inflammation and dysfunction in asthma. Methods Subjects included 78 patients with overall controlled asthma. We measured whole-breath or within-breath respiratory system resistance (Rrs) and reactance (Xrs) using a commercially available multi-frequency FOT device (MostGraph-01), and assessed the correlation with the fraction of exhaled nitric oxide (FeNO), alveolar nitric oxide concentration (CANO), maximal NO flux in the conductive airways (J'awNO), and the N2 phase III slope of single breath N2 washout (delta N2). Results The differences between inspiratory and expiratory phases of Xrs at 5 Hz (X5), resonant frequency (Fres), and a low-frequency reactance area (ALX) were significantly correlated with CANO; however, there was no correlation between respiratory impedance and FeNO or J'awNO. The delta N2 values were significantly correlated with whole-breath, inspiratory, and expiratory Rrs and Xrs, except for R20. Conclusions and Clinical Relevance We conclude that respiratory impedance reflects peripheral airway inflammation and ventilation inhomogeneity.
- Published
- 2013
9. Occupational hypersensitivity pneumonitis in a green tea manufacturer
- Author
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Yuko Tanaka, Takafumi Suda, Toshihiro Shirai, Yoshiyuki Oyama, Noriyuki Enomoto, and Kazuhiro Asada
- Subjects
Pulmonary and Respiratory Medicine ,Pathology ,medicine.medical_specialty ,Granuloma ,Intradermal skin testing ,business.industry ,green tea ,Case Report ,medicine.disease ,Green tea ,Dermatology ,Environmental agent ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Thoracoscopic lung biopsy ,Rare case ,occupation ,medicine ,Medical history ,030212 general & internal medicine ,business ,hypersensitivity pneumonitis ,Hypersensitivity pneumonitis - Abstract
Hypersensitivity pneumonitis (HP) is caused by numerous agents, and one of its histopathological features is poorly formed granulomas. We report here a rare case of occupational HP caused by green tea, showing well‐formed granulomas. The patient, a 54‐year‐old woman who had worked for 15 years in a green tea factory, was referred for abnormal chest X‐ray shadows with cough and breathlessness over a 2‐month period. The chest X‐ray and high‐resolution computed tomography showed diffuse bilateral ground‐glass opacities and poorly defined centrilobular nodules. Histopathological examination of the thoracoscopic lung biopsy specimens showed bronchiolocentric interstitial pneumonia with well‐formed granulomas. Although the form of granulomas were atypical, laboratory data, CT findings, and intradermal skin testing suggested the diagnosis of subacute HP caused by green tea. After transfer to a different department, her condition improved markedly. Taking a precise medical history and avoidance of the suspected environmental agent proved useful in diagnosing this condition. © 2016 The Authors. Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology
- Published
- 2016
10. Pollen count and exhaled nitric oxide levels in a seasonal allergic rhinitis patient
- Author
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Takafumi Suda, Toshihiro Shirai, Eisuke Mochizuki, and Kazuhiro Asada
- Subjects
Pulmonary and Respiratory Medicine ,Veterinary medicine ,Pollen season ,business.industry ,food and beverages ,Cedar pollinosis ,Case Reports ,respiratory system ,medicine.disease_cause ,medicine.disease ,Annual change ,Allergic rhinitis ,respiratory tract diseases ,fractional exhaled nitric oxide ,Japanese cedar ,annual change ,Animal science ,pollen count ,Pollen ,Exhaled nitric oxide ,Medicine ,business ,Pollen count ,Asthma - Abstract
The subject was a 52-year-old man with Japanese cedar pollinosis, which developed between February and May. He had no history of asthma and was an ex-smoker. He underwent fractional exhaled nitric oxide (FeNO) measurements twice a week from 2010 to 2012. The pollen counts in 2010 were the lowest during the last decade, and the FeNO level was less than 30 ppb for the whole year. In contrast, the mean pollen count in 2011 was very high and the patient’s FeNO level rose to more than 100 ppb. The mean pollen count in 2012 was comparable with that of 2010; however, high counts were detected in April and May, and the FeNO level rose to 70 ppb during the latter stages of the pollen season. These results indicate that pollen counts should be taken into consideration during the interpretation of FeNO data in asthma or allergic rhinitis.
- Published
- 2014
11. Metastatic pulmonary malignant melanoma showing a ring-shaped and halo signs
- Author
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Mika Saigusa, Toshihiro Shirai, Kazuhiro Asada, Hiroyuki Muro, and Toshihiro Masuda
- Subjects
Pulmonary and Respiratory Medicine ,Pathology ,medicine.medical_specialty ,business.industry ,Melanoma ,Disease progression ,medicine.disease ,Ring (chemistry) ,030218 nuclear medicine & medical imaging ,Metastatic tumours ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Rare case ,medicine ,Pulmonary metastasis ,Halo ,medicine.symptom ,business ,Halo sign - Abstract
Classically, metastatic tumours are solid, multiple, well-circumscribed, and rarely cavitary. This rare case of metastatic pulmonary malignant melanoma showed a ring-shaped ground-glass opacity and then the halo sign, depending on the disease progression.
- Published
- 2018
12. Elevated alveolar nitric oxide concentration after environmental challenge in hypersensitivity pneumonitis
- Author
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Kingo Chida, Kazuhiro Asada, Satoru Morita, Takafumi Suda, Toshihiro Shirai, and Masaki Ikeda
- Subjects
Pulmonary and Respiratory Medicine ,Home environment ,business.industry ,Surfactant protein D ,Environmental exposure ,medicine.disease ,Nitric oxide ,Pulmonary function testing ,chemistry.chemical_compound ,chemistry ,Male patient ,Anesthesia ,Clinical value ,Medicine ,business ,Hypersensitivity pneumonitis - Abstract
We describe a 57-year-old male patient admitted to hospital with hypersensitivity pneumonitis (HP) that resolved without treatment. The total and alveolar nitric oxide (NO) concentrations were measured on initial admission and after re-exposure to his home environment. Following environmental exposure he became ill again, alveolar NO concentration was increased to the same level as on initial admission and impaired pulmonary function and radiologic abnormalities were found. It suggested a diagnosis of environmentally induced HP. The clinical value of measuring alveolar NO as an acute-phase reactant in HP is demonstrated in this patient.
- Published
- 2010
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