ISSN 2187-4360 CODEN: GYDKA9 岐阜薬科大学紀要 第 61 号 平成24年6月30日 THE ANNUAL PROCEEDINGS OF GIFU PHARMACEUTICAL UNIVERSITY No. 61 目 総 2012 次 説 糖尿病網膜症の発症進展におけるポリオール代謝経路の関与 ・・・・加藤憲明・・・・(1) 脳虚血後神経細胞障害における小胞体ストレスの役割 ・・・・種田靖久、原英彰・・・・(11) がん化学療法における薬剤師業務の拡大とその評価に関する研究 ・・・・藤井友和、神谷恒行、足立哲夫・・・・(19) 研究論文 (平成 23 年1月より平成 23 年 12 月までに発表) ・・・・(29) 岐 薬 紀 要 岐 阜 薬 科 大 学 Ann. Proc. 岐阜市大学西1丁目25番地4 Gifu Pharm. Univ. Gifu Pharmaceutical University 1-25-4 Daigaku-Nishi, Gifu 501-1196 岐阜薬科大学紀要 Vol. 61, 1-10 (2012) 1 ―総説― 糖尿病網膜症の発症進展における ポリオール代謝経路の関与 加藤憲明 要約:血管合併症である糖尿病網膜症は代謝異常により発症進展すると考えられている。周皮細胞は血管ネットワークに おいて、内皮細胞の安定化や成熟の他に内皮細胞の刺激および誘導に関与している。一旦、周皮細胞-内皮細胞の相互関 係が破綻すると、基底膜の肥厚および血管透過性の亢進が起こり、増殖網膜症へ進展していく。我々はポリオール代謝に 注目し、ストレプトゾトシン誘発糖尿病ラットを用いて、ポリオール代謝異常と周皮細胞の障害について検討した。アル ドース還元酵素阻害剤によるポリオール代謝異常の是正は網膜毛細血管での周皮細胞消失、基底膜肥厚および毛細血管瘤 の発現を抑制した。そこで,ポリオール代謝の意義を明らかにする為に、培養周皮細胞を用いて、ポリオール代謝の増強 が細胞障害を強めるかどうかを検討した。周皮細胞の障害はポリオール代謝の増強によって強まった。続いて、我々は 2 型糖尿病モデルである自然発症糖尿病トリイ(SDT)ラットを用いて、ポリオール代謝異常の抑制作用が進行した網膜症 に有効であるか検討した。ポリオール代謝の抑制は進行した網膜症を抑制した。以上より、ポリオール代謝異常は糖尿病 網膜症の発症期から進行期の全般にわたり関係することが示唆された。 索引用語:周皮細胞、毛細血管瘤、ポリオール代謝、アルドース還元酵素阻害剤、糖尿病網膜症 The Association of Polyol Pathway in Onset and Progression of Diabetic Retinopathy Noriaki KATO Abstract: The pathological changes of diabetic retinopathy, a vascular complication of diabetes, are thought to be caused by metabolic disturbances. Pericytes are involved in endothelial cell stimulation and guidance, as well as in endothelial stabilization and maturation in the vascular network. Once the pericyte-endothelial cell interaction breaks down, thickening of the basement membrane and increase in permeability occur, resulting in the onset of proliferative retinopathy. We focused on the polyol pathway, and investigated the association between the abnormality of the polyol pathway and the pericyte damage in a rat model of streptozotocin-induced diabetes. Correction of the polyol pathway disturbance by treatment with an aldose reductase inhibitor inhibited the onset of pericyte loss, thickening of the basement membrane and development of microaneurysms of the retinal capillaries. Therefore, to elucidate the significance of the polyol pathway, we examined whether activation of the pathway may potentiate the damage to the retinal pericytes. The damage to the pericytes was potentiated by activation of the polyol pathway. Furthermore, we investigated the inhibitory effects of the polyol pathway on advanced diabetic retinopathy in spontaneously diabetic Torii rats, a type Ⅱ diabetic model. Correction of the disturbed polyol pathway suppressed the progression of diabetic retinopathy. In conclusion, these results suggest that abnormality of the polyol pathway may contribute to the pathology in all stages of diabetic retinopathy. Key phrases: pericytes, microaneurysm, polyol pathway, aldose reductase inhibitor, diabetic retinopathy 株式会社 三和化学研究所 製薬研究所 薬効評価グループ(〒511-0406 三重県いなべ市北勢町塩崎 363) Pharmacological Study Group, Pharmaceutical Research Laboratories, Sanwa Kagaku Kenkyusho Co., Ltd. (363, Shiosaki, Hokusei, Inabe, Mie 511-0406, JAPAN) 加藤憲明:糖尿病網膜症の発症進展におけるポリオール代謝経路の関与 2 1.緒言 胞や内皮細胞が高血糖状態で障害されて発症するとされ ている。病変の主座である網膜毛細血管は、管腔構造を形 厚生労働省が定期的に行っている国民健康・栄養調査に 成する内皮細胞とその周囲で基底膜を共有して被覆する よると、糖尿病が強く疑われる人は平成 9 年 約 690 万人、 周皮細胞から成るが、相互が密接に作用して、血管機能の 平成 14 年 約 740 万人であり、最も新しい平成 19 年の調 恒常性を維持している。周皮細胞は、1)可溶性メディエ 査では約 890 万人と報告されている 1)。福岡県久山町が実 ターや細胞-細胞間接触を通じて内皮細胞とコミュニケー 施した平成 15 年の疫学調査では、40 歳以上の全住民の 2% ションをとり、2)基底膜の合成、再構築および維持を図 が糖尿病網膜症と報告されており、この結果を全国の 40 り、3)Rho シグナルを介して微小血管の緊張を調整して 歳以上の総人口に換算すると、糖尿病網膜症患者数は約 いる 4)。また、周皮細胞は内皮細胞の成長 5)および遊走 2) 6) 134 万人と推定されている 。平成 19 年の調査では糖尿病 を抑制する。網膜の毛細血管では他組織の毛細血管に比べ、 が強く疑われる人と糖尿病の可能性を否定できない人を 周皮細胞の比率が非常に高い 7)。したがって、網膜毛細血 合わせると約 2210 万人と試算されていることから、糖尿 管で周皮細胞が障害を受けた場合、周皮細胞および内皮細 病網膜症の潜在的な患者数は非常に多いことが予測でき 胞の機能的相互作用の破綻を招き、基底膜肥厚や網膜血管 る。 透過性の亢進が起こると考えられている。基底膜肥厚は血 初期網膜症である単純網膜症では、毛細血管瘤、網膜出 管の剛性を増し血管拡張機能を低下させて、微小循環障害 血、硬性白斑および網膜浮腫が発現し、増殖前網膜症を経 や虚血状態を招き、それによって過剰産生される血管内皮 て増殖網膜症へと進展すると、新生血管、線維血管性増殖 増殖因子(vascular endothelial growth factor: VEGF)によっ 組織が形成され、硝子体出血や牽引性網膜剥離が起こり、 て、血管新生を伴った増殖網膜症に進展すると考えられて 重度の視力障害(失明)に至る 3)。後天性視力障害の原因 。 いる(Fig. 1 8)) 疾患として、糖尿病網膜症は緑内障に次いで第 2 位、視力 障害者の 1/5 を占め、大きな社会問題になっている。糖尿 病網膜症は網膜血管の疾患であり、特に毛細血管の周皮細 Fig. 1 Schematic representation of the progression of diabetic retinopathy Pericytes interact directly with the normal retinal capillary endothelium (a) within the basement membrane via close contacts and gap junctions ensuring basal tone a(ⅰ) and growth arrest a(ⅱ). Persistent hyperglysemia leads to RhoGTPase induction of pericyte contraction b(ⅰ) causing reversal of EC growth arrest b(ⅱ) and disrupted matrix contact b(ⅲ) prior to or in the absence of pericyte death/dropout. Basement membrane thickening and leaky, narrow capillaries contribute to thrombosis, ischemia, and the first detectable abnormalities of NPDR. In response to the resultant hypoxia, soluble mediators of angiogenesis, such as VEGF, are released to develop collateral nutrient supply by forming nascent capillary tubes (c). These new blood vessels are highly permeable and fragile and disrupt easily causing hemorrhage and the vision loss characteristic of PDR (d). (Reprinted from Willard et al.(2012), with permission) 岐阜薬科大学紀要 Vol. 61, 1-10 (2012) 糖尿病網膜症での主な代謝異常ではポリオール代謝 3 および毛細血管病変がポリオール代謝異常とどう関係す (polyol pathway)異常、プロテインキナーゼ C(protein るのか AR 阻害剤であるフィダレスタット kinase C: PKC)の活性化、酸化ストレス(oxidative stress) {(+)-(2S,4S)-6-fluoro-2’,5’-dioxospiro[chroman-4’ 増大およびグリケーション(glycation)促進が報告され、 -imidazolidine]-2-carboxamide}を用いて検討した。また、 中でもポリオール代謝は PKC 活性化、酸化ストレス増大 SDH 過剰発現培養周皮細胞を用いて、ポリオール代謝異 およびグリケーション促進と密接に関連している(Fig. 2 常が細胞障害にどのように影響するのか、活性酸素種 9) )。ポリオール代謝は 2 段階からなる簡単な系であり、第 (reactive oxygen species: ROS)産生、[3H]Thymidine 取り 1 反応はアルドース還元酵素(aldose reductase: AR, EC 込み量および VEGF 発現に対するフィダレスタットの作 1.1.1.21)が還元型ニコチンアミドアデニンジヌクレオチ 用で検討した。網膜症は重症化すると、増殖性変化を呈し ド リ ン 酸 ( nicotinamide adenine dinucleotide phosphate てくる。ポリオール代謝異常の是正が増殖性変化を伴った reduced form: NADPH)を補酵素にして、ソルビトール より進行した網膜症にも有効であるかどうかを、自然発症 (sorbitol)を産生し、第 2 反応ではソルビトール脱水素酵 糖尿病トリイ(Spontaneously Diabetic Torii: SDT)ラット(2 素(sorbitol dehydrogenase: SDH, EC 1.1.1.14)が、酸化型ニ 型糖尿病モデル)を用いて、網膜病変の頻度および眼内液 コ チ ン ア ミ ド ア デ ニ ン ジ ヌ ク レ オ チ ド ( nicotinamide 中 VEGF 蛋白に対するフィダレスタットの作用をもとに adenine dinucleotide: NAD)を補酵素にして、フルクトース 検討した。 ( fructose ) を 産 生 す る 。 ポ リ オ ー ル 代 謝 亢 進 に よ る NADPH 過 剰 消 費 は 還 元 型 グ ル タ チ オ ン ( reduced glutathione: GSH)の減少を招き、酸化ストレスが増大する。 また NAD の過剰消費は de novo のジアシルグリセロール (diacylglycerol: DAG)合成を促進し、その結果、PKC を 活性化させると考えられている。グリケーションはポリオ ール代謝から生成されるフルクトースおよびその代謝物 2.網膜の毛細血管病変とポリオール代謝異常の関係 STZ 誘発糖尿病ラットの毛細血管病変に対するフィダレ スタットの作用 雄性スプラーグドーリー(Spague-Dawley : SD)ラット により亢進するとされている。主要な代謝異常とリンクす に 0.05 M のクエン酸緩衝液に溶解した STZ ることから、ポリオール代謝異常は糖尿病網膜症の発症お (Sigma-Chemical Co.)を 40 mg/kg の割合でラット尾静脈 よび進展に密接に関与していると考えられている。 内に投与して糖尿病を誘発した。STZ 投与後 4 日目の血漿 中グルコース濃度が 15.8 mmol/L 以上のラットを糖尿病と し、次の 4 群に群分けした:(1)糖尿病対照群(diabetic control group)、 (2)0.5 mg/kg/day フィダレスタット投与 、 糖尿病群(0.5 mg/kg/day fidarestat-treated diabetic group) (3)1 mg/kg/day フィダレスタット投与糖尿病群(1 mg/kg/day fidarestat-treated diabetic group)、 (4) 2 mg/kg/day フィダレスタット投与糖尿病群(2 mg/kg/day fidarestat-treated diabetic group) 。フィダレスタットは 5%ア ラビアゴム溶液に懸濁して、糖尿病誘発後 4 日目より、1 日 1 回、15 ヶ月間強制経口投与した。薬物最終投与 3 時 間後に、深麻酔下でラットの眼球を摘出し、病理評価に用 いた。角膜に切り込みを入れたのち、眼球を 0.1 mol/l のカ コジル酸緩衝液で調製した 1 % glutaraldehyde 液で固定し Fig. 2 Acceleration of polyol pathway and related metabolic disturbances AR: aldose reductase, SDH: sorbitol dehydrogenase, GR: glutathione reductase, GP: glutathione peroxidase, SOD: superoxide dysmutase, DAG: diacylglycerol, G3P: glycerol 3-phosphate, PA: phosphatidic acid, F3-P: fructose 3-phosphate, 3-DG: 3-deoxyglucosone ポリオール代謝の律速酵素である AR は血管周皮細胞に 存在していることが報告されている 10)。本総説では、1 型 糖尿病モデルであるストレプトゾトシン(streptozotocin: STZ)誘発糖尿病ラットを用いて、網膜の周皮細胞の障害 た。カコジル酸緩衝液で洗浄した後、パラフィンに包埋し、 組織切片(約 4 μm の厚さ)を作成した。血管基底膜の染 色は periodic acid-Schiff 液を用いて行い、毛細血管瘤は hematoxyline-eosin 液で染色した後、Yanoff らの基準 11)に 従って同定した。糖尿病ラットの毛細血管の基底膜の厚さ が正常血管の基底膜の厚さの 150 % 以上の場合、肥厚あ りとした 12)。周皮細胞の消失は、網膜内網状層および外網 状層に位置する血管について、周皮細胞の核と内皮細胞の 核の比をもとに評価した 13)。 毛細血管瘤(Fig. 3b)は糖尿病対照群で 8 匹中 6 匹 (有 4 加藤憲明:糖尿病網膜症の発症進展におけるポリオール代謝経路の関与 病率 75%) 認められた(Fig. 4 上段)。正常群では認められ で認められた(Fig. 5)。フィダレスタットは周皮細胞の消 なかった(10 匹中 0 匹)。フィダレスタット 0.5 mg/kg/day 失を 0.5 mg/kg/day の用量から有意に抑制した(Fig. 5)。毛 投与群、1 mg/kg/day 投与群および 2 mg/kg/day 投与群では 細血管瘤の有病率および周皮細胞の消失の相関係数を求 10 匹中 4 匹(有病率 40%)、9 匹中 3 匹(有病率 33%)お めたところ、- 0.94 であり、両者は負の相関を示した(P < よび 6 匹中 0 匹(有病率 0%)に毛細血管瘤が認められた 0.05)。 (Fig. 4 上段)。フィダレスタットの毛細血管瘤の発生に対 する抑制効果は用量依存的であった。 Fig. 3 Microaneurysm in the retinal capillaries of streptozotocin-induced diabetic rats a: normal capillary, b: microaneurysm The result was cited from ref 14. 毛細血管の基底膜肥厚は糖尿病対照群の全例で認めら れた(Fig. 4 下段) 。これに対して、フィダレスタット投与 群では毛細血管瘤の結果と同様に、用量依存的にその頻度 は減少し、2 mg/kg/day 投与群では基底膜肥厚は認められ Fig. 5 Effect of fidarestat on the decrease in pericytes in the retinal capillaries of streptozotocin-induced diabetic rats Each column and vertical line represents mean ± S.E.M. for ** *** 6 to 10 rats. , P < 0.01; , P < 0.001 vs. diabetic control group (ANOVA plus LSD methods). : The area between the outer plexiform layer and the inner nuclear layer. : The area between the inner plexiform layer and the nerve fiber layer. The result was cited from ref 14. 糖尿病対照群のソルビトール量は正常群に比べ、約 5 倍 増加していた(0.05±0.01 vs. 0.26±0.02 μmol/g tissue, 平均 値±標準誤差, P < 0.001)が、フィダレスタットはこのソ ルビトール量増加を用量依存的に抑制した(0.5 mg/kg/day 投与群:0.21±0.01 μmol/g tissue, 1 mg/kg/day 投与群:0.20± 0.01 μmol/g tissue(P < 0.05), 2 mg/kg/day 投与群:0.17±0.02 μmol/g tissue, P < 0.01) 。糖尿病対照群の血漿中グルコース 濃度は正常対照群に比べ約 3 倍増加していた(9.4±0.3 vs. 30.1±2.4 mmol/L, P < 0.001)が、フィダレスタットはこれ に影響しなかった。 なかった(Fig. 4 下段)。 Fig. 4 Effects of fidarestat on the histopathological changes in the retina of streptozotocin-induced diabetic rats Each column represents the percent of appearance. Figures in parentheses indicate the number of rats with and without the ** *** change, respectively. , P < 0.01; , P < 0.001 vs. diabetic control group (chi-square test). : appearance, : absence The result was cited from ref 14. 3. 網膜周皮細胞障害におけるポリオール代謝の関与 SDH 過剰発現培養周皮細胞の調製 ウシ網膜より周皮細胞を単離し、その細胞を 20%ウシ胎 仔血清添加のダルベッコ変法イーグル培地(Gibco-BRL) にて培養した。ヒト SDH のための cDNA コーディングは テンプレートとしてのヒト細小血管内皮細胞ラムダ cDNA ライブラリ (Stratagene)と 2 つのオリゴヌクレオ チドプライマー(5’-GCACTCCAGAGCCAAAAGAG-3’ および 5’-CTGAGATCCCAAGACTGTGG-3’)15)を用いた 周皮細胞の消失は網膜外網状層と内顆粒層の間の部位 ポリメラーゼ連鎖反応によって増幅した。PCR 増幅 cDNA 岐阜薬科大学紀要 Vol. 61, 1-10 (2012) 5 フラグメントは発現ベクターである pBK-CMV (Stratagene, しかし、SDH 過剰発現は 5 mM における ROS 産生には影 La Jolla, CA, U.S.A.)にクローンした。周皮細胞はヒト SDH 響しなかった(データ示さず)。ポリオール代謝の最初の cDNA か空のベクターのどちらかを FuGENE 6 トランス 反応を阻害するフィダレスタットは SDH 過剰発現細胞の フェクション試薬(Roche Diagnostics)を用いてトランス ROS 産生量増強を完全に抑制した(Fig. 6)。 フェクションした。 細胞への[3H]Thymidine 取り込み量は高グルコース刺激 により軽度であるが、有意に減少した。SDH 過剰発現に 周皮細胞障害に対するフィダレスタットの作用 より取り込み量はさらに減少した(Fig. 7) 。フィダレスタ 細胞の障害は周皮細胞中 ROS 産生量、[3H]Thymidine 取 ットは ROS 産生抑制作用と同様に、SDH 過剰発現細胞に り込み量および周皮細胞中 VEGF mRNA 発現量で評価し お ける[3H]Thymidine 取り込み量減少を完全に抑制した た。ROS 産生量は蛍光プローブである CM-H2DCFDA (Fig. 7)。 (Molecular Probes)を用いて測定した。SDH または mock をトランスフェクションした細胞は、0.3 μM のフィダレ スタットまたは 1 mM の N-acetylcysteine(NAC)の存在下 で、5 mM または 30 mM のグルコースにて 2 日間インキュ ベートした。その後、細胞を 10 μM の CM-H2DCFDA にて 37℃で 45 分間インキュベートしたのち、EZS-FL-蛍光プレ ートリーダー(Asahi Techno Glass)を用いて、EZScan-FL for Windows program の方法で測定を行った。[3H]Thymidine 取り込み量は SDH または mock をトランスフェクション した細胞を、0.3 μM のフィダレスタットまたは 1 mM の NAC の存在下で、5 mM または 30 mM のグルコースにて 4 日間インキュベートした後測定した。VEGF mRNA は 0.3 μM のフィダレスタットまたは 1 mM の NAC の存在下で、 5 mM または 30 mM のグルコースにて 6 日間インキュベー トした SDH または mock をトランスフェクションした細 + 胞から、Poly(A) RNAs を取り出し、定量 RT-PCR 法にて 測定した 16)。周皮細胞中 ROS の産生は、5 mM に比べ 30 mM のグルコース濃度で軽度に増加した。30 mM での ROS 産生量は SDH を過剰発現した細胞の方が、過剰発現 していない細胞に比べ強力に増加していた (Fig. 6)。 3 Fig. 7 Effects of 5 or 30 mM glucose on [ H]thymidine incorporation in SDH- or mock-transfected pericytes. SDH- or mock-transfected pericytes were treated with 5 or 30 mM glucose in the presence or absence of 0.3 mM 3 fidarestat or 1 mM NAC for 4 days, and then, [ H] thymidine incorporation was determined as described under * ‘Material and methods.’ , P < 0.01 vs. control with # mock-transfected cells (Student’s t-test). , P < 0.01 vs. mock-transfected 30 mM glucose- treated cells. HG, 30 mM glucose; SDH, sorbitol dehydrogenase; NAC, N-acetylcysteine. The result was cited from ref 17. 高グルコース刺激により周皮細胞の血管内皮増殖因子 (VEGF)mRNA 発現は有意に増加したが、SDH 過剰発現 によりさらに増加した(Fig. 8)。フィダレスタットおよび NAC は SDH 過剰発現細胞の VEGF mRNA 発現の増強を抑 制した(Fig. 8)。 Fig. 6 Effects of 5 or 30 mM glucose on intracellular reactive oxygen species generation in SDH- or mock-transfected pericytes SDH- or mock-transfected pericytes were treated with 5 or 30 mM glucose in the presence or absence of 0.3 mM fidarestat or 1 mM NAC for 2 days. Then, reactive oxygen species were quantitatively analyzed. *, P < 0.01 vs. control with mocktransfected cells (Student’s t-test). #, P < 0.01 vs. mocktransfected 30 mM glucose-treated cells. HG, 30 mM glucose; SDH, sorbitol dehydrogenase; NAC, N-acetylcysteine; ROS, reactive oxygen species. The result was cited from ref 17. 加藤憲明:糖尿病網膜症の発症進展におけるポリオール代謝経路の関与 6 Fig. 9 Effects of 5 or 30 mM glucose on intracellular sorbitol and fructose levels in cultured pericytes SDH- or non-transfected pericytes were treated with 5 or 30 mM glucose in the presence or absence of 0.3 mM fidarestat for 6 days. Then, intracellular sorbitol and fructose levels were determined as described under * # ‘Materials and methods”. and , P < 0.01 compared to sorbitol and fructose levels of the control cells, respectively (Student’s t-test). HG, 30 mM glucose; SDH, sorbitol dehydrogenase. The result was cited from ref 17. 4.増殖性網膜病変とポリオール代謝異常の関係 Fig. 8 Effects of 5 or 30 mM glucose on VEGF mRNA regulation in SDH- or mock-transfected pericytes (A) SDH- or mock-transfected pericytes were treated with 5 or 30 mM glucose in the presence or absence of 0.3 mM fidarestat or 1 mM NAC for 6 days, and then 30 ng + poly(A) RNAs were transcribed and amplified by PCR. Each lower panel shows the expression of b-actin genes. PCR amplification for b-actin mRNA was performed for 25 cycles. (B) Quantitative representation of VEGF gene induction. Data were normalized by the intensity of b-actin mRNA-derived signals and related to the value of the * control with mock-transfected cells. , P <0.01 compared to the value of the control with mock-transfected cells (Student’s t-test). HG, 30 mM glucose; SDH, sorbitol dehydrogenase; NAC, N-acetylcysteine; VEGF, vascular endothelial growth factor. The result was cited from ref 17. SDT ラットの増殖性網膜病変に対するフィダレスタット の作用 日本クレアより入手した雄性 SDT ラットおよび SD ラ ットを実験に用いた。SDT ラットのうち、随時血糖が 19.4 mmol/L 以上のラットを糖尿病が発症したものとみなし、 (1)糖尿病対照群(SDT)、 (2)低用量フィダレスタット 投与群(8 mg/kg/day)、(3)高用量フィダレスタット投与 群(32 mg/kg/day)に群わけした。フィダレスタット投与 群の SDT ラットには、標準飼料(CRF-1, Oriental Yeast Co, Ltd., Tokyo, Japan)にフィダレスタットを含有した混合飼 料を糖尿病発症時(約 20 週齢)から 40 週間与えた。40 週間投与後に蛍光血管造影法および病理組織学的手法に て網膜症の評価を行った。病理組織学的評価は深麻酔下に 周皮細胞中ポリオール代謝異常に対するフィダレスタッ て摘出した眼球を固定液(mixture of 2.5% paraformaldehyde トの作用 and 1% glutaraldehyde in 0.15 M phosphate buffer)に浸して SDH をトランスフェクションした細胞、またはしてい 固定した後、洗浄してパラフィンに包埋した。作成した 厚 ない細胞を、0.3 μM のフィダレスタットの存在下または さ 4 μm の切片を hematoxyline-eosin 液で染色して、既報 19) 非存在下において、5 mM または 30 mM のグルコースにて に準じて、糖尿病ラットに牽引性網膜剥離に類似した網膜 6 日間インキュベートした。細胞中ソルビトール量および 隆起または視神経周囲に広範囲の蛍光漏出が認められた フルクトース量の測定を液体クロマトグラフィー・タンデ 場合に進行した網膜症ありとした。 ム質量分析法により行った 18)。高グルコース刺激により周 糖尿病網膜症の有病率はフィダレスタット低用量およ 皮細胞中ソルビトール量およびフルクトース量は有意に び高用量投与群はいずれも 0 %(0/14 眼および 0/21 眼)で 増加したが、フィダレスタットはこれらの増加を強力に抑 あり、糖尿病対照群の有病率 66.6 % (2/18 眼)より有意 制した(Fig. 9)。 に低かった(P < 0.001)。糖尿病網膜症の典型的な変化、 例えば、牽引性網膜剥離に類似した網膜隆起は糖尿病対照 群に多く認められたが、フィダレスタット投与群では認め られなかった(Fig. 10A)。蛍光血管造影でみられた特徴的 岐阜薬科大学紀要 Vol. 61, 1-10 (2012) 7 Fig. 10 Effect of fidarestat on diabetic retinopathy (A): Large retinal folds mimic tractional retinal detachment (arrow) in SDT control group, but not in fidarestat-treated SDT groups and normal group. B): Extensive leakage of fluorescein around the optic disc in SDT control group, but not in fidarestat-treated SDT groups and normal group. SDT, spontaneously diabetic Torii rat; Fida, fidarestat. The result was cited from ref 20. な変化は視神経周囲の広範囲な蛍光漏出であり、糖尿病対 照群では多く認められたが、フィダレスタット投与群では 認められなかった(Fig. 10B)。 SDT ラットの眼内液中 VEGF 蛋白増加および網膜中ポリ オール代謝異常に対するフィダレスタットの作用 眼内液(房水および硝子体液の混液)中 VEGF 蛋白濃度 の測定はサンドイッチ酵素免疫測定法(ELISA)にて、マ ウス VEGF 測定キット(R&D System)を用いて測定した。 糖尿病対照群の VEGF 蛋白量(324.7±76.4 pg/ml)は正常 群 (40.4±10.0 pg/ml)に比べ、有意に高値であった(P < 0.01, Fig. 11)。フィダレスタットは、この VEGF 蛋白の増 加を用量依存的に抑制した(低用量群: 65.3±4.5 pg/ml, P <0.05, 高用量群: 47.7±10 pg/ml, P < 0.001) 。 糖 尿 病 対 照 群 の 網 膜 中 ソ ル ビ ト ー ル 量 ( 23.2 ± 4.7 nmol/mg protein, 平均値±標準誤差)は正常群(1.1±0.1 Fig. 11 Effect of fidarestat on the increase in vascular endothelial growth factor in ocular fluids in spontaneously diabetic Torii rats Each value represents mean ±S.E.M. for 6 to 9 rats. ## * , P < 0.01 vs. normal group (Student’s t-test). , P < 0.05; *** , P < 0.001 vs. SDT control group (Dunnett’s test). SDT, spontaneously diabetic Torii rats; Fida, fidarestat; VEGF, vascular endothelial growth factor. The result was cited from ref 20. nmol/mg protein)に比べ、有意に高値であった(P < 0.05)。 フ ィ ダ レ ス タ ッ ト 投 与 群 で は 、 低 用 量 群 が 2.7 ± 1.1 nmol/mg protein(P < 0.01)であり、高用量群は 0.7±0.2 5.考察 nmol/mg protein(P < 0.001)であった。糖尿病対照群の網 膜中フルクトース量(13.7±1.2 nmol/mg protein)は正常群 (3.7±0.9 nmol/mg protein)に比べ、有意に高値であった (P < 0.001)。フィダレスタット投与群では、低用量群が 6.8±5.0 nmol/mg protein であり、高用量群は 6.3±2.5 nmol/mg protein であった。SDT 対照群の血漿中グルコース 濃度は正常群に比べ有意に高かった(9.3±0.4 vs. 42.8±3.4 mmol/L, P < 0.001)が、フィダレスタットは SDT ラットの 血漿中グルコース濃度に影響を与えなかった。 STZ 誘発糖尿病ラットを用いて、網膜の周皮細胞の消失 と毛細血管病変(毛細血管瘤、血管基底膜肥厚)の発現に ついて検討し、AR 阻害剤でこれら病変が抑制されるか検 討した。本検討では、STZ 糖尿病ラットの初期網膜病変で ある周皮細胞の消失、毛細血管基底膜の肥厚および毛細血 管瘤が AR 阻害剤であるフィダレスタットによって抑制さ れることが示された。周皮細胞の障害が糖尿病網膜症の発 症に関係することが示唆されたことから、周皮細胞にヒト SDH を過剰発現させ、ポリオール代謝異常が周皮細胞の 障害にどう関与しているかを検討した。高グルコース濃度 曝露により周皮細胞の ROS 産生量および VEGF mRNA 発 加藤憲明:糖尿病網膜症の発症進展におけるポリオール代謝経路の関与 8 現は増加し、[3H]Thymidine 取り込み量は減少した。これ 抑制することは、SDH 過剰発現による有害反応から周皮 らの変化は SDH を過剰発現するとさらに強まった。フィ 細胞を保護する上で有用であると考えられた。 ダレスタットは SDH 過剰発現細胞における増強作用をい ずれも抑制した。 周皮細胞は内皮細胞の異常増殖を制御し、内皮細胞のプ ロスタサイクリン産生能力の維持に関与することで細小 周皮細胞は内皮細胞の増殖、分化および毛細血管の血流 血管の恒常性維持に中心的な役割を果たしている 24) 。 を制御することから、細小血管の局所ホメオスタシス、す VEGF は糖尿病網膜症の多くの機能変化および構造変化 なわち全身循環の維持に重要な役割を果たしている 21)。網 に関与している 23), 膜において、周皮細胞の消失は血管壁の脆弱化を招き、毛 胞障害および VEGF 産生は、周皮細胞および内皮細胞の機 細血管瘤を惹起する。毛細血管瘤は、網膜外網状層および 能的相互作用の破綻を招き、網膜血管透過性亢進、血栓形 内顆粒層の間で発現し、同じ部位で周皮細胞の消失が観察 成および血管形成など糖尿病網膜症にみられる臨床所見 された。さらに、周皮細胞の消失が毛細血管瘤の発現頻度 を引き起こす要因となると考えられる。Tilton ら 28)はソル と相関することが示された。AR はシュワン細胞およびメ ビトールレベルが 11 倍に増加しているにもかかわらず、 10) 25-27) 。したがって、SDH による周皮細 。こ SDH 阻害薬が糖尿病ラットの眼内組織中の血管機能障害 れらの結果より、糖尿病では周皮細胞内のポリオール代謝 を改善したと報告している。この報告は本検討結果を支持 が亢進し、これをきっかけとして周皮細胞が変性し、脱落 するものであり、糖尿病網膜症の発症に SDH が重要であ すると考えられた。強力な AR 阻害薬であるフィダレスタ ることを示唆している。以上の検討より、糖尿病網膜症に ットは網膜中ポリオール代謝異常を抑制し、さらに周皮細 は周皮細胞の障害が重要であり、ポリオール代謝異常が密 胞の消失および毛細血管瘤の発現を抑制したことから、ポ 接に関与していることが示唆されたが、より進んだ網膜症 リオール代謝異常が糖尿病網膜症の発症に密接に関連し ではその関与は変わるのだろうか。それを検討する為に、 ていることが示唆された。一方、他の病理所見として、網 進行した糖尿病網膜病変を呈する SDT ラットを用いて、 膜毛細血管の基底膜肥厚が糖尿病対照群の全例で観察さ フィダレスタットの有効性を検討した。SDT ラット長期モ れた。基底膜肥厚は基底膜の剛性を増し血管拡張機能を低 デルでは、牽引性網膜剥離に類似の網膜隆起および視神経 下させて、微小循環障害や虚血を起こし 22)、この微小循環 周囲での広範囲の蛍光漏出が認められた。網膜では、ポリ 障害が糖尿病網膜症の進行の主たる危険因子である オール(ソルビトールおよびフルクトース)の増加がみら サンギウム細胞と同様に、周皮細胞に存在している 23) 。フィダレスタ れ、眼内液では VEGF の増加がみられた。フィダレスタッ ットは毛細血管の基底膜肥厚を用量依存的に抑制したこ トはいずれの代謝パラメーターの異常も用量依存的に抑 とから、糖尿病での網膜中ポリオール代謝異常の抑制が、 制し、糖尿病網膜症の発現を強力に抑制した。本検討によ VEGF の増加を抑制し、それが結果的に糖尿病網膜症の発 り、高血糖下でのポリオール代謝異常の抑制作用は VEGF 症抑制につながっている可能性も考えられる。 増加を抑制し、進行した網膜症発現を抑制したものと考え VEGF の産生を増加させると考えられる 本検討において、SDH 過剰発現は高グルコース曝露の られた。 周皮細胞の ROS 産生を増強させることが示された。増加 STZ ラットでは、発現する変化が毛細血管瘤および血管 した ROS が周皮細胞の障害を増強することは次の事実か 基底膜肥厚などの初期変化であり、増殖性の変化は発現し ら明らかである:(1)SDH 過剰発現によって、高グルコ ない。これに対して、SDT ラットは進行した網膜病変、す 3 ース曝露による周皮細胞の[ H]Thymidine 取り込み量の減 なわち、網膜肥厚を伴った牽引性網膜剥離および視神経周 少および VEGF mRNA 発現の増加がさらに強まった。 (2) 囲の広範囲の血管透過性亢進が発現する 19), 抗酸化物質である NAC が、高グルコース曝露時の SDH 過 ットの血糖値は STZ ラットに比べてはるかに高い。した 剰発現による周皮細胞の ROS 産生増強を完全に抑制し、 がって、SDT ラットでは、ポリオール代謝の亢進が STZ [3H]Thymidine 取り込み量減少および VEGF mRNA 発現増 ラットに比べより強く起こり、VEGF 産生の程度も強くな 加を抑制した。フィダレスタットは 30 mM グルコースに ると考えられる。STZ ラットおよび SDT ラットの検討に 3 29-30) 。SDT ラ おいて増強した SDH 過剰発現周皮細胞の[ H]Thymidine 取 おいて、フィダレスタットは血糖に対して作用を示してい り込み量減少を完全に抑制した。また、周皮細胞中のソル ないことから、一連の網膜症への作用は血糖コントロール ビトール蓄積を抑制した。一方、SDH 過剰発現は、5 mM によるものでなく、ポリオール代謝亢進の抑制によるもの グルコースでは ROS 産生に影響を与えなかった。これら である。 の結果は、高グルコースでのソルビトール蓄積が SDH に VEGF は増殖網膜症を引き起こす重要な蛋白である 31-32)。 よる ROS 産生反応の律速段階であることを示唆している。 VEGF は網膜内の血管透過性を亢進し、血管新生を促して、 したがって、ポリオール代謝の 2 番目の反応を触媒する 最終的に血管新生緑内障を形成する SDH は、周皮細胞の障害に密接に関わっていると考えら 生は硝子体出血と牽引性網膜剥離の主な原因となる。増殖 れ、ソルビトール蓄積を AR 阻害薬のフィダレスタットで 網膜症に合併して発症する血管新生緑内障は VEGF 産生 33) 。網膜内の血管新 岐阜薬科大学紀要 Vol. 61, 1-10 (2012) による最も悲惨な結果である。SDT ラットは目立った網膜 9 8.引用文献 内血管新生を示さないが、血管透過性の亢進は顕著にみら れた。眼内液中の VEGF 蛋白量はフィダレスタットの投与 1) 厚生労働省, 平成 19 年国民健康・栄養調査報告 (2007). によって、ほぼ正常レベルまで抑制されたことから、この 作用が血管透過性亢進および牽引性網膜剥離の抑制につ 2) 安田美穂, 新しい眼科,24, 1287-1290 (2007). ながる可能性が示唆された。 3) 山下英俊,川崎良 編,糖尿病網膜症 専門医による ベストアドバイス,診断と治療社 (2003). 以上の結果より、ポリオール代謝異常は初期糖尿病網膜 症だけでなく、増殖性変化を伴う進行した網膜症に関与す ることが明らかとなった。 6.結論 STZ 誘発糖尿病ラットは網膜内の毛細血管において、周 4) 5) 6) 7) 8) 皮細胞の消失を示し、フィダレスタットはこの周皮細胞の 消失を抑制した。また、毛細血管の基底膜肥厚および毛細 9) Kutcher M.E., Herman I.M., Microvas. Res., 77, 235–246 (2009). Orlidge A., D’Amore P.A., J. Cell Biol., 105, 1455-1462 (1987). Sato Y., Rifkin D.B., J. Cell Biol., 109, 309-315 (1989). Motiejunaite R., Kazlauskas A., Exp. Eye Res., 86, 171–177 (2008). Willard A.L., Herman I.M., J. Ophthalmol., 2012, Article ID 209538. (Epub 2012). 堀田饒 編, 糖尿病合併症治療のイノベーション 血管瘤の発現を抑制した。周皮細胞の消失と毛細血管瘤の -ARI (アルドース還元酵素阻害薬) -,医薬ジャー 有病率の関係は、負の相関関係が認められた。高グルコー ナル社 (2002). ス濃度曝露により周皮細胞中の ROS 産生および VEGF 10) mRNA 発現は増加し、[3H]Thymidine 取り込み量は減少し た。これらの変化は SDH を過剰発現するとさらに強まっ 11) た。フィダレスタットは SDH 過剰発現細胞における増強 作用を抑制した。SDT ラットを用いた検討では、牽引性網 膜剥離に類似した網膜隆起または視神経周囲の広範囲な 12) 蛍光漏出を伴う網膜症が SDT ラットで認められたがフィ ダレスタットはこの発現を抑制した。この時、フィダレス 13) タットは SDT ラットの眼内液中 VEGF 蛋白増加に対して も抑制作用を示した。本検討結果より、ポリオール代謝異 14) 常が初期糖尿病網膜症の発現だけでなく、増殖網膜症の発 現に対しても関係することが示唆され、糖尿病網膜症の病 態を解明する上で有用な知見となると考えられた。 7.謝辞 15) 16) 17) 本稿を終えるにあたり、本研究に関し多大なる御指導と 御鞭撻を賜りました岐阜薬科大学生体機能解析学大講座 18) 薬効解析学研究室 原 英彰 教授に深甚なる謝意を表しま す。また、糖尿病網膜症の病理評価の遂行に際し、多大な 19) る御指導を賜りました自治医科大学附属さいたま医療セ ンター眼科 梯 彰弘 教授、細胞を用いた評価に際し、御 指導を賜りました久留米大学医学部糖尿病性血管合併症 病態・治療学講座 山岸 昌一 教授に深謝致します。合わ 20) せて、本研究の機会を頂き、終始御懇篤なる御指導および 御指導を賜りました株式会社三和化学研究所 鈴木 常正 取締役常務執行役員ならびに温かい御協力を頂きました 21) 株式会社三和化学研究所の各位に心より御礼申し上げま す。 22) 23) Akagi Y., Kador P.F., Kuwabara T., Kinoshita J.H., Invest. Ophthalmol. Vis. Sci., 24, 1516-1519 (1983). Yanoff M., Fine B.S., 15 DIABETES MELLITUS, in Yanoff, M., Fine, B.S. (Ed), Ocular Pathology: A Color Atlas, Philadelphia, J.B. Lippincott Company, pp.187-195 (1988). McCaleb M.L., McKean M.L., Hohman T.C., Laver N., Robison Jr W.G., Diabetologia, 34, 695-701 (1991). Akita M., Mizuno K., Matsubara A., Nakano K., Kurono M., Acta. Med. Okayama, 47, 299-304 (1993). Kato N., Yashima S., Suzuki T., Nakayama Y., Jomori T., J. Diabetes Comp., 17, 374-379 (2003). Lee F.K., Cheung M.C., Chung S., Genomics, 21, 354-358 (1994). Yamagishi S., Fujimori H., Yonekura H., Yamamoto Y., Yamamoto H., Diabetologia, 41, 1435-1441(1998). Amano S., Yamagishi S., Kato N., Inagaki Y., Okamoto T., Makino M., Taniko K., Hirooka H., Jomori T., Takeuchi M., Biochem. Biophy. Res. Commun., 299, 183-188 (2002). Guerrant G., Moss C.W., Anal. Chem., 56, 633-638 (1984). Kakehashi A., Saito Y., Mori K., Sugi N., Ono R., Yamagami H., Shinohara M., Tamemoto H., Ishikawa S.E., Kawakami M., Kanazawa Y., Diabetes Metab. Res. Rev., 22, 455-461 (2006). Kakehashi A., Takezawa M., Toyoda F., Kinoshita N., Kambara C., Yamagami H., Kato N., Ishikawa S., Kawakami M., Kanazawa Y., Open Diabetes J., 4, 101-107 (2011). Shepro D., Morel N.M.L., FASEB J., 7, 1031-1038 (1993). Tooke J.E., Clin. Sci., 70, 119-125 (1986). Aiello L.P., Avery R.L., Arrigg P.G., Keyt B.A., Jampel 10 24) 25) 26) 27) 28) 29) 30) 31) 32) 33) 加藤憲明:糖尿病網膜症の発症進展におけるポリオール代謝経路の関与 H.D., Shah S.T., Pasquale L.R., Thieme H., Iwamoto M.A., Park J.E., Nguyen H.V., Aiello L.M., Ferrara N., King G.L., N. Engl. J. Med., 331, 1480-1487 (1994). Yamagishi S., Kobayashi K., Yamamoto H., Biochem. Biophys. Res. Commun., 190, 418-425 (1993). Adamis A.P., Miller J.W., Bernal M.T., D'Amico D.J., Folkman J., Yeo T.K., Yeo K.T., Am. J. Ophthalmol., 118, 445-450 (1994). Murata T., Ishibashi T., Khalil A., Hata Y., Yoshikawa H., Inomata H., Ophthalmic. Res., 27, 48-52 (1995). Tolentino M.J., Miller J.W., Gragoudas E.S., Chatzistefanou K., Ferrara N., Adamis A.P., Arch. Ophthalmol., 114, 964-970 (1996). Tilton R.G., Chang K., Nyengaard J.R., Van den Enden M., Ido Y., Williamson J. R., Diabetes, 44, 234-242 (1995). Shinohara M., Masuyama T., Shoda T., Takahashi T., Katsuda Y., Komeda K., Kuroki M., Kakehashi A., Kanazawa Y., Int. J. Exp. Diabetes Res., 1, 89-100 (2000). Shinohara M., Masuyama T., Kakehashi A., In: Shafrir, E., Ed. Animal models of diabetes.-frontiers in research.2nd ed. CRC Press, Boca Raton(FL), pp. 311-321 (2007). Aiello L.P., Pierce E.A., Foley E.D., Takagi H., Chen H., Riddle L., Ferrara N., King G.L., Smith L.E., Proc. Natl. Acad. Sci. USA., 92, 10457-10461 (1995). Pe'er J., Folberg R., Itin A., Gnessin H., Hemo I., Keshet E., Br. J. Ophthalmol., 80, 241-245 (1996). Tolentino M.J., Miller J.W., Gragoudas E.S., Jakobiec F.A., Flynn E., Chatzistefanou K., Ferrara N., Adamis A.P., Ophthalmology, 103, 1820-1828 (1996). 9.特記事項 本総説は、岐阜薬科大学博士論文(乙 341 号)の内容を 中心にまとめたものである。 岐阜薬科大学紀要 Vol. 61, 11-18 (2012) 11 ―総説― 脳虚血後神経細胞障害における小胞体ストレスの役割 種田靖久 a), b) , 原英彰 a) * 要約:近年、細胞死の原因として、従来知られていたミトコンドリア障害や DNA 障害によるものとは異なる、小胞体機 能の破綻(小胞体ストレス)が関与することが明らかになってきた。小胞体ストレスは、アルツハイマー病などの神経変 性疾患の神経細胞死メカニズムに関与していることが示唆され、アポトーシスシグナルの新たな発信地として注目を集め ている。そこで、脳虚血後神経細胞障害の病態・機序を解明するための一環として、動物脳虚血モデルにおける小胞体ス トレスの役割について検討した。砂ネズミ前脳虚血モデルにおける一過性脳虚血誘発海馬 CA1 野選択的神経細胞死およ びマウス中大脳動脈閉塞モデルにおける永久閉塞誘発神経細胞死において小胞体ストレスの関与が認められた。そこで、 新規脳卒中治療薬探索のため、小胞体ストレスにより誘導される分子シャペロン BiP の選択的誘導薬(BiP inducer X: BIX) の脳保護作用について検討した。BIX は、砂ネズミ前脳虚血誘発海馬 CA1 野選択的神経細胞死およびマウス中大脳動脈 永久閉塞誘発神経細胞死を抑制した。以上より、脳虚血後神経細胞障害の機序に小胞体ストレス誘導性アポトーシスの関 与が示唆され、BiP 選択的誘導薬は神経細胞保護作用を有する新規な脳卒中治療薬の候補となる可能性が示唆された。 索引用語:アポトーシス、BiP、小胞体ストレス、脳虚血、神経細胞死 Involvement of Endoplasmic Reticulum Stress in the Neuronal Death Induced by Ischemia Yasuhisa OIDA a), b), Hideaki HARA a) * Abstract: Recent studies have revealed that perturbation of endoplasmic reticulum (ER) functions, which is called ER stress, induces apoptosis. ER stress, which is caused by an accumulation of unfolded proteins in the ER lumen, is associated with neurodegenerative diseases such as Alzheimer disease. The purpose of this study was to provide new insights into the pathogenesis of brain ischemia for development of new therapeutic approaches to ischemic brain diseases. We suggest that ER stress is involved in the CA1-selective neuronal cell death and permanent middle cerebral artery occlusion (MCAO) induced cell death. Furthermore, to investigate a possible role of a selective inducer of BiP (BIX), we evaluated the neuroprotective effects of BIX against acute ischemic neuronal damage. BIX provided significant protection against CA1-selective neuronal cell death and permanent MCAO-induced cell death. In conclusion, ER stress plays an important causal role both in transient and permanent ischemic damage, and drugs which selectively induce BiP may exert a neuroprotective effect and may be a candidate of new therapeutic treatments of stroke. Keyphrases: apoptosis, BiP, ER stress, ischemia, neuronal cell death 1.緒 言 血管障害には頭蓋内出血(脳出血、くも膜下出血)があり、 虚血性脳血管障害は脳梗塞(脳血栓、脳塞栓)、一過性脳 脳血管障害(脳卒中)は、主として出血性脳血管障害 虚血(transient ischemic attack: TIA)、可逆性脳虚血性神経 と虚血性脳血管障害とに分類することができる。出血性脳 症状発作(reversible ischemic neurological deficit: RIND)に a) b) 岐阜薬科大学生体機能解析学大講座薬効解析学研究室(〒501-1196 岐阜市大学西 1-25-4) Department of Biofunctional Evaluation, Molecular Pharmacology, Gifu Pharmaceutical University (1-25-4 Daigakunishi, Gifu 501-1196, JAPAN) 大垣市民病院薬剤部(〒503-8502 大垣市南頬町 4-86) Department of Pharmacy, Ogaki Municipal Hospital (4-86 Minaminokawa-cho, Gifu 503-8502, JAPAN) 12 種田靖久ら:脳虚血後神経細胞障害における小胞体ストレスの役割 分類することができる。従来、我が国は出血性脳血管障害 による死亡が虚血性脳血管障害によるそれよりも多いと されてきたが、1975 年頃から、脳血管閉塞に起因する虚 血性脳梗塞死が脳出血死よりも多発するようになり、現在 日本の死亡原因の第 3 位を占めている。脳卒中による死亡 のうち、脳梗塞が約 60%、脳出血が約 25%、クモ膜下出 血が 10%を占めている。虚血性脳血管障害は、片麻痺、 運動性失語、感覚性失語、同名半盲などの脳局所性症状、 さらには総合的な機能である知的障害を伴って発症し、か つ、それらの脱落症状が後遺症として残存するとされてい る。これらは血栓症、塞栓症を原因とする脳梗塞の臨床像 であり、突然に脳梗塞として発症するものもあるが、その 臨床経過中には、いくつかの段階、すなわち、TIA あるい は RIND を経て、最終的に脳梗塞に至る場合が多い。 脳 血 管 障 害 は 虚 血 領 域 に よ っ て 全 脳 虚 血 ( global ischemia)および局所性脳虚血(focal ischemia)に分類す ることができる。虚血性脳血管障害のうちで、治療の必要 Fig. 1 ER-stress response signal pathway ASK1, apoptosis signal-regulating kinase 1;ATF, activating transcription factor; CHOP, C/EBP homology protein; ER, endoplasmic reticulum; ERAD, ER-associated degradation; IRE, inositol-requiring enzyme; JNK, c-Jun N-terminal kinase; GRP, glucose-regulated protein; PERK, doublestranded RNA-activated protein kinase-like ER resident kinase; SEK, stress-activated protein kinase; TRAF, tumor necrosis factor receptor-associated factor; XBP1, X-box binding protein 1. 性が最も求められるものは神経脱落症状が可逆性である 小胞体ストレスに対するストレス応答としては、以前 TIA あるいは RIND などの発症予防である。また、TIA は から unfolded protein response(UPR)や小胞体膜に局在す 脳の虚血性疾患のみならず、狭心症などの虚血性心疾患を る 転 写 因 子 sterol regulatory element-binding protein はじめとする全身の動脈硬化症病態への警告発作でもあ (SREBP)によるコレステロール代謝調節機構の存在が る。そこで、脳虚血による神経細胞死のメカニズムを解明 知られていたが、最近では、このストレス応答がアルツハ し、神経保護や虚血耐性効果のある薬剤の開発や、梗塞巣 イマー病、パーキンソン病およびポリグルタミン病などの 拡大を予防する治療が期待されている。 神経変性疾患および脳卒中の神経細胞死メカニズムに関 小胞体はすべての真核細胞に存在する細胞内小器官で 与していることが示唆され、アポトーシスシグナルの新た ある 1)。小胞体は、分泌タンパク質並びに膜貫通タンパク な発信地としての小胞体の役割が注目を集めている 2)。特 質が規則正しく折り畳まれ、糖鎖修飾やジスルフィド に神経細胞は神経栄養因子などの分泌タンパク質を盛ん (S-S)結合によってその立体構造を整える場であるとと に合成しており、発達した小胞体が豊富に存在するため もに、細胞内カルシウムの主要な貯蔵庫として、またリン 3) 脂質、コレステロール、さらにはセラミドの合成など、脂 えられる。 、小胞体を起源とするアポトーシスが起こりやすいと考 質代謝の主要器官として、きわめて多岐にわたる生理機能 そこで本総説では、砂ネズミ前脳虚血モデルおよびマ を有している。小胞体内腔には、immunogloblin heavy chain ウス中大脳動脈永久閉塞(middle cerebral artery occlusion; binding protein/ glucose-regulated protein 78(BiP/ GRP78; 以 MCAO)モデルを用いて、脳虚血による神経細胞死のメカ 下 BiP)、GRP94、GRP170/ oxygen-regulated protein 150 ニズムと小胞体ストレス誘導性アポトーシスの関連を検 (GRP170/ ORP150)などの多種類の分子シャペロンが存 討した。さらに、これらのモデルに対して、小胞体ストレ 在し、それらの介添えによって、タンパク質の折り畳みが スの代表的なマーカーであり分子シャペロン BiP の選択 行われている。特に BiP は小胞体内腔タンパク質の 5-10% 的誘導薬 BiP inducer X(BIX)4)の薬理学的保護作用を検 を占めるといわれるほど豊富に存在している。一方、低酸 討した。 素、アミノ酸飢餓および遺伝子変異など、タンパク質およ び脂質の品質管理に影響を及ぼす刺激により小胞体の機 2.動物脳虚血モデルと小胞体ストレスの関与 能は低下し、異常タンパク質が小胞体内に蓄積する。この 状態が小胞体ストレス(endoplasmic reticulum stress; ER 砂ネズミ前脳虚血誘発選択的神経細胞障害における小胞 stress)と呼ばれる状態である。このような危機的状況に 体ストレスの関与 陥ると、細胞は小胞体ストレス応答と呼ばれる生体防御機 構を作動させる(Fig. 1)。 神経細胞は虚血に対して弱いが、すべての神経細胞が一 様に虚血に対して弱いのではなく、ほぼ一様な虚血を一過 性に負荷すると、特に弱い細胞、または神経細胞群が存在 することが明らかにされている 5, 6)。これを選択的脆弱性 (selective vulnerability)と呼び海馬の CA1 野は、選択的 岐阜薬科大学紀要 Vol. 61, 11-18 (2012) 13 脆弱性を示す代表的部位の一つである。そこで、脳卒中に BiP の発現は海馬 CA1 野において、虚血 12 時間から早期 対して選択的脆弱性を示す細胞群の神経細胞障害機構に に有意な上昇が認められ、虚血 3 日後で最大となった。海 おける小胞体ストレスの役割を解明することを目的とし 馬 CA3 野においては、虚血 1 日後でのみ有意に上昇した。 て、砂ネズミ前脳虚血モデルを用いて、一過性脳虚血後の 歯状回および大脳皮質においては、BiP 発現に変化は認め 海馬 CA1 野錐体細胞の選択的神経細胞死に対する小胞体 られなかった(Fig. 3)。 ストレスの関与を検討した。 砂ネズミの両側総頸動脈を杉田式クリップ(No.51)で 10 分間結紮して選択的神経細胞死を誘発した。砂ネズミ を虚血 12 時間、1、3 および 7 日後に pentobarbital 麻酔し、 4% paraformaldehyde 含有 0.1 M phosphate buffer(PB)(pH 7.4)を左心室内に注入して灌流固定(灌流圧 130 cm H2O) し免疫染色に用いた。BiP は分子シャペロンであるが、同 時に小胞体ストレスの代表的なマーカーでもある。また、 C 末端に特徴的な Lys-Asp-Glu-Leu(KDEL)配列を持つ小 胞 体 常 在 性 の タ ン パ ク 質 で あ る た め 、 anti-KDEL monoclonal antibody を用いて免疫組織学的検討を行うこ とにより、その局在を検討した。Anti-KDEL monoclonal antibody により、 BiP 以外に GRP 94 も一部認識されるが、 主に BiP が認識されることがこれまでのウェスタンブロ ット解析による検討で明らかとなっている。 BiP の海馬および大脳皮質における発現は、海馬 CA1 野錐体細胞において虚血 12 時間および 1 日後で、また、 海馬 CA3 野においては虚血 1 日および 3 日後に上昇して いた。歯状回および大脳皮質には変化は認められなかった (Fig. 2)。 Fig. 3 Change in levels of BiP in gerbil hippocampus and cortex By Western blot analysis, BiP was apparently detectable in sham-operated gerbils. In the hippocampal CA1, BiP was significantly increased at 12 h, then increased progressively to peak at 3 days after the ischemia. In the hippocampal CA3, BiP was increased only at 1 day after the ischemia. In the DG and cortex, no increases were detected. Values are expressed as the mean ± S.E. (n = 4 - 9). *, P < 0.05; **, P < 0.01 vs. sham. The result was cited from ref 7. ウェスタンブロット解析で海馬 CA1 野において神経細 胞死が認められる虚血 3 日後で最大となったことは、免疫 染色の結果とは異なるものであった。一般に、虚血に対し グリア細胞は耐性を示すことが知られている。これらの知 見より、虚血後期における BiP の発現にはグリア細胞の関 与が高いと考えられる。BiP 発現の局在を検討した結果、 神経細胞死が起こった後では、アストロサイトにおいて一 部その発現が認められた(データ未提示)。このことは、 虚血後期では、虚血に耐性を示すアストロサイトなどでも 小胞体ストレス応答が認められ、小胞体ストレスに対して Fig. 2 Change in levels of BiP in gerbil hippocampus and cortex Immunohistochemistry for BiP showed very weak immunoreactivity in the sham-operated brains. In the hippocampal CA1, immunoreactibity was slightly elevated at 12 h, and peaked at 1 day after ischemia. In the hippocampal CA3, immunoreactivity was strong at 1 and 3 days after the ischemia. In the DG and cortex, immunoreactivity was unchanged by ischemia. Scale bar = 50 μm. Boxed areas are shown at higher magnification view of CA1. Scale bar = 10 μm. DG, dentate gyrus. The result was cited from ref 7. 防御機構を働かせていることが示唆された。 さらに、選択的神経細胞死への関与として、小胞体由来 アポトーシスシグナル経路のうち、CHOP/GADD153 を介 する経路に注目し、CHOP および CHOP の上流に位置す る ATF-4 をそれぞれ免疫組織学的検討およびウェスタン ブロット解析にて検討を行った。その結果、海馬 CA1 野 における ATF-4 および CHOP の発現の時間経過は、虚血 による形態学的変化と一致した(データ未提示)。 また、ウェスタンブロット解析のため、同様の方法で虚血 マウス中大脳動脈閉塞脳虚血後神経細胞障害における小 12 時間、1、3 および 7 日後に断頭し、脳を摘出後、顕微 胞体ストレスの関与 鏡下で海馬 CA1 野、CA3 野、歯状回および大脳皮質をそ 虚血による障害は、虚血の範囲(中心部と辺縁部)・時 れぞれ単離して用いた。ウェスタンブロット解析では、 間および再灌流の有無などによって、そのストレスの種類 14 種田靖久ら:脳虚血後神経細胞障害における小胞体ストレスの役割 および程度はかなり異なってくる。脳虚血(脳梗塞)の場 も大脳皮質において強く現れた(Fig. 5) 。 合、虚血中心部(コア領域)の神経細胞では、直ちに血流 低下と代謝の低下が起こり、細胞死が引き起こされるが、 虚血周辺部(ペナンブラ領域)の神経細胞では、血流低下 後もしばらく細胞死は起こらず、この間にさまざまな種類 の細胞内ストレス応答が認められる。この間に、いかにし て神経細胞を保護し、細胞死を食い止めるかが、脳梗塞治 療を行う上で、重要なポイントの一つとなっている。また、 臨床上、永久脳虚血は一過性脳虚血よりも高頻度に発症す ることから、マウス中大脳動脈閉塞(MCAO)誘発神経細 胞死における小胞体ストレスの関与を検討した。 左脳側中大脳動脈の閉塞はフィラメント栓子を挿入す ることにより行った 8, 9)。すなわち、実体顕微鏡下、左脳 側 中 大 脳 動 脈 を 頸 動 脈 か ら silicone resin 混 合 物 (Xantopren+ Activator Liquid)で先端を覆った 8-0 ナイロ ンモノフィラメント(Ethicon, Somerville, NJ, USA)を挿 入し閉塞した。マウスを MCAO 2、6、12 時間、1 および 3 日後に pentobarbital 麻酔し、4% paraformaldehyde 含有 0.1 M PB(pH 7.4)を左心室内に注入して灌流固定 (灌流圧 130 cm H2O)し免疫染色に用いた。BiP は線条体、大脳皮 質ともに MCAO 2 時間後から徐々に上昇し始め、12 時間 Fig. 5 Change in levels of BiP expression in the striatum and cortex after MCAO Western blot analysis showed that BiP was detectable. Quantitative analysis fo Western blotting showed that the expression level of BiP was significantly increased in the striatum at 1 day and in the cortex at both 12 h and 1 day. Values are expressed as the mean ± S.E. (n = 3 - 7). *, P < 0.05; **, P < 0.01 vs. Control. C, Control; The result was cited from ref 10. 後に最大に達した。MCAO 1 日および 3 日後の線条体にお ATF-4 の発現レベルは、線条体では MCAO 12 時間後に いてほとんどの神経細胞は消失していたが、残った神経細 上昇したが、1 日後には元に戻った。大脳皮質では 12 時 胞では強い免疫反応性が認められた(Fig. 4)。 間から 1 日後にかけて上昇した。CHOP の発現は、線条体 では MCAO 6 時間後より上昇し、神経細胞が消失した後 も残存神経細胞では強い免疫反応性が認められた。大脳皮 質では 12 時間から 1 日後にかけて発現上昇が認められた。 ATF-4 および CHOP は共に MCAO 後の早期に梗塞領域下 (特に梗塞周辺領域である大脳皮質)で上昇したが、明ら かな形態学的変化は見られなかった(データ未提示)。 3.脳虚血後神経細胞障害に対する 分子シャペロン選択的誘導薬の保護作用 Fig. 4 Change in levels of BiP expression in the striatum and cortex after MCAO Immunostaning for BiP in the striatum and cortex at 0 h, 2 h, 6 h, 12 h, 1 day, and 3 days after MCAO. Expression of BiP increased gradually from 2 h onwards both striatum and cortex. Scale bar = 20 μm. Contra, Contralateral; Ipsi, Ipsilateral; MCAO, middle cerebral artery occlusion. The result was cited from ref 10. 砂ネズミ前脳虚血誘発海馬 CA1 野選択的神経細胞障害に 対する BIX の保護作用 脳虚血時には多くのアポトーシス関連遺伝子の発現や 誘導を認めることが報告されており、これらの遺伝子を制 御することにより、神経細胞を虚血から保護することも可 能と考えられ、今後の新たな脳保護療法として開発される また、ウェスタンブロット解析のため、同様の方法で ことが期待される。小胞体ストレスに対し防御機構を高め MCAO 6、12 時間、1 および 3 日後に断頭し、脳を摘出後、 る薬剤が新しい治療薬となり得ると考えられたことから、 顕微鏡下で線条体および大脳皮質をそれぞれ単離して用 BiP の選択的誘導薬である BIX の神経細胞保護作用を検 いた。ウェスタンブロット解析では、線条体において BiP 討した。 は MCAO 12 時間後に上昇傾向を示し、1 日後に有意に上 砂ネズミの両側総頸動脈を杉田式クリップで 5 分間結 昇し、3 日後には元の状態に戻った。大脳皮質において 紮して選択的神経細胞死を誘発した。BIX は 10% dimethyl BiP は、MCAO 12 時間および 1 日後に有意に上昇し、3 sulfoxide(DMSO)に溶解し、脳定位固定装置 (Narishige) 日後には元の状態に戻った。BiP の発現上昇は線条体より を用いて、虚血 30 分前に 10 μg/5 μl および 40 μg/5 μl 宛投 岐阜薬科大学紀要 Vol. 61, 11-18 (2012) 15 与した。Control 群には 10% DMSO のみを投与した。投与 (Xantopren+ Activator Liquid)で先端を覆った 8-0 ナイロ 部位は、Paxinos and Franklin(Elsevier Science)の脳図譜 ンモノフィラメント(Ethicon, Somerville, NJ, USA)を挿 に従って右側脳室内(posterior to bregma: 0.6 mm; lateral to 入し閉塞した。BIX は 10% DMSO に溶解し、MCAO 5 分、 midline: 1.2 mm; into the dural surface: 2.0 mm)にカニュー 3 時間および 6 時間後に 20 μg/2 μl 宛投与した。Control 群 レを介して 2 分間かけて投与した。カニューレは投与後、 には 10% DMSO のみを投与した。投与部位は、Paxinos and そのままの状態で 3 分間保持した。砂ネズミを虚血 7 日後 Franklin(Elsevier Science)の脳図譜に従って右側脳室内 に pentobarbital 麻酔し、4% paraformaldehyde 含有 0.1 M PB (posterior to bregma: 0.1 mm; lateral to midline: 0.9 mm; into (pH 7.4)を左心室内に注入して灌流固定(灌流圧 130 cm the dural surface: 2.0 mm)に 2 分間かけて投与した。MCAO H2O)し免疫染色に用いた。その結果、溶媒投与群におい 1 日 後 に 断 頭 し 、 mouse brain matrix ( RBM-2000C, て虚血 7 日後にほとんどの海馬 CA1 野錐体細胞が細胞死 Activational Systems, Warren, MI, USA)を用いて前脳を 2 を起こした。BIX 40 μg 脳室内投与により、虚血後の神経 mm の 厚 さ で 5 切 片 作 成 し 、 そ の 断 片 を 2% 細胞死を抑制した(Fig. 6) 。 2,3,5-triphenyltetrazolium chloride(TTC)で 10-15 分間染色 した。梗塞部位はデジタルカメラ(Nikon Cool PIX4500) を用いて記録し、Image J を用いて梗塞面積を測定し梗塞 体積を計算した。脳浮腫は次の公式 (infarct volume + ipsilateral undamaged volume – contra lateral volume) ×100/contralateral volume(%)によって算出した 9)。MCAO 1 日後において、BIX は MCAO 5 分および 3 時間後投与で 梗塞体積および脳浮腫を抑制した。MCAO 6 時間後投与で は抑制する傾向が認められたが、有意ではなかった(Fig. 7)。 Fig. 6 Histological analysis of hippocampus after ischemia in gerbil (A) Representative photomicrographs of CV-positive and NeuN-positive cells in the hippocampal CA1. Scale bar = 50 μm. (B) Quantitative analysis of CV-positive cells in hipopcampal CA1. (C) Quantitative analysis of NeuN-positive cells in hipopcampal CA1. Values are expressed as the mean ± S.E. (n = 5 - 8).*, P < 0.05; **, P < 0.01 vs. control. CV, cresyl violet; NeuN, neuronal nuclei. The result was cited from ref 11. マウス中大脳動脈永久閉塞誘発神経細胞障害に対する BIX の therapeutic time window:これまでの臨床試験成績 から、虚血性脳血管障害の血栓溶解療法の therapeutic time window は側副血行の発達具合にもよるが、虚血発症後 3 時間以内と考えられている。そこで、永久閉塞における虚 血周辺(ペナンブラ)領域の保護とその therapeutic time window を見い出すことを目的として、BIX の虚血後投与 における検討を MCAO モデルを用いて行った。 左脳側中大脳動脈の閉塞はフィラメント栓子を挿入す ることにより行った 8, 9)。すなわち、実体顕微鏡下、左脳 側 中 大 脳 動 脈 を 頸 動 脈 か ら silicone resin 混 合 物 Fig. 7 Effects of BIX administered after ischemia on a therapeutic window after MCAO in mice (A) TTC staining of coronal brain sections (2 mm thick) at 1 day after permanent MCAO in representative mice. Upper panels, vehicle-injected (control) mice. Lower panels, BIX (intracerebroventricular injection at 20 μg)-treated mice. (B) Brain infarct area measured at 1 day after MCAO. Brains were removed and the forebrains sliced into five coronal 2 mm sections. * P<0.05; ** P<0.01 vs. control (n = 7 - 11). (C and D) Effects of BIX on infarct volume and brain swelling (measured at 1 day after MCAO). Values are expressed as the mean ± S.D. (n = 7 - 11). * P<0.05; ** P<0.01 vs. control. MCAO, middle cerebral artery occlusion. The result was cited from ref 12. 16 種田靖久ら:脳虚血後神経細胞障害における小胞体ストレスの役割 の発現は中心領域(主に線条体)よりも周辺領域(主に大 脳皮質)で強いことを明らかにした(Figs. 4, 5)。 4.考 察 これまでの脳虚血再灌流後の小胞体ストレスの関与は、 砂ネズミ前脳虚血誘発選択的神経細胞障害における小 胞体ストレスの関与について検討を行った。その結果、砂 ネズミ前脳虚血による海馬 CA1 野の選択的神経細胞死の 機序において、小胞体ストレスの関与が示唆された。砂ネ ズミ前脳虚血モデルにおいて、分子シャペロン BiP の発現 は、正常状態においてはいずれも低レベルであったのに対 し、海馬 CA1 野錐体細胞において虚血 12 時間および 1 日後で、海馬 CA3 野では虚血 1 日および 3 日後で上昇し ていた。一方、歯状回および大脳皮質においては、脳虚血 後 BiP の明らかな発現上昇は認められなかった(Fig. 2)。 また、BiP の発現はウェスタンブロット解析を用いても検 1)BiP mRNA は 30 分間虚血再灌流 6 時間後から 24 時間 後にかけて上昇した 16) 、2)1 時間虚血再灌流後 MCA 領 域下において BiP タンパク質は虚血 5 時間後から 23 時間 後にかけて上昇し、47 時間後には減少した 17)、そして 3) 30 分間虚血再灌流 4 時間後から 24 時間後にかけて線条体 において ATF-4 および CHOP タンパク質の上昇がみられ た 18) 、などの報告がある。今回の検討ではこれらの先行 研究の報告と比較すると、BiP および CHOP タンパク質発 現においては同様の発現変化を示すが、ATF-4 タンパク質 発現は異なる変化を示した。この実験結果の一部の矛盾は、 おそらく虚血モデル(再灌流モデル vs. 永久閉塞モデル) の違いによると考えられる。再灌流モデルと比較して、永 討を行ったが、免疫染色と同様に、海馬 CA1 野において 久閉塞モデルでは特に線条体において血流の極端な低下 虚血 12 時間後から発現が上昇し始め、虚血 3 日後で最大 が続く。中心領域における上記小胞体ストレスマーカーの となった。海馬 CA3 野においては、虚血 1 日後のみ発現 発現レベルは再灌流モデルよりも永久閉塞モデルにおい が上昇した。歯状回および大脳皮質においては、脳虚血後 て少ないと考えられる。以上、小胞体ストレスは永久脳虚 発現上昇は認められなかった(Fig. 3)。虚血による神経細 血障害に重要な役割を果たしており、その関与は虚血中心 胞死が起こらない早期に BiP の上昇が海馬 CA1 野におい (コア)領域よりも周辺(ペナンブラ)領域において強い て選択的に認められたことは免疫染色およびウェスタン ブロットにおいても同様であったが、神経細胞死が起こっ た後の発現に違いが認められた。虚血後期では、アストロ サイトにおいて一部その発現が認められた(データ未提 示)ことから、虚血に耐性を示すアストロサイトなどでも 小胞体ストレス応答が認められ、小胞体ストレスに対して 防御機構を働かせていることが示唆された。 CHOP は通常の状態では発現しておらず、小胞体スト レスによって著明に誘導される。CHOP を欠損した細胞で は小胞体ストレス誘導性アポトーシスが抑制される 13, 14, 15) 。本検討では、選択的神経細胞死への関与として、ATF-4 および CHOP をそれぞれ免疫組織学的検討およびウェス タンブロット解析にて検討を行った。海馬 CA1 野におけ る ATF-4 および CHOP 発現の時間経過は、虚血による形 態学的変化と一致したことから、虚血早期からの著明な小 胞体ストレスの負荷による防御機構の破綻によりアポト ーシスシグナルが虚血 1 日後を境界として活性化された と考えられる。 臨床上、一過性脳虚血よりも永久脳虚血の方が高頻度 に発症する。さらに、脳卒中周辺領域における小胞体スト レスの役割については未だ十分に解明されていない。また、 これまでの研究においてもその多くが脳虚血再灌流モデ ルで検討されている。そこで、次にマウス中大脳動脈閉塞 (MCAO)モデルを用いて、永久閉塞誘発神経細胞死にお ける小胞体ストレスの関与について検討を行った。その結 果、BiP 発現は MCAO 12 時間後から 1 日後で最大に達し、 3 日後には正常値にまで戻ること、並びに小胞体ストレス と考えられる。 UPR は PERK や IRE1 により調整され、BiP は小胞体内 の不良タンパク質に結合し、小胞体トランスデューサーの 活性化を調節する 19)。正常時では、BiP は PERK や IRE1 の luminal domain に結合し、これらの活性化を抑制する。 小胞体ストレス時には、BiP は不良タンパク質に結合する ため PERK や IRE1 から解離し、その結果これらのトラン スデューサーが活性化されやすくなる。BiP は小胞体スト レスにより誘導され、その上昇によって神経損傷を防ぐこ とが示唆されていることから 20, 21, 22)、BiP の発現上昇は神 経保護と相関して発現する可能性が示唆された。それ故、 UPR を制御することが脳虚血による細胞保護に有効であ る可能性が考えられる。 現在、脳卒中患者に種々の薬物療法が試みられている が、十分に有効性が認められる薬物は見い出されていない のが現状である。そこで、本検討では、小胞体ストレスに 対し防御機構を高める薬剤が新しい治療薬となり得ると 考えられたことから、砂ネズミ前脳虚血モデルを用いて、 BiP の選択的誘導薬である BIX の保護作用について検討 した。その結果、BIX は形態学的検討および免疫組織学的 検討において、一過性脳虚血による神経細胞死に対して虚 血 30 分前に投与することで保護効果を示した(Fig. 6) 。 さらに、永久閉塞における虚血周辺領域の保護とその therapeutic time window を見い出すことを目的として、BIX の虚血後投与における検討を MCAO モデルを用いて行っ た。その結果、BIX は永久閉塞による神経細胞死に対して、 虚血 3 時間後投与まで梗塞体積および脳浮腫を抑制した 岐阜薬科大学紀要 Vol. 61, 11-18 (2012) 17 (Fig. 7)。我々の研究から、ヒト神経芽細胞腫である って虚血前あるいは虚血後早期に BiP を誘導しておくこ SK-N-SH 細胞において、BiP mRNA は BIX 5 μM 添加後よ とで、虚血によって引き起こされるストレスに対する防御 り徐々に上昇し、4 時間後に最大に達し、6 時間後までそ 機構が働いたことによると考えられる。 4) の発現レベルは維持されることが認められている 。同様 5.結 に、BiP タンパク質の発現レベルは BIX 5 μM 添加後より 論 12 時間まで上昇することが認められている。MCAO モデ ルを用いた検討により、BiP タンパク質は MCAO 1 日後ま 砂ネズミ前脳虚血モデルにおいて、海馬 CA1 野錐体細 で上昇することが明らかにされたことから、虚血後早期に 胞において虚血早期より BiP の発現上昇が認められた。ま BIX を投与することで小胞体ストレスに対し保護作用を た、マウス中大脳動脈永久閉塞モデルにおいて、虚血中心 示した可能性が考えられる。 領域である線条体および周辺領域の大脳皮質において これまでの研究から BIX は、1 μM から 50 μM にかけ BiP の発現上昇が認められ、周辺領域における発現レベル て濃度依存的に BiP mRNA を誘導することが認められ、 は中心領域におけるそれよりも高値であった。さらに、 また、BiP 以外のシグナル(XBP-1 のスプライシング、 BiP の選択的誘導薬は、一過性虚血後の海馬 CA1 野錐体 CHOP など)は誘導せず、小胞体ストレスを負荷しないこ 細胞の神経細胞死を抑制し、永久虚血後の therapeutic time とが知られている 。また、SK-N-SH 細胞を用いた検討に window は 3 時間であった。以上より、砂ネズミ前脳虚血 おいて、tunicamycin による細胞死を BIX は 5 μM で抑制 誘発海馬 CA1 野選択的神経細胞死およびマウス中大脳動 し、50 μM の高用量を用いた検討においても ATF6 経路以 脈永久閉塞誘発神経細胞死の機序には、小胞体ストレスの 4) 4) 外による BiP mRNA の誘導は認められていない 。これら 関与、すなわち小胞体ストレス誘導性アポトーシスの関与 の結果から、BIX による BiP 誘導のメカニズムは他の小胞 が示唆された。また、BiP の選択的誘導薬は神経細胞保護 体ストレス誘導薬(thapsigargin や tunicamycin など)によ 作用を有する新規な脳虚血治療薬の候補となる可能性が るそれとは異なるものであることが示唆される。また、小 示唆された。 胞体ストレストランスデューサーの活性化は、PERK や 6.謝 IRE1 の luminal domain から BiP が解離することによって 引き起こされることから、BIX による BiP の薬物的な誘導 により、豊富な BiP が小胞体ストレストランスデューサー に結合することで、これらの活性化が抑制されると考えら れる。 高等動物においては、少なくとも 4 種類の UPR が存在 するが、Yoshida らは、これらの応答機構が時間的に規定 されていると報告している 23)。PERK による翻訳抑制機構 の解除は、GADD34 と PP1c の働きによって行われる。ま た、ATF6 経路によるシャペロン遺伝子の転写誘導が IRE1-XBP1 経路による EDEM の転写誘導よりも早く起こ 本稿を終えるに臨み、本研究の遂行にあたり終始御懇 切なるご助言を賜りました岐阜薬科大学生体機能解析学 大講座薬効解析学研究室准教授 助教 謝致します。最後に、BIX の御提供並びに貴重な御助言を 賜りました大阪大学大学院医学系研究科精神医学教室 工 藤 喬臨床教授並びに広島大学大学院医歯薬学総合研究科 分子細胞情報学 今泉 和則教授に深謝致します。 7.参考文献 の転写誘導よりもかなり遅れて起こる。これらのことから、 既存のシャペロン、ERAD 因子による処理が試みられる。 1) それでも異常タンパク質を処理できない時には、2)小胞 体シャペロンが誘導されてフォールディングを促進する。 2) また、3)ERAD 因子が誘導されてフォールディングだけ でなく分解も促進される。これらの応答機構によっても処 理できない場合には、4)アポトーシスが誘導されて細胞 ごと処理を行う。このような多段階の防御機構が高等生物 3) 4) には備わっていると考えられている。また、小胞体膜上の 複数のセンサータンパク質が、個別の応答機構を特異的に 制御することによって、時系的な多段階応答を可能にして 5) 6) いると考えられている。 以上、BIX による虚血に対する保護作用は、BIX によ 嶋澤 雅光先生並びに同 鶴間 一寛先生に深謝致します。また、種々のご協 力を頂きました薬効解析学研究室 守本亘孝氏に心から感 る。さらに、小胞体ストレスによるアポトーシスは EDEM 小胞体ストレスの初期には、1)翻訳が一時的に抑制され、 辞 7) Alberts B., Johnson A., Lewis J., Raff M., Roberts K., Walter P., MOLCULAR BIOLOGY OF THE CELL fourth edition. Garland Science, 689-710 (2002). Ferri K.F., Kroemer G., Nat. Cell Biol., 3, E255-63 (2001). Fawcett D.W., The Cell. W.B. Saunders Company, 318-319 (1981). Kudo T., Kanemoto S., Hara H., Morimoto N., Morihara T., Kimura R., Tabira T., Imaizumi K., Takeda M., Cell Death Differ., 15, 364-375 (2008). Kirino T., Brain Res., 239, 57-69 (1982). Pulsinelli W.A., Brierley J.B., Plum F., Ann Neurol., 11, 491-498 (1982). Oida Y., Shimazawa M., Imaizumi K., Hara H., 18 8) 9) 10) 11) 12) 13) 14) 15) 16) 17) 18) 19) 20) 21) 22) 23) 種田靖久ら:脳虚血後神経細胞障害における小胞体ストレスの役割 Neuroscience, 151, 111-119 (2008). Hara H., Huang P.L., Panahian N., Fishman M.C., Moskowitz M.A., J. Cereb. Blood Flow Metab., 16, 605-611 (1996). Hara H., Friedlander R.M., Gagliardini V., Ayata C., Fink K., Huang Z., Shimizu-Sasamata M., Yuan J., Moskowitz M.A., Proc. Natl. Acad. Sci. USA, 94, 2007-2012 (1997). Morimoto N., Oida Y., Shimazawa M., Miura M., Kudo T., Imaizumi K., Hara H., Neuroscience, 147, 957-967 (2007). Oida Y., Izuta H., Oyagi A., Shimazawa M., Kudo T. Imaizumi K., Hara H., Brain Research, 1208, 217-224 (2008). Oida Y., Hamanaka J., Hyakkoku K., Shimazawa M., Kudo T., Imaizumi K., Yasuda T., Hara H., Neuroscience Letters, 484, 43-46 (2010). Zinszner H., Kuroda M., Wang X., Batchvarova N., Lightfoot R.T., Remotti H., Stevens J.L., Ron D., Genes Dev., 12, 982-995 (1988). Oyadomari S., Takeda K., Takiguchi M., Gotoh T., Matsumoto M., Wada I., Akira S., Araki E., Mori M., Proc. Natl. Acad. Sci. USA, 98, 10845-10850 (2001). Gotoh T., Oyadomari S., Mori K., Mori M., J. Biol. Chem., 277, 12343-12350 (2002). Qi X., Okuma Y., Hosoi T., Kaneko M., Nomura Y., Brain Res. Mol. Brain Res., 130, 30-38 (2004). Shibata M., Hattori H., Sasaki T., Gotoh J., Hamada J., Fukuuchi Y., Neuroscience, 118, 491-499 (2003). Hayashi T., Saito A., Okuno S., Ferrand-Drake M., Dodd R.L., Chan P.H., J. Cereb. Blood Flow Metab., 25, 41-53 (2005). Bertolotti A., Zhang Y., Hendershot L.M., Harding H.P., Ron D., Nat. Cell Biol., 2, 326-332 (2000). Wang X.Z., Lawson B., Brewer J.W., Zinszner H., Sanjay A., Mi L.J., Boorstein R., Kreibich G., Hendershot L.M., Ron D., Mol. Cell Biol., 16, 4273-42808 (1996). Rao R.V., Peel A., Logvinova A., del Rio G., Hermel E., Yokota T., Goldsmith P.C., Ellerby L.M., Ellerby H.M., Bredesen D.E., FEBS Lett., 514, 122-128 (2002). Reddy R.K., Mao C., Baumeister P., Austin R.C., Kaufman R.J., Lee A.S., J. Biol. Chem., 278, 20915-20924 (2003). Yoshida H., Matsui T., Hoshokawa N., Kaufman R.J., Nagata K., Mori K., Dev. Cell, 4, 265-271 (2003). 8.特記事項 本総説は岐阜薬科大学博士論文(乙第 337 号)の内容を 中心にまとめたものである。 岐阜薬科大学紀要 Vol. 61, 19-27 (2012) 19 ―総説― がん化学療法における薬剤師業務の拡大とその評価に関する研究 藤井友和 a, b) * a) , 神谷恒行 , 足立哲夫 b) 要約:がん化学療法の安全管理において、薬剤師による処方鑑査の役割は大きい。著者らは、がん化学療法を受ける患者 を対象とし、処方鑑査に必要な項目を一目で確認できる「薬学的管理情報付き抗がん剤無菌調製記録」を汎用コンピュー タソフトである Microsoft Office Excel を用いて作成した。本記録の薬学的管理情報を積極的に活用することで、より早い 段階で精度の高い疑義照会を行うことができるようになり、抗がん剤の減量やレジメンの変更など重要な処方変更に貢献 することで患者の不利益を未然に防ぐことができた。次に、抗がん剤の適正使用推進の観点から、がん化学療法における 薬物相互作用に関する実態調査を行った。そのロジスティック回帰分析の結果、がん化学療法と緩和療法における相加・ 相乗効果を期待した併用を除いた“意図しない相互作用”について、併用薬数の増加と他院で処方されている薬剤の併用 がリスクを有意に増大させることが明らかとなった。また、cytochrome P450(CYP)で代謝される抗がん剤やジフェンヒ ドラミンを含むレジメンを使用したがん化学療法を行う場合、降圧薬、糖尿病用薬、中枢神経抑制作用を有する薬剤等を 併用する場合など注意すべき状況を絞り込むことで処方鑑査や経過観察でのチェックポイントを明確にすることができ た。さらに、糖尿病合併がん患者を対象に、がん化学療法開始後の血糖値およびヘモグロビン A1c(以下、HbA1c)値に 及ぼすデキサメタゾン併用の影響について調査した。その結果、12 ヵ月後までの血糖値および HbA1c 値の変化量とその 間の累積デキサメタゾン投与量との間に有意な正の相関関係が認められた。また、解析結果から累積デキサメタゾン投与 量 150 mg を一つの指標として厳格な血糖コントロールの導入を考慮する必要があることを提示できた。 索引用語:がん化学療法、安全管理、薬学的管理情報、意図しない相互作用、糖尿病合併がん患者 Evaluation of the Pharmacist’s Effort for Cancer Chemotherapy Tomokazu FUJII a, b) * a) , Tsuneyuki KAMIYA , Tetsuo ADACHI b) Abstract: For the safety management of cancer chemotherapy, pharmacists are expected to play an important role in prescription checking. Therefore, we prepared “aseptic preparation records attached with pharmaceutical management information (PMI)” using the comment function of Microsoft Office Excel to facilitate quick referencing concerning matters necessary for prescription checking in patients undergoing cancer chemotherapy. The active use of PMI attached to these records made earlier and more precise inquiries possible, contributing to important changes in prescriptions such as dose reductions and regimen changes, and preventing the disadvantaging of patients in advance. From the viewpoint of promotion for proper use of the anticancer agents, we analyzed information on drug interactions among patients undergoing cancer chemotherapy. Logistic-regression analysis showed that the risks of “unintended drug interactions”, which are drug interactions other than the additive or synergistic effects expected from the combination of medications administered for cancer chemotherapy and palliative care therapy are heightened by increases in the numbers of concomitant drugs and the presence of drugs prescribed by other clinics. Then, we have to pay attention to unintended drug interactions and to perform follow-up carefully when we administer regimens that include diphenhydramine or anticancer drugs that are metabolized by cytochrome P450 (CYP), or when administering antihypertensive drugs, antidiabetic drugs or central nervous system suppressants as concomitant drugs. In addition, we investigated the influence of dexamethasone on blood sugar level and of hemoglobin A1c (HbA1c) value in cancer patients with concurrent diabetes. A significant positive correlation was observed between the accumulation of dexamethasone and change of blood sugar level or HbA1c within 12 months. It was suggested that severe control of pathophysiological conditions of diabetes is necessary when the accumulated dosage of dexamethasone exceeds 150 mg. a) JA 愛知厚生連渥美病院薬剤科(〒441-3415 愛知県田原市神戸町赤石 1-1) Department of Pharmacy, Kouseiren Atsumi Hospital, Aichi (1-1 Akaishi, Kanbe-cho, Tahara-shi, Aichi 441-3415, Japan) b) 岐阜薬科大学 臨床薬剤学研究室(〒501-1196 岐阜市大学西 1-25-4) Laboratory of Clinical Pharmaceutics, Gifu Pharmaceutical University (1-25-4 Daigaku-nishi, Gifu 501-1196, Japan) 20 藤井友和ら:がん化学療法における薬剤師業務の拡大とその評価に関する研究 Key phrases: Cancer Chemotherapy, Safety Management, Pharmaceutical Management Information, Unintended Drug Interactions, Cancer Patient with Concurrent Diabetes 1.緒 言 薬剤管理指導などに薬剤師が積極的に関与することが必 須であると考えられるが、関与の方法は各医療機関の特色 がんは、1981 年以降、それまで約 30 年間にわたり第 1 や人員、設備面などから様々であり、「できることからま 位だった脳血管疾患と入れ替わり死亡原因の第 1 位を占 ず始めていく」ことがシステムの確立や充実には欠かせな める疾患となっている。現在、がんによる年間の死亡者数 い姿勢であると思われる。集学的治療と言われるがん医療 は 30 万人を超え、総死亡者数の約 3 割を占めるまでに増 における薬剤師の役割としては、安全管理と抗がん剤適正 加している(平成 22 年度厚生労働省死因順位別にみた死亡 使用の推進に集約することができるが、医師からは、個別 数 ・ 死 亡 率 の 年 次 推 移 : http//www.mhlw.go.jp/toukei/ の患者に対する薬剤管理指導を通して患者quality of life saikin/hw/jinkou/suii09/deth7.html)。がんの罹患数も人口の (QOL)の向上に貢献したり、レジメン管理や臨床研究へ 高齢化に伴い増加し続けており、がん患者の治療は、がん 積極的に関与し薬学的観点から助言したりすることが求 センターなどのがん専門病院だけでなく、一般の病院や診 められている 2)。一方、看護師からも、薬物療法の中でも 療所においても日常的に広く行われるようになっている。 最もハイリスクながん化学療法における安全管理と支持 がんの撲滅が国民的課題となっている昨今、分子標的薬 療法の提案を含む副作用管理、あるいは患者のセルフケア など新しい作用機序をもつ抗がん剤や新規抗がん剤を組 を支援するための薬剤管理指導と看護にあたるスタッフ み込んだレジメンが次々と開発され、がん医療の急速な高 への情報提供など、薬剤師が職能を発揮することに大きな 度化・細分化が進んでいる。そのため、医師、薬剤師、看 期待が寄せられている 3)。 護師、放射線技師、臨床検査技師などが、各職種の専門性 本総説では、がん化学療法における安全管理および抗が を活かしたチーム医療を実践し、がん患者に最善の医療を ん剤の適正使用推進の観点から、JA 愛知厚生連渥美病院 提供することが必要とされている 1)。 (以下、当院)にて設備や人員を考慮しながら段階的に行 医薬品の適正使用はすべての疾患の薬物療法に共通す る問題であるが、細胞傷害作用をもつ抗がん剤はその特性 ってきた薬剤師業務の拡大による効果を検証し得られた 知見を述べる。 上治療域が非常に狭く、抗腫瘍効果とともに薬物有害反応 も不可避であり、投与計画も複雑であることから、投与量、 2.「薬学的管理情報付き抗がん剤無菌調製記録」の作成 投与速度、投与間隔などを誤ったために起きた医療事故や とその有用性 4) それによるがん患者の死亡事故などに関する報道があと を絶たない。2003 年 11 月には「医療機関における医療事 がん化学療法の安全管理においては、特別な薬剤部門シ 故防止対策の強化について」として、各医療機関において ステムの構築や優れたレジメン管理機能を備えた電子カ 抗がん剤を処方する場合の条件を明確にし、処方ミスを防 ルテの導入により処方鑑査の精度を向上させることが理 止する対策を講じ、薬剤部において抗がん剤の種類、投与 想ではあるが 5, 6)、費用の問題もあり、がん化学療法を行 量などの二重確認を可能な限り行うなど安全体制を確立 う全ての施設にこれらを導入することは不可能と思われ するとともに、それが有効に機能しているか確認すること る。一方、市販のコンピュータソフトを利用したシステム という医政発第 1127004 号・薬食発第 1127001 号厚生労働 の開発や、手書き処方チェックシートの作成など費用をか 省 医 政 局 ・ 医 薬 食 品 局 長 通 知 (http://www.mhlw.go.jp/stf/ けずに成果を上げている報告もある 7, 8)。 shingi/2r9852000000mhcq-att/2r9852000000mi01.pdf#search=' 当院では、処方鑑査に必要な項目を一目で確認できる薬 )が出され、翌年の 6 月にも「医療機関における医療事故 学的管理情報を汎用コンピュータソフトである Microsoft 防止対策の強化・徹底について」として、レジメンによる Office Excel のコメント機能を利用して付記した抗がん剤 処方を活用したり、販売名が類似した抗がん剤は一般名を 無菌調製記録を作成し、本ツールの導入前後における疑義 併記したりするなど、処方ミス防止策を講じるほか、薬歴 照会に対する処方変更率、疑義照会のタイミング、処方変 管理の徹底、調剤・投薬時のダブルチェックなど二重、三 更事例などを比較することでこの「薬学的管理情報付き抗 重の対策を講じることという医政発第 0602012 号・薬食発 がん剤無菌調製記録」の有用性について評価を行った。 第 0602007 号 厚 生 労 働 省 医 政 局 ・ 医 薬 食 品 局 長 通 知 (http://www.info.pmda.go.jp/iryoujiko/file/20040602-1.pdf#sea rch=')が出された。事故防止対策として、レジメン管理に 基づく処方の点検、注射用抗がん剤の無菌調製、患者への 調査期間 処方鑑査および無菌調製時に電子カルテ(MegaOakHR) の内容を確認し、抗がん剤無菌調製記録にはレジメン名称 岐阜薬科大学紀要 Vol. 61, 19-27 (2012) 21 と抗がん剤調製日のみを入力していた時期を期間 A(2008 棟や外来化学療法室で得た副作用発生状況やレジメン変 年 1 月~2008 年 6 月の 6 ヶ月間)、「薬学的管理情報付き 更予定、調剤および無菌調製時に得た投与量変更や検査結 抗がん剤無菌調製記録」の処方鑑査および抗がん剤無菌調 果への対応に関する情報などを各担当者が各々の現場で 製への活用開始後の時期を期間 B(2009 年 1 月~2009 年 薬学的管理情報として積極的に入力する運用とした。 6 月の 6 ヶ月間)とした。 疑義照会率および処方変更率 「薬学的管理情報付き抗がん剤無菌調製記録」の導入 各調査期間中のレジメン数および注射抗がん剤処方せ オリジナルな情報共有ツールである「薬学的管理情報付 ん枚数は、それぞれ期間 A:21 レジメン、457 枚、期間 B: き抗がん剤無菌調製記録」の一例を図 1 に示す。従来使用 24 レジメン、510 枚というように増加傾向にあったが、疑 していた抗がん剤無菌調製記録は Microsoft Office Excel の 義照会件数および疑義照会率は、期間 A:26 件、5.7%、 1シートに1ヶ月分のカレンダーを作成し、患者 ID、患 期間 B:21 件、4.1%であり、期間 A に比べ期間 B の疑義 者氏名、レジメン名称、入院外来区分、抗がん剤調製日を 照会件数は減少傾向(p=0.08:χ2 検定)にあった。一方、処 入力するだけのシンプルなものであった。そこへ Microsoft 方変更件数および処方変更率は、期間 A:11 件、42.3%、 Office Excel のコメント機能を利用して、抗がん剤の処方 期間 B:16 件、76.2%で処方変更件数が有意に増加(p=0.03) 鑑査に必要な薬物治療歴、身長・体重・体表面積、投与量、 していた。本ツール導入前の期間 A では、抗がん剤の処 投与速度、投与後の副作用などの発生状況、次回の処方変 方量が標準投与量より少ない場合には全てのケースで疑 更予定などの情報を確認し入力する本ツールを作成した。 義照会を行っていたが、導入後の期間 B では患者の病態 各患者の化学療法施行日のセルにカーソルを合わせると を考慮した減量であることを薬学的管理情報で把握でき 薬学的管理情報が表示され、必要な情報を確認することが ている場合には疑義照会をしていない。その結果、真に重 できるようにした。本調製記録は院内全ての電子カルテの 要な疑義照会の割合が増加したことにより、疑義照会件数 端末で参照および編集することができ、病棟、外来化学療 が減少したにも関わらず処方変更件数が増加したものと 法室、注射調剤室、抗がん剤混合調製室などの各現場で得 考えられた。 た情報をその場で入力することができる。入力した情報は 抗がん剤投与前日に行う計数調剤時あるいは投与当日の 無菌調製時に最新の情報に更新する運用とした。また、病 図 1. 疑義照会の内容分類、件数およびタイミング 各調査期間中に行った疑義照会の内容を従来の報告 9-13) 薬学的管理情報付き抗がん剤無菌調製 22 藤井友和ら:がん化学療法における薬剤師業務の拡大とその評価に関する研究 を参考に分類し集計した結果を表 1 に示す。期間 A では、 処方鑑査に要する時間は、期間 A と同様の方法では平 抗がん剤の投与量に関する疑義照会が 12 件と最も多く、 均 178.4 ± 19.7 秒(n=30、最短 147 秒、最長 220 秒)、期間 次いで当日の血液検査結果への対応が 7 件、抗がん剤希釈 B と同様の方法では平均 56.6 ± 7.6 秒(n=30、最短 44 秒、 液の種類・量が 3 件であり、期間 B では、抗がん剤の投 最長 69 秒)であり、本ツールの導入により処方鑑査に要 与量および当日の血液検査結果への対応に関する疑義照 する時間は有意に短縮(p<0.01: Welch’s t-test 検定)された。 会件数が各々6 件と最も多く、次いで前投薬処方漏れ、投 本ツールの導入による安全管理上の効果として、薬学的 与スケジュール、投与速度に関する疑義照会が各々2 件で 管理情報が副作用の回避につながった可能性がある処方 あった。また、期間 A では抗がん剤の投与量に関する 12 変更の事例の一部を以下に示す。 --------------------------------------------------------------------------- 件の疑義照会のうち 2 件(17%)のみが処方変更されたの 事例1:mFOLFOX6 の 8 クール終了後に末梢神経障害 に対し、期間 B では 6 件の疑義照会のうち 5 件(83%) が発症し、次回から FOLFIRI に変更する予定であること が処方変更された。 疑義照会のタイミングについては、外来化学療法のプロ を主治医とディスカッションした病棟薬剤師が、薬学的管 トコールが提出された時点や入院化学療法の事前オーダ 理情報欄にその旨を記載した。2 週間後に再度 mFOLFOX6 入力がなされた時点で行う“計数調剤前”、抗がん剤注射処 がオーダされたため、調剤担当薬剤師が疑義照会したとこ 方せんに基づく計数調剤を行う際の“計数調剤時”、抗がん ろ FOLFIRI に変更された。 --------------------------------------------------------------------------- 剤治療当日の“無菌調製時”という 3 つの時点に分類し集計 した。計数調剤前に疑義照会を行った件数は、期間 A で 事例2:FEC 初回に Grade3 の好中球減少が発症し、次 は全 26 件中 3 件(11.5%)であったのに対し、期間 B で 回より 20%減量するとカルテに記載されていた。情報を得 は全 21 件中 8 件(38.1%)と有意に増加(p=0.03:χ2 検定) た病棟薬剤師がその旨を薬学的管理情報欄に記載した。次 していた。一方、計数調剤時に疑義照会を行った件数は、 のクールも前回と同量でオーダされたため無菌調製担当 期間 A の 13 件(50.0%)から期間 B の 4 件(19.0%)と有 薬剤師が疑義照会したところ減量された。 --------------------------------------------------------------------------- 意に減少(p=0.03:χ2 検定)してした。無菌調製時の件数は、 これらの事例は、レジメンに基づく処方鑑査だけでは発 期間 A の 10 件(38.5%)と期間 B の 9 件(42.9%)であり 見されにくく、薬学的管理情報が無ければ計数調剤や無菌 有意な差はなかった(p=0.76)。このように疑義照会のタ 調製の段階でも気づくことができなかった可能性が高い イミングが早くなった理由としては、本ツールの活用で薬 と思われた。 剤師間の情報の共有が可能となり、主に病棟担当薬剤師が 岩本ら 13) 、中西ら 14)は、病棟担当薬剤師と抗がん剤無 積極的に情報収集するとともに事前入力されたオーダ内 菌調製担当薬剤師の担う役割は異なり、各々が入手できる 容の確認を行うようになったためと考えられた。 情報や疑義照会の内容が異なることから、両者の連携を高 めることが重要であると述べている。「薬学的管理情報付 業務の効率化および安全管理における効果 表 1. 疑義照会の内容分類別の件数、処方変更率および疑義照会のタイミング 期間 A 期間 B 疑義照会のタイミング 計数 計数 無菌 調剤前 調剤時 調製時 件数 変更件数 (%) 12 3 2(17) 2(67) 2 1 10 2 2 2(100) 0 0 0 抗がん剤の種類 抗がん剤の規格 投与速度 当日の血液検査結果への対応 抗がん剤投与24時間以内の G-CSFのオーダ 0 1 0 7 合計 抗がん剤投与量 抗がん剤希釈液の種類・量 前投薬処方漏れ (ジフェンヒドラミン) 投与スケジュール (投与日・休薬期間・内服 抗がん剤処方漏れ) 疑義照会のタイミング 計数 計数 無菌 調剤前 調剤時 調製時 件数 変更件数 (%) 0 0 6 1 5(83) 0 4 1 2 0 0 0 0 2 2 2(100) 0 0 2 0 0 0 2 2(100) 2 0 0 0 1(100) 0 3(43) 0 0 0 0 0 1 0 0 0 0 0 7 1 0 2 6 1(100) 0 2(100) 3(50) 0 0 1 0 1 0 1 0 0 0 0 6 1 1(100) 0 0 1 1 1(100) 0 0 1 26 11 (42.3%) 21 16 (76.2%) 3 13 10 (11.5%) (50.0%) (38.5%) 8 4 9 (38.1%) (19.0%) (42.9%) 岐阜薬科大学紀要 Vol. 61, 19-27 (2012) 23 き抗がん剤無菌調製記録」を積極的に活用し、各々の現場 用注意の記載がある薬剤が含まれていた。抗がん剤自体に で得た情報を入力し共有することで患者個々の病態を考 併用注意をもつ薬剤が多いうえに、複数の抗がん剤を併用 慮した的確な疑義照会を行うことが可能となった結果、抗 したり、前投薬としてデキサメタゾンや塩酸ジフェンヒド がん剤の減量やレジメンの変更など重要な処方変更に寄 ラミンなどの併用注意の多い薬剤を組み込んだレジメン 与し、患者ベネフィットの向上に貢献することができたと が多いためと考えられた。 考えている。 対象患者と薬物相互作用に関する情報の調査 3.がん化学療法施行患者の使用薬剤を対象とした薬物相 互作用の実態調査 15) 2009 年 9 月~2010 年 8 月の 1 年間に外来および入院化 学療法にて点滴抗がん剤を使用した 83 名中、薬剤管理指 導を行った患者 80 名に対し処方された薬剤を対象とした。 がん化学療法においては、単剤での治療効果には限界が 80 名の患者の年齢の中央値(範囲)は 63 歳(33 歳~88 あるため複数の抗がん剤を併用し効果の増強を図ったり、 歳)であり、男性 37 名、女性 43 名であった。外来患者は 副作用を軽減するための支持療法剤を併用したりするこ 19 名、入院患者は 22 名、外来と入院の両方で治療を行っ とが一般的に行われている。さらに、がん患者にはがん以 た患者は 39 名であった。がん種は大腸がん 24 名、乳がん 外の疾患に対する治療薬が抗がん剤・支持療法剤と併用さ 21 名、胃がん 14 名、膵臓がん 7 名、肺がん 5 名、前立腺 れるケースも多いことから、がん化学療法施行患者におけ がん 3 名、食道がん 2 名、その他 4 名であった。抗がん剤 る薬物相互作用については当該患者の使用レジメンから 治療および緩和治療に併用された薬剤数の中央値(範囲) 可能性のある相互作用を把握し、患者に不利益な相互作用 は 4(0~21)であった。他院の処方薬を服用している患 の発生を未然に防ぐことが必要と思われる。しかしながら、 者数は 26 名(32.5%)、当院他科の処方薬を服用している 一部の薬剤間の相互作用に関する報告 16-26) はあるものの、 抗がん剤とその併用薬との間の相互作用全般に関しては Riechelmann らの報告 27)など、非常に限定的である。 患者数は 17 名(21.3%)であった。また、緩和治療を行っ ている患者数は 19 名(23.8%)であった。 薬剤管理指導時に作成した対象患者の薬歴と、各薬剤の そこで、がん化学療法施行患者に処方されている薬剤に 添付文書および SAFE-DI Matrix Search((株)SAFE)を用 ついて、添付文書などに記載されている薬物相互作用の組 いて薬物相互作用の検索を行い、当該患者に処方されてい み合わせの調査を行い、相互作用の発生に繋がるリスク因 る薬剤の間で確認される相互作用情報の有無とその件数 子を明らかにするとともに重点的に注意を払うべき薬剤 を算出した。 の抽出を行った。 薬物相互作用の組み合わせの実態 抗がん剤および支持療法剤の薬物相互作用情報 併用注意に該当する組み合わせの薬剤を併用している 院内登録レジメンで使用している抗がん剤および支持 患者は 80 名中 72 名(90.0%)であり、抽出された相互作 療法剤について、各薬剤の添付文書を用いて相互作用に関 用の組み合わせの総件数は 532 件であった。なお、併用禁 する情報として併用禁忌の組み合わせおよび併用注意の 忌に該当する組み合わせはなかった。この 532 件から、単 組み合わせを調査した。 一レジメン中の抗がん剤とステロイドの併用、降圧薬同士 62 種類の院内登録レジメンに含まれる抗がん剤(便宜 の併用および糖尿病薬同士の併用など、意図した併用療法 上レボホリナートを含む)21 種類中の 8 種類(38.1%:シ を除いた組み合わせを “意図しない相互作用”の組み合 クロホスファミド(注射用)、シクロホスファミド(内服 わせとすると、これに該当する組み合わせの薬剤を併用し 用)、フルオロウラシル、パクリタキセル、イリノテカン、 ている患者は、80 名中 54 名(67.5%)であり、その件数 カペシタビン、テガフール・ギメラシル・オテラシルカリ は 207 件であった。対象患者 80 名に対し、実際に抗がん ウム、レボホリナート)、支持療法剤 7 種類中の 1 種類 剤に併用されていた薬剤は、悪心・嘔吐、胃部不快感、口 (14.3%:アプレピタント)、合計 28 種類中の 9 種類 内炎などの消化器症状や末梢神経障害などの副作用への (32.1%)に併用禁忌の記載が確認された。併用注意の記 対策目的の薬剤が最も多く 58 名(72.5%)の患者が服用し 載は抗がん剤 21 種類中の 19 種類(90.5%)、支持療法剤 7 ていた。次に多かったのがカルシウム拮抗薬やアンジオテ 種類中の 6 種類(85.7%)、合計 28 種類中の 25 種類(89.3%) ンシンⅡ受容体拮抗薬などの降圧薬 29 名(36.3%)、続い に確認された。なお、併用注意の記載がなかった薬剤は、 て睡眠薬 21 名(26.3%)、経口糖尿病薬やインスリン製剤 ベバシズマブ、セツキシマブ、グラニセトロンの 3 剤のみ などの糖尿病用薬 18 名(22.5%)、以下、オピオイド、脂 であった。 質異常症治療薬、精神神経用薬などが続いた。抗がん剤治 また、院内登録レジメン中 35 レジメン(56.5%)に併用 禁忌の記載がある薬剤が含まれ、62 レジメンすべてに併 療や緩和治療の薬剤に対して併用薬のない患者は 80 名中 4 名(5.0%)であった。 24 藤井友和ら:がん化学療法における薬剤師業務の拡大とその評価に関する研究 表 2. 意図しない相互作用の組み合わせをもつリスク因子 リスク因子の検索 相互作用(併用注意の組み合わせ)をもつリスクとなる 因子を抽出するため、ロジスティック回帰分析を行った。 “意図しない相互作用”に限定した場合、年齢、性別、入 院・外来区分、がん種の違いは相互作用の組み合わせをも つリスク因子とならなかったが、“併用薬数の増加”のオ ッズ比が 1.250(p=0.033)、“他院で処方されている薬剤の 使用”のオッズ比が 1.954(p=0.014)であり、この 2 つの 状況が相互作用の組み合わせをもつ有意なリスク因子と なることが判明した(表 2)。そこで、これらのリスク因 子に着目してさらに分析した結果、他院で処方された薬剤 があるグループではそれがないグループに比べ降圧薬 (p<0.01 )、 糖 尿 病 用 薬 ( p=0.03)、 脂 質 異 常 症 治療薬 (p<0.01)の併用が有意に多いことが判明した。 がん化学療法施行時に注意が必要な相互作用の組み合わ せ 背景 年齢 性別 男性 女性 入院・外来区分 外来 入院 外来・入院両方 がん種 大腸がん 乳がん 胃がん 膵臓がん 肺がん 前立腺がん 食道がん その他 オッズ比 p 値 0.977 0.427 1.0 (referent) 0.907 1.0 (referent) 0.877 1.0 (referent) 0.413 0.708 1.0 (referent) 0.322 0.650 1.0 (referent) 1.000 1.250 3.000 0.333 1.000 0.500 1.500 1.0 (referent) 1.000 0.761 0.345 0.277 1.000 0.639 0.742 1.250 0 .0 33 1.954 0 .0 14 1.574 0.813 0.106 0.814 併用薬の数 他院の処方薬の使用 当院他科の処方薬の使用 緩和治療の薬の使用 剤(塩酸ジフェンヒドラミンを除く)との組み合わせ 16 207 件の“意図しない相互作用”に該当する組み合わせ 件が続いた。件数は少なかったが、イリノテカン、シクロ のうち、抗がん剤治療と緩和治療に用いる薬剤およびこれ ホスファミド、ビノレルビン、パクリタキセルなどいずれ らの副作用対策に用いる薬剤と、それ以外の併用薬との間 も cytochrome P450(CYP)が代謝に関与する抗がん剤と の相互作用の組み合わせは 167 件であった。その内容を分 併用薬との組み合わせが 6 件認められた。 類したところ、表 3 に示すように、デキサメタゾンと降圧 以上の結果より、CYP で代謝される抗がん剤、デキサ 薬との組み合わせが 49 件と最も多く、塩酸ジフェンヒド メタゾンを含むレジメンと降圧薬または糖尿病用薬の併 ラミンと中枢抑制作用を有する薬剤(オピオイドを含む) 用、ジフェンヒドラミンを含むレジメンと中枢抑制作用を との組み合わせ 31 件、デキサメタゾンと糖尿病用薬との 有する薬剤(オピオイドを含む)の併用、緩和治療でオピ 組み合わせ 29 件、オピオイドと中枢抑制作用を有する薬 オイドを使用している患者における中枢抑制作用を有す 表 3. 抗がん剤治療および緩和治療に用いる薬剤と併用薬との間の意図しない相互作用の組み合わせ 相互作用の分類 イリノテカン 抗 が ん 剤 : 併用薬 件数 人数 3 2 相互作用の実例 イトラコナゾール、ニフェジピン、フェニトイン シクロホスファミド : 併用薬 1 1 プレドニゾロン ビノレルビン : 併用薬 1 1 ニフェジピン パクリタキセル : 併用薬 1 1 ニフェジピン デキサメタゾン : 降圧薬 49 25 ロサルタンカリウム/ヒドロクロロチアジド、カンデサルタンシレキセ チル、バルサルタン/ヒドロクロロチアジド、ベシル酸アムロジピン、 ニフェジピン、塩酸ジルチアゼム、テルミサルタン、メシル酸ドキサゾ シン 等 デキサメタゾン : 糖尿病用薬 29 15 グリメピリド、グリベンクラミド、ミチグリニドカルシウム水和物、ピオ グリタゾン塩酸塩、ミグリトール、ボグリボース、インスリン製剤 デキサメタゾン : NSAIDs 8 6 ジクロフェナクナトリウム、メロキシカム、ロキソプロフェンナトリウム、 塩酸ジフェンヒドラミン : 中枢抑制作用を有する薬剤 (オピオイドを含む) 31 16 アルプラゾラム、ハロペリドール、プロクロルペラジン、フルニトラゼ パム、ブロチゾラム、塩酸リルマザホン、酒石酸ゾルピデム、オキシ コドン塩酸塩、塩酸モルヒネ、フェンタニル経皮吸収型製剤 オピオイド : 中枢抑制作用を有する薬剤 (ジフェンヒドラミンを除く) 16 8 エチゾラム、フルニトラゼパム、ハロペリドール、ブロチゾラム、塩酸 リルマザホン、酒石酸ゾルピデム プロクルペラジン : 中枢抑制作用を有する薬剤 (ジフェンヒドラミンを除く) 5 2 エチゾラム、フルニトラゼパム、ブロチゾラム、酒石酸ゾルピデム その他 23 16 ジクロフェナクナトリウム : ロサルタンカリウム/ヒドロクロロチアジ ド、ジクロフェナクナトリウム : アスピリン、デキサメタゾン : フェニト イン、デキサメタゾン : イトラコナゾール 等 NSAIDs : Non-Steroidal Anti-Inflammatory Drugs 岐阜薬科大学紀要 Vol. 61, 19-27 (2012) る薬剤の併用など、注意すべき組み合わせを絞り込むこと 25 積デキサメタゾン投与量 ができた。現状では初回から外来での化学療法を行ってい デキサメタゾンが投与された 14 名の糖尿病合併がん患 る患者が薬剤管理指導を希望しない場合は薬剤師が薬剤 者の平均血糖値は、表 4 に示すように、がん化学療法開始 管理に十分に関与できないケースがある。今回の結果から、 直前(0 ヵ月)の血糖値に比べ、3 ヵ月後(p=0.896: paired 他院の処方薬を服用している場合に“意図しない相互作 t 検定)、6 ヵ月後(p=0.621)、12 ヵ月後(p=0.536)の血糖 用”のリスクが高くなる可能性があることが判明したため、 値はいずれも有意な変化ではなかったものの経時的に上 がん化学療法開始前に患者が現在服用しているすべての 昇する傾向にあった。一方、HbA1c 値についても、3 ヵ月 薬剤を確認する必要があると考えられた。 後(p=0.158)、6 ヵ月後(p=0.856)、12 ヵ月後(p=0.379) において有意な変化は認められなかった。 4.糖尿病合併がん患者の血糖コントロールに及ぼすデキ サメタゾンの影響 28) がん化学療法における制吐 29)や浮腫軽減 30)など患者 次に、がん化学療法を行っていない(デキサメタゾン未 使用)対照糖尿病患者の検査値と比較した結果、血糖値に ついては 0 ヵ月(p=0.379: t 検定)、3 ヵ月後(p=0.258)、6 ヵ月後(p=0.126)では両群間に有意差は認められなかっ QOL の向上や、抗がん剤投与時のアレルギー反応予防 31) たが、12 ヵ月後(p=0.018)ではデキサメタゾン使用の糖 という安全性の向上を目的として、デキサメタゾンが多く 尿病合併がん患者の血糖値の方が有意に高値であった。 のレジメンに併用されており、糖尿病を合併しているがん HbA1c 値については 0 ヵ月(p=0.679)、3 ヵ月後(p=0.084)、 患者にも処方される場合が多い。一方、デキサメタゾンは 6 ヵ月後(p=0.193)、12 ヵ月後(p=0.068)のいずれの時期 糖尿病を増悪するおそれがあることから、コントロール不 でも、両群間に有意な差は認められなかったもののデキサ 良の糖尿病患者への投与は原則禁忌となっている。また、 メタゾン使用がん患者の方が高値を示す傾向にあった。 経口糖尿病剤やインスリン製剤と併用する場合はそれら の作用を減弱するおそれがあるため、用量について注意す ることと添付文書に記載されている。しかし、糖尿病合併 がん患者の血糖コントロールに及ぼすデキサメタゾン長 期投与の影響については明らかにされておらず、リスクと ベネフィットのバランスを考えるうえでのデキサメタゾ ン使用量の指標がないのが現状である。そこで当院の糖尿 病合併がん患者におけるデキサメタゾンの投与量と血糖 表 4. 糖尿病合併がん患者の血糖値,HbA1c 値の経時 的推移 血糖値(mg/dL) 糖尿病合併がん患者 0 ヵ月 3 ヵ月後 6 ヵ月後 12 ヵ月後 173.2 179.8 192.0 196.4 ± ± ± ± コントロールとの関係について調査を行った。 対象患者および調査項目 2006 年 4 月~2011 年 9 月の間に、12 ヵ月以上がん化学 療法および糖尿病治療を継続しデキサメタゾンが投与さ れた患者 14 名を診療支援システムを用いて電子カルテよ 糖尿病患者 (デキサメタゾン使用)(デキサメタゾン未使用) 83.4 93.6 87.4 72.1 P=0.018 158.2 150.1 153.7 159.9 ± ± ± ± 62.9 52.8 54.2 57.2 HbA1c(%) 糖尿病合併がん患者 糖尿病患者 (デキサメタゾン使用)(デキサメタゾン未使用) 0 ヵ月 3 ヵ月後 6 ヵ月後 12 ヵ月後 7.12 7.72 7.18 7.58 ± ± ± ± 1.18 1.79 1.44 1.36 7.00 6.82 6.65 6.97 ± ± ± ± 1.10 0.99 1.01 1.09 り抽出した。対象患者は男性 10 名、女性 4 名、平均年齢 は 61.6 ± 7.2 歳であった。がん種は膵臓がん、胆道がん、 さらに、累積デキサメタゾン投与量と 0 ヵ月からの血糖 大腸がん、乳がん、膀胱がん、前立腺がんの 6 がん種(Stage 値および HbA1c 値の変化量との間の相関性について検討 ⅠB~Ⅳ)、使用レジメンは 11 種類(実施クール数 4~18) した結果、3 ヶ月後ならびに 6 ヵ月後までの累積デキサメ であり、すべての患者でデキサメタゾンが併用されていた。 タゾン投与量はその間の血糖値変化量および HbA1c 値変 これら対象患者の血糖値(抗がん剤投与日の随時血糖値)、 化量のいずれとの間にも有意な相関関係は認められなか HbA1c 値(但し Japan Diabetes Society 値)、累積デキサメタ ったのに対し、12 ヵ月後までの累積デキサメタゾン投与 ゾン投与量について調査を行った。また、がん化学療法を 量はその間の血糖値変化量(r=0.697、 p=0.006)および HbA1c 行っていない(デキサメタゾン未使用)対照糖尿病患者と 値変化量(r=0.712、p=0.004)のいずれとの間にも有意な して、2010 年 4 月~2011 年 4 月の間に、抗がん剤治療お 正の相関関係が認められた(図 2)。また、12 ヵ月後まで よびデキサメタゾンを含むステロイドの投与歴がなく、1 の血糖値変化量と HbA1c 値変化量の間には有意な強い相 年以上糖尿病治療を継続した 2 型糖尿病患者 929 名の血糖 関性が認められた(r=0.823、p=0.0003) 。 値および HbA1c 値のデータを抽出した。 松村ら 32)は外来がん化学療法患者 54 名を対象とした 調査で、経時的に血糖値が上昇し、18.5%の患者が新たに 糖尿病合併がん患者の血糖値および HbA1c 値の推移と累 糖尿病を発症していると報告している。本調査では、対象 26 藤井友和ら:がん化学療法における薬剤師業務の拡大とその評価に関する研究 5.結 論 累積デキサメタゾン投与量 疑義照会時の処方変更率の増加には、情報共有ツールで ある「薬学的管理情報付き抗がん剤無菌調製記録」の寄与 するところが大きく、本ツールの導入により処方鑑査に要 する時間が有意に短縮し、より早い段階で精度の高い疑義 照会を行うことが可能となった。その結果、抗がん剤の減 量やレジメンの変更など重要な処方変更に関与し患者ベ (mg) ネフィットの向上に貢献することができた。また、がん化 学療法施行患者の使用薬剤を対象とした薬物相互作用の 12 ヵ月後までの血糖値(mg/dL)の変化 実態調査を行った結果、相互作用が発生するリスク因子を 明らかにするとともに、注意すべき組み合わせを絞り込む 累積デキサメタゾン投与量 ことで処方鑑査や経過観察でのチェックポイントを明確 ての解析から、累積デキサメタゾン投与量が 150 mg を超 (mg) ん剤の適正使用推進に大いに貢献できているものと考え にすることができた。さらに、糖尿病合併がん患者の血糖 値および HbA1c 値に及ぼすデキサメタゾンの影響につい えることが予想される場合には血糖コントロールをより 厳格に行う必要があることを見出した。以上より、著者ら の取り組みは 4, 15, 28, 33-35)、がん化学療法の安全管理と抗が られた。 本研究で得られた知見は、その活用に際し特別なシステ 12 ヵ月後までの HbA1C (%)の変化 ムや技術を必要としないため、国の方針であるがん医療の 図 2. 累積デキサメタゾン投与量と 12 ヵ月までの 血糖値および HbA1c 値の変化量との相関性 均霑化において、薬剤師が広く専門的な職能を発揮するう 患者の 12 ヵ月間の血糖値には有意な変化は認められなか の全体像をとらえた安全管理から患者個別の適正使用を ったものの経時的に上昇する傾向にあり、これは、デキサ すすめていく本研究手法は、他の領域の薬物療法にも応用 メタゾン未使用の対照糖尿病患者ではみられない傾向で することが可能で、当該薬物療法のさらなる質の向上に貢 あった。さらに、糖尿病合併がん患者の 12 ヵ月後の血糖 献できるものと思われる。 えで有用な情報であると考えられた。また、がん化学療法 値は対照糖尿病患者のそれに比べ有意に高い値を示した。 また、12 ヵ月までの累積デキサメタゾン投与量とその間 6.引用文献 の血糖値および HbA1c 値の変化量との間には有意な正の 相関関係が認められた。累積デキサメタゾン投与量が図 2 1) 北条泰輔, 国枝卓, 齋藤完治, 米村雅人, 橋本浩伸, の相関性のグラフにおける近似直線の y 軸切片の値(約 宇佐美至, 樋口順一, 小井土啓一, 赤木徹, 佐橋幸子, 150 mg)を超える範囲では、血糖値および HbA1c 値の 12 加藤裕久, 牧野好倫, 伊藤巌, 中山綾乃, 小島良紀, ヵ月間の変化量がともに正の値になることが読み取れる。 川崎敏克, 市田泰彦, “がん専門薬剤師を目指すため デキサメタゾンの使用量は患者により大きく異なるが、今 の抗がん剤業務ハンドブック”, じほう, 東京, 2006, pp.1-39. 回の対象患者 14 名の平均ではがん化学療法開始 12 ヵ月後 に累積デキサメタゾン使用量がほぼ 150 mg に達していた。 2) 中村清吾, 月刊薬事, 49, 1501-1504 (2007). また、12 ヵ月後までの血糖値変化量と HbA1c 値変化量の 3) 田墨恵子, 月刊薬事, 49, 1505-1507 (2007). 間には有意な強い相関性が認められると同時に、その近似 4) Fujii T., Nomura K., Sawayanagi N., Nakamura H., Iwase S., Adachi T., Kamiya T., Jpn. J. Pharm. Health Care Sci., 37, 179-186 (2011). 5) 佐藤雄己, 阿部智英, 鈴木陽介, 西村文宏, 半田有希 直線がほぼ原点を通ることから、血糖値および HbA1c 値の いずれの変化量もデキサメタゾンを併用して長期間がん 化学療法を行う際の血糖コントロールの指標となること、 子, 河島史絵, 伊藤弘樹, 大津智, 白尾國昭, 武山正 累積デキサメタゾン投与量 150 mg を一つの指標として厳 格な血糖コントロールの導入を考慮する必要があること が示唆された。 治, 日本病院薬剤師会雑誌, 46, 373-377 (2010). 6) 合澤啓二, 宮崎美香, 福永栄子, 吉田稔, 橋本幸広, 仲 田 清 幸 , 日 本 病 院 薬 剤 師 会 雑 誌 , 44, 1247-1250 岐阜薬科大学紀要 Vol. 61, 19-27 (2012) 誌, 44, 396-400 (2008). 24) Thompson M.E., Highley M.S., Ann. Oncol., 14, 500 (2003). 25) Brown M.C., Pharmacotherapy, 17, 631-633 (1997). 26) Gilbar P.J., Brodribb T.R., Ann. Pharmacother., 35, 1367-1370 (2001). 27) Riechelmann R.P., Tannock I.F., Wang L., Saad E.D., Taback N.A., Kizyzanowska M.K., J. Natl. Cancer Inst., 99, 592-600 (2007). 佐藤雄己, 安部智英, 鈴木陽介, 西村文宏, 半田有希 28) 藤井友和, 鈴木宏, 澤柳直樹, 中村治彦, 塚本久之, (2008). 7) 砂田和幸, 三阪高春, 二渡久智, 松枝文子, 新村弥生, 岸本真, 長ヶ原琢磨, 荻尾夕起子, 吉村真, 日本病院 薬剤師会雑誌, 44, 1777-1781 (2008). 8) 鈴木薫, 松田美樹子, 石山ふみ, 緒方操, 長岡由香, 庄司好子, 小嶋文良, 仲川義人, 日本病院薬剤師会雑 9) 27 子, 河島史絵, 伊東弘樹, 大津智, 白尾國昭, 武山正 柴田孝太郎, 足立哲夫, 神谷恒行, 日本病院薬剤師会 治, 日本病院薬剤師会雑誌, 46, 373-377 (2010). 雑誌, 48, 627-631 (2012). 10) 北川直子, 一木孝治, 篠原義剛, 浅原稔生, 牛尾敏彦, 29) 一般社団法人日本癌治療学会編, “制吐薬適正使用ガ 江藤精二, 髙橋浩二郎, 日本病院薬剤師会雑誌 , 44, イドライン第 1 版”,金原出版株式会社,東京, 2010, 1359-1363 (2008). 11) 宮本康敬, 鈴木吉成, 堀雄史, 天野祐里, 山本知広, 後藤実穂, 渡邉進士, 田中達郎, 大西一功, 川上純一, 日本病院薬剤師会雑誌, 43, 1222-1226 (2007). 12) 上野千奈美, 酒井洋子, 樫本考司, 今田雅子, 坂本健 一, 原田保徳, 日本病院薬剤師会雑誌 , 45, 385-389 (2009). 13) 岩本卓也, 佐々木典子, 杉本浩子, 石橋美紀, 川瀬亮 介, 奥田真弘, 日本病院薬剤師会雑誌, 44, 1065-1069 (2008). 14) 中西晶子, 名徳倫明, 末村奈津子, 岩本千晶, 冨田由 美, 田井ひろ子, 川口進一, 日本病院薬剤師会雑誌 , 43, 1525-1528 (2007). 15) 藤井友和, 野村賢一, 澤柳直樹, 中村治彦, 塚本久之, 足立哲夫, 神谷恒行, 医療薬学, 37, 573-578 (2011). 16) 井出貴之, 勝山善彦, 小川由則, 酒井圭一, 本郷一博, 松 永 民 秀 , 大 森 栄 , 日 本 病 院 薬 剤 師 会 雑 誌 , 46, 789-791 (2010). 17) 内田佳菜子, 豊田 隆, 川端康弘, 中山 昇, 水谷義勝, 日本病院薬剤師会雑誌, 41, 1013-1016 (2005). 18) 深海広平, 関 恭子, 北村瑞穂, 丸尾栄次, 竹田克明, 辻野政司, 白石幸成, 前田頼伸, 日本病院薬剤師会雑 誌, 44, 286-288 (2008). 19) 五十嵐弘幸, 前田康裕, 笠松依子, 福山公美子, 寺下 朋江, 伊藤妃佐子, 水野賀夫, 佐野正毅, 高嶋孝次郎, 日本病院薬剤師会雑誌, 45, 1321-1324 (2009). 20) Konishi H., Morita K., Minouchi T., Nakajima M., Matsuda M., Yamaji A., Ann. Pharmacother., 36, 831-834 (2002). 21) Camidge R., Reigner B., Cassidy J., Grange S., Abt M., Weidekamm E., Jodrell D., J. Clin. Oncol., 23, 4719-4725 (2005). 22) 髙木麻里, 望月千枝, 田村麻衣, 稲本優子, 志村和子, 藤川郁世, 桝 喜恵, 脇條康哲, 日本病院薬剤師会雑 誌, 44, 1511-1514 (2008). 23) 小嶋文良, 志田敏宏, 山澤真之, 加藤祐太, 後藤眞弥, 白石 正, 医療薬学, 35, 778-781 (2009). pp.36-38. 30) Schrivers D., Wanders J., Dirix L., Prove A., Vonck I., Oosterom A.V., Kaye S., Ann. Oncol., 4, 610-611 (1993). 31) Onetto N., Canetta R., Winograd B., Catane R., Dugan M., Grechko J., Burroughs J., Rozencweig M., J. Natl. Inst. Monogr., 15, 131-139 (1993). 32) 松村千佳子,倉田義昭, 柳田佐江子, 中村暢彦, 青松 幸雄, 小林経宏, 桑田博文, 日本病院薬剤師会雑誌 , 45, 1209-1212 (2009). 33) 藤井友和, 野村賢一, 澤柳直樹, 中村治彦, 岩瀬定利, 足立哲 夫, 神谷恒行, 日本 病院薬 剤師 会 雑誌 , 46, 1377-1380 (2010). 34) 藤井友和, 藤目光良, 齋竹達郎, 水藤博章. 渥美病院 における薬剤師の外来化学療法に対する取り組み. 医療薬学, 31, 729-734 (2005). 35) 野村賢一, 藤井友和, 中村治彦, 澤柳直樹, 神谷恒行, 日本病院薬剤師会雑誌, 45, 225-229 (2009). 7.特記事項 本総説は、岐阜薬科大学博士論文(甲 133 号)の内容を 中心にまとめたものである。 28 研 究 論 文 抄 録 Abstracts of Published Reports (2011. 1 ~ 2011. 12) 29 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Bioorg. Med. Chem. 19, 1721-1728 (2011)] [Lab. of Pharmaceutical & Medicinal Chemistry] Synthesis and Evaluation of Cyclic RGD-boron Cluster Conjugates to Develop Tumor-selective Boron Carriers for Boron Neutron Capture Therapy. Sadaaki KIMURA, Shin-ichiro MASUNAGA, Tomohiro HARADA, Yasuo KAWAMURA, Satoshi UEDA, Kensuke OKUDA and Hideko NAGASAWA* Boron-containing agents play a key role in successful boron neutron capture therapy (BNCT). Icosahedral boron cluster-Arg-Gly-Asp (RGD) peptide conjugates were designed, synthesized, and evaluated for the biodistribution to develop tumor-selective boron carriers. Integrin αvβ3 is an attractive target for anti-tumor drug delivery because of its specific expression in proliferating endothelial and tumor cells of various origins. Preparation of o-carborane derivatives involved microwave irradiation, and resulted in high yields in a short time. An in vitro cell adhesion assay and biodistribution experiments indicated that GPU-201 showed comparable tumor uptake and a significantly longer retention in tumors compared with BSH. [Bioorg. Med. Chem. 19, 5392-5401 (2011)] [Lab. of Pharmaceutical & Medicinal Chemistry] Isolation, Identification, and Biological Evaluation of HIF-1-modulating Compounds from Brazilian Green Propolis. Hisanori HATTORI, Kensuke OKUDA, Tetsuji MURASE, Yuki SHIGETSURA, Kosuke NARISE, Gregg L. SEMENZA and Hideko NAGASAWA* The tumor microenvironment is characterized by hypoxia, low-nutrient levels, and acidosis. Five compounds, such as baccharin (3), beturetol (4), kaempferide (5), isosakuranetin (6), and drupanin (9), that modulate HIF-1-dependent luciferase activity were identified from Brazilian green propolis using reporter assay. Compounds 3, 9 and 5 reduced HIF-1-dependent luciferase activity. They inhibited expression of the HIF-1alpha protein and HIF-1 downstream target genes including VEGFA. They also exhibited significant anti-angiogenic effects. These small molecules screened from Brazilian green propolis may be useful as lead compounds for the development of novel therapies against ischemic cardiovascular disease and cancer. [Heterocycles 83, 1315-1328 (2011)] [Lab. of Pharmaceutical & Medicinal Chemistry] Polycyclic N-Heterocyclic Compounds. Part 70: Synthesis of 5-Amino-1,2-dihydrofuro[2,3-b]pyrido[3’,2’:4,5]thieno[3,2-d]pyridines and Related Compounds. Evaluation of Effects on Lipoprotein Lipase mRNA Expression. Kensuke OKUDA*, Hideyasu TAKECHI, Takashi HIROTA and Kenji SASAKI Reaction of 3-(3-cyanopropoxy)thieno[2,3-b]pyridine-2-carbonitriles with potassium tert-butoxide gave 5-amino-1,2-dihydrofuro[2,3-b]pyrido[3’,2’:4,5]thieno[3,2-d]pyridines via a Truce-Smiles rearrangement. The 5-amino group was transformed to the chloro derivatives which were allowed to react with various nucleophiles. Effects of the newly synthesized compounds on lipoprotein lipase mRNA expression were also evaluated. The previously unreported parent compound, furo[2,3-b]pyrido[3’,2’:4,5]thieno[3,2-d]pyridine, was also synthesized. [J. Heterocycl. Chem. 48, 715-719 (2011)] [Lab. of Pharmaceutical & Medicinal Chemistry] Polycyclic N-Heterocyclic Compounds. Part 66: Synthesis of N-[2-([1,2,4]Oxadiazol-5-yl)cyclopenten-1-yl]formamide Oximes and Their Evaluation as Inhibitors of Platelet Aggregation. Kensuke OKUDA*, Ying-Xue ZHANG, Hiromi OHTOMO, Takashi HIROTA and Kenji SASAKI N-[2-([1,2,4]Oxadiazol-5-yl)cyclopenten-1-yl]formamide oximes were synthesized by fusion of (6,7-dihydro-5H-cyclopenta[1,2-d]pyrimidin-4-yl)amidines and/or their amide oximes with hydroxylamine hydrochloride through a subsequent rearrangement reaction. Assay of the products for anti-platelet aggregation activity revealed that certain of them showed promising inhibitory effect on arachidonic acid-induced platelet aggregation. 30 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [J. Heterocycl. Chem. 48, 1407-1413 (2011)] [Lab. of Pharmaceutical & Medicinal Chemistry] Polycyclic N-Heterocyclic Compounds. Part 67: Reaction of 6,7-Substituted N-(Quinazolin-4-yl)amidine Derivatives with Hydroxylamine Hydrochloride: Formation of in Vitro Inhibitors of Pentosidine. Kensuke OKUDA*, Hideki MUROYAMA and Takashi HIROTA Reactions of N-(quinazolin-4-yl)amidines and their amide oximes with hydroxylamine hydrochloride gave cyclization products that were formed by an initial ring cleavage of the pyrimidine component followed by a ring closure formation of 1,2,4-oxadiazole to give N-[2-([1,2,4]oxadiazol-5-yl)phenyl]formamide oximes. All isolated products were evaluated for in vitro inhibitory activity on the formation of pentosidine, which is one of representative advanced glycation end products. Some products exhibited significant inhibitory activity against pentosidine formation. [Synth. Commun. 41, 812-819 (2011)] [Lab. of Pharmaceutical & Medicinal Chemistry] Polycyclic N-Heterocyclic Compounds. Part 68: Reactions of 3-(2-Bromoethyl)quinazolin-4(3H)-one and 3-(2-Bromoethyl)-5,6,7,8-tetrahydroquinazolin-4(3H)-one with Primary Alkylamines via a Dimroth-type Rearrangement. Kensuke OKUDA*, Hiromi OHTOMO, Tsuyoshi TAGATA, Takashi HIROTA and Kenji SASAKI The reaction of 3-(2-bromoethyl)quinazolin-4(3H)-one with ethyl- and n-propylamine gave abnormal fused 3-alkyl-4-alkyliminoquinazolines via a Dimroth-type rearrangement, as well as normal substituted 3-(2-alkylaminoethyl) derivatives in methanol. The reaction of 3-(2-bromoethyl)-5,6,7,8-tetrahydroquinazolin-4(3H)-one with primary alkylamines was also investigated for the scope of this rearrangement reaction. [Bull. Chem. Soc. Jpn. 84, 386-394 (2011)] [Lab. of Pharmaceutical & Medicinal Chemistry] Design and Synthesis of Fluorescent Probe for Polyhistidine Tag Using Macrocyclic Nickel(II) Complex and Fluorescein Conjugate. Masayasu TAKI, Fumiyoshi ASAHI, Tasuku HIRAYAMA* and Yukio YAMAMOTO We report a newly designed polyhistidine tag (His-tag) targeting fluorescent probe, NiLODCF, based on the fluorophore displacement mechanism. A macrocyclic nickel(II) complex (NiLO) was employed as a novel binding site for a His-tag motif, and we chose 2-4-dichlorofluorescein (DCF) as the fluorophore. A hypochromic absorption shift of NiLODCF from the metal-unbound form (LODCF) suggested that the phenolic oxygen atom of DCF interacted directly with the NiLO complex, resulting in efficient fluorescence quenching. When a model peptide having a hexahistidine sequence (H6Y1) was added to the solution of NiLODCF, a significant fluorescence enhancement in the emission was observed. These results indicate that NiLOcan serve as a novel binding site for the polyhistidine sequence and that NiLODCF would be applicable to a switchable fluorescent probe for such His-tagged proteins. [J. Mol. Biol. 408, 18-25 (2011)] [Lab. of Pharmaceutical & Medicinal Chemistry] Human Spire Interacts with the Barbed End of the Actin Filament. Takuto ITO, Akihiro NARITA, Tasuku HIRAYAMA*, Masayasu TAKI, Shohei IYOSHI, Yukio YAMAMOTO, Yuichiro MAEDA and Toshiro ODA Spire is an actin nucleator that initiates actin polymerization at a specific place in the cell. Similar to the Arp2/3 complex, spire was initially considered to bind to the pointed end of the actin filament when it generates a new actin filament. Subsequently, spire was reported to be associated with the barbed end (B-end); thus, there is still no consensus regarding the end with which spire interacts. Here, we report direct evidence that spire binds to the B-end of the actin filament, under conditions where spire accelerates actin polymerization. Using electron microscopy, we visualized the location of spire bound to the filament by gold nanoparticle labeling of the histidine-tagged spire, and the polarity of the actin filament was determined by image analysis. In addition, our results suggest that multiple spires, linked through one gold nanoparticle, enhance the acceleration of actin polymerization. 31 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [J. Mol. Biol. 408, 29-30(2011)] [Lab. of Pharmaceutical & Medicinal Chemistry] Electron Microscopic Visualization of the Filament Binding Mode of Actin-Binding Proteins. Takuto ITO, Tasuku HIRAYAMA*, Masayasu TAKI, Shohei IYOSHI, Shuheng DAI, Shuichi TAKEDA, Chieko KIMURA-SAKIYAMA, Toshiro ODA, Yukio YAMAMOTO, Yuichiro MAEDA and Akihiro NARITA A large number of actin-binding proteins (ABPs) regulate various kinds of cellular events in which the superstructure of the actin cytoskeleton is dynamically changed. Thus, to understand the actin dynamics in the cell, the mechanisms of actin regulation by ABPs must be elucidated. Moreover, it is particularly important to identify the side, barbed-end or pointed-end ABP binding sites on the actin filament. However, a simple, reliable method to determine the ABP binding sites on the actin filament is missing. Here, a novel electron microscopic method for determining the ABP binding sites is presented. This approach uses a gold nanoparticle that recognizes a histidine tag on an ABP and an image analysis procedure that can determine the polarity of the actin filament. This method will facilitate future study of ABPs. [Tetrahedron 67, 1158–1165 (2011)] [Lab. of Organic Chemistry] Halogen-Deuterium Exchange Reaction Mediated by Tributyltin Hydride using THF-d8 as the Deuterium source. Tomonobu MUTSUMI, Hiroki IWATA, Kazuo MARUHASHI, Yasunari MONGUCHI and Hironao SAJIKI* A regioselective deuteration method for a wide variety of aromatic compounds using the halogen–deuterium exchange reaction initiated by Bu3SnH using THF-d8 as the deuterium source was developed. [Eur. J. Org. Chem. 3361–3367 (2011)] [Lab. of Organic Chemistry] Pyridine-N-oxide Mediated Oxidation of Diarylalkynes with Palladium on Carbon. Yoshinari SAWAMA, Masato TAKUBO, Shigeki MORI, Yasunari MONGUCHI and Hironao SAJIKI* Pyridine N-oxide works as an effective oxidant of 1,2-diarylalkynes at 120 °C to form benzil derivatives under Pd/C-catalyzed solvent-free conditions, and Pd/C could be reused up to five times after simple filtration. [Chem. Lett. 40, 910–912 (2011)] [Lab. of Organic Chemistry] Pd/C-Catalyzed and Water-Mediated Hiyama Cross-Coupling Reaction using an Electron-Deficient Phosphine Ligand. Takayoshi YANASE, Shigeki MORI, Yasunari MONGUCHI and Hironao SAJIKI* The Pd/C-catalyzed Hiyama cross-coupling reaction between a variety of aryl halides and aryltriethoxysilanes was developed. Since only small amounts of the 10% Pd/C (0.5 mol %) and phosphine ligand (1.0 mol %) are required for efficient reaction, the protocol would be practical for the construction of biphenyl derivatives. 32 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Tetrahedron 67, 8628–8634 (2011)] [Lab. of Organic Chemistry] Palladium on Carbon-Catalyzed Solvent-Free and Solid-Phase Hydrogenation and Suzuki–Miyaura Reaction. Yasunari MONGUCHI, Yuki FUJITA, Shota HASHIMOTO, Mariko INA, Tohru TAKAHASHI, Ryo ITO, Kei NOZAKI, TomohiroMAEGAWA and Hironao SAJIKI* The solvent-free and solid-phase hydrogenation of various reducible functionalities was efficiently catalyzed by heterogeneous palladium on carbon (Pd/C) under ambient hydrogen pressure and temperature. The Pd/C-catalyzed Suzuki–Miyaura coupling reaction between solid aryl bromides and solid arylboronic acids to generate the corresponding solid biaryls was also achieved under the totally solid-phase conditions. [ChemCatChem 3, 1624–1628 (2011)] [Lab. of Organic Chemistry] Facile Hydrogenation of Ketones Catalyzed by Platinum on Carbon under Ordinary Pressures and Temperatures. Yuta FUJIWARA, Youhei IWASAKI, Tomohiro MAEGAWA, Yasunari MONGUCHI and Hironao SAJIKI* An efficient and practical procedure for the hydrogenation of aliphatic and aromatic ketones under mild reaction conditions is established. The method is highly effective even for the hydrogenation of sterically hindered ketones. Furthermore, the selective hydrogenation of the carbonyl group of aromatic ketones was achieved with the aromatic nuclei and the resulting secondary benzyl alcohol moiety still intact on addition of catalytic amount of pyridine. [Angew. Chem. Int. Ed. 50, 12232–12235 (2011)] [Lab. of Organic Chemistry] Reversing the Reactivity of Carbonyl Functions with Phosphonium Salts: Enantioselective Total Synthesis of (+)-Centrolobine. Hiromichi FUJIOKA, Kenzo YAHATA, Ozora KUBO, Yoshinari SAWAMA*, Tomohito HAMADA and Tomohiro MAEGAWA Step saver: Carbonyl groups with lower reactivities can be transformed in the presence of more reactive ones by treatment with PPh3 (or PEt3) and TMSOTf prior to the reaction (see scheme; TMS=trimethylsilyl, Tf=trifluoromethanesulfonyl). This methodology can be applied to reduction and alkylation reactions, and enabled the short asymmetric total synthesis of (+)-centrolobine with the highest overall yield reported to date. [Chem. Commun. 47, 9894–9896 (2011)] [Lab. of Organic Chemistry] An Unusual Reaction of a-Alkoxyphosphonium Salts with Grignard Reagents under an O2 Atmosphere. Hiromichi FUJIOKA , Akihiro GOTO , Kazuki OTAKE , Ozora KUBO , Yoshinari SAWAMA* and Tomohiro MAEGAWA An unusual and novel reaction of α-alkoxyphosphonium salts, generated from O,O-acetals and Ph3P, with Grignard reagents under an O2 atmosphere afforded alcohols in moderate to high yields. It was clarified by isotopic labelling experiments that the reaction proceeded via a novel radical pathway. 33 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Tetrahedron Lett, 52, 3821-3824 (2011)] [Lab. of Pharmaceutical Synthetic Chemistry] Tandem Oxidation/Bromination of Ethyl Aromatics to α,α-Dibromoacetophenones with Molecular Oxygen under Visible Light Irradiation. Norihiro TADA, Kazunori BAN, Takafumi ISHIGAMI, Tomoya NOBUTA, Tsuyoshi MIURA and Akichika ITOH* A facile synthesis of α,α-dibromoacetophenones from ethyl-substituted aroms. by aerobic photooxidn. was developed. This synthetic method achieved oxidative dibromination of arom. Et groups by using inexpensive and easily handled Br sources, harmless visible light, and O2. [Chem. Pharm. Bull. 59, 906-908 (2011)] [Lab. of Pharmaceutical Synthetic Chemistry] Oxidative Photodecarboxylation of α-Hydroxycarboxylic Acid Derivatives with FSM-16 under Visible Light Irradiation of Fluorescent Lamp. Norihiro TADA, Yoko MATSUSAKI, Tsuyoshi MIURA and Akichika ITOH* Hydroxycarboxylic acids were converted to the corresponding carbonyl compounds under aerobic photo-oxidative conditions in the presence of FSM-16 under visible light irradiation by a fluorescent lamp. This synthetic protocol is the first example of FSM-16 functioning as a photocatalyst by visible light. [Org. Lett. 13, 2576-2579 (2011)] [Lab. of Pharmaceutical Synthetic Chemistry] One-pot Metal-free Syntheses of Acetophenones from Styrenes through Aerobic Photo-oxidation and Deiodination with Iodine. Tomoya NOBUTA, Shin-ichi HIRASHIMA, Norihiro TADA, Tsuyoshi MIURA and Akichika ITOH* A one-pot synthetic protocol of acetophenones from styrenes with mol. oxygen, visible light, and mol. iodine is reported. This procedure involves aerobic photo-oxidn. and deiodination in one pot and provides the first report of metal-free direct syntheses of acetophenones from styrenes. [Green Chem. 13, 1669-1671 (2011)] [Lab. of Pharmaceutical Synthetic Chemistry] Facile Aerobic Photooxidation of Methyl Group in the Aromatic Nucleus in the Presence of an Organocatalyst under VIS Irradiation. Norihiro TADA, Kasumi HATTORI, Tomoya NOBUTA, Tsuyoshi MIURA and Akichika ITOH* We report a useful method for a facile synthesis of carboxylic acids from Me aroms. by aerobic photooxidn. using VIS irradn. and easily handled 2-chloroanthraquinone as org. catalysts under mild conditions such as an air atm. and ambient pressure and temp. This is a more environmentally benign oxidn. than previous methods, which require drastic reaction conditions. 34 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Tetrahedron Lett. 52, 875-877 (2011)] [Lab. of Pharmaceutical Synthetic Chemistry] Facile Aerobic Photo-oxidative Synthesis of α-Diketones from Alkynes. Tomoya NOBUTA, Norihiro TADA, Kasumi HATTORI, Shin-ichi HIRASHIMA, Tsuyoshi MIURA and Akichika ITOH* We report a useful method for facile aerobic photo-oxidative synthesis of α-diketones from alkynes with MgBr2·OEt2. This procedure provides a practical synthetic method of α-diketones using easily handled bromine sources, harmless visible light, and mol. oxygen as terminal oxidant. [Green Chem. 13, 2347-2350 (2011)] [Lab. of Pharmaceutical Synthetic Chemistry] Efficient Synthesis of Gem-dihydroperoxides with Molecular Oxygen and Anthraquinone under Visible Light Irradiation with Fluorescent Lamp. Lei CUI, Norihiro TADA, Hiroaki OKUBO, Tsuyoshi MIURA and Akichika ITOH* An efficient dihydroperoxidn. protocol of various carbonyl compds. with mol. oxygen and anthraquinone in 2-propanol under visible light irradn. with a fluorescent lamp, which produced corresponding gem-dihydroperoxides in high yields, is reported. [Synlett. 1381-1384 (2011)] [Lab. of Pharmaceutical Synthetic Chemistry] Direct Synthesis of α-Keto Esters from Ethylbenzenes using 48% Aqueous HBr by Aerobic Visible Light Photooxidation. Norihiro TADA, Kazunori BAN, Tomoya NOBUTA, Shin-ichi HIRASHIMA, Tsuyoshi MIURA and Akichika ITOH* We report that ethylbenzenes can be directly oxidized to the corresponding α-keto esters with mol. oxygen in the presence of 48% aq. HBr under visible light irradn. This synthetic procedure is the first example for direct prepn. of the corresponding α-keto esters from ethylbenzenes. [Tetrahedron: Asymmetry 22, 1028-1034 (2011)] [Lab. of Pharmaceutical Synthetic Chemistry] Direct Asymmetric Aldol Reactions in Water with a β-Aminosulfonamide Organocatalyst. Tsuyoshi MIURA*, Mariko INA, Kie IMAI, Kosuke NAKASHIMA, Yumi YASAKU, Naka KOYATA, Yasuoki MURAKAMI, Nobuyuki IMAI, Norihiro TADA and Akichika ITOH β-Aminosulfonamide organocatalyst promoted the direct asym. aldol reactions of aldehydes with ketones in brine or in the presence of water to afford the corresponding anti-aldol products in moderate to excellent yields with up to 97% ee. 35 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Tetrahedron 67, 6340-6346 (2011)] [Lab. of Pharmaceutical Synthetic Chemistry] Direct Asymmetric Aldol Reactions in Brine with Recyclable Fluorous β-Aminosulfonamide Organocatalysts. Tsuyoshi MIURA*, Kie IMAI, Hikaru KASUGA, Mariko INA, Norihiro TADA, Nobuyuki IMAI and Akichika ITOH Fluorous organocatalyst I promotes direct asym. aldol reactions of ketones with aryl aldehydes in brine, leading to the synthesis of the corresponding anti-aldol products in high yields with up to 96% ee. Fluorous organocatalyst I is easily recovered by solid-phase extn. using fluorous silica gel and can be reused up to five times without purifn. [Synlett 2896-2900 (2011)] [Lab. of Pharmaceutical Synthetic Chemistry] Catalytic Oxidative Cleavage of 1,3-Diketones to Carboxylic Acids by Aerobic Photooxidation with Iodine. Norihiro TADA, Motoki SHOMURA, Lei CUI, Tomoya NOBUTA, Tsuyoshi MIURA and Akichika ITOH* The catalytic oxidative cleavage of 1,3-diketones to the corresponding carboxylic acids by aerobic photooxidn. with iodine under irradn. with a high-pressure mercury lamp was reported. [Tetrahedron: Asymmetry 22, 1605-1609 (2011)] [Lab. of Pharmaceutical Synthetic Chemistry] Asymmetric Michael Reactions of α,α-Disubstituted Aldehydes with Maleimides Using a Primary Amine Thiourea Organocatalyst. Tsuyoshi MIURA*, Akira MASUDA, Mariko INA, Kosuke NAKASHIMA, Shohei NISHIDA, Norihiro TADA and Akichika ITOH Primary amine thiourea organocatalyst (S)-3,5-(F3C)2C6H3NHCSNHCH(CH2Ph)CH2NH2 was used to promote Michael addns. of bulky α,α-disubstituted aldehydes, such as isobutyraldehyde with maleimides to afford the adducts in high to excellent yields and with up to 91% ee. [Tetrahedron Lett. 52, 4158-4160 (2011)] [Lab. of Pharmaceutical Synthetic Chemistry] Asymmetric Michael Additions of Aldehydes to Maleimides Using a Recyclable Fluorous Thiourea Organocatalyst. Tsuyoshi MIURA*, Shohei NISHIDA, Akira MASUDA, Norihiro TADA and Akichika ITOH Fluorous thiourea organocatalyst I promoted the Michael reaction of aldehydes with maleimides to afford the corresponding adducts in high yields with ≤99% ee. Organocatalyst I could be easily recovered as an insol. ppt. from the reaction mixt. by simple filtration and could be reused without significant loss of catalytic activity. 36 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Chem. Commun. 47, 1875-1877 (2011)] [Lab. of Pharmaceutical Synthetic Chemistry] An Effective and Catalytic Oxidation Using Recyclable Fluorous IBX. Tsuyoshi MIURA*, Kosuke NAKASHIMA, Norihiro TADA and Akichika ITOH Oxidn. of alcs. in the presence of a catalytic amt. of fluorous IBX and Oxone as a co-oxidant resulted in the corresponding carbonyl compds. in good to high yields. The fluorous IBX is readily recovered as insol. fluorous IBA from the reaction mixt. by simple filtration, and can be reused without significant loss of catalytic activity. [Synlett 410-414 (2011)] [Lab. of Pharmaceutical Synthetic Chemistry] β-Aminosulfonamide-catalyzed Direct Asymmetric Aldol Reaction in Brine. Tsuyoshi MIURA*, Mariko INA, Kie IMAI, Kosuke NAKASHIMA, Akira MASUDA, Norihiro TADA, Nobuyuki IMAI and Akichika ITOH Direct asym. aldol reactions of aldehydes RCHO (R = Ph, 4-O2NC6H4, 3-MeOC6H4, etc.) with ketones in the presence of a catalytic amt. of β-aminosulfonamide PhCH2CH(NHTf)CH2NH2 (I) and trifluoroacetic acid in brine gave the corresponding anti-aldols, e.g. II, in high yields with up to 96% enantiomeric excess. The anti-aldol products obtained by using the β-aminosulfonamide catalyst have the opposite abs. configuration to those obtained using the sulfonamide catalyst PhCH2CH(NH2)CH2NHTf previously reported by the authors. [Chem. Pharm. Bull. 59, 239-248(2011)] [Lab. of Pharmacognosy] Occurrence of C-Glucoside of Resveratrol Oligomers in Hopea parviflora. Naohito ABE, Tetsuro ITO, Masayoshi OYAMA, Ryuichi SAWA, Yoshikazu TAKAHASHI, Veliah CHELLADURAI and Munekazu IINUMA* Investigation of the highly polar chemical constituents in the stem of Hopea parviflora (Dipterocarpaceae) resulted in the isolation of four new resveratrol derivatives, hopeasides A and B (resveratrol pentamers), C (resveratrol trimer), and D (resveratrol dimer) together with nine known resveratrol oligomers. The new structures have a common partial structure of the 1-hydroxy-1-(3,5-dihydroxy-2-C-glucopyranosylphenyl)-2-(4-hydroxyphenyl)ethane-2-yl group after oxidative condensation of (E)-resveratrol-10-C-β-glucopyranoside. The structures were determined by spectroscopic analysis including 2D-NMR and computer-aided molecular modeling. The biogenetic relationship of the isolates and NMR characteristics caused by steric hindrance are also discussed in this paper. [Chem. Pharm. Bull. 59, 452-457(2011)] [Lab. of Pharmacognosy] Resveratrol Derivatives from Vatica Albiramis. Naohito ABE, Tetsuro ITO, Masayoshi OYAMA, Ryuichi SAWA, Yoshikazu TAKAHASHI and Munekazu IINUMA* Three new stilbene derivatives, albiraminols A (resveratrol hexamer), B (resveratrol dimer), and vatalbinoside F (mono-glucoside of resveratrol dimer), along with malibatol were isolated from acetone soluble portions of the stem of Vatica albiramis. The structures of the isolates were established on the basis of spectroscopic analyses, including a detailed NMR spectroscopic investigation. The biosynthetic aspects of the isolates are discussed in this paper. Albiraminol A is composed of tetrameric resveratrol (vaticanol B) and dimeric resveratrol and is the first instance of the resveratrol derivative bearing a 5,6,11,12-tetrahydro-5,11-epoxydibenzo[a,e][8]annulene ring system. Albiraminol B possesses a novel 4,5-dihydro-13-oxabenzo[3,4]azuleno[7,8,1-jkl]phenanthrene skeleton in the framework. 37 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Heterocycles 83, 571-580(2011)] [Lab. of Pharmacognosy] Resveratrol Dimers with an Oxabicyclo Ring in Vatica Albiramis. Naohito ABE, Tetsuro ITO, Masayoshi OYAMA, Ryuichi SAWA, Yoshikazu TAKAHASHI and Munekazu IINUMA* Investigation of the chemical constituents in the stem of Vatica albiramis (Dipterocarpaceae) resulted in the isolation of six stilbenoid derivatives, albiraminols C, D, and vatalbinosides G-J. We determined their structures by spectroscopic anal. including two- dimensional NMR, comparison of the NMR data based on isomerism, and computer-aided molecular modeling. They had two resveratrol units and are the first instance of resveratrol derivatives bearing an oxabicyclo[3.2.2]nonadiene ring system. [Nippon Shokuhin Kagaku Gakkaishi 18, 71-76(2011)] [Lab. of Pharmacognosy] Purification of Antioxidant from Cherry Leaf by High Speed Counter-current Chromatography and On-line HPLC/DPPH Radical Scavaging Assay. Koichi INOUE, Tomomi KIMURA, Hiroyuki KOJIMA, Masayoshi OYAMA, Munekazu IINUMA*, Hisao OKA and Tomoaki HINO In this study, the identification and purification of antioxidant compound from cherry leaf was proposed by a novel strategy of high-speed countercurrent chromatography (HSCCC) purification for the efficient and effective discovery of antioxidant from natural product based on online HPLC method with radical scavenging assay. The purification of this antioxidant form cherry leaf extract was performed by HSCCC with optimal two-phase solvent system. Using mass spectrometric and NMR analyses, this antioxidant was identified to 3-O-caffeoylquinic acid. Due to the advantages derived from online HPLC with DPPH radical scavenging assay and HSCCC technique, a efficient and effective strategy has been developed for the discovery of antioxidants from natural products. [Food Chem. 126, 289-294(2011)] [Lab. of Pharmacognosy] Inhibitory Effects of Flavonoid Glycosides Isolated from the Peel of Japanese Persimmon (Diospyros Kaki Fuyu) on Antigen-stimulated Degranulation in Rat Basophilic Leukaemia RBL-2H3 Cells. Tomohiro ITOH, Kenji OHGUCHI, Chizuru NAKAJIMA, Masayoshi OYAMA, Munekazu IINUMA*, Yoshinori NOZAWA, Yukihiro AKAO and Masafumi ITO We found that two distinct flavonoid glycosides isolated from the peel of Japanese persimmon (Diospyros kaki Fuyu), isoquercitrin (Isq) and hyperin (Hyp), are capable of inhibiting antigen-stimulated degranulation in rat basophilic leukemia RBL-2H3 cells. In order to elucidate the underlying mechanisms, we examined effects of Isq and Hyp on cellular responses induced by antigen stimulation. These results indicate that inhibition of antigen-stimulated degranulation by Isq and Hyp is mainly due to suppression of intracellular Ca2+ elevation. Our findings suggest that Isq and Hyp would be beneficial for alleviating symptoms of type I allergy. [Heterocycles 83, 1603-1610(2011)] [Lab. of Pharmacognosy] New Furanocoumarins from the Fruits of Melicope Triphylla. Ken-ichi NAKASHIMA, Masayoshi OYAMA, Tetsuro ITO, Hiroko MURATA and Munekazu IINUMA* Four new furanocoumarins were isolated from the fruits of Melicope triphylla (Rutaceae), together with two known coumarins, nine flavonoids, two alkaloids, and methyl p-geranyloxy-trans-cinnamate. The structures of the newly identified compounds were determined by extensive 1D- and 2D-NMR spectroscopic analyses to be linear-types of furanocoumarins bearing a hydroxyl or a hydroperoxy group on the geranyloxy side chain. 38 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Tetrahedron Lett. 52, 4694-4696(2011)] [Lab. of Pharmacognosy] Melicodenines A and B, Novel Diels-Alder Type Adducts Isolated from Melicope Denhamii. Ken-ichi NAKASHIMA, Masayoshi OYAMA, Tetsuro ITO, Joko Ridho WITONO, Dedy DARNAEDI, Toshiyuki TANAKA, Jin MURATA and Munekazu IINUMA* Two novel Diels-Alder type adducts, melicodenines A and B, were isolated from the leaves of Melicope denhamii (Seem.) T. G. Hartley and their structures were established by spectroscopic analyses, including extensive 2D NMR experiments. Melicodenine A is a bisquinolinone alkaloid comprised of two N-methylflindersines, while melicodenine B is the first naturally occurring quinolinone-acetophenone conjugate composed of N-methylflindersines and an evodionol methyl ether. [BMC Med. 9, 69-87(2011)] [Lab. of Pharmacognosy] α-Mangostin Extracted from the Pericarp of the Mangosteen (Garcinia Mangostana Linn) Reduces Tumor Growth and Lymph Node Metastasis in an Immunocompetent Xenograft Model of Metastatic Mammary Cancer Carrying a p53 Mutation. Masa-Aki SHIBATA, Munekazu IINUMA*, Junji MORIMOTO, Hitomi KUROSE, Kanako AKAMATSU, Yasushi OKUNO, Yukihiro AKAO and Yoshinori OTSUKI Mammary tumors, induced by inoculation of BALB/c mice syngeneic with metastatic BJMC3879luc2 cells, were subsequently treated with α-mangostin using mini-osmotic pumps and histopathologically examined. The antimetastatic activity of α-mangostin as detected in mammary cancers carrying a p53 mutation in the present study may have specific clinical applications. In addition, α-mangostin may have chemopreventive benefits and/or prove useful as an adjuvant therapy, or as a complementary alternative medicine in the treatment of breast cancer. [Anal. Sci. 27, 217-220 (2011)] [Lab. of Pharmaceutical Analytical Chemistry] Functional Preconcentration Tip of Total Volume Injection for ESI/MS Analysis of DNA Adducts. Hiroya MURAKAMI, Mio KOGUCHI, Yukihiro ESAKA, Bunji UNO* and Yasushi ISHIHAMA We have developed a simple method to significantly improve the sensitivity in the LC/MS analysis of DNA adducts. A preconcentration tip for the selective recovery of DNA adducts was prepared. Using this tip, the total amount of DNA adducts in a treated DNA sample was injected in a one-shot manner into an LC/MS system. We were able to improve the sensitivity by more than one order of magnitude in concentration. This method will be a useful tool for the quantitative determination of trace DNA adducts. [Chem. Lett. 40, 268-269 (2011)] [Lab. of Pharmaceutical Analytical Chemistry] Oxidation of Guanosine to the Imidazolone Derivative via Proton-coupled Electron Transfer to Hydroperoxy Radical Derived from Superoxide. Hiroya MURAKAMI, Yukihiro ESAKA, Tatsushi NAKAYAMA and Bunji UNO* Oxidation of guanosine (G) with electrochemically generated superoxide (O2•-) leads to the imidazolone (Iz) derivative as a single-electron oxidation product of G. A crucial step in the mechanism of the oxidation is the proton-coupled electron transfer (PCET) from G to the hydroperoxy radical (HO2•) that is derived from O2•-. 39 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Anal. Sci. 27, 315-320 (2011)] [Lab. of Pharmaceutical Analytical Chemistry] Structural and Spectral Characteristics of the Cross-linked Dimer Derived from Electrooxidation of Cyclic 1,N2-Propanoguanosine. Hiroya MURAKAMI, Yukihiro ESAKA and Bunji UNO* The acetaldehyde-derived cyclic propano adduct of 2′-deoxyguanosine was easily oxidized electrochemically into the cross-linked dimer as an oxidative product. The structural and spectroscopic characteristics of the dimer were investigated by MS, NMR, UV, and DFT calculations. The dimer formation was inferred from the chemical formula as C28H36N10O12 provided by the high-resolution ESI-MS results. The C2–N5 linkage between the two monomers in the dimer was deduced from the 1D-NMR spectral results. In addition, the correlations in the 2-D NMR spectra were consistently explained by the structure of the C2–N5 cross-linked dimer. UV spectral measurements also support the C2–N5 linking in the dimer formation. The formation of the cross-link dimer is expected to interfere with DNA replication and to contribute to acetaldehyde-mediated genotoxicity. [Clin. Exp. Pharmacol. Physiol. 38, 658-665 (2011)] [Lab. of Pharmaceutical Analytical Chemistry] Cilostazol Protects the Heart against Ischaemia Reperfusion Injury in a Rabbit Model of Myocardial Infarction: Focus on Adenosine, Nitric Oxide and Mitochondrial KATP Channels. Yushan BAI, Muqier, Hiroya MURAKAMI, Masamitsu IWASA, Shohei SUMI, Yoshihisa YAMADA, Hiroaki USHIKOSHI, Takuma AOYAMA, Kazuhiko NISHIGAKI, Genzou TAKEMURA, Bunji UNO* and Shinya MINATOGUCHI The present study examined whether or not cilostazol reduces the myocardial infarct size, and investigated its mechanism in a rabbit model of myocardial infarction. Japanese white rabbits underwent 30 min of coronary occlusion, followed by 48 h of reperfusion. Cilostazol or vehicle was given intravenously 5 min before ischaemia. 8SPT, l-NAME or 5-HD was given intravenously 5 min before cilostazol injection. The findings in this study show that cilostazol reduces the myocardial infarct size by increasing adenosine and NOx levels. Cilostazol might provide a new strategy for the treatment of coronary heart disease. [J. Control. Release 149, 81-88 (2011)] [Lab. of Pharmaceutical Engineering] Mucoadhesive Nanoparticles for the Simultaneous Delivery of Macromolecules and Permeation Enhancers to the Intestinal Mucosa: In vitro and In vivo Evaluation. Abdallah MAKHLOF, Martin WERLE, Yuichi TOZUKA and Hirofumi TAKEUCHI* The feasibility of combining safe permeation enhancers in a mucoadhesive particulate system for the oral delivery of peptide drugs was investigated. Polyelectrolyte complex nanoparticles (NPs) were prepared by ionic interaction of spermine (SPM) with polyacrylic acid (PAA) polymer. The cellular transport of fluorescein isothiocyanate dextran (FD4) showed higher permeation enhancing profiles of SPM–PAA NPs, as compared to SPM solution or PAA NPs prepared by ionic gelation with MgCl2. Confocal microscopy images of rats' small intestine confirmed previous findings in Caco-2 cells and revealed a strong and prolonged penetration of FD4 from the mucosal to the basolateral side of the intestinal wall. [Eur. J. Pharm. Biopharm. 76, 238-244 (2010)] [Lab. of Pharmaceutical Engineering] In vitro and in vivo Evaluation of WGA-Carbopol Modified Liposomes as Carriers for Oral Peptide Delivery. Abdallah MAKHLOF, Martin WERLE, Yuichi TOZUKA and Hirofumi TAKEUCHI* Surface modification of liposomal nanocarriers with a novel polymer–lectin conjugate was proposed for enhancing the systemic uptake of encapsulated peptide and protein therapeutics after oral administration. Wheat germ agglutinin (WGA) was covalently attached to carbopol (CP) using the carbodiimide method. The uptake of WGA–CP liposomes by Caco-2 cells was significantly higher than that of non-modified or CP liposomes.The involvement of active transport mechanism for the cellular uptake of the modified liposomes, mediated mainly by binding of WGA to its specific cell membrane receptors. The pharmacological efficacy of calcitonin, a model peptide drug, was enhanced by more than 20- and 3-fold following peroral administration of calcitonin-loaded WGA–CP liposomes when compared to non-modified and CP liposomes, respectively. 40 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Eur. J. Pharm. Sci. 42, 445-451 (2011)] [Lab. of Pharmaceutical Engineering] A pH-Sensitive Chitosan Nanoparticulate System for the Peroral Delivery of Insulin. Abdallah MAKHLOF, Yuichi TOZUKA and Hirofumi TAKEUCHI* In the current study, chitosan nanoparticles (CS NPs) were formulated by ionic cross-linking with hydroxypropyl methylcellulose phthalate (HPMCP) as a pH-sensitive polymer and evaluated for the oral delivery of insulin. In vitro results revealed a superior acid stability of CS/HPMCP NPs with a significant control over insulin release and degradation in simulated acidic conditions with or without pepsin. After s.c. injection to rats, no significant difference in the hypoglycemic effect of insulin solution or insulin-loaded CS/HPMCP NPs was observed, confirming the physico-chemical stability and biological activity of the entrapped peptide. Following peroral administration, CS/HPMCP NPs increased the hypoglycemic effect of insulin by more than 9.8 and 2.8-folds as compared to oral insulin solution and insulin-loaded CS/tripolyphosphate (TPP) NPs, respectively. [Drug Delivery 18, 562–569 (2011)] [Lab. of Pharmaceutical Engineering] N-trimethyl Chitosan-Modified Liposomes as Carriers for Oral Delivery of Salmon Calcitonin. Aiwen HUANG, Abdallah MAKHLOF, Qineng PING, Yuichi TOZUKA and Hirofumi TAKEUCHI* The aim of this work was to investigate the role of N-trimethyl chitosan- (TMC-) coated liposomes in the oral administration of calcitonin. TMC-coated liposomes containing calcitonin were prepared and characterized as having a particle size of 262 nm, zeta potential of 35.8 mV and high entrapment efficiency (89.1%). The results in confocal laser microscopy showed that TMC-coated liposomes prolonged the residence time and increased the penetration effect of the liposomal system compared to non-coated liposomes. The study of pharmacological effects confirmed that TMC-coated liposomes increased the area above the blood calcium concentration-time curves (AAC) from 3.13 ± 20.50 to 448.84 ± 103.56 compared to the calcitonin solution. These results support the feasibility of TMC-coated liposomes as a new oral delivery system for peptide and protein drugs. [Asian. J. Pharm.Sci. 6, 101-108 (2011)] [Lab. of Pharmaceutical Engineering] Completely Dry Process for the Desired Release Profile of Poorly Water Insoluble Drugs by a Temperature-controllable Twin Screw Kneader. Yohei HOASHI, Yuichi TOZUKA and Hirofumi TAKEUCHI* Completely dry process was performed using a twin-screw kneader with hydrophilic porous silica in order to make solid dispersions of indomethacin, risperidone and fenofibrate at melting temperature of each drug. On the powder X-ray diffraction, nitrogen adsorption and differential scanning calorimetry analyses, indomethacin and risperidone in solid dispersion changed to an amorphous state to adsorb onto silica pores. However, crystalline form of fenofibrate in solid dispersion was maintained in spite of the adsorption of fenofibrate onto silica pores. A remarkable dissolution enhancement of the drugs from kneaded products was achieved by making the solid dispersion system with porous silica. Melt kneading process to make solid dispersion with porous silica was found to be an effective technology to enhance the dissolution rate. [Biol. Pharm. Bull. 34, 894-897 (2011)] [Lab. of Pharmaceutical Engineering] Fluorescence Investigation of the Retinal Delivery of Hydrophilic Compounds via Liposomal Eyedrops. Kohei HIRONAKA, Takuya FUJISAWA, Hitoshi SASAKI, Yuichi TOZUKA, Kazuhiro TSURUMA, Masamitsu SHIMAZAWA,Hideaki HARA and Hirofumi TAKEUCHI* We examined the feasibility of using submicron-sized liposomes (ssLips) for retinal delivery of hydrophilic compounds, which would also have a wide range of applications. To evaluate the uptake into conjunctival cell line and the intraocular behavior of hydrophilic compound-containing ssLips after eyedrop application, fluorometric investigation was carried out by using a hydrophilic fluorescence probe, 5(6)-carboxyfluorescein (CF). CF being entrapped within the liposomes markedly enhanced both the uptake of CF into conjunctival cells and CF-oriented emission in the retina in mice after eyedrop application. ssLips of appropriate composition were considered to have good potential to carry hydrophilic compounds into the retina. 41 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Eur. J. Pharm. Biopharm. 79, 119-125 (2011)] [Lab. of Pharmaceutical Engineering] Edaravone Loaded Liposome for Retinal Protection against Oxidative Stress-Induced Retinal Damage. Kohei HIRONAKA, Yuta INOKUCHI, Takuya FUJISAWA, Hiroki SHIMAZAKI, Mai AKANE, Yuichi TOZUKA, Kazuhiro TSURUMA, Masamitsu SHIMAZAWA, Hideaki HARA and Hirofumi TAKEUCHI* To optimize the retinal protective effects of submicron-sized liposomes (ssLips) containing edaravone for intravitreal administration, we investigated the effects of liposomal formulation on the pharmacological effects. Edaravone-loaded EPC-ssLip, by a calcium acetate gradient method, scavenged intracellular H2O2 radical more strongly than DSPC-ssLip. The edaravone-loaded EPC-ssLip significantly reduced NMDA-induced ganglion cell layer (GCL) cell death compared with free edaravone. These results may be related to the release profile of the edaravone from ssLips across the inner layers of the retina including GCL, indicating effective retinal protection of EPC-ssLip compared to that of DSPC-ssLip. [Int. J. Pharm. 410, 114-117 (2011)] [Lab. of Pharmaceutical Engineering] α-Glucosyl Hesperidin Induced Improvement in Bioavailability of Pranlukast Hemihydrate Using High-Pressure Homogenization. Hiromasa UCHIYAMA, Yuichi TOZUKA, Fusatoshi ASAMOTO and Hirofumi TAKEUCHI* The α-glucosyl hesperidin (Hsp-G)-induced improvement of both the dissolution and absorption properties of pranlukast hemihydrate (PLH) was achieved by means of a high-pressure homogenization (HPH) processing. The amount of dissolved PLH gradually increased with the pass number of HPH processing, and was extremely higher than the PLH solubility after the HPH processing. The amount of PLH that had permeated through the Caco-2 cell monolayers was improved in the case of HPH-processed PLH/Hsp-G (1/10). The bioavailability of PLH from HPH-processed PLH/Hsp-G (1/10) showed a 3.9- and 2.2-fold improvement over the PLH crystal in terms of Cmax and AUC values, respectively. High-pressure homogenization provides a good opportunity for molecular-level interaction of PLH and the associated structure of Hsp-G to occur. [Eur. J. Pharm. Sci. 43, 71-77 (2011)] [Lab. of Pharmaceutical Engineering] Fluorescence Investigation of a Specific Structure Formed by Aggregation of Transglycosylated Stevias: Solubilizing Effect of Poorly Water-Soluble Drugs. Hiromasa UCHIYAMA, Yuichi TOZUKA, Fusatoshi ASAMOTO and Hirofumi TAKEUCHI* We investigated the solubility-enhancing effect of Stevia-G towards hydrophobic materials by using fluorescence spectroscopy. The plot of the pyrene I1/I3 ratio versus the Stevia-G concentration showed a sigmoidal curve as a function of the Stevia-G concentration, suggesting the existence of a hydrophobic environment around pyrene molecules under high Stevia-G concentrations. The critical micelle concentration calculated from the pyrene I1/I3 plot was about 16 mg/mL. Based on results from the static quenching plots, the micellar aggregation number of Stevia-G was estimated as ca.15. Therefore, the hydrophobic steviol-skeleton of Stevia-G made a hydrophobic core around a hydrophobic molecule. This specific structure formed by Stevia-G molecules led to an enhancement of the apparent solubility of poorly water-soluble drugs. [Eur. J. Pharm. Biopharm. 79, 559-565 (2011)] [Lab. of Pharmaceutical Engineering] A Novel Application of α-Glucosyl Hesperidin for Nanoparticle Formation of Active Pharmaceutical Ingredient by Dry-Grinding. Yuichi TOZUKA, Masaaki IMONO, Hiromasa UCHIYAMA and Hirofumi TAKEUCHI* The effectiveness of α-glucosyl hesperidin (Hsp-G) as a novel grinding aid for the preparation of drug nanoparticles by dry grinding was investigated. Poorly water-soluble drugs and Hsp-G were mixed at a weight ratio of 1/5 and ground for 60 min by a vibrational ball mill. Administration of the ground mixture of glibenclamide/Hsp-G to rats resulted in a significantly higher rate of decrease in blood glucose levels than that of untreated glibenclamide. The area above the time-curve of plasmaglucose concentrations using the ground mixture of glibenclamide/Hsp-G was 6-fold higher than that using untreated glibenclamide. The improved dissolution rate due to nanoparticle formation of glibenclamide, induced by co-grinding with Hsp-G, was responsible for this improvement. 42 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [J. Pharm. Sci. 100, 4421-4431 (2011)] [Lab. of Pharmaceutical Engineering] NMR Investigation of a Novel Excipient, α-Glicosylhesperidin as a Suitable Solubilizing Agent for Poorly Water-Soluble Drugs. Junying ZHANG, Yuichi TOZUKA*, Hiromasa UCHIYAMA, Kenjirou HIGASHI, Kunikazu MORIBE, Hirofumi TAKEUCHI and Keiji YAMAMOTO α-Glucosylhesperidin (Hsp-G), a functional food additive, significantly enhances the solubility and bioavailability of poorly water-soluble drugs despite little surface activity. Herein, we present investigations into the underlying mechanism by nuclear magnetic resonance techniques. Dynamic light scattering and two-dimensional nuclear Overhauser effect spectroscopy measurements demonstrated that Hsp-G molecules self-associated into particular small micelles, with the flavanone skeleton forming a hydrophobic core, and surrounding sugar groups working as a shell. Solubility enhancement was due to the incorporation of drugs into Hsp-G micelle. Hsp-G micellization process with little loss of surface tension is a unique observation in surface and interface science. [Chem. Pharm. Bull. 59, 1299-1302 (2011)] [Lab. of Pharmaceutical Engineering] Molecular States of p-Dimethylaminobenzonitrile Coground with β-Cyclodextrin Investigated Using Solid-state Fluorescence Spectroscopy. Yutaka INOUE, Nana HASEGAWA, Yuichi TOZUKA*, Etsuo YONEMOCHI, Toshio OGUCHI, Kenjirou HIGASHI, Kunikazu MORIBE and Keiji YAMAMOTO Changes in molecular states of p-dimethylaminobenzonitrile (DMABN) coground with β-cyclodextrin (β-CD) were examined using solid-state fluorescence measurements. Solid-state fluorescence measurements revealed emission by DMABN crystals in a twisted intermolecular charge-transfer state at 473 nm. DMABN in the DMABN/β-CD coprecipitate had a fluorescence emission peak at 393 nm due to its planar structure. In contrast, DMABN in a DMABN/β-CD ground mixture had an emission peak at 473 nm due to its twisted structure. [Int. J. Pharm. 420, 191-197 (2011)] [Lab. of Pharmaceutical Engineering] Guest Molecular Size-Dependent Inclusion Complexation of Parabens with Cholic Acid. Kunikazu MORIBE, Miyuki MASAKI, Ryo KINOSHITA, Martin WERLE, Junying ZHANG, Waree LIMWIKRANT, Kenjirou HIGASHI, Yuichi TOZUKA*, Toshio OGUCHI and Keiji YAMAMOTO Effects of p-hydroxybenzoate (paraben) ester chain length on the stoichiometry and structure of grindinginduced inclusion complexes with cholic acid (CA) were investigated. Ethyl-, n-propyl-, and isopropyl-parabens formed equimolar inclusion complexes with CA, and the complex structures were of the β-trans bilayer type. In contrast, the stoichiometry of the CA-paraben complex was 2:1, and the structure was of the α-gauche bilayer type when isobutylparaben was used as a guest molecule. Although the stoichiometries and structures of the complexes differed, solid-state NMR showed that the molecular states of parabens in the complexes were similar and independent of the ester chain length. Mechanical forces and thermal activation by grinding were important factors in the mechanism of CA-paraben complex formation. [J. Photopolym. Sci. Thechnol. 24, 467–470 (2011)] [Lab. of Pharmaceutical Physical Chemistry] Immobilization of Proteins onto the Self-Assembled Phospholipid Layer Fabricated by Plasma-Assisted Method. Shin-ichi KONDO*, Yasushi SASAI, Yukinori YAMAUCHI and Masayuki KUZUYA In this paper, we studied the effect of the concentration of phosphatidyl choline (PC) suspension containing stearic acid (StA) on the thermal stability of self-assembled phospholipid layer. The thermal stability of the self-assembled phospholipid layer incorporating StA depended on the concentration of PC suspension. We immobilized three kinds of enzymes as model proteins on the self-assembled phospholipid layer incorporating StA. The maximum value of surface density of enzyme tended to be inversely proportional to the molecular weight. We also studied the activity of β-galactosidase (BG) immobilized onto the self-assembled phospholipid layer incorporating StA. The specific activity of BG immobilized was higher than that of BG directly immobilized on a polymer surface. It was suggested that the self-assembled phospholipid layer would act as a good bio-interface. 43 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [J. Photopolym. Sci. Thechnol. 24, 417–420 (2011)] [Lab. of Pharmaceutical Physical Chemistry] Fabrication of Scaffold for Cell Adhesion on Plasma-irradiated Polystyrene. Yasushi SASAI*, Yuko TANAKA, Shin-ichi KONDO, Yukinori YAMAUCHI and Masayuki KUZUYA In this study, to fabricate a versatile platform for the immobilization of bioactive molecules on chemically inert polystyrene (PS) substrate, vinylmethylether maleic acid copolymer (VEMAC) was immobilized on plasma-irradiated PS petri dish through a coupling reaction of hydroxyl group indroduced on PS substrate by Ar plasma-irradiation with carboxyl group of VEMAC. For cell culture application, cell adhesive peptide “GRGDS” was conjugated with VEMAC immobilized on PS. The results indicated that GRGDS peptide conjugated with VEMAC immobilized on plasma-irradiated PS was specifically recognized by cell surface of NIH3T3 and stimulated cell adhesion and proliferation. [J. Photopolym. Sci. Thechnol. 24, 475–478 (2011)] [Lab. of Pharmaceutical Physical Chemistry] Surface Functionalization of DLC Thin Films. Yukinori YAMAUCHI, Masayuki KUZUYA, Yasushi SASAI and Shin-ichi KONDO* The Diamond-like carbon (DLC) thin films have been widely used in a variety of industrial fields due to the attractive properties, such as high hardness, low friction coefficient, optical transparency, chemical inertness, and high electrical resistivity. In this study, we attempted to construct the high functional surface of DLC thin films for industrial and biological needs by plasma surface treatment. The graft polymerization underwent on the surface of DLC films by adding a monomer under an aerobic condition, so that the treated DLC films possessed highly-functionalized surface. It was suggested that the present procedure would be one of the fundamental methods to fabricate the advanced DLC film with long-acting functional surface. [Chem. Pharm. Bull. 59, 1200–1202 (2011)] [Lab. of Pharmaceutical Physical Chemistry] Characterization of Novel pH-Sensitive Polymeric Micelles Prepared by the Self-Assembly of Amphipilic Block Copolymer with Poly-4-vinylpyridine Block Synthesized by Mechanochemical Solid-State Polymerization. Shin-ichi KONDO*, Keitarou YAMAMOTO, Yuka SAWAMA, Yasushi SASAI, Yukinori YAMAUCHI and Masayuki KUZUYA We fabricated novel pH-sensitive polymeric micelles consisting of amphiphilic block copolymer containing pyridyl groups as side chains in the hydrophobic block. A decrease in pH resulted in deformation of the polymeric micelles over a very narrow pH range (between pH 5.7 and 5.6). Interestingly, micellization and demicellization occurred reversibly in this narrow pH range. Polymeric micelles incorporating 5-fluorouracil (5FU) were also prepared. Decreasing the pH of this polymeric micelle solution from 7 to 5.5 resulted in the rapid release of 5FU at pH 5.6; the drug was completely released within 30 min. [J. Phar. Nutri. Sci. 1, 124–129 (2011)] [Lab. of Pharmaceutical Physical Chemistry] Novel Synthesis of Macromonomers by Mechanochemical Reaction for Application to Polymeric Micelles. Shin-ichi KONDO*, Masashi TUKAMOTO, Yasushi SASAI, Yukinori YAMAUCHI and Masayuki KUZUYA We have presented the first example of the synthesis of macromonomers by mechanochemical reaction of polymethylmethacrylate (PMMA) and maleic anhydride (MA). The ESR spectrum of the fractured sample of PMMA and MA showed a broad singlet, which was apparently different from the spectrum of PMMA mechanoradical. We underwent the UV-labeling of the fractured samples of PMMA and MA to confirm the formation of macromonomers. The gel permeation chromatograms of UV-labeled compounds derived from this fractured sample showed a broad peak in a polymer region with refractive index detector and UV detector, which indicates that macromonomers bounding MA would be produced. This method seems to be applicable for a wide variety of polymers to synthesize macromonomers possessing MA. 44 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [J. Toxicol. Sci. 35, 209-215 (2011)] [Lab. of Hygienic Chemistry & Molecular Toxicology] Cadmium Toxicity is Caused by Accumulation of p53 through the Down-regulation of Ube2d Family Genes in vitro and in vivo. Maki TOKUMOTO, Yasuyuki FUJIWARA, Akinori SHIMADA, Tatsuya HASEGAWA, Yoshiyuki SEKO, Hisamitsu NAGASE* and Masahiko SATOH Cadmium (Cd) causes renal dysfunction with damage to kidney proximal tubule cells; however, the precise mechanisms of the toxicity remain unclear. To investigate the mechanisms of Cd-induced renal toxicity, we examined the effects of Cd on the ubiquitin-proteasome system, particularly the expression and function of Ube2d family members in the NRK-52E cells and mice. The results suggest that the Cd-induced accumulation of p53 may be due to inhibition of p53 degradation through the down-regulation of Ube2d family genes, and that Cd induces p53-dependent apoptosis in renal tubular cells. Moreover, Ube2d family members may be one of the critical targets of renal toxicity caused by Cd. [J. Toxicol. Sci. 35, 209-215 (2011)] [Lab. of Hygienic Chemistry & Molecular Toxicology] DNA Microarray Analysis of Normal Rat Kidney Epithelial Cells Treated with Cadmium. Maki TOKUMOTO, Tomoaki OHTSU, Akiko HONDA, Yasuyuki FUJIWARA, Hisamitsu NAGASE* and Masahiko SATOH In order to elucidate the transcriptional response of kidney epithelial cells to cadmium, the gene expression pattern was examined in normal rat kidney epithelial cells (NRK-52E cells) exposed to 50 µM cadmium for 4 hr using DNA microarray. Cadmium was found to increase the expression of 73 genes and decrease the expression of 42 genes in NRK-52E cells before the development of cytotoxicity. [Biomaterials 32, 4185-4193 (2011)] [Lab. of Hygienic Chemistry & Molecular Toxicology] Enhanced in vivo Gene Transfer into the Placenta Using RGD Fiber-mutant Adenovirus Vector. Kazufumi KATAYAMA, Rie FURUKI, Hideaki YOKOYAMA, Makoto KANEKO, Masashi TACHIBANA, Ichiro YOSHIDA, Hisamitsu NAGASE, Keiichi TANAKA, Fuminori SAKURAI, Hiroyuki MIZUGUCHI, Shinsaku NAKAGAWA and Tsuyoshi NAKANISHI* In the current study, as a part of a thorough evaluation of the fiber-mutant adenovirus vector carrying the Arg-Gly-Asp (RGD) peptide sequence (Ad-RGD) in preclinical studies, we designed an experiment to investigate in detail the distribution of Ad-RGD compared with conventional adenovirus vector (WT-Ad) in pregnant mice. As a result, Ad-RGD had substantial placental tropism, at 10–100 times that of WT-Ad. Ad-RGD showed high levels of transduction efficiency in in vitro-differentiated trophoblast stem cells, in which higher expression of αvβ3 integrin than in undifferentiated cells was observed. Our results suggest that the use of Ad-RGD or another RGD-mediated targeting strategy holds promise for drug delivery to the placenta. [J. Environ. Sci. 23, 125-132 (2011)] [Lab. of Hygienic Chemistry & Molecular Toxicology] Screening of Agonistic Activities against Four Nuclear Receptors in Wastewater Treatment Plants in Japan Using a Yeast Two-hybrid Assay. Daisuke INOUE, Koki NAKAMA, Kazuko SAWADA, Taro WATANABE, Hisae MATSUI, Kazunari SEI, Tsuyoshi NAKANISHI* and Michihiko IKE In the current study, we examined the agonistic activities on four NRs (estrogen receptor α, thyroid hormone receptor α, retinoic acid receptor α and retinoid X receptor α) of untreated and treated wastewater from municipal wastewater treatment plants (WWTPs) in Japan using a yeast two-hybrid assay. Investigation of the influent and effluent of seven WWTPs revealed that agonistic activities against NRs were always detected in the influents and partially remained in the effluents. These results indicate that municipal wastewater in Japan commonly contains endocrine disrupting chemicals that exert agonistic activities on NRs, and that some of these chemicals are released into the aquatic environment. Further study is required to assess their possible risks in detail. 45 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Biochim. Biophys. Acta. 1809, 56-62 (2011)] [Lab. of Hygienic Chemistry & Molecular Toxicology] The Zinc-sensing Transcription Factor MTF-1 Mediates Zinc-induced Epigenetic Changes in Chromatin of the Mouse Metallothionein-I Promoter. Fumika OKUMURA, Yong LI, Norio ITOH, Tsuyoshi NAKANISHI*, Masakazu ISOBE, Glen K. ANDREWS and Tomoki KIMURA Metallothionein (MT) is a cysteine-rich protein active in zinc homeostasis, cadmium detoxification, and so on. MT-I gene transcription is regulated by metal response element-binding transcription factor-1 (MTF-1), which is recruited to the promoter by zinc. In the current study, we examined alterations in the chromatin structure of the MT-I promoter associated with enhanced transcriptional activation. We demonstarated that rapid disruption of nucleosome structure at the MT-I promoter is mediated by zinc-responsive recruitment of an active MTF-1-coactivator complex. [J. Toxicol. Sci. 36, 173-180 (2011)] [Lab. of Hygienic Chemistry & Molecular Toxicology] Chromium (VI) Inhibits Mouse Metallothionein-I Gene Transcription by Modifying the Transcription Potential of the Co-activator p300. Tomoki KIMURA, Fumika OKUMURA, Akira ONODERA, Tsuyoshi NAKANISHI*, Norio ITOH and Masakazu ISOBE The production of metallothioneins (MTs), is induced by heavy metals such as Zn and Cd. MTs maintain Zn homeostasis and attenuate heavy metal-induced cytotoxicity by sequestering these metals and lowering their intracellular concentrations. In the current study, we have shown that the inhibition by Cr(VI) was partially overcome by the overexpression of p300 or MTF-1 in an MT-I promoter-driven luciferase reporter assay system and have determined MT-I mRNA levels. Our results suggest that the inhibitory effects of Cr(VI) on MT-I transcription may be due to its effects on the histone acetyltransferase (HAT)-independent transactivation ability rather than the HAT-dependent, histone deacetylase release-related transactivation ability of p300. [Biomed. Res. 32, 1-7 (2011)] [Lab. of Molecular Biology] Caffeic Acid Phenethyl Ester Reduces Spinal Cord Injury-evoked Locomotor Dysfunction. Masaki KASAI, Hidefumi FUKUMITSU, Hitomi SOUMIYA and Shoei FURUKAWA* Caffeic acid phenethyl ester (CAPE) is a component of propolis, which is a substance taken from the hives of honeybees, and is known to exhibit an anti-inflammatory activity. In the present study, we evaluated the effect of CAPE on functional locomotor recovery after spinal cord injury (SCI) caused by hemi-transection, because inflammatory responses are a major cause of the secondary injury observed following SCI and play a pivotal role in regulating the pathogenesis of acute and chronic SCI. When CAPE was i.p.-administered at a dosage of 10 µmol/kg, it enhanced the recovery of locomotor function and reduced the lesion size while suppressing the expression of the mRNAs for a pro-inflammatory cytokine interleukin-1β and the inflammatory enzymes, inducible nitric oxide synthase and cyclooxygenase-2. These results suggest CAPE to be a promising therapeutic tool for reducing the secondary neuronal damage following primary physical injury to the spinal cord. [J.Neurosci.Res. 89, 1342-1350 (2011)] [Lab. of Molecular Biology] Prenatal Immune Challenge Compromises Development of Upper-Layer but not Deeper-Layer Neurons of the Mouse Cerebral Cortex. Hitomi SOUMIYA, Hidefumi FUKUMITSU* and Shoei FURUKAWA Maternal infection during pregnancy is an environmental risk factor for the offspring to develop severe brain disorders, including schizophrenia. However, little is known about the neurodevelopmental mechanisms underlying the association between prenatal exposure to infection and emergence of cognitive dysfunctions later in life. By injecting the viral mimetic polyriboinosinic-polyribocytidylic acid (Poly I:C) into mice, we investigated the influence of maternal immune challenge (MIC) during pregnancy on the development of the cerebral cortex. Without affecting the cell number or density of the cortical neurons, MIC significantly compromised gene-expression profiles and synaptic development in the upper- but not in deeper-layer neurons. These abnormalities in the upper-layer neurons may underlie the development of psychiatric brain emerging after MIC. 46 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [J. Neurosci. Res. 89, 1575-1585 (2011)] [Lab. of Molecular Biology] Prenatal Immune Challenge Compromises the Normal Course of Neurogenesis during Development of the Mouse Cerebral Cortex. Hitomi SOUMIYA, Hidefumi FUKUMITSU* and Shoei FURUKAWA Our previous study showed that MIC compromised the expression properties and the synaptogenesis of cortical upper-layer neurons. The objective of the current study was to examine further whether MIC has an influence on the cellular-biological features of the cortical progenitors that generate distinct cortical neuronal subtypes. We found the following abnormalities in the cortex of mice given the prenatal Poly I:C injection during later stages of cortical neurogenesis. First, proliferative activity and the expression of Pax6, a master regulatory gene for cortical progenitors, were significantly decreased in the cortical progenitors. Second, the laminar allocation and gene expression were significantly altered in the daughter neurons generated at the same birth dates. These results demonstrate that specific abnormalities in the cortical progenitors preceded deficits in neuronal phenotypes after MIC. [Toxicol. Appl. Pharmacol.257, 385-395 (2011)] [Lab. of Molecular Biology] A Superoxide Anion-scavenger, 1,3-Selenazolidin-4-one Suppresses Serum Deprivation-induced Apoptosis in PC12 Cells by Activating MAP Kinase. Atsuyoshi NISHINA, Hirokazu KIMURA, Kunihisa KOZAWA, Geoffroy SOMMEN, Takao NAKAMURA, Heinz HEIMGARTNER, Mamoru KOKETSU and Shoei FURUKAWA* Synthetic organic selenium compounds, such as ebselen, may show glutathione peroxidase-like antioxidant activity and have a neurotrophic effect. We synthesized 1,3-selenazolidin-4-ones, new synthetic organic selenium compounds to study their possible applications as antioxidants or neurotrophic-like molecules. 2-[3-(4-Methoxyphenyl)-4-oxo-1,3-selenazolidin-2-ylidene] malononitrile (compound b) showed the strongest superoxide anion-scavenging activity among the 6 of 2-methylene-1,3selenazolidin-4-ones examined. The compound b induced the phosphorylation of MAP kinase in PC12 cells; the activity was equivanlent to NGF, indicated that the compound b suppressed serum deprivation-induced apoptosis via activation of MAP kinase. [Int. J. Toxico. 30, 690-699 (2011)] [Lab. of Molecular Biology] 3-(2,6-Dimethylphenyl)-2-selenoxo-1,3-thiazolidin-4-one Suppresses Hydrogen Peroxide-Induced Cytotoxicity on PC12 Cells via Activation of MAPK. Atsuyoshi NISHINA, Hirokazu KIMURA, Kunihisa KOZAWA, Geoffroy SOMMEN, Francesco FAVERO, Heinz HEIMGARTNER,, Mamoru KOKETSU and Shoei FURUKAWA* We newly synthesized organic selenium compounds (5-membered ring compounds) including 2-selenoxo-1,3-thiazolidin4-ones (compounds A) and 3-alkoxy-4,5-dihydro-5-selenoxo-1H-1,2,4-triazole-1-carboxylates (compounds B). The O(2) (-)-scavenging activities were markedly different among compounds; 3-(2,6-Dimethylphenyl)-2-selenoxo-1,3- thiazolidin-4-one (compound Aa) exhibited the strongest activity. Compound Aa activated ERK1/2 of the PC12 cell, as did ebselen, and suppressed hydrogen peroxide-induced cytotoxicity more potently than ebselen. In addition, the toxicity of compound Aa was less than that of ebselen. These results indicate that compound Aa is a candidate drug to prevent oxidative stress-induced cell death. [J. Cell. Biochem. 112, 244-255 (2011)] [Lab. of Clinical Pharmaceutics] Extracellular-Superoxide Dismutase Expression during Monocytic Differentiation of U937 Cells. Tetsuro KAMIYA*, Junya MAKINO, Hirokazu HARA, Naoki INAGAKI and Tetsuo ADACHI We observed the reduction of extracellular-superoxide dismutase (EC-SOD) and Cu,Zn-SOD during the differentiation of U937 cells induced by 12-O-tetradecanoylphorbol acetate (TPA). The reduction of EC-SOD and Cu,Zn-SOD was attenuated by pretreatments with GF109203X (an inhibitor of protein kinase C (PKC)), diphenyleneiodonium (an inhibitor of NADPH oxidase (NOX)) and U0126 (an inhibitor of mitogen-activated protein kinase kinase (MEK)/extracellular-signal regulated kinase (ERK)). We also determined the involvement of newly synthesized protein and the instability of mRNA in the reduction of EC-SOD. Overall, our results suggest that the expression of EC-SOD is decreased by TPA through intracellular signaling consisting of PKC, NOX-derived reactive oxygen species and MEK/ERK. 47 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Neurochem. Int. 58, 35-43 (2011)] [Lab. of Clinical Pharmaceutics] Endoplasmic Reticulum Stress Inducers Provide Protection against 6-Hydroxydopamine-Induced Cytotoxicity. Hirokazu HARA*, Tetsuro KAMIYA and Tetsuo ADACHI In this study, we investigated whether ER stress exerts preconditioning effects on 6-OHDA-induced cytotoxicity in SH-SY5Y cells. Pretreatment with ER stress inducers protected against the cytotoxicity. We also found that thapsigargin (Tg) induced the expression of the antioxidant gene HO-1. Flow cytometric analysis revealed that reactive oxygen species generated by 6-OHDA were suppressed in cells pretreated with Tg. Moreover, the specific eIF2α phosphatase inhibitor salubrinal augmented Tg-induced HO-1 expression. The reporter assay revealed that Tg stimulated the antioxidant response element (ARE) that is located in regulatory regions of antioxidant genes. Taken together, our data suggest that preconditioning effects induced by Tg mediate an adaptive response to 6-OHDA-induced cytotoxicity via phosphorylation of eIF2α and activation of the ARE. [Jpn. J. Pharm. Health Care Sci. 37, 179-186 (2011)] [Lab. of Clinical Pharmaceutics] A Scheme for the Safety Management of Cancer Chemotherapy –Effective Use of Aseptic Preparation Records of Anticancer Agents Attached with Pharmaceutical Management Information–. Tomokazu FUJII, Kenichi NOMURA, Naoki SAWAYANAGI, Haruhiko NAKAMURA, Sadatoshi IWASE, Tetsuo ADACHI* and Tsuneyuki KAMIYA Pharmacists are expected to play an important role in the safety management of cancer chemotherapy by checking prescriptions. We prepared aseptic preparation records with pharmaceutical management information (PMI) using the comment function of Microsoft Office Excel to facilitate quick referencing concerning items needed for prescription checking for patients undergoing cancer chemotherapy. The active use of the PMI with these records allowed inquiries to be made earlier and more precisely, facilitating important changes in prescriptions such as dose reductions and regimen changes, and helping prevent any discomfort or inconvenience to patients. [Free Radic. Res. 45, 692-698 (2011)] [Lab. of Clinical Pharmaceutics] ER Stress Inducer, Thapsigargin, Decreases Extracellular-Superoxide Dismutase through MEK/ERK Signaling Cascades in COS7 Cells. Tetsuro KAMIYA*, Aya OBARA, Hirokazu HARA, Naoki INAGAKI and Tetsuo ADACHI We demonstrated that thapsigargin, an endoplasmic reticulum (ER) stress inducer, decreased extracellular-superoxide dismutase (EC-SOD) expression, whereas the expression of Cu,Zn-SOD and Mn-SOD was not changed. On the other hand, another ER stress inducer, tunicamycin, did not affect the expression of EC-SOD. Further, we showed that thapsigargin has the ability to activate extracellular-signal regulated kinase (ERK), but tunicamycin does not. Moreover, pretreatment with U0126, an inhibitor of mitogen-activated protein kinase kinase (MEK)/ERK, suppressed thapsigargin-triggered EC-SOD reduction, suggesting that MEK/ERK signaling should play an important role in the regulation of EC-SOD in COS7 cells under ER stress conditions. [Biol. Pharm. Bull. 34, 1297-1300 (2011)] [Lab. of Clinical Pharmaceutics] Effect of Hypoxia Mimetic Cobalt Chloride on the Expression of Extracellular-Superoxide Dismutase in Retinal Pericytes. Tetsuo ADACHI*, Kazunari AIDA, Hiroko NISHIHARA, Tetsuro KAMIYA and Hirokazu HARA The initial clinical stage of diabetic retinopathy (DR) is characterized by the development of intraretinal microvascular abnormalities. The increased formation of reactive oxygen species (ROS) is thought to be a key event in the pathogenesis of DR. Treatment with cobalt chloride (CoCl2) decreased the expression of extracellular-superoxide dismutase (EC-SOD) but not other SOD isozymes in pericytes accompanied with an increase of intracellular ROS production. We observed the activation of caspase-3 and DNA fragmentation as signs of apoptotic process by CoCl2 treatment. The decrease in EC-SOD expression accompanied with elevation of ROS level in pericytes under hypoxia might induce and/or promote the ROS-triggered apoptosis of pericytes and the development of pathogenesis in DR. 48 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Free Radic. Res. 45, 1083–1092 (2011)] [Lab. of Clinical Pharmaceutics] Endoplasmic Reticulum Stress Induces Retinal Endothelial Permeability of Extracellular-Superoxide Dismutase. Tetsuo ADACHI*, Hiroyuki YASUDA, Shinsuke NAKAMURA, Tetsuro KAMIYA, Hirokazu HARA, Hideaki HARA and Tsunehiko IKEDA The aim of this study was to determine the reasons why the intravitreal level of extracellular-superoxide dismutase (EC-SOD) increases in proliferative diabetic retinopathy patients by the investigation of two possibilities: firstly, change of EC-SOD expression in retina; secondly, leakage of EC-SOD through endothelial monolayer by the treatment with endoplasmic reticulum (ER) stress inducers because ER stress is known to be involved in the vascular impairment in diabetic retinopathy. Our observations suggest that ER stress leads to the down-regulation of claudin-5 among tight junction proteins and may induce the elevation of endothelial permeability and leakage of EC-SOD into vitreous body. [Biol. Pharm. Bull. 34, 1443-1447 (2011)] [Lab. of Clinical Pharmaceutics] Extracellular-Superoxide Dismutase Expression in COS7 Cells Exposed to Cadmium Chloride. Aya OBARA, Tetsuro KAMIYA*, Misato IZUMI, Hirokazu HARA, Harutaka YAMADA and Tetsuo ADACHI In this study, exposure to cadmium chloride (CdCl2) enhanced intracellular reactive oxygen species (ROS) generation and induced COS7 cell death. Moreover, exposure to CdCl2 decreased the expression of extracellular-superoxide dismutase (EC-SOD) at mRNA and protein levels, but not of other SOD isozymes, Cu,Zn-SOD and Mn-SOD. The reduction of EC-SOD and cell viability was partially attenuated by pretreatment with an antioxidant, N-acetylcysteine. Further, we determined the involvement of p38-mitogen-activated protein kinase (p38-MAPK) in the reduction of EC-SOD. From these observations, p38-MAPK signaling cascades activated by ROS play a pivotal role in the reduction of EC-SOD, and it is concluded that the reduction of EC-SOD leads to a decrease in the resistance to oxidative stress of CdCl2-exposed COS7 cells. [Bioorg. Med. Chem. 19, 5559-5568 (2011)] [Lab. of Clinical Pharmaceutics] Inhibitory Effects of Chalcone Glycosides Isolated from Brassica Rapa L. 'Hidabeni' and Their Synthetic Derivatives on LPS-Induced NO Production in Microglia. Hirokazu HARA*, Yoko NAKAMURA, Masayuki NINOMIYA, Ryosuke MOCHIZUKI, Tetsuro KAMIYA, Elias AIZENMAN, Mamoru KOKETSU and Tetsuo ADACHI In this study, we examined the effects of chalcone glycosides isolated from Brassica rapa L. ‘hidabeni’ on lipopolysaccharide (LPS)-induced NO production using rat immortalized microglia HAPI cells. Compound A2 inhibited LPS-induced inducible NO synthase (iNOS) expression and NO production. However, A2 did not affect nuclear factor-κB and mitogen-activated protein kinase pathways. A2 suppressed LPS-induced phosphorylation and nuclear translocation of STAT1. These results indicate that the inhibitory effect of A2 is due to the prevention of STAT signaling. [Immunol. Lett. 135, 144-150 (2011)] [Lab. of Clinical Pharmaceutics] Allograft Inflammatory Factor-1 is Overexpressed and Induces Fibroblast Chemotaxis in the Skin of Sclerodermatous GVHD in a Murine Model. Aihiro YAMAMOTO, Eishi ASHIHARA, Yoko NAKAGAWA, Hiroshi OBAYASHI, Mitsuhiro OHTA, Hirokazu HARA*, Tetsuo ADACHI, Takahiro SENO, Masatoshi KADOYA, Masahide HAMAGUCHI, Hidetaka ISHINO, Masataka KOHNO, Taira MAEKAWA and Yutaka KAWAHITO Allograft inflammatory factor (AIF)-1 is thought to be involved in the immune response. We demonstrated that immunoreactive AIF-1 and IL-6 were significantly expressed in infiltrating mononuclear cells and fibroblasts in thickened skin of Scl GVHD mice. Wound healing assay revealed that rAIF-1 increased the migration of normal human dermal fibroblasts directly, but cell growth assay did not show that rAIF-1 increased the proliferation of them. These findings suggest that AIF-1, which can induce the migration of fibroblasts and the production of IL-6 in affected skin tissues, is an important molecule promoting fibrosis in GVHD. 49 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Hypertens. Res. 34, 686-692 (2011)] [Lab. of Clinical Pharmaceutics] Olmesartan Improves Endothelial Function in Hypertensive Patients: Link with Extracellular Superoxide Dismutase. Shunichi TAKIGUCHI, Makoto AYAORI, Harumi UTO-KONDO, Maki IIZUKA, Makoto SASAKI, Tomohiro KOMATSU, Bonpei TAKASE, Tetsuo ADACHI*, Fumitaka OHSUZU and Katsunori IKEWAKI Endothelial dysfunction in essential hypertension is an independent predictor for future cardiovascular events. We therefore performed a prospective, randomized crossover trial in which an angiotensin II type 1 receptor antagonist, olmesartan and calcium channel blocker, amlodipine, were compared in 31 essential hypertensive patients. Results showed that olmesartan, but not amlodipine, significantly improved endothelial function as evaluated by flow-mediated vasodilation (FMD) in the brachial artery. Finally, although overall changes in plasma extracellular superoxide dismutase (EC-SOD) levels were not modulated by either treatment, for olmesartan there was a positive correlation between changes in FMD and those in EC-SOD levels. [Seitaishiryobunseki 34, 151–158 (2011)] [Lab. of Clinical Pharmaceutics] Pathologic Background to Apo E- and TG-rich Lipoproteins Revealed by Discrimination via Linear Regression. Naoko IKOSHI, Akira TANAKA, Yojiro MAEHATA, Masaichi-Chang-il LEE, Eisuke MAEHATA, Matsuo TANIYAMA, Takahiro IMAZATO, Kazunari MATSUMOTO, Noriko ISHIDA, Tsuyoshi NAKAMURA, Hiroji SHIMOMURA, Teruo SHIBA, Naoya KISHIKAWA, Naotada KURODA, Minoru INOUE, Ikukatsu SUZUKI and Tetsuo ADACHI* We analyzed the clinical data for Apo E and triglyceride (TG) using discrimination via linear regression. The individuals above the regression line had significantly higher Apo E and TG levels. Apo E significantly correlated with increases in insulin resistance (HOMA-R) and serum amyloid A (SAA) and decrease in HDL-C and adiponectin. The results suggest that an Apo E- and TG-rich status may constitute a risk of atherosclerosis in metabolic syndrome (MS) and impaired glucose tolerance (IGT). [Redox Rep. 15, 131-137 (2010)] [Lab. of Clinical Pharmaceutics] The Effect of Hypoxia Mimetic Cobalt Chloride on the Expression of EC-SOD in 3T3-L1 Adipocytes. Tetsuro KAMIYA*, Hirokazu HARA, Naoki INAGAKI and Tetsuo ADACHI It is well known that hypoxic adipocytes are in an increased oxidative stress. Extracellular-superoxide dismutase (EC-SOD) is an anti-inflammatory enzyme that protects cells from reactive oxygen species (ROS). Previous reports showed that plasma EC-SOD levels in type 2 diabetes patients were significantly and inversely related to the body mass index, homeostasis model assessment-insulin resistance index; however, the mechanisms of EC-SOD and adiponectin reductions during hypoxia remain poorly understood. Here, we demonstrate that cobalt chloride (CoCl2) decreases EC-SOD and adiponectin in 3T3-L1 adipocytes by intracellular ROS-independent, but tumor necrosis factor-α (TNF-α) and c-jun N-terminal kinase-dependent mechanisms. From these results, it is possible that TNF-α is a key regulator of the reduction of EC-SOD and adiponectin in CoCl2-treated 3T3-L1 adipocytes, and we speculated that the reduction of EC-SOD and adiponectin would lead to and/or promote metabolic disorders. [Redox Rep. 15, 250-258 (2010)] [Lab. of Clinical Pharmaceutics] Regulation of Extracellular-superoxide Dismutase in Rat Retina Pericytes. Tetsuo ADACHI*, Hiroyuki YASUDA, Kazunari AIDA, Tetsuro KAMIYA, Hirokazu HARA, Ken-ichi HOSOYA, Tetsuya TERASAKI and Tsunehiko IKEDA Diabetic retinopathy (DR) is regarded as a disease of the retinal microvascular system and metabolic abnormalities that are characteristic of oxidative stress and endoplasmic reticulum (ER) stress have been identified in the retina. Treatment with own conditioned medium significantly decreased EC-SOD expression in pericytes, while the expression of VEGF and TNF-α were elevated. Moreover, the cell viability of pericytes changed in a manner similar to that of EC-SOD expression. Continuous flow of culture media neutralized the ER-stress triggered decrease of EC-SOD expression. The stagnation of factors related to ER-stress around pericytes might reduce EC-SOD expression under pathophysiological conditions such as retinal edema, and this could induce and/or promote the intraretinal microvascular impairment and development of athogenesis in DR. 50 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [J. Jpn. Soc. Hosp. Pharm. 46, 1377-1380 (2010)] [Lab. of Clinical Pharmaceutics] Pharmacists' Efforts to Evaluate Safety Management of Cancer Chemotherapy. Tomokazu FUJII, Kenichi NOMURA, Naoki SAWAYANAGI, Haruhiko NAKAMURA, Sadatoshi IWASE, Tetsuo ADACHI* and Tsuneyuki KAMIYA At Kouseiren Atsumi Hospital, pharmacists’ sphere of activity was stepwise widened. Pharmacists manage regimens for cancer chemotherapy and perform the aseptic preparation of all anticancer agents at present. In this study, we found the percentage of inquiries and prescription changes were increased and the number of incident was decreased with expansion of pharmacists’ sphere of activity. In addition inquiries about the results of blood tests on the day of administration and about the premedication based on individualized information about each patient were increased. Furthermore, the number of incident concerning preparation and administration were decreased. From these results, it is suggested that our approach contributed to safety management of cancer chemotherapy. [Endocr J. 57, 423-430 (2010)] [Lab. of Clinical Pharmaceutics] Effect of Pioglitazone on Various Parameters of Insulin Resistance Including Lipoprotein Subclass according to Particle Size by a Gel-permeation High-performance Liquid Chromatography in Newly Diagnosed Patients with Type 2 Diabetes. Koji NAKANO, Goji HASEGAWA, Michiaki FUKUI, Masahiro YAMASAKI, Kiyoshi ISHIHARA, Tooru TAKASHIMA, Yoshihiro KITAGAWA, Aya FUJINAMI, Mitsuhiro OHTA, Hirokazu HARA, Tetsuo ADACHI*, Masakazu OGATA, Hiroshi OBAYASHI and Naoto NAKAMURA Pioglitazone, an insulin-sensitizing agent has been reported to have anti-arteriosclerotic effects. The aim of this study was to obtain a better understanding of the mechanism involved in the insulin sensitizing effect of pioglitazone. The results in this study suggest that the hypoglycemic effect of pioglitazone is achieved mainly through improvement of hepatic insulin resistance, and that pioglitazone may have an antiatherosclerotic effect by decreasing serum atherogenic modified-LDL and by increasing adiponectin. [Arch. Biochem. Biophys.515, 80-88 (2011)] [Lab. of Pharmaceutics] AMP-Activated Protein Kinase Modulates the Gene Expression of Aquqporin 9 via Forkhead Box a2. Yuichi YOKOYAMA, Kazuhiro IGUCHI, Shigeyuki USUI and Kazuyuki HIRANO* We investigated the transcriptional regulation of the AQP9 gene by AMP-activated protein kinase (AMPK). An AMPK activator, AICAR, was observed to suppress the expression of the AQP9 gene in HepG2 cells by promoting the phosphorylation of AMPK and AKT/PKB. Forkhead box a2 (Foxa2) was speculated to be one of the transcriptional regulators of AQP9 gene expression repressed by AICAR from the results of a reporter gene assay and knock-down of the Foxa2 gene by a specific siRNA. AICAR was determined to induce the phosphorylation and nuclear exclusion of Foxa2. Leptomycin B prevented nuclear export of Foxa2 triggered by AICAR. These results suggest that the activated AMPK by AICAR causes suppression of the gene expression of AQP9 through transcriptional regulation by Foxa2. [Tumour Biol. 32, 1097–1102 (2011)] [Lab. of Pharmaceutics] Androgen Receptor W741C and T877A Mutations in AIDL cells, an Androgen-independent Subline of Prostate Cancer LNCaP cells. Takashi OTSUKA, Kazuhiro IGUCHI, Kazuhiro FUKAMI, Kenichiro ISHII, Shigeyuki USUI, Yoshiki SUGIMURA and Kazuyuki HIRANO* The androgen-independent LNCaP (AIDL) cell line was generated by maintaining prostate cancer LNCaP cells in a hormone-deprived medium. The aim of this study was to clarify the mechanisms underlying androgen sensitivity in AIDL cells. AR protein levels were induced by R1881 and DHT in LNCaP cells, but not in AIDL cells. AIDL cells harbored a missense substitution (TGG → TGT) in the AR gene, which caused a point mutation at codon 741 (W741C). Double T877A and W741C AR mutants have been previously reported to exhibit reduced androgen sensitivity. Hence, the low-androgen-sensitive responses of AIDL cells may be explained, at least in part, by AR gene mutations. 51 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [J. Androl. 32, 144–150 (2011)] [Lab. of Pharmaceutics] Castration- and Aging-induced Changes in the Expression of Zinc Transporter and Metallothionein in Rat Prostate. Kazuhiro IGUCHI, Naoaki MORIHARA, Shigeyuki USUI, Minoru HAYAMA, Yoshiki SUGIMURA and Kazuyuki HIRANO* To clarify the mechanisms underlying zinc homeostasis in prostate, we examined zinc content and the expression of zinc transporters and metallothioneins in the prostates of aged or castrated rats. The expression of the zinc transporter Slc30a2 (Znt2) in ventral prostate (VP) of aged rats (21 months) was approximately 21-fold higher than that in VP of young rats (4 months), and zinc levels in VP of young rats increased significantly compared with that in aged rats. Decreased metallothionein-3 (Mt3) expression was observed in LP of castrated rats, and this reduction was prevented by testosterone replacement. Zinc content and Mt3 expression levels correlated significantly in rat LP. Our findings suggest that Mt3 could play a critical role in zinc homeostasis in rat LP. [J Neurol Sci. 303, 95-99 (2011)] [Lab. of Medical Therapeutics & Molecular Therapeutics] Patterns of levels of biological metals in CSF differ among neurodegenerative diseases. Isao HOZUMI* , Tatsuya HASEGAWA , Akiko HONDA , Kazuhiro OZAWA , Yuichi HAYASHI , Kazunori HASHIMOTO , Megumi YAMADA , Akihiro KOUMURA , Takeo SAKURAI , Akio KIMURA , Yuji TANAKA , Masahiko SATOH and Takashi INUZUKA We measured the levels of some biological metalsin the cerebrospinal fluid (CSF) in patients with neurodegenerative diseases (52 patients with amyotrophic lateral sclerosis (ALS)), 21 patients with Alzheimer's disease (AD), and 20 patients with Parkinson's disease (PD) by inductively coupled plasma mass spectrometry (ICP-MS). In ALS, the levels of Mg (p<0.01 significant difference), Fe, Cu (p<0.05), and Zn (p<0.10) in CSF were higher than those in controls. In AD, the levels of Cu and Zn in CSF were significantly higher in patients with late-onset AD (p<0.01). In PD, we found significantly increased levels of especially Cu and Zn in particular (p<0.01) and Mn (p<0.05) in CSF. These findings suggest that Cu and Zn in particular play important roles in the onset and/or progression of ALS, AD, and PD. [Intern Med. 50, 2021-2024 (2011)] [Lab. of Medical Therapeutics & Molecular Therapeutics] Diffuse skeletal muscles uptake of [(18)f] fuluorodeoxyglucose on positron emission tomography in primary muscle peripheral T-cell lymphoma. Yuji TANAKA , Yuichi HAYASHI , Junichi KATO , Megumi YAMADA , Akihiro KOUMURA , Takeo SAKURAI , Akio KIMURA , Isao HOZUMI* , Yuichiro HATANO , Yoshinobu HIROSE , Tsuyoshi TAKAMI , Hiroshi NAKAMURA , Senji KASAHARA , Hisashi TSURUMI , Hisataka MORIWAKI and Takashi INUZUKA A 40-year-old man presented with weakness of neck extensor muscles. Primary skeletal muscle non-Hodgkin's lymphoma of T-cell immunophenotype is extremely rare and fluorodeoxyglucose-positron emission tomography demonstrated striking fluorodeoxyglucose uptake in multiple skeletal muscles and served as a quite useful modality for the diagnosis of this patient. [J Neurol. 258, 421-426 (2011)] [Lab. of Medical Therapeutics & Molecular Therapeutics] Is there a delayed gastric emptying of patients with early-stage, untreated Parkinson's disease? : An analysis using the 13C-acetate breath test. Yuji TANAKA , Tomohiro KATO, Hiroshi NISHIDA , Megumi YAMADA , Akio KIMURA , Takeo SAKURAI , Yuichi HAYASHI , Akihiro KOUMURA , Isao HOZUMI* , Hiroshi ARAKI , Masahiko MURASE, Masahito NAGAKI , Hisataka MORIWAKI and Takashi INUZUKA During the pre-symptomatic stage of Parkinson's disease (PD), the idiopathic PD related abnormal synuclein immunostaining is confined to the medulla oblongata and olfactory bulb, according to Braak. Delayed gastric emptying may be one of markers of the pre-clinical stage of PD. 52 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [J Neuroimmunol. 233, 175-180 (2011)] [Lab. of Medical Therapeutics & Molecular Therapeutics] Identification of antibodies as biological markers in serum from multiple sclerosis patients by immunoproteomic approach. Takeo SAKURAI , Akio KIMURA , Megumi YAMADA , Akihiro KOUMURA , Yuichi HAYASHI ,Yuji TANAKA , Isao HOZUMI* and Takashi INUZUKA We identified the antibody against mitochondrial heat shock protein 70 (mtHSP70) in serum from multiple sclerosis (MS) patients by proteomics-based analysis. Results of our study suggest that not only the anti-PGAM1 antibody but also the anti-mtHSP70 antibody is good diagnostic markers of MS and the combination of both these antibodies is useful for a more specific diagnosis of MS. [J Pharmacol Exp Ther. 338, 337-344 (2011)] [Lab. of Medical Therapeutics & Molecular Therapeutics] Fasudil and ozagrel in combination show neuroprotective effects on cerebral infarction after murine middle cerebral artery occlusion. Akihiro KOUMURA , Junya HAMANAKA , Kazuhiro TSURUMA , Masamitsu SHIMAZAWA , Isao HOZUMI* , Takashi INUZUKA and Hideaki HARA Rho kinase (ROCK), one of the serine/threonine kinases, is involved in pathologic conditions, and its activation causes neuronal cell death. The findings indicate that the combination treatment of fasudil and ozagrel may be useful as a potential therapeutic strategy for the treatment of stroke. [Neuroscience .189, 293-298 (2011)] [Lab. of Medical Therapeutics & Molecular Therapeutics] Metallothionein-III prevents neuronal death and prolong life span in amyotrophic lateral sclerosis model mice. Kazunori HASHIMOTO , Yuichi HAYASHI , Kazuhiko WATABE , Takashi INUZUKA and Isao HOZUMI* We explored the expression and effects of MT-III on the motor neurons of spinal cords of ALS model mice (G93A Cu/Zn superoxide dismutase (SOD-1) mutant-transgenic (Tg) mice) using a retrograde viral delivery system. Once-weekly injection of the adenovirus encoding LacZ or MT-III gene was started at the age of 20 weeks, which was the mean age of ALS onset. Gene expression was detected in the motor neurons of the lumbar spinal cord. The mean life spans were 163.20±7.72 days, 159.50±3.27 days, and 178.14±12.97 days in the untreated group, LacZ group, and MT-III group, respectively. We demonstrated that MT-III prevents the loss of motor neurons of ALS model mice and prolongs the life span, even when the administration is started at the time of onset. [J. Virol. 85, 4606-4611 (2011)] [Lab. of Microbiology] A Tryptophan-rich Motif in the Human Parainfluenza Virus Type 2 V Protein is Critical for the Blockade of Toll-like Receptor 7 (TLR7)- and TLR9-dependent Signaling. Yoshinori KITAGAWA, Mayu YAMAGUCHI, Min ZHOU, Takayuki KOMATSU, Machiko NISHIO, Tsuyoshi SUGIYAMA*, Kenji TAKEUCHI, Masae ITOH and Bin GOTOH Plasmacytoid dendritic cells (pDCs) do not produce alpha interferon (IFN-α) unless viruses cause a systemic infection or overcome the first-line defense provided by conventional DCs and macrophages. We show here that even paramyxoviruses, whose infections are restricted to the respiratory tract, have a V protein able to prevent Toll-like receptor 7 (TLR7)- and TLR9-dependent IFN-α induction specific to pDCs. Mutational analysis of human parainfluenza virus type 2 demonstrates that the second Trp residue of the Trp-rich motif (Trp-X3-Trp-X9-Trp) in the C-terminal domain unique to V, a determinant for IRF7 binding, is critical for the blockade of TLR7/9-dependent signaling. 53 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [PLoS One 6, e26526. (2011)] [Lab. of Microbiology] Specific Egg Yolk Immunoglobulin as a New Preventive Approach for Shiga-toxin-mediated Diseases. Paola NERI, Shunji TOKORO, Ryo KOBAYASHI, Tsuyoshi SUGIYAMA, Kouji UMEDA, Takeshi SHIMIZU, Takao TSUJI, Yoshikatsu KODAMA, Keiji OGUMA and Hiroshi MORI* In this study, we immunized chickens with formalin-inactivated Stx-1 or Stx-2, and obtained immunoglobulin Y (IgY) from the egg yolk. Anti-Stx-1 IgY and anti-Stx-2 IgY recognized the corresponding Stx A subunit and polymeric but not monomeric B subunit. Anti-Stx-1 IgY and anti-Stx-2 IgY suppressed the cytotoxicity of Stx-1 and Stx-2 to HeLa 229 cells, without cross-suppressive activity. In vivo, the intraperitoneal or intravenous administration of these IgY rescued mice from death caused by intraperitoneal injection of the corresponding toxin at a lethal dose. Moreover, oral administration of anti-Stx-2 IgY reduced the mortality of mice infected intestinally with EHEC O157:H7. Our results therefore suggest that anti-Stx IgY antibodies may be considered as preventive agents for Stx-mediated diseases in EHEC infection. [Bioorg. Med. Chem. Lett. 21, 801-804 (2011)] [Lab. of Biochemistry] Structure of Rat Aldose Reductase-like Protein AKR1B14 Holoenzyme: Probing the Role of His269 in Coenzyme Binding by Site-directed Mutagenesis. Krithika SUNDARAM, Urmi DHAGAT, Satoshi ENDO, Roland CHUNG, Akira HARA* and Ossama EL-KABBANI Rat aldose reductase-like protein (AKR1B14) is the ortholog of mouse vas deferens protein (AKR1B7) playing roles in detoxification of reactive aldehydes and synthesis of prostaglandin F2α. The crystal structure of the binary complex (AKR1B14-NADPH) was determined at 1.86Å resolution, and showed that the adenine ring and the 2'-phosphate group of the coenzyme formed π-stacking and electrostatic interactions with the imidazole ring and ND1 atom, respectively, of His269, which is not conserved in other aldose reductase-like proteins. The interactions were supported by site-directed mutagenesis of His269 to Arg, Phe and Met, which increased the Km for NADPH by 4, 7 and 127-fold, respectively. This is the first report of the tertiary structure of a rodent AKR1B7 ortholog, which describes the role of a novel dual interaction for the non-conserved His269 in coenzyme binding. [Bioorg. Med. Chem. Lett. 21, 2564-2567 (2011)] [Lab. of Biochemistry] Probing the Inhibitor Selectivity Pocket of Human 20α-Hydroxysteroid Dehydrogenase (AKR1C1) with X-Ray Crystallography and Site-directed Mutagenesis. Ossama EL-KABBANI, Urmi DHAGAT, Midori SODA, Satoshi ENDO, Toshiyuki MATSUNAGA and Akira HARA* Human 20α-hydroxysteroid dehydrogenase (AKR1C1) is an important drug target due to its role in the development of lung and endometrial cancers, premature birth and neuronal disorders. We report the crystal structure of AKR1C1 complexed with the first structure-based designed inhibitor 3-chloro-5-phenylsalicylic acid (CPSA, Ki=0.86 nM) bound in the active site. The binding of CPSA to AKR1C1 resulted in a conformational change in the side chain of Phe311 to accommodate the bulky phenyl ring substituent at the 5-position of the inhibitor. The contributions of the nonconserved residues Leu54, Leu306, Leu308 and Phe311 to the binding were further investigated by site-directed mutagenesis, and the effects of the mutations on the Ki value were determined. The L54V and L306A mutations resulted in 6- and 81-fold increases, respectively, in Ki values compared to the wild-type enzyme. [J. Nat. Prod. 74, 1201-1206 (2011)] [Lab. of Biochemistry] Selective Inhibition of the Tumor Marker Aldo-keto Reductase Family Member 1B10 by Oleanolic Acid. Mayuko TAKEMURA, Satoshi ENDO, Toshiyuki MATSUNAGA, Midori SODA, Hai-Tao ZHAO, Ossama EL-KABBANI, Kazuo TAJIMA, Munekazu IINUMA and Akira HARA* AKR1B10 was recently suggested as a therapeutic target in the treatment of several types of cancer. Selective inhibition of AKR1B10 compared with AKR1B1 is required for the development of anticancer agents. In this study, we have examined AKR1B10 inhibition by seven pentacyclic triterpenes that show potential anticancer properties. Among them, oleanolic acid (OA) was found to be the most potent competitive inhibitor (Ki=72 nM) with the highest AKR1B10/AKR1B1 selectivity ratio of 1370. OA also inhibited the cellular metabolism by AKR1B10 (IC50, 4 μM) and decreased mitomycin C tolerance of colon cancer HT29 cells. Thus, the selective and potent inhibition of AKR1B10 by OA may be related to a possible cancer inhibitory role. 54 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Anal. Chem. 8, 1131-1136 (2011)] [Lab. of Biochemistry] Geometrical Separation Method for Lipoproteins Using Bioformulated-fiber Matrix Electrophoresis: Size of High-density Lipoprotein Does not Reflect Its Density. Mari TABUCHI, Makoto SEO, Takayuki INOUE, Takeshi IKEDA, Akinori KOGURE, Ikuo INOUE, Shigehiro KATAYAMA, Toshiyuki MATSUNAGA*, Akira HARA and Tsugikazu KOMODA In this study, we describe a novel geometrical electrophoretic separation technique incorporating recently developed nanotechnology (Nata de Coco) to analyze high-density lipoprotein (HDL), a beneficial component of the cholesterol fraction. A dyslipidemia patient given a 1-month treatment of fenofibrate showed an inverse relationship between HDL density and size. Direct microscopic observation and morphological observation of fractionated HDL particles confirmed a lack of relationship between particle density and size. This new technique may improve diagnostic accuracy and medical treatment for lipid related diseases. [Anti-Cancer Drugs 22, 402-408 (2011)] [Lab. of Biochemistry] Involvement of the Aldo-keto Reductase, AKR1B10, in Mitomycin-c Resistance through Reactive Oxygen Species-Dependent Mechanisms. Toshiyuki MATSUNAGA*, Yumi YAMANE, Keiko IIDA, Satoshi ENDO, Yoshiko BANNO, Ossama EL-KABBANI and Akira HARA The human aldo-keto reductase (AKR) 1B10 is suggested as a tumor marker in various solid tumors. Using colon cancer cells, we found that AKR1B10 was induced with acquisition of resistance to the anticancer drug mitomycin-c (MMC). In the resistant cells, treatment with an AKR1B10 inhibitor decreased their MMC tolerance. In the nonresistant cells, overexpression and silencing of AKR1B10 decreased and increased, respectively, susceptibility to cytotoxic effects of MMC and 4-hydroxy-2-nonenal, which was formed as a product of lipid peroxidation by MMC treatment. These results suggest a role of AKR1B10 in the development of MMC resistance, which may be mediated by its ability to detoxify cytotoxic aldehydes including 4-hydroxy-2-nonenal. [Chem. Biol. Interact. 191, 364-370 (2011)] [Lab. of Biochemistry] Protective Effect of Rat Aldo-keto Reductase (AKR1C15) against Endothelial Cell Damage Elicited by 4-Hydroxy-2-nonenal. Toshiyuki MATSUNAGA*, Yuhki SHINODA, Yukari INOUE, Satoshi ENDO, Ossama EL-KABBANI and Akira HARA We here investigated whether aldo-keto reductase (AKR) 1C15 acts as a protective factor against endothelial damage elicited by 4-hydroxy-2-nonenal (HNE) and oxidized lipoproteins. Treatment of endothelial cells with HNE provoked apoptosis through reactive oxygen species formation, mitochondrial dysfunction and caspase activation. AKR1C15 converted HNE into less toxic 1,4-dihydroxy-2-nonene, and its overexpression markedly decreased the HNE susceptibility. The AKR1C15 overexpression also suppressed the viability loss caused by oxidized low-density lipoprotein and its lipidic fraction. Collectively, these data indicate an anti-atherogenic function of AKR1C15 through the protection of endothelial cells from damage elicited by toxic lipids such as HNE. [Free Radic. Res. 45, 848-857 (2011)] [Lab. of Biochemistry] Aldo-keto Reductase 1C15 as a Quinone Reductase in Rat Endothelial Cells Involved in Redox Cycling of 9,10-Phenanthrenequinone. Toshiyuki MATSUNAGA*, Yuuki SHINODA, Yukari INOUE, Yuki SHIMIZU, Mariko HAGA, Satoshi ENDO, Ossama EL-KABBANI and Akira HARA 9,10-Phenanthraquinone (PQ) damaged rat endothelial cells via induction of CCAAT/enhancer-binding protein-homologous protein (CHOP), an apoptotic factor derived from endoplasmic reticulum stress. The PQ-mediated CHOP induction was strengthened by a proteasome inhibitor (MG132) and the MG132-induced PQ sensitization was abolished by inhibitor of reactive oxygen species (ROS), suggesting that ROS generation and proteasomal dysfunction are responsible for the PQ-induced CHOP upregulation. PQ provoked the aldo-keto reductase (AKR) 1C15 upregulation and the PQ-induced damage was augmented by the enzyme overexpression, suggesting the presence of a negative feedback loop exacerbating the quinone toxicity in rat endothelial cells. 55 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Chem. Biol. Interact. 191, 261-268 (2011)] [Lab. of Biochemistry] Roles of Rat and Human Aldo-keto Reductases in Metabolism of Farnesol and Geranylgeraniol. Satoshi ENDO*, Toshiyuki MATSUNAGA, Chisato OHTA, Midori SODA, Ayano KANAMORI, Yukio KITADE, Satoshi OHNO, Kazuo TAJIMA, Ossama EL-KABBANI and Akira HARA Farnesol (FOH) and geranylgeraniol (GGOH) are produced from the mevalonate pathway, and catabolized into the carboxylic acids. We investigated the intracellular distribution, sequences and properties of the oxidoreductases responsible for the metabolic steps in rat tissues. The oxidation of FOH and GGOH into their aldehyde intermediates were mainly mediated by alcohol dehydrogenases 1 and 7, and the subsequent step into the carboxylic acids was catalyzed by a microsomal aldehyde dehydrogenase. In addition, the major reductase catalyzing the aldehyde intermediates into alcohol forms was identified as AKR1C15 in rats and AKR1B10 and AKR1C3 in humans. The overall metabolism from FOH to farnesoic acid in cultured cells was significantly increased by addition of AKR1C3 inhibitors. Thus, AKRs may play an important role in controlling the bioavailability of FOH and GGOH. [Biochimie 93, 1476-1486 (2011)] [Lab. of Biochemistry] Activation of Aldo-keto Reductase Family Member 1B14 (AKR1B14) by Bile Acids: Identification of the Bile Acid-binding Site by Site-directed Mutagenesis. Satoshi ENDO*, Toshiyuki MATSUNAGA, Anna FUJITA, Tsukasa KURAGANO, Midori SODA, Krithika SUNDARAM, Urmi DHAGAT, Kazuo TAJIMA, Ossama EL-KABBANI and Akira HARA AKR1B14 is involved in the synthesis of prostaglandin F2α and detoxification of 4-oxononenal formed by lipid peroxidation. The NADPH-linked reductase activity of AKR1B14 was activated by various bile acids. Kinetic analyses of the activation by glycochenodeoxycholic acid, together with fluorescence changes and protection against 4-oxononenal-induced inactivation by bile acid, indicate that the bile acid binds to the enzyme and its coenzyme binary complex as a non-essential activator. Moreover, molecular docking studies and site-directed mutagenesis suggest that His269 plays a key role in significant activation through its electrostatic interaction with the carboxyl group of bile acid, facilitating the release of NADP+. [Environ. Toxicol. 26, 224-232 (2011)] [Lab. of Pharmacology] Characterization of Skin Inflammation Induced by Repeated Exposure of Toluene, Xylene and Formaldehyde in Mice. Asaka SAITO, Hiroyuki TANAKA*, Haruki USUDA, Tomonori SHIBATA, Sayaka HIGASHI, Hirotaka YAMASHITA, Naoki INAGAKI and Hiroichi NAGAI Volatile organic compounds (VOCs) are considered the main cause of sick building syndrome; however, the toxic threshold and the mechanisms of cutaneous reaction induced by long-time VOC exposure have not been clarified. In the present study, we investigated the effect of repeated painting of VOCs onto mouse skin. Various concentrations of toluene, xylene, and formaldehyde (FA) were applied once a week for 5 weeks. While FA solution (2-10%) induced remarkable ear swelling and caused evident infiltration of inflammatory cells, high concentrations of toluene and xylene (50 or 100%) evoked mild ear swelling and marginal inflammatory cell invasion. These findings demonstrate that FA has more potent irritancy against skin than toluene or xylene. [Int. Arch. Allergy Immunol. 157, 194-201 (2011)] [Lab. of Pharmacology] Induction of Thymic Stromal Lymphopoietin Production by Xylene and Exacerbation of Picrylchloride-Induced Allergic Inflammation in Mice. Nozomi SATOU, Kenji ISHIHARA, Masahiro HIRATSUKA, Hiroyuki TANAKA*, Yasuo ENDO, Saburo SAITO, Yoichiro IWAKURA, Warren J LENARD and Noriyasu HIRASAWA Some chemical compounds in the environment worsen allergic inflammation. Here, we examined whether organic solvents induce the production of thymic stromal lymphopoietin (TSLP) which elicits Th2-type immune responses. Organic solvents were painted on the earlobes of BALB/c mice. Among the aromatic compounds, xylene and trimethylbenzene caused apparent TSLP production. The TSLP level in the xylene-treated earlobes reached a maximum at 24 h, and TSLP was expressed in epithelial tissues. Xylene promoted the picryl chloride-induced thickening of the ear and IL-4 production, which were reversed in TSLP receptor knockout mice, demonstrating that TSLP production induced by xylene is responsible for the exacerbation of allergic inflammation. 56 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Eur. J. Pharmacol. 667, 389-395 (2011)] [Lab. of Pharmacology] Role of Hematopoietic Prostaglandin D Synthase in Biphasic Nasal Obstruction in Guinea Pig Model of Experimental Allergic Rhinitis. Daisuke KAJIWARA, Hiroki AOYAGI, Kazuhiko SHIGENO, Michinori TOGAWA, Katsunao TANAKA, Naoki INAGAKI* and Kazuhisa MIYOSHI We investigated the role of hematopoietic prostaglandin D synthase (H-PGDS) in biphasic nasal obstruction in guinea pig allergic rhinitis using a new specific inhibitor (TAS-204). Treatment with oral TAS-204 for 15 days during the period of antigen challenges suppressed increases in nasal airway resistance in both phases. The late phase nasal obstruction was almost completely abrogated by inhibiting H-PGDS alone. Eosinophil infiltration in nasal lavage fluid and nasal hyperresponsiveness to histamine was also reduced by TAS-204 administration. These findings suggest that H-PGDS plays a critical role in the development of allergic rhinitis, especially in the induction of late phase nasal obstruction. [Proc. Natl. Acad. Sci. USA 108, 10349-10354 (2011)] [Lab. of Molecular Pharmacology] On-off System for PI3-Kinase-Akt Signaling Through S-Nitrosylation of Phosphatase with Sequence Homology to Tensin (PTEN). Naoki NUMAJIRI, Kumi TAKASAWA, Tadashi NISHIYA, Hirotaka TANAKA, Kazuki OHNO, Wataru HAYAKAWA, Mariko ASADA, Hiromi MATSUDA, Kaoru AZUMI, Hideaki KAMATA, Tomohiro NAKAMURA, Hideaki HARA*, Masabumi MINAMI, Stuart A. LIPTON and Takashi UEHARA Low concentrations of nitric oxide (NO), as found in the penumbra, preferentially S-nitrosylate phosphatase with sequence homology to tensin (PTEN), whereas higher concentrations of NO, known to exist in the ischemic core, also S-nitrosylate Akt. In the penumbra, inhibition of PTEN (but not Akt) activity by S-nitrosylation would be expected to contribute to cell survival. In contrast, in the ischemic core, S-nitrosylation of Akt formation would inhibit this neuroprotective pathway. Thus, we identify unique sites of PTEN and Akt regulation by means of S-nitrosylation, resulting in an "on-off" pattern of control of Akt signaling. [Eur. J. Neurosci. 33, 843-855 (2011)] [Lab. of Molecular Pharmacology] Involvement of Endoplasmic Reticulum Stress on Neuronal Cell Death in the Lateral Geniculate Nucleus in the Monkey Glaucoma Model. Yasushi ITO, Masamitsu SHIMAZAWA, Yuta INOKUCHI, Hajime YAMANAKA, Kazuhiro TSURUMA, Kazuyuki IMAMURA, Hirotaka ONOE, Yasuyoshi WATANABE, Makoto AIHARA, Makoto ARAIE and Hideaki HARA* We investigated whether endoplasmic reticulum (ER) stress was involved in the pathophysiological mechanisms underlying neuronal death of the lateral geniculate nucleus (LGN) after intraocular pressure (IOP) elevation. In the LGN region, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL)-positive cells, polyubiquitin, phosphorylation of eukaryotic initiation factor 2α and C/EBP-homologous protein were also detected at 11-24 weeks after the laser photocoagulation treatment. These findings indicate that ER stress may play a pivotal role in neuronal death of the LGN after IOP elevation. [CNS Neurosci. Ther. 17, 294-304 (2011)] [Lab. of Molecular Pharmacology] Apoptosis-Inducing Factor and Cyclophilin a Cotranslocate to the Motor Neuronal Nuclei in Amyotrophic Lateral Sclerosis Model Mice. Hirotaka TANAKA, Hiroki SHIMAZAKI, Masataka KIMURA, Hiroshi IZUTA, Kazuhiro TSURUMA, Masamitsu SHIMAZAWA and Hideaki HARA* We investigated the process of motor neuron degeneration in amyotrophic lateral sclerosis (ALS) and to determine whether the cyclophilin A (CypA)- apoptosis-inducing factor (AIF) complex would play a role in inducing motor neuronal cell death in mutant superoxide dismutase 1 (SOD1)(G93A)ALS model mice. In the spinal cords of SOD1(G93A) mice, the expressions of CypA and AIF were detected in the motor neurons, and CypA and AIF cotranslocated to the motor neuronal nuclei with CypA. Furthermore, the expression of CypA was detected in GFAP-positive astrocytes, but not in CD11b-positive microglial cells. These results suggest that CypA and AIF may play cooperative and pivotal roles in motor neuronal death in the murine ALS model. 57 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Curr. Neurovasc. Res. 8, 86-94 (2011)] [Lab. of Molecular Pharmacology] Blockade of Phosphodiesterase-III Protects against Oxygen-glucose Deprivation in Endothelial Cells by Upregulation of VE-Cadherin. Mitsunori ISHIGURO, Yukiya SUZUKI, Keisuke MISHIRO, Mamoru KAKINO, Kazuhiro TSURUMA, Masamitsu SHIMAZAWA, Shinichi YOSHIMURA, Toru IWAMA and Hideaki HARA* We examined whether cilostazol might promote expression of adhesion molecules in endothelial cells, thereby preventing deterioration of endothelial barrier functions. Human brain microvascular endothelial cells were exposed to 6-h oxygen-glucose deprivation (OGD). Cilostazol and db-cAMP prevented OGD-stress injury in endothelial cells by promoting VE-cadherin expression, but not PECAM-1. Cilostazol promotes VE-cadherin expression through cAMP/protein kinase A-dependent pathways in brain endothelial cells; thus, cilostazol effects on adhesion molecule signaling may provide protection against OGD stress in endothelial cells. [Neuroscience 185, 116-124 (2011)] [Lab. of Molecular Pharmacology] Forebrain Specific Heparin-binding Epidermal Growth Factor-like Growth Factor Knockout Mice Show Exacerbated Ischemia and Reperfusion Injury. Atsushi OYAGI, Nobutaka MORIMOTO, Junya HAMANAKA, Mitsunori ISHIGURO, Kazuhiro TSURUMA, Masamitsu SHIMAZAWA and Hideaki HARA* In this study, we investigated the possible role of Heparin-binding epidermal growth factor-like growth factor (HB-EGF) in ischemia and reperfusion injury following a middle cerebral artery occlusion (MCAO). The levels of HB-EGF mRNA in the cerebral cortex of wild-type (WT) mice were significantly increased 3-24 h after MCAO and reperfusion. Cerebral infraction in HB-EGF knockout mice was aggravated at 1 day and 6 days after MCAO and reperfusion compared with WT mice. These results indicate that HB-EGF may play a pivotal role in ischemia and reperfusion injury and that endogenously synthesized HB-EGF is necessary for both the neuroprotective effect and for regulation of cell proliferation in the subventricular zone. [Brain Res. 1419, 97-104 (2011)] [Lab. of Molecular Pharmacology] Heparin-Binding EGF-Like Growth Factor is Required for Synaptic Plasticity and Memory Formation. Atsushi OYAGI, Shigeki MORIGUCHI, Atsumi NITTA, Kenta MURATA, Yasuhisa OIDA, Kazuhiro TSURUMA, Masamitsu SHIMAZAWA, Kohji FUKUNAGA and Hideaki HARA* In this study, we assessed the role of heparin-binding epidermal growth factor-like growth factor (HB-EGF) in learning and memory by testing HB-EGF conditional knock-out mice (KO) in two different learning tasks, and evaluated the long-term potentiation (LTP) in hippocampus slices from these mice. The HB-EGF KO mice were impaired in spatial memory in the Morris water maze and in fear learning in a passive avoidance test. HB-EGF KO mice also showed an impaired LTP, and reduction in activity of Ca2+/calmodulin-dependent protein kinase II (CaMKII) and phosphorylated GluR1. These results confirm the importance of the HB-EGF in synaptic plasticity and memory formation. [Pharmacol. Pharm. 2, 10-16 (2011)] [Lab. of Molecular Pharmacology] Restraint-induced Expression of Endoplasmic Reticulum Stress-related Genes in the Mouse Brain. Mitsue ISHISAKA, Takashi KUDO, Masamitsu SHIMAZAWA, Kenichi KAKEFUDA, Atsushi OYAGI, Kana HYAKKOKU, Kazuhiro TSURUMA and Hideaki HARA* Previously, increases in an endoplasmic reticulum (ER) stress-related protein were reported in the temporal cortex of subjects with major depressive disorder who had died by suicide. The present study was designed to investigate whether acute stress could affect the ER stress response. Mice were immobilized for a period of 6 hr and then expression of ER stress response-related genes was measured by real-time PCR. After a 6 hr restraint stress, mRNA levels of ER stress-related genes, such as the 78-kilodalton glucose regulated protein (GRP78), the 94-kilodalton glucose regulated protein (GRP94), and calreticulin, were increased in the cortex, hippocampus, and striatum of mouse brain. These results suggest that acute stress may affect ER function and that ER stress may be involved in the pathogenesis of restraint stress, including the development of depression. 58 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Biol. Pharm. Bull. 34, 1481-1486 (2011)] [Lab. of Molecular Pharmacology] Luteolin Shows an Antidepressant-like Effect via Supressing Endoplasmic Reticulum Stress. Mitsue ISHISAKA, Kenichi KAKEFUDA, Mika YAMAUCHI, Kazuhiro TSURUMA, Masamitsu SHIMAZAWA, Akifumi TSURUTA and Hideaki HARA* In the present study, we investigated the effects of luteolin on endoplasmic reticulum stress-induced neuronal cell death. Luteolin significantly suppressed tunicamycin-induced cell death at 1 to 10 µM in human neuroblastoma cells. Luteolin increased in the expression of the 78 kDa glucose-regulated protein and 94 kDa glucose-regulated protein and decreased in the cleavage activation of caspase-3. Additionally, to investigate whether chronic luteolin treatment has an antidepression effect, we performed some behavioral tests. Chronic luteolin treatment showed antidepressant-like effects in behavioral tests and, luteolin attenuated the expression of endoplasmic reticulum stress-related proteins in the hippocampus of corticosterone-treated depression model mice. These findings indicate that luteolin has antidepressant-like effects, partly due to the suppression of endoplasmic reticulum stress. [Life Sci. 88, 411-417 (2011)] [Lab. of Molecular Pharmacology] Automated Experimental System Capturing Three Behavioral Components During Murine Forced Swim Test. Etsuko HAYASHI, Midori SHIMAMURA, Kazuyoshi KURATANI, Mine KINOSHITA and Hideaki HARA* An automated experimental system applying a commercially available video image analyzer was developed for the simultaneous detection and measurement of three behavioral components; immobility, swimming (horizontal movements) and climbing (vertical movements) that occur in the murine forced swim test (FST). In 2-4 min time span analysis, all four antidepressants reduced immobility and increased climbing significantly, desipramine and bupropion increased swimming significantly, while imipramine and fluvoxamine did not. The automated experimental system enabled efficient and accurate analysis of the three murine behaviors during FST at once. Climbing could be more sensitive parameter to detect anti-depressant-like effect than immobility in this system. [J. Pharmacol. Toxicol. Methods. 64, 119-123 (2011)] [Lab. of Molecular Pharmacology] An Automated Evaluation System for Analyzing Antinociceptive Effects on Intracolonic Capsaicin-induced Visceral Pain-related Licking Behavior in Mice. Etsuko HAYASHI, Tomohiro KOBAYASHI, Yasuteru SHIROSHITA, Kazuyoshi KURATANI, Mine KINOSHITA and Hideaki HARA* The development of automated detection systems for animal behaviors is increasing, and SCLABA® (Noveltec Inc., Kobe, Japan) is a commercially available analysis system originally developed for analyzing scratching behaviors in rodents, based on distances between points in videotaped images. Here, we used this software to automate analysis of abdominal licking behavior associated with visceral pain in mice. We demonstrated that visceral pain-related licking behaviors after intracolonic capsaicin treatment can be automatically detected by applying commercially available image analysis software. This automated experimental system is very efficient and useful to evaluate antinociceptive effect of a test compound on visceral pain. [Arterioscler. Thromb. Vasc. Biol. 31, 1041-1048 (2011)] [Lab. of Molecular Pharmacology] Tissue Kallikrein Inhibits Retinal Neovascularization via the Cleavage of Vascular Endothelial Growth Factor-165. Shinsuke NAKAMURA, Nobutaka MORIMOTO, Kazuhiro TSURUMA, Hiroshi IZUTA, Yoshika YASUDA, Noriaki KATO, Tsunehiko IKEDA, Masamitsu SHIMAZAWA and Hideaki HARA* To identify the role of tissue kallikrein in retinal neovascularization, we investigated the antiangiogenic effect by using an in vitro and in vivo angiogenesis model. Tissue kallikrein in vitreous fluid was markedly elevated in proliferative diabetic retinopathy patients,.and it inhibited vascular endothelial growth factor-165 (VEGF165)-induced tube formation, proliferation, and migration in vitro angiogenesis model. Tissue kallikrein reduced the pathological vascular changes in retinal neovascularization. These findings indicate that tissue kallikrein is partly involved in pathogenesis of proliferative diabetic retinopathy and may be a promising therapeutic agent that could cleave VEGF165 itself when administered by a peripheral route. 59 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Invest. Ophthalmol. Vis. Sci. 52, 7289-7297 (2011)] [Lab. of Molecular Pharmacology] Edaravone-Loaded Liposome Eyedrops Protect against Light-induced Retinal Damage in Mice. Hiroki SHIMAZAKI, Kohei HIRONAKA, Takuya FUJISAWA, Kazuhiro TSURUMA, Yuichi TOZUKA, Masamitsu SHIMAZAWA, Hirofumi TAKEUCHI and Hideaki HARA* To investigate the pharmacologic effects of eyedrops containing liposomes loaded with edaravone against light-induced retinal damage in mice. Eyedrop administration of edaravone-loaded submicron-sized liposomes (ssLips) significantly prevented both the retinal dysfunction and the shrinkage of the outer nuclear layer compared with the control group (treated with empty ssLips) after 5 days of light exposure. This marked protection was not found in the group treated with free edaravone. Edaravone-loaded ssLips showed a stronger inhibition of in vitro light-induced reactive oxygen species production and cell death than did free edaravone. These finding suggest that edaravone-loaded ssLips protect against light-induced retinal dysfunction by eyedrop administration, and liposomal eyedrops may become one of the therapeutic candidates for drug delivery to posterior eye segments. [Invest. Ophthalmol. Vis. Sci. 52, 9710-9720 (2011)] [Lab. of Molecular Pharmacology] Ligation of the Pterygopalatine and External Carotid Arteries Induces Ischemic Damage in the Murine Retina. Hiromi OGISHIMA, Shinsuke NAKAMURA, Tomohiro NAKANISHI, Shunsuke IMAI, Mamoru KAKINO, Fumiya ISHIZUKA, Kazuhiro TSURUMA, Masamitsu SHIMAZAWA and Hideaki HARA* This study aimed to characterize the functional and morphologic changes in a murine model of ocular ischemic disease caused by vascular occlusion. The ligation of both the pterygopalatine artery (PPA) and the external carotid artery (ECA) significantly reduced ocular blood flow and narrowed the blood vessels. Five hours of ischemia induced the retinal dysfunction and retinal damages. Edaravone, a free radical scavenger, significantly reduced the retinal ischemic damage. These findings indicate that the murine model in which both the PPA and the ECA are ligated may be useful to clarify the pathologic mechanisms of retinal ischemic diseases and to evaluate neuroprotective drugs that target retinal ischemic injury. [Curr. Neurovasc. Res. 8, 25-34 (2011)] [Lab. of Molecular Pharmacology] An Arylidene-thiazolidinedione Derivative, GPU-4, without PPARγ Activation, Reduces Retinal Neovascularization. Shinsuke NAKAMURA, Kei HAYASHI, Haruka TAKIZAWA, Tetsuji MURASE, Kazuhiro TSURUMA, Masamitsu SHIMAZAWA, Hiroki KAKUTA, Hideko NAGASAWA and Hideaki HARA* We investigated whether GPU-4, 5-arylidene-2,4-thiazolidinedione derivative, has anti-angiogenic activity regarding human retinal microvascular endothelial cells (HRMECs) and retinal neovascularization in a mouse model of retinopathy of prematurity. GPU-4 inhibited the vascular endothelial growth factor-induced radicals, proliferation, and migration in HRMECs without a PPARγ-mediated effect. Furthermore, systemic administration of GPU-4 inhibited the development of retinal neovascularization in a murine oxygen-induced retinopathy model. These findings indicate that GPU-4 suppressed in vitro and in vivo retinal neovascularization partly by a radical scavenging effect. [J. Neurosci. Res. 89, 1783-1794 (2011)] [Lab. of Molecular Pharmacology] Involvement of Bid and Caspase-2 in Endoplasmic Reticulum Stress- and Oxidative Stress-induced Retinal Ganglion Cell Death. Rumi UCHIBAYASHI, Kazuhiro TSURUMA, Yuta INOKUCHI, Masamitsu SHIMAZAWA and Hideaki HARA* We investigated the mechanisms of endoplasmic reticulum (ER) stress- and oxidative stress-induced RGC death in vitro and in vivo. In an in vitro study, both Bid and caspase-2 inhibitors protected against cultured retinal ganglion cells (RGC-5) death from ER stress or oxidative stress. A caspase-2 inhibitor did not inhibit BH3-interacting domain death agonist (Bid) cleavage, although a Bid inhibitor reduced the increase of caspase-2 activity in ER stress-induced RGC-5 death. A Bid inhibitor also reduced the increase of caspase-2 activity in oxidative stress-induced RGC-5 death. In an in vivo study, a Bid inhibitor inhibited N-methyl-D-aspartate (NMDA)- or ER stress-induced mouse retinal damage. These findings indicate that a common mechanism through Bid and caspase-2 exists in both ER stress- and oxidative stress-induced RGC death. 60 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Mol. Vision 17, 3556-3565 (2011)] [Lab. of Molecular Pharmacology] Unoprostone Reduces Oxidative Stress- and Light-induced Retinal Cell Death, and Phagocytotic Dysfunction, by Activating BK Channels. Kazuhiro TSURUMA, Yuka TANAKA, Masamitsu SHIMAZAWA, Yukihiko MASHIMA and Hideaki HARA* The current study investigated the effects and the underlying mechanism of action of unoprostone on oxidative stress- and light irradiation-induced damage in photoreceptor and retinal pigment epithelial cultures. Unoprostone and its major metabolite, M1, protected against light- or H2O2-induced cell death in a mouse retinal cone cell line, 661W cells, and against light-induced phagocytotic dysfunction in a human retinal pigment epithelial cell line (ARPE-19) cells. Additionally, iberiotoxin, a selective inhibitor of BK channel, inhibited the protective effects of unoprostone and M1. These findings indicate that unoprostone has protective effects on oxidative stress- and light irradiation-induced damage in vitro and that these effects are mediated by activation of BK channels. [Eur. J. Pharmacol. 650, 110-119 (2011)] [Lab. of Molecular Pharmacology] Crocetin Prevents Retinal Degeneration Induced by Oxidative and Endoplasmic Reticulum Stresses via Inhibition of Caspase Activity. Mika YAMAUCHI, Kazuhiro TSURUMA, Shunsuke IMAI, Tomohiro NAKANISHI, Naofumi UMIGAI, Masamitsu SHIMAZAWA and Hideaki HARA* In this study, we investigated the effects of crocetin, a carotenoid that is the aglicone of crocin, on retinal damage. Crocetin at a concentration of 3 μM showed the inhibitory effect of 50-60% against tunicamycin- and H2O2-induced RGC-5 cell (a retinal cell line) death and inhibited increase in caspase-3 and -9 activity. Moreover, crocetin inhibited the enzymatic activity of caspase-9 in a cell-free system. Crocetin at 100 mg/kg, p.o. significantly inhibited photoreceptor degeneration and retinal dysfunction in mice after excessive light exposure. These results indicate that crocetin has protective effects against retinal damage in vitro and in vivo, suggesting that the mechanism may inhibit increase in caspase-3 and -9 activities after retinal damage. [Curr. Eye Res. 36, 1153-1163 (2011)] [Lab. of Molecular Pharmacology] Increased Expression of Tight Junctions in APRE-19 Cells Under Endoplasmic Reticulum Stress. Tadanobu YOSHIKAWA, Nahoko OGATA, Hiroshi IZUTA, Masamitsu SHIMAZAWA, Hideaki HARA* and Kanji TAKAHASHI To investigate the effects of endoplasmic reticulum (ER) stress on the tight junctions of the retinal pigment epithelial (RPE) cells in vitro. The expressions of the mRNAs and/or proteins of ER-stress releted factors were significantly increased in ARPE-19 cells, a human RPE cell line, under ER stress induced by tunicamycin (TM) and thapsigargin (TG). The mRNAs of VEGF were also increased by both TM and TG. The proteins and mRNAs of occludin and claudin-1 were significantly increased by TM and TG, and that of zonula occludens (ZO)-1 was significantly increased by TG. Immunohistochemistry showed that the staining of ZO-1, occludin and claudin-1 under ER stress was stronger than that of the control. A significant increase of cell permeability measured by transepithelial electrical resistance was observed after exposure to TM and TG. [Neurosci. Lett. 488, 87-91 (2011)] [Lab. of Molecular Pharmacology] SUN N8075, a Novel Radical Scavenger, Protects against Retinal Cell Death in Mice. Mai AKANE, Masamitsu SHIMAZAWA, Yuta INOKUCHI, Kazuhiro TSURUMA and Hideaki HARA* In this study, we examined the effect of SUN N8075, a radical scavenger with neuroprotective properties, on murine retinal damage induced by intravitreous injection of N-methyl-D-aspartate (NMDA) or high-intraocular pressure (IOP). In both models, systemic administration of SUN N8075 decreased the cell loss in the ganglion cell layer (GCL) after retinal damage occurred. Moreover, SUN N8075 reduced the number of apoptotic cells and the expression of an oxidative stress marker in GCL in the NMDA model. These findings suggest that SUN N8075 has a neuroprotective effect against retinal damage, presumably via the radical scavenging effect. 61 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [J. Agric. Food Chem. 59, 528-536 (2011)] [Lab. of Molecular Pharmacology] Purple Rice Extract and Anthocyanidins of the Constituents Protect against Light-induced Retinal Damage in Vitro and in Vivo. Junji TANAKA, Tomohiro NAKANISHI, Kenjirou OGAWA, Kazuhiro TSURUMA, Masamitsu SHIMAZAWA, Hiroshi SHIMODA and Hideaki HARA* This study evaluated the protective effects of purple rice (Oryza sativa L.) bran extract (PRE) and its major anthocyanidins (cyanidin and peonidin) against light-induced retinal damage. In an in vitro experiment, viability of 661W (a cultured murine photoreceptor cell line) after light treatment was improved by PRE, cyanidin, and peonidin. PRE, peonidin, and cyanidin exhibited radical scavenging activities. In an in vivo mouse experiment, intravitreous injection of PRE significantly suppressed photoreceptor degeneration induced by exposure to light. These findings suggest that PRE and its anthocyanidins possess protective effects with antioxidation mechanism in both in vitro and in vivo models of retinal diseases. [Phytother. Res. 25, 1160-1165 (2011)] [Lab. of Molecular Pharmacology] The Protective Effect and Action Mechanism of Vaccinium Myrtillus L. on Gastric Ulcer in Mice. Kenjirou OGAWA, Atsushi OYAGI, Junji TANAKA, Saori KOBAYASHI and Hideaki HARA* Vaccinium myrtillus L. anthocyanoside (VMA) is used as a folk medicine to treat diseases related to gastric ulcers in northern Europe. However, the effects of VMA and its detailed mechanism on gastric ulcer have not been investigated sufficiently. Therefore, the aim of the present study was to investigate the protective effects of VMA on gastric mucosal damage in a murine gastric ulcer model. VMA (10, 30 and 100 mg/kg, p.o.) significantly protected gastric mucosa against HCl/ethanol-induced gastric ulcers. Furthermore, VMA inhibited lipid peroxide levels in a concentration-dependent manner and showed high scavenging activity against the superoxide anion radical (·O2-) and the hydroxyl radical (·OH). Anthocyanidins also showed scavenging activity against the ·O2-, while only delphinidin showed high scavenging activity against the ·OH. These findings indicate that the protective effects of VMA on HCl/ethanol-induced gastric mucosal injury may be partially due to the antiperoxidative effects of anthocyanidins. [BioFactors 37, 25-30 (2011)] [Lab. of Molecular Pharmacology] The Aantianxiety-like Effect of Astaxanthin Extracted from Paracoccus Carotinifaciens. Yasushi NISHIOKA, Atsushi OYAGI, Kazuhiro TSURUMA, Masamitsu SHIMAZAWA, Takashi ISHIBASHI and Hideaki HARA* Astaxanthin is a red carotenoid pigment and is widely found in living organisms. In this study, to investigate the effects of astaxanthin on anxiety and depression, we performed some behavioral trials including the elevated plus maze test, hole-board test, forced swim test, and tail suspension test. Astaxanthin (100 and 300 mg/kg/day for 10 days, p.o.) significantly increased the time spent in open arms in the elevated plus maze test and increased the head-dipping count and duration in the hole-board test. On the other hand, astaxanthin (10, 100, 300, and 500 mg/kg/day for 10 days, p.o.) did not change the immobility time in the forced swim test or the tail suspension test. In conclusion, in mice, astaxanthin exerted anxiolytic-like effects, but not antidepressant-like effects. [Chem.Res. Toxicol. 24, 1845–1852 (2011)] [Lab. of Clinical Pharmacy] The Pivotal Role of Intracellular Calcium in Oxaliplatin-Induced Inhibition of Neurite Outgrowth but Not Cell Death in Differentiated PC12 Cells. Miki TAKESHITA, Yoshiko BANNO, Mitsuhiro NAKAMURA, Mayuko OTSUKA, Hitomi TERAMACHI, Teruo TSUCHIYA* and Yoshinori ITOH To elucidate the molecular mechanisms of oxaliplatin-induced neurotoxicity and the effects of Ca/Mg against this toxicity, we examined the effect of Ca/Mg on oxaliplatin-induced inhibition of neurite outgrowth in PC12 cells, a commonly used neuronal cell model. We suggest that the inhibition of neurite outgrowth but not tumor cell death induced by oxaliplatin is partly associated with reductions in [Ca2+] i and GAP-43 expression, and this inhibition was suppressed by the addition of Ca/Mg. Therefore, it may be assumed that Ca/Mg is useful for protecting against oxaliplatin-induced neurotoxicity without reducing the antitumor activity of oxaliplatin. 62 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [YAKUGAKU ZASSHI. 131,587-595 (2011)] [Lab. of Clinical Pharmacy] Development of Skill Scale for Communication Skill Measurement of Pharmacis. Hitomi TERAMACHI*, Natsuki KOMADA, Katsuya TANIZAWA, Yumi KUZUYA and Teruo TSUCHIYA To purpose of this study was to develop the pharmacist communication skill scale. A 38 items scale was made and 283 pharmacists responded. The original questionnaire consisted of 38 items, with 1-5 graded Likert scale. Completed responses of 228 pharmacists data were used for testing the reliability and the validity of this scale. From factor analysis, four factors were chosen among the 31 items as follows: patient respect reception skill, problem discovery and solution skill, positive approach skill, feelings processing skill. The correlation coefficient between this original scale and the KiSS-18 (Social Skill) received high score (r=0.694). The reliability of this scale showed high internal consistency (Cronbach α coefficient=0.951), so the result of test for the validity of this scale supports high content validity. Thus we propose adoption pharmacist communication skill scale to carry a brief eponymous name as TePSS-31.The above findings indicate that this developed scale possess adequate validity and reliability for practical use. [Jpn. J.Pharm.Health Care Sci. 37, 195-201 (2011)] [Lab. of Clinical Pharmacy] Questionnaire Survey and Analysis for Lecture "Feelings Management in the Communication”. Hitomi TERAMACHI*, Kennosuke TSUBOI, Natsuki KOMADA, Yumi KUZUYA, Kunihiro HISADA and Teruo TSUCHIYA We examined for "Feelings management in the Communication" of this lecture with the KiSS-18 standard, introduced by Akio Kikuchi, which is a social skill measurement standard. We also examined the link with the social skill and the feelings management in the communication of the pharmacists. We carried out questionnaire survey on pharmacists (n=254) who attended the lecture of November 29, 2009. The collection rate was 92.1%, and the response rate was 79.9%. Three factors ("Trouble processing skill", "Smooth conversation skill", and "Problem solution skill") were extracted for a factor analysis for 18 questions of the KiSS-18 standard. The covariance structure analysis, proposed in the casual model infers that "Smooth conversation skill" affects the total factor, and it is possible to cope with trouble management, and the succeeding steps in the model. [Jpn. J.Pharm.Health Care Sci. 37, 535-541 (2011)] [Lab. of Clinical Pharmacy] Questionnaire Survey on Usage of Patient Drug Information Leaflets. Yumi KUZUYA, Hitomi TERAMACHI, Kennosuke TSUBOI, Masahiro YASUDA, Takashi MIZUI, Katsutoshi GOTO, Kazuhumi YONEDA and Teruo TSUCHIYA* With the inclusion of a fee for providing drug information in the medical fee charging structure in 1996, the provision of information on drug information leaflets (hereinafter simply called "leaflets") became more prominent. However, as some patients have said they do not read leaflets or they do not need them, we lelt that the drug information provided on leaflets should be reevaluated to have it better reflect the fee charged.To do this, we conducted a survey of patients (n=195, age: 17 - 93 year) on their usage of leaflets. Almost all of patients read leaflets and kept them. We also found that patients had a keen sense of the necessity of leaflets and were satisfied with them. In addition, level of need for leaflets and opinions on the way information should be provided on them varied with age group. [Jpn. J.Pharm.Health Care Sci. 37, 653-660 (2011)] [Lab. of Clinical Pharmacy] Development of a Measurement Scale for Cancer Patients Communication Skill for Pharmacists. Hitomi TERAMACHI*, Natsuki KOMADA, Hitomi SHIGA, Kento TAMURA and Teruo TSUCHIYA We have developed a pharmacist communication skill scale for cancer patients. First, we formulated 41 questions for improving the communication skill needed for reception of the cancer patients. Then we carried out a questionnaire (41 questions with 1-5 graded Likert scale), survey on pharmacists (n=584) during August 2010. The collection and the response rate was 36.3%. Finally, five factors ("Problem solution skill", "Patient psychology understanding skill", "self-control skill", "End period reception skill", and "Reporting skill to a patient and the family") were extracted for a factor analysis from 29 questions. The correlation coefficient between this original scale and the KiSS-18 (Social Skill) received high score (r=0.618). The reliability of this scale showed high internal consistency (Cronbach α coefficient=0.916) ; thus the result of test for the validity of this scale supports high content validity. We propose adoption of this pharmacist communication skill scale to carry a brief name as Topics-29. 63 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Jpn. J.Pharm.Health Care Sci. 37, 681-692 (2011)] [Lab. of Clinical Pharmacy] Development and Evaluation of a ‘Practical Training Management Evaluation Web System’. Hitomi TERAMACHI*, Yumi KUZUYA, Yukihiro YAMAMOTO and Teruo TSUCHIYA We have developed ‘practical training management evaluation web system’ with the web browser to conduct a more effective and smooth the long term practical training for 6-year curriculum of pharmaceutical education at the Gifu Pharmaceutical University. We used this web system for long term practical training in 2010. At the end of the training, a questionnaire survey was carried out for students, pharmacists and university teachers. Particularly, the pharmacists working at the pharmacy highly evaluated many questions, including the questions for necessity and satisfactions of this web systems, than the hospital pharmacist. We infer that this web system was very useful for pharmacists working at the pharmacy on the support of the long term practical training. Generally, many students, pharmacists and university teachers evaluated that this web system is highly necessary and offer high satisfaction for the long term practical training. We conclude that we are successful in developing this web system. [J. Pharm. Commun. 8, 3-11 (2011)] [Lab. of Clinical Pharmacy] Questionnaire Survey and Analysis for Five Years to Early Exposure (Pharmacy Visit) Program Use at Gifu Pharmaceutical University Pharmacy. Hitomi TERAMACHI*, Eiji SAKAI and Teruo TSUCHIYA At Gifu Pharmaceutical University, a visit to the Gifu Pharmaceutical University pharmacy as a part of the early exposure program was implemented for first year students from 2006 to 2010. After this community pharmacy visit, a questionnaire survey was conducted among the students who had participated in this program, about this addition to the curriculum. The pharmacists (n=6)who had conducted training this program, also answered a different questionnaire. Due to active participation of most students during the visit, a significantly higher level of satisfaction with the program than that was previously expected was achieved. Furthermore, many students commented that their experience in this program increased their motivation for future training. Almost all students considered it to be useful. These results indicate that an early exposure increased the interest of students in medical care. [J. Pharm. Commun. 9(1), 5-16 (2011)] [Lab. of Clinical Pharmacy] Construction and Evaluation of Medical Communication Lessons Utilizing Pharmacist Trainer®. Hitomi TERAMACHI*, Sayaka HIGASHI, Yuzo TAKAHASHI and Teruo TSUCHIYA We developed a pharmacist simulator (Pharmacist Trainer®) as education stratagem in medical communication for pharmaceutical education. Pharmacist Trainer® had teaching materials in which a learner gains correspondence training along with a simulated patient model of computer graphic. First time interview had three cases and provision of information had four cases. About video, first time interview had three cases and provision of information had five cases. With these two stratagem, we offered medical communication lessons for 4th- year students (n = 76) at our university. After lesson, a questionnaire survey was conducted. The results suggested that students could learn communication knowledge and master communication skills (ratios more than grade 4: 77%, 71%). Covariance structure analysis shows that students were interested in curriculum additions that make use of Pharmacist Trainer® and videos, as it helps their self learning and learning communication skills. [J. Gifu Byoyaku 53, 11-16 (2011)] [Lab. of Clinical Pharmacy] Questionnaire Survey and Analysis for Five Years to Early Exposure (Hospital Visit) Program Use at Gifu Pharmaceutical University Pharmacy. Hitomi TERAMACHI*, Eiji SAKAI, Shoei FURUKAWA, Shingo KATSUNO and Teruo TSUCHIYA At Gifu Pharmaceutical University, hospital visits were introduced as an early exposure program for first year students (2006: n=123, 2007: n=126, 2009: n=144, 2010: n=129, 201: n=140) from 2006 to 2011. After this hospital visits, a questionnaire survey was conducted among the students who had participated in this program, about this addition to the curriculum. Many students commented that their experience in this program increased their motivation for future training. Almost all students considered it to be useful. These results indicate that an early exposure increased the interest of students in medical care. 64 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Palliative Care Research 6, 109-118 (2011)] [Lab.of Pharmacy Practice & Social Science] Effectiveness of a Group Seminar on Opioids for Lung Cancer Patients. Makoto NAKASHIMA, Hiromitsu KATO, Takuya GOTO, Syuichi MATSUMOTO, Sayo ISHII, Toshitaka SUZUKI, Kimiyasu SANO, Tatsuo KATO, Masumi SUZUI and Tadashi SUGIYAMA* We conducted a group seminar for lung cancer patients. The purpose of the group seminar was to eliminate the negative notions about opioids and to impart the right knowledge about these drugs. After completion of the group seminar, the understanding and knowledge about opioids increased, as indicated by the responses of the patients to all of the questions. Complete elimination of the negative notion about opioids could not be achieved through the group seminar. However, the group seminar was thought to be one of the useful methods of educating patients. If a patient resists treatment with opioids, control of pain may be delayed. This in turn would hamper improvement of the quality of life. Therefore, we consider that it is necessary that a patient has the right knowledge about opioids beforehand. [Jpn. J. Pharm. Health Care Sci. 37, 419-424 (2011)] [Lab.of Pharmacy Practice & Social Science] Development of a Checking Method in Preparation of the Liquid Cancer Chemotherapeutic Agents. Makoto NAKASHIMA, Akira TAKAHASHI, Takuya GOTO, Mie NOMURA, Tomomi SUZUKI, Yukiko SHIBATA, Kimio WAKABAYASHI, Hiromitsu KATO, Takahiro KUMAGAI, Syuichi MATSUMOTO, Masumi SUZUI and Tadashi SUGIYAMA* We devised the cheking system to see if preparation did precisely. The checking procedure is measurement of weight of vials and ampules that include drug before and after preparation, then we compare net different weight to theoretical different weight. By this checking method, we could detect that net different weight was out of tolerance level reliably when net different weight was +4% or -8% away for theoretical different weight. To do the check, preparation time was extended, but the difference was not statistically significant. Therefore, regarding to get the correctness in preparation of liquid cancer chemotherapeutic agents, we consider this checking method is useful. [J. Jpn. Soc. Health care Manag.12, 85 - 89(2011)] [Lab.of Pharmacy Practice & Social Science] The Approach of Chemotherapy Committee about the Reduction of Medicine Costs by the Proper Use of the Antiemetics. Makoto NAKASHIMA and Tadashi SUGIYAMA* The preventive administration of the antiemetics which selected based on expression risk level of nausea and emesis occurred by cancer chemotherapy is effective method. In the Nagara medical center, chemotherapy committee reviewed usage of the antiemetic in reference to a National Comprehensive Cancer Network guideline. We compared medicine cost of the antiemetics which administered after a change with the estimation in cases where we did not change it. The medicine cost fell by 49.5% a year. In addition, the increase of the incidence of nausea and emesis was not showed by deletion of the granisetron. By selecting antiemetic appropriately in reference from a guideline, medicine costs fell without letting incidence of nausea and emesis increase, and we able to reduce the burden of the patient. [Jpn. J. Pharm. Health Care Sci. 37, 721-727 (2011)] [Lab.of Pharmacy Practice & Social Science] Development of Anticancer Chemotherapy Support Software and its Evaluation. Makoto NAKASHIMA, Takuya GOTO, Sachika MAETA, Mie NOMURA, Yukiko SHIBATA, Kimio WAKABAYASHI, Hiromitsu KATO, Takahiro KUMAGAI, Nobuyuki MISHIWA, Masumi SUZUI and Tadashi SUGIYAMA* We developed a software package using Microsoft Excel for supporting works related to cancer chemotherapy. This support software facilitates management of the dosage schedule of anticancer agents and accurate count of the anticancer agent to be used and creation of worksheets for various purposes such as selecting the most cost-effective vials and ampoules, calculating the quantity of medicinal solution to be prepared. We believe that this support software is extremely useful in the efficient and safe management of works related to cancer chemotherapy. 65 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Biochim. Biophys. Acta. 1811, 119–128 (2011)] [Lab. of Drug Informatics] Heterogeneous Sphingosine-1-phosphate Lyase Gene Expression and its Regulatory Mechanism in Human Lung Cancer Cell Lines. Hiromi ITO, Kayo YOSHIDA, Masashi MURAKAMI, Kazumi HAGIWARA, Noriko SASAKI, Misa KOBAYASHI, Akira TAKAGI, Tetsuhito KOJIMA, Sayaka SOBUE, Motoshi SUZUKI, Keiko TAMIYA-KOIZUMI, Mitsuhiro NAKAMURA*, Yoshiko BANNO, Yoshinori NOZAWA and Takashi MURATE The role of sphingolipid metabolic pathway has been recognized in determining cellular fate. Although sphingolipid degradation has been extensively studied, gene expression of human sphingosine 1-phosphate lyase (SPL) catalyzing sphingosine 1-phosphate (S1P) remains to be determined. Among 5 human lung cancer cell lines examined, SPL protein levels paralleled the respective mRNA and enzyme activities. High SPL transcription of H1155 cells was regulated by Sp1 and GATA-4/Sp1 complex formation, both of which bind to Sp1 sites of the 5'-SPL promoter. [J. Chromatogr. B. 879, 1029-1032 (2011)] [Lab. of Drug Informatics] Direct-injection HPLC Method of Measuring Micafungin in Human Plasma using a Novel Hydrophobic/Hydrophilic Hybrid ODS Column. Hiroaki URANISHI, Mitsuhiro NAKAMURA*, Hiroki NAKAMURA, Yukari IKEDA, Mayuko OTSUKA, Zenichiro KATO, Teruo TSUCHIYA A direct-injection HPLC-based method has been developed for determining amounts of micafungin in human plasma using a novel hydrophobic/hydrophilic hybrid ODS column. The method is easy to perform and requires only 10 ìL of a filtered plasma sample. The chromatographic separations were carried out with a gradient mode. The fluorescence detection wavelengths of excitation and emission were set at 273 nm and 464 nm, respectively. The calibration curve of micafungin showed good linearity in the range of 0.5-20.0 ìg/mL (r(2)=1.00). The inter-day accuracy ranged from -9.8 to 1.5%. The precisions were less than 10%. This method is useful for the determination of micafungin in human plasma. [Mutagenesis. 26(2), 323–330 (2011)] [Lab. of Radiochemistry] Effect of Cigarette Smoke on Mutagenic Activation of Environmental Carcinogens by Cytochrome P450 2A8 and Inactivation by Glucuronidation in Hamster Liver. Kenjiro TATEMATSU*, Akihiro KOIDE, Masao HIROSE, Akiyoshi NISHIKAWA and Yukio MORI To elucidate the mechanism underlying suppression of N-nitrosobis(2-oxopropyl)amine (BOP)-induced hamster pancreatic carcinogenesis by cigarette smoke (CS), hepatic levels of metabolic enzymes and mutagenic activation were assayed in hamsters exposed to CS for 4 weeks. CS exposure enhanced the levels of cytochrome P450 (CYP) 1A2 and 2A8 and mutagenicities of several mutagens with liver S9. However, no CS-induced alterations in the level of CYP2B, which is associated with BOP activation, and the mutagenic activities of BOP and other pancreatic carcinogens, were observed. CS enhanced UDP-glucuronyltransferase (UDPGT) activities towards 4-nitrophenol (4-NP). These results indicate that suppression of BOP-induced pancreatic carcinogenesis by CS might be attributed to increased detoxification by 4-NP UDPGT and not decreased CYP2B activation. [Shoyakugaku Zasshi 65, 108-113 (2011)] [Lab. of Herbal Garden] A Quantitative Analysis of Schizandrin and Gomisin A in Schisandrae Fructus. Takaomi Tagami, Keiko Arimoto, Michiho Ito, Yuko Osumi, Mamoru Okasaka, Tomonari Kanaya, Eiji Sakai*, Yasuo Shimada, Yoshitaka Takai, Takaomi Tagami, Kayoko Tokura, Kenichi Nakajima, Mamoru Noguchi, Takashi Hashizume, Yoichi Hista, Gisho Honda, Masataka Moriyasu, Yutaka Yamamoto and Tsuguo Yokokura. Schisandrae Fructus is the fruit of Schisandra chinensis Baillon (Schisandraceae), whichi has been used as an ingredient of kampo formula such as Shoseiryuto. In order to control quality of this crude drug, several methods to analyze schizandrin and gomisin A in Schisandrae Fructus have been in reported. They use harmful solvents and acetonitrile; however acetonitrile has been short supply recently. A method for quantitative analysis using HPLC without acetonitrile or harmful solvents eas developed and was applied to 50 market samples for comparison. Schizandrin and gomisin A were both found in much greater quantities in the seeds than in the flesh of the fruits. 66 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- [Chemistry & Biodiversity. 8, 476-482 (2011)] [Lab. of Herbal Garden] Three New Constituents from the Roots of Erythrina variegata and Their Antibacterial Activity against Methicillin-Resistant Staphylococcus aureus. Hitohi Tanaka, Ikunori Atsumi, Osamu Shirota, Setsuko Sekita, Eiji Sakai*, Masaru Sato, Jin Murata, Hiroko Murata, Dedy Darnaedi and Ih-Sheng Chen Two new isoflavonoids, eryvarins V and W (1 and 2, resp.), and a new chromen-4-one derivative, eryvarin X (3), along with three known isoflavonoids, were isolated from the roots of Erythrina variegata. Their structures were established by spectroscopic analyses. Compound 1 is a rare naturally occurring isoflavanone which possesses a OH group at C(3). Among the new compounds 1-3, 2 exhibited a potent antibacterial activity against methicillin-resistant Staphylococcus aureus (MRSA) strains. 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- 67 紀 要 論 文 (1) 平島真一, 多田教浩, 三浦剛, 伊藤彰近:光 と 酸 素 を 活 用 す る 簡 便 な 酸 化 プ ロ セ ス の 開 発 に 関 する研究. [岐阜薬科大学紀要 60, 1-9 (2011)] (2) 力石裕一,伊豆田洋志,足立哲夫,原英彰:増殖糖尿病網膜症患者の硝子体中細胞外スーパーオキシド ジスムターゼ (EC-SOD) の役割. [岐阜薬科大学紀要 60, 31-40 (2011)] (3) 藤原佑太, 佐治木弘尚:不 均 一 系 白 金 族 触 媒 を 用 い た 高 効 率 的 H-D 交 換 反 応 に 関 す る 研 究 . [岐阜薬科大学紀要 60, 41–50 (2011)] 総 説 (1) Hideko NAGASAWA:Pathophysiological Response to Hypoxia - from the Molecular Mechanisms of Malady to Drug Discovery: Drug Discovery for Targeting the Tumor Microenvironment. [J. Pharmacol. Sci. 115, 446-452 (2011)] (2) 門口泰也, 佐治木弘尚:高分子担持方機能性触媒の開発. [高分子論文集 68, 232-241 (2011)] (3) 伊藤哲朗:フタバガキ科植物に含有するオリゴスチルベノイドの構造と生物活性. [薬学雑誌 131, 93-100 (2011)] (4) 戸塚裕一:機能性食品添加剤とのナノコンポジット形成による医薬品の溶解性および吸収性の改善. [ファームテクジャパン 27, 1675-1679 (2011)] (5) Makoto SEO, Ryo KOBAYASHI and Hisamitsu NAGASE: Immunotoxic Effects of Trichloroethylene and Tetrachloroethylene. [J. Health Sci. 57, 488-496 (2011)] (6) 中西剛:核内受容体を介した有機金属毒性の分子基盤〜有機スズ化合物による免疫機能修飾の可能性〜. [臨床免疫・アレルギー科 55, 535-542 (2011)] (7) 中西剛:核内受容体を介した有機スズ化合物毒性の分子メカニズム. [Biomed. Res. Trace Elements 22, 15-21 (2011)] (8) 中西剛:内分泌かく乱化学物質による胎盤機能修飾. [ホルモンと臨床 59, 153-161 (2011)] (9) 中西剛:核内受容体を応用した化学物質の検出. [ぶんせき 434, 84-91 (2011)] (10) 福光秀文:マウス大脳皮質神経細胞層の構築に及ぼす細胞外液性因子の影響. [薬学雑誌 131, 1317-1321 (2011)] (11) Ossama EL-KABBANI, Urmi DHAGAT and Akira HARA : Inhibitors of Human 20α-Hydroxysteroid Dehydrogenase (AKR1C1). [J. Steroid Biochem. Mol. Biol. 125, 105-111 (2011)] (12) 稲垣直樹:ハプテン誘導 AD マウスモデル・薬効評価;タクロリムス外用薬と瘙痒抑制. 68 岐阜薬科大学紀要 Vol. 56 -研究論文抄録- [皮膚アレルギーフロンティア (別冊) 9, 13-17 (2011)] (13) 田中宏幸, 山下弘高, 稲垣直樹:システィニルロイコトリエンに関する最近の話題. [アレルギーの臨床 31, 47-52 (2011)] (14) Masamitsu SHIMAZAWA and Hideaki HARA:Novel Situations of Endothelial Injury in Stroke ― Mechanisms of Stroke and Strategy of Drug Development: Protective Effects of Antiplatelet Agents Against Stroke. [J. Pharmacol. Sci. 116, 30-35 (2011)] (15) Junya HAMANAKA and Hideaki HARA:Involvement of Toll-Like Receptors in Ischemia-Induced Neuronal Damage. [Cent. Nerv. Syst. Agents Med. Chem. 11, 107-113 (2011)] (16) 石黒光紀, 原英彰:脳梗塞及び脳出血に対する抗血小板剤シロスタゾールの保護作用. [薬学雑誌 131, 513-521 (2011)] (17) 中村信介, 原英彰:カリジノゲナーゼの抗 VEGF 作用. [眼薬理 25, 54-57 (2011)] (18) 嶋澤雅光, 原英彰:PET を用いた緑内障早期診断法の確立. [PET ジャーナル 13, 10-11 (2011)] (19) 新家眞, 北澤克明, 山本哲也, 澤田明, 岩瀬愛子, 山本精一郎, 吉村健一, 原英彰, 嶋澤雅光, 伊藤保志, 山嶋哲盛, 今村和幸, 笹岡正顕, 太田貴史, 水野憲, 川北耕二, 大橋靖雄, 白土城照, 山崎芳夫, 松本長太, 玉置泰裕, 相原一, 富所敦男, 永原幸, 山上淳吉, 古関信之, 石井清, 高山淳, 長谷川智之, 間山千尋, 内 田彩子, 山田秀之, 大橋正明, Yi-Ning CHEN, 佐伯忠賜朗, 重枝崇史, 村田博, Kelvin Lee, 鶴我英和, Mao NAKAYAMA, 山岸麗子:緑内障:眼圧非依存障害因子への挑戦 ―ネズミ・サル・そしてヒトへ― [日本眼科学会雑誌 115, 213-237 (2011)] (20) 阿部康二, 岡田靖, 原英彰:日本人の脳梗塞治療における抗血小板療法と脳出血 ―CSPS II の結果を受 けて― [J. New Rem. Clin. (新薬と臨床) 60, 201-209 (2011)] (21) 杉山正, 堀内正, 土屋照雄:薬科大学がおこなう生涯教育―附属薬局が主催する臨床教育を中心に― [薬学雑誌 131, 33-40 (2011)] (22) Mitsuhiro NAKAMURA:Analyses of Benzodiazepines and their Metabolites in Various Biological Matrices by LC-MS(/MS). [Biomed. Chromatogr. 25, 1283-1307 (2011)] 著 書 (1) 宇野文二 (分担執筆):第 1 章分析化学の基礎概念, 第 2 章化学平衡, 第 4 章定量の基礎. [コアカリ対応 分析化学 第 3 版 (丸善出版) pp. 2-44, pp. 109-120 (2011)] (2) 宇野文二 (分担執筆):第 5 章化学平衡. [基礎薬学・分析化学 I 第 4 版 (廣川書店) pp. 67-123 (2011)] (3) 竹内洋文 (分担編集、分担執筆), 戸塚裕一 (分担執筆):2.4 ドラッグデリバリーシステム, 5.3 製剤試験 と規格. [最新製剤学第 3 版 (廣川書店) pp.199-226, pp.410-426 (2011)] (4) 竹内洋文 (分担執筆):3.3 拡散と溶解. 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- 69 [新薬剤学改訂第 3 版 (南江堂) pp.323-332 (2011)] (5) 竹内洋文 (分担執筆), 田原耕平 (分担執筆):第 4 章 2 剤型修飾による難吸収性薬物の消化管並びに経粘 膜吸収改善, ポリマーコーティングリポソームを用いた難吸収性薬物の消化管並びに経肺吸収性の改善. [難吸収性薬物の吸収改善と新規投与製剤の開発 (シーエムシー出版) pp.133-140 (2011)] (6) 竹内洋文(分担執筆):ペプチド性薬物の経口・経肺吸収をめざしたポリマーコーティングリポソームの 設計 [遺伝子医学 MOOK 別冊・ペプチド・タンパク性医薬品の新規 DDS 製剤の開発と応用 (メディカルドゥ) pp.124-133 (2011)] (7) Yasushi SASAI, Shin-ichi KONDO, Yukinori YAMAGUCHI and Masayuki KUZUYA (分担執筆):Cold Plasma Techniques for Pharmaceutical and Biomedical Engineering. [Biomedical Engineering-Trends in Materials Science (InTech) pp.101-122 (2011)] (8) 永瀬久光(分担執筆): [学校と学校薬剤師 2011 (薬事日報社) pp.123-130 (2011)] (9) 中西 剛(分担執筆): [NEW 医薬品の安全性学・第2版 (廣川書店) pp.127-138 (2011)] (10) 中西 剛(分担執筆): [コンパス衛生薬学・第1版 (南江堂) pp.343-363 (2011)] (11) 杉山剛志, 高橋圭太, 森 裕志 (分担執筆):第 4 章 4.ローヤルゼリー中に含まれる中鎖脂肪酸による LPS シグナル制御. [エンドトキシン・自然免疫研究 14 -自然免疫と生体防御- (医学図書出版) pp.53-55 (2011)] (12) 稲垣直樹 (分担執筆):第 11 章免疫疾患治療薬, 第 16 章病原微生物に作用する薬物. [最新基礎薬理学 (廣川書店) pp.299-313, pp.413-436 (2011)] (13) Kazuyuki IMAMURA, Masamitsu SHIMAZAWA, Hirotaka ONOE, Yasuyoshi WATANABE, Kiyoshi ISHII, Chihiro MAYAMA, Takafumi AKASAKI, Satoshi SHIMEGI, Hiromichi SATO, Kazuhiro NAKADATE, Hideaki HARA and Makoto ARAIE (分担執筆):Chapter 17. Central Changes in Glaucoma: Neuroscientific Study Using Animal Models. [The Mystery of Glaucoma (InTech) pp.307-330 (2011)] (14) 土屋照雄 (分担執筆): [2011 年版 実習へ行く前の 覚える医薬品集―服薬指導に役立つー (廣川書店) (2011)] (15) 土屋照雄 (分担執筆): [モデル・コアカリキュラムに沿った わかりやすい病院実務実習テキスト第 2 版 (じほう) (2011)] (16) 寺町ひとみ (分担執筆): [モデル・コアカリキュラムに沿った わかりやすい病院実務実習テキスト第 2 版 (じほう) (2011)] (17) 舘知也 (分担執筆): [モデル・コアカリキュラムに沿った わかりやすい病院実務実習テキスト第 2 版 (じほう) (2011)] (18) 寺町ひとみ (分担執筆): [コアカリキュラム対応 薬学生・薬剤師のための ヒューマニズム (羊土社) (2011)] (19) 杉山正 (分担執筆): [2011 年版 実習に行く前の 覚える医薬品集-服薬指導に役立つ- (廣川書店) (2011)] (20) 中村光浩 (分担執筆): [医薬品情報学 (廣川書店) (2011)] 70 岐阜薬科大学紀要 Vol. 56 -研究論文抄録- (21) 立松憲次郎 (分担執筆):第1章 原子核,第5章 原子核反応. [放射化学・放射薬品学・第2版 (廣川書店) pp.1-10, pp.69-88 (2011)] (22) 酒井英二 (分担執筆): [第十六改正日本薬局方解説書 (廣川書店) (2011)] (23) 酒井英二 (分担執筆): [台所の薬草ガイドブック (日本植物園協会) (2011)] (24) 酒井英二 (分担執筆):薬学教育と漢方. [漢方と最新治療 (世論時報社) pp.329-333 (2011)] そ の 他 (1) 上田聡, 永澤秀子:創薬を指向した多様なベンゾオキサゾール類の触媒的合成法の開発. [Organic Square 37, 2-4 (2011)] (2) 佐治木弘尚:常温常圧でPCBを分解無害化する方法. [グローバルネット (財団法人地球・環境フォーラム) 242, 10–11 (2011)] (3) 竹内洋文:中部談話会報告. [粉体工学会誌 48, 656 (2011)] (4) 竹内洋文:製剤と粒子設計部会報告. [粉体工学会誌 48, 859 (2011)] (5) 竹内洋文:新規素材のトレンドを探る(巻頭言). [ファームテクジャパン 27, 2353 (2011)] (6) 田原耕平:粉末吸入製剤に用いられるキャリアー乳糖に関する国際会議レポート. [ファームテクジャパン 27, 1625-1627 (2011)] (7) 永瀬久光:学校の環境衛生管理 ―「学校環境衛生基準」に基づく水・室内空気の管理について―. [建築設備士 43, 1-16 (2011)] (8) 藤井友和,花村美帆,丸山康典,菅原志保,栗木玲子,中尾真隆,佐藤英和,笹尾武史,植村大志,伊 藤誠一,山本倫久,神谷恒行,足立哲夫,斉藤寛子:外来がん化学療法における薬学的管理支援ワーク シートを利用した薬剤師教育ツールの作成と評価.-愛知県病院薬剤師会オンコロジー研究会第5分科 会の取り組み-. [愛知県病院薬剤師会雑誌 38, 12-21 (2011)] (9) 井口和弘:アンドロゲン受容体を標的としたホルモン不応性前立腺癌治療薬の可能性. [上原記念生命科学財団研究報告集 25 (2011)] (10) 林祐一, 山田恵, 香村彰宏, 吉倉延亮, 原田斉子, 木村暁夫, 田中優司, 保住功, 犬塚貴:終末期の筋萎縮 性側索硬化症に対する呼吸苦緩和への取り組み. [岐阜県内科医会雑誌 25, 85-89 (2011)] (11) 稲垣直樹 (分担研究):マウスモデルを用いた掻痒発現機序の解析と天然物を対象とした掻痒抑制物質の 探索. [厚生労働科学研究費補助金 (免疫アレルギー疾患予防・治療研究事業)平成 22 年度・分担研究報告書 23 (2011)] (12) 田中宏幸 (分担研究):マウス喘息モデルを用いた難治化・重症化因子の探索―ダニ抗原誘発喘息様病態 岐阜薬科大学紀要 Vol. 61 -研究論文抄録- 71 モデルを用いた検討―. [厚生労働科学研究費補助金 (免疫アレルギー疾患予防・治療研究事業)平成 22 年度・分担研究報告書 100 (2011)] (13) 原英彰:創薬のパラダイムシフト-見方を変えれば世界が変わる-. [日薬理誌 138, 133-134 (2011)] (14) 酒井英二:アラビアガムの粗原料の形態学的手法による識別方法の開発. [日本食品化学研究財団 第 17 回研究成果報告書 (2011)] (15) 酒井英二 (分担研究):漢方薬に用いられる薬用植物の内部及び外部形態情報にかんする研究. [厚生労働省科学研究費補助金 (創薬基盤推進研究事業 漢方薬に使用される薬用植物の総合データベー ス構築のための基盤整備に関する研究)平成 22 年度 総括・分担研究報告書 (2011)] (16) 杉浦春雄,杉浦浩子,植屋悦男:キャンプ体験とポジティブ感情の変化について. [健康レクリエーション研究会雑誌 7, 17-22 (2011)] (17) 杉浦春雄:ボウリングはポジティブ感情向上に寄与するか?. [健康レクリエーション研究会雑誌 7, 43-46 (2011)] 編集委員 稲垣直樹, 澤岡 藩, 中西 剛, 三浦 剛, ジョン ガニング 岐阜薬科大学紀要 第 61 号 (非売品) 発行日 平成24年6月30日 発行所 岐 〒501-1196 編集者 発行者 阜 薬 科 大 学 岐阜市大学西1丁目25番地4 稲 垣 直 樹 THE ANNUAL PROCEEDINGS OF GIFU PHARMACEUTICAL UNIVERSITY Vol. 61 June 2012 CONTENTS Reviews The Association of Polyol Pathway in Onset and Progression of Diabetic Retinopathy ··· Noriaki KATO ···(1) Involvement of Endoplasmic Reticulum Stress in the Neuronal Death Induced by Ischemia ··· Yasuhisa OIDA, Hideaki HARA ···(11) Evaluation of the Pharmacist’s Effort for Cancer Chemotherapy ··· Tomokazu FUJII, Tsuneyuki KAMIYA, Tetsuo ADACHI ···(19) Abstracts of Published Reports (January – December, 2011) Published Annually by Gifu Pharmaceutical University 1-25-4 Daigaku-Nishi, Gifu 501-1196, Japan ············(29)
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