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  1. Article: A Case Report of Drug Interactions Between Nirmatrelvir/Ritonavir and Tacrolimus in a Patient With Systemic Lupus Erythematosus.

    Yamamoto, Nanae / Tsuchiya, Yuichi / Fukuda, Mio / Niiro, Hiroaki / Hirota, Takeshi

    Cureus

    2024  Volume 16, Issue 1, Page(s) e52506

    Abstract: Nirmatrelvir/ritonavir is a treatment for COVID-19 consisting of nirmatrelvir, which has anti-SARS-CoV-2 activity, and ritonavir, a booster to maintain blood levels. Ritonavir is known to be a potent inhibitor of cytochrome P450 3A (CYP3A), and ... ...

    Abstract Nirmatrelvir/ritonavir is a treatment for COVID-19 consisting of nirmatrelvir, which has anti-SARS-CoV-2 activity, and ritonavir, a booster to maintain blood levels. Ritonavir is known to be a potent inhibitor of cytochrome P450 3A (CYP3A), and interactions with CYP3A-metabolized drugs, such as the immunosuppressant tacrolimus, can be problematic. Ritonavir's inhibition of CYP3A is irreversible due to covalent binding, and its inhibitory effects are expected to persist until replaced by new CYP3A. Here, we report a case where the combination of nirmatrelvir/ritonavir and tacrolimus resulted in toxic tacrolimus blood levels. A patient on tacrolimus for systemic lupus erythematosus (SLE) developed COVID-19 and was prescribed nirmatrelvir/ritonavir. After starting the combination of nirmatrelvir/ritonavir and tacrolimus, the patient's tacrolimus blood levels became abnormally high, leading to the discontinuation of these drugs due to symptoms of tacrolimus toxicity. Even after ritonavir blood levels had fallen below the detection limit, the decline in tacrolimus blood levels was delayed. The CYP3A inhibition of ritonavir persists even when its blood concentration decreases, emphasizing the need for careful consideration of concomitant medications before starting nirmatrelvir/ritonavir therapy. Adjustments or discontinuation may be necessary.
    Language English
    Publishing date 2024-01-18
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.52506
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: [Effector B cells in autoimmune diseases].

    Niiro, Hiroaki

    Nihon Rinsho Men'eki Gakkai kaishi = Japanese journal of clinical immunology

    2015  Volume 38, Issue 5, Page(s) 412–420

    Abstract: The advent of B-cell targeted agents has prompted reappraisal of the role of B cells in the pathogenesis of autoimmune diseases (AID). Most notably, pathogenic B cells not only are the source of antibodies but also function as potent effectors mainly via ...

    Abstract The advent of B-cell targeted agents has prompted reappraisal of the role of B cells in the pathogenesis of autoimmune diseases (AID). Most notably, pathogenic B cells not only are the source of antibodies but also function as potent effectors mainly via antigen presentation and costimulation, and release of pro-inflammatory cytokines. Along with recent findings showing the existence of regulatory B cells, the role of B cells in AID seems more complicated than previously thought. Autoreactive B cells normally remain innocuous by the multi-layered mechanisms of self-tolerance during ontogeny. Disruption of these mechanisms, however, leads to the development of AID, where pathogenic effector B cells are enriched in particular B cell subsets. Given risk/benefit considerations, a novel strategy to selectively target the function of effector B cells would be more preferable than the nonselective B-cell depletion achieved by anti-CD20 therapy in AID.
    MeSH term(s) Autoimmune Diseases/drug therapy ; Autoimmune Diseases/immunology ; B-Lymphocyte Subsets/immunology ; Humans
    Language Japanese
    Publishing date 2015
    Publishing country Japan
    Document type English Abstract ; Journal Article ; Review
    ZDB-ID 2019767-6
    ISSN 1349-7413 ; 0911-4300
    ISSN (online) 1349-7413
    ISSN 0911-4300
    DOI 10.2177/jsci.38.412
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Low avidity observed for anti-citrullinated peptide antibody is not a general phenomenon for autoantibodies.

    Yamada, Hisakata / Haraguchi, Akihisa / Tsuru, Tomomi / Kondo, Masakazu / Sagawa, Fumiaki / Niiro, Hiroaki / Nakashima, Yasuharu

    Annals of the rheumatic diseases

    2023  Volume 82, Issue 12, Page(s) 1637–1638

    MeSH term(s) Humans ; Autoantibodies ; Peptides ; Arthritis, Rheumatoid ; Peptides, Cyclic ; Citrulline
    Chemical Substances Autoantibodies ; Peptides ; Peptides, Cyclic ; Citrulline (29VT07BGDA)
    Language English
    Publishing date 2023-07-10
    Publishing country England
    Document type Letter
    ZDB-ID 7090-7
    ISSN 1468-2060 ; 0003-4967
    ISSN (online) 1468-2060
    ISSN 0003-4967
    DOI 10.1136/ard-2023-224303
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  4. Article ; Online: Streptococcal Toxic Shock Syndrome due to Streptococcus dysgalactiae subsp. equisimilis from Retroperitoneal Panniculitis during the treatment with anti-IL-6 receptor antibody: A Case Report.

    Fujimoto, Sho / Eriguchi, Yoshihiro / Nakamura, Rinto / Kamikawa, Sota / Yonekawa, Akiko / Miyake, Noriko / Ono, Nobuyuki / Niiro, Hiroaki

    Modern rheumatology case reports

    2024  

    Abstract: A 53-year-old man with adult-onset Still's disease developed severe streptococcal toxic shock syndrome (STSS) due to Streptococcus dysgalactiae subsp. equisimilis (SDSE), following retroperitoneal panniculitis. He was receiving tocilizumab (TCZ), an ... ...

    Abstract A 53-year-old man with adult-onset Still's disease developed severe streptococcal toxic shock syndrome (STSS) due to Streptococcus dysgalactiae subsp. equisimilis (SDSE), following retroperitoneal panniculitis. He was receiving tocilizumab (TCZ), an interleukin-6 receptor inhibitor. The modifying effect of TCZ on the immune response and the pathophysiology of SDSE infection may have led to retroperitoneal panniculitis and atypical STSS with delayed shock and flare of soft tissue inflammation.
    Language English
    Publishing date 2024-01-12
    Publishing country England
    Document type Journal Article
    ISSN 2472-5625
    ISSN (online) 2472-5625
    DOI 10.1093/mrcr/rxae001
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  5. Article ; Online: Successful Treatment of Systemic Sclerosis-related Pericarditis with Mycophenolate Mofetil and Low-dose Prednisolone.

    Higashioka, Kazuhiko / Migita, Rioko / Ota, Toshiyuki / Uchino, Ayumi / Niiro, Hiroaki

    Internal medicine (Tokyo, Japan)

    2022  Volume 61, Issue 20, Page(s) 3125–3130

    Abstract: We herein report a case of systemic sclerosis (SSc)-related pericarditis successfully treated with mycophenolate mofetil (MMF) and low-dose prednisolone (PSL). The patient was a 72-year-old woman with anti-centromere antibody. Her clinical manifestations ...

    Abstract We herein report a case of systemic sclerosis (SSc)-related pericarditis successfully treated with mycophenolate mofetil (MMF) and low-dose prednisolone (PSL). The patient was a 72-year-old woman with anti-centromere antibody. Her clinical manifestations were Raynaud phenomenon, bilateral pleural effusion, pericardial effusion and skin tightness. Based on the findings of exudative pericardial effusion with the absence of pulmonary arterial hypertension from the results of the cardiac catheter and pericardiocentesis, she was diagnosed with SSc-related pericarditis and treated with PSL10 mg and MMF 1 g per day, leading to the complete resolution of pericarditis. These findings suggested that MMF and low-dose PSL were effective for SSc-related pericarditis.
    MeSH term(s) Aged ; Female ; Humans ; Mycophenolic Acid/therapeutic use ; Pericardial Effusion/drug therapy ; Pericardial Effusion/etiology ; Pericarditis/diagnosis ; Pericarditis/drug therapy ; Pericarditis/etiology ; Prednisolone/therapeutic use ; Scleroderma, Systemic/complications ; Scleroderma, Systemic/drug therapy
    Chemical Substances Prednisolone (9PHQ9Y1OLM) ; Mycophenolic Acid (HU9DX48N0T)
    Language English
    Publishing date 2022-03-12
    Publishing country Japan
    Document type Case Reports ; Journal Article
    ZDB-ID 32371-8
    ISSN 1349-7235 ; 0021-5120 ; 0918-2918
    ISSN (online) 1349-7235
    ISSN 0021-5120 ; 0918-2918
    DOI 10.2169/internalmedicine.8844-21
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  6. Article ; Online: Correction to: Effectiveness and safety of sarilumab in patients with rheumatoid arthritis: A multicenter, retrospective, inverse probability of treatment-weighted analysis based on the FRAB-registry.

    Harada, Hiroshi / Kondo, Masakazu / Maeyama, Akira / Fukuda, Takaaki / Ikemura, Satoshi / Shono, Eisuke / Tsuru, Tomomi / Inoue, Yasushi / Yoshizawa, Seiji / Niiro, Hiroaki / Nakashima, Yasuharu

    Clinical rheumatology

    2024  Volume 43, Issue 5, Page(s) 1787–1791

    Language English
    Publishing date 2024-03-15
    Publishing country Germany
    Document type Published Erratum
    ZDB-ID 604755-5
    ISSN 1434-9949 ; 0770-3198
    ISSN (online) 1434-9949
    ISSN 0770-3198
    DOI 10.1007/s10067-024-06907-6
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  7. Article ; Online: Peripheral helper-T-cell-derived CXCL13 is a crucial pathogenic factor in idiopathic multicentric Castleman disease.

    Harada, Takuya / Kikushige, Yoshikane / Miyamoto, Toshihiro / Uno, Kazuko / Niiro, Hiroaki / Kawakami, Atsushi / Koga, Tomohiro / Akashi, Koichi / Yoshizaki, Kazuyuki

    Nature communications

    2023  Volume 14, Issue 1, Page(s) 6959

    Abstract: Castleman disease (CD) is a rare lymphoproliferative disorder. Among subtypes of CD, idiopathic multicentric CD-not otherwise specified (iMCD-NOS) has a poor prognosis and its pathogenesis is largely unknown. Here we present a xenotransplantation model ... ...

    Abstract Castleman disease (CD) is a rare lymphoproliferative disorder. Among subtypes of CD, idiopathic multicentric CD-not otherwise specified (iMCD-NOS) has a poor prognosis and its pathogenesis is largely unknown. Here we present a xenotransplantation model of iMCD-NOS pathogenesis. Immunodeficient mice, transplanted with lymph node (LN) cells from iMCD-NOS patients, develop iMCD-like lethal inflammation, while mice transplanted with LN cells from non-iMCD patients without inflammation serve as negative control. Grafts depleted of human CD3
    MeSH term(s) Humans ; Animals ; Mice ; Castleman Disease/etiology ; Castleman Disease/pathology ; Lymph Nodes/pathology ; Inflammation/complications ; T-Lymphocytes/pathology ; Chemokine CXCL13
    Chemical Substances CXCL13 protein, human ; Chemokine CXCL13
    Language English
    Publishing date 2023-10-31
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2553671-0
    ISSN 2041-1723 ; 2041-1723
    ISSN (online) 2041-1723
    ISSN 2041-1723
    DOI 10.1038/s41467-023-42718-0
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  8. Article: Case Report: Resolution of remitting seronegative symmetrical synovitis with pitting edema during nivolumab therapy for gastric cancer.

    Ohmura, Hirofumi / Kondo, Moe / Uenomachi, Masato / Ariyama, Hiroshi / Ito, Mamoru / Tsuchihashi, Kenji / Ayano, Masahiro / Niiro, Hiroaki / Akashi, Koichi / Baba, Eishi

    Frontiers in oncology

    2023  Volume 13, Page(s) 1260818

    Abstract: The anti-programmed cell death-1 (PD-1) antibody nivolumab has been shown to significantly prolong the survival of patients with unresectable advanced or recurrent gastric cancer (AGC). However, immune-related adverse events (irAEs), which show different ...

    Abstract The anti-programmed cell death-1 (PD-1) antibody nivolumab has been shown to significantly prolong the survival of patients with unresectable advanced or recurrent gastric cancer (AGC). However, immune-related adverse events (irAEs), which show different profiles from those of cytotoxic agents or conventional molecular-targeted drugs including tyrosine kinase inhibitors, have been reported. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare autoimmune disorder with acute-onset, rheumatoid factor-negative, symmetric synovitis associated with limb edema observed in elderly persons. A case of RS3PE syndrome that developed after administration of nivolumab for advanced gastric cancer is reported. This is the first report of a case of RS3PE syndrome as an irAE caused by nivolumab in a patient with gastric cancer.
    Language English
    Publishing date 2023-10-05
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2649216-7
    ISSN 2234-943X
    ISSN 2234-943X
    DOI 10.3389/fonc.2023.1260818
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  9. Article ; Online: Relationships between Type 1 interferon signatures and clinical features of the new-onset lupus patients in Japan.

    Shirahama, Yuri / Hashimoto, Aki / Ono, Nobuyuki / Takeyama, Yukiko / Maruyama, Akihito / Inoue, Takuya / Tada, Yoshifumi / Niiro, Hiroaki

    Modern rheumatology

    2023  Volume 34, Issue 2, Page(s) 346–351

    Abstract: Objectives: The objective of the study is to investigate the relationships between Type 1 interferon (T1-IFN) signatures and clinical characteristics of lupus patients.: Methods: We examined 49 new-onset lupus patients who were diagnosed between 1999 ...

    Abstract Objectives: The objective of the study is to investigate the relationships between Type 1 interferon (T1-IFN) signatures and clinical characteristics of lupus patients.
    Methods: We examined 49 new-onset lupus patients who were diagnosed between 1999 and 2017. The patients treated with >10 mg of prednisolone or hydroxychloroquine were excluded from this study. Serum T1-IFN signatures were revealed by a functional reporter assay and standardized by recombinant IFN-α. Patient backgrounds, clinical findings, and treatments were retrospectively extracted from their electrical medical records. Clinical data were also available, including SLE Disease Activity Index of SLE patients on admission.
    Results: T1-IFN signatures of lupus patients closely correlated with lupus disease activities, such as SLE Disease Activity Index-2K, white blood cell, C3 levels, and the titre of double-strand DNA antibody. We found fever and acute lupus dermatitis closely associated with T1-IFN signature.
    Conclusions: In lupus patients, fever and acute lupus dermatitis are good indicators of a strong T1-IFN signature.
    MeSH term(s) Humans ; Japan ; Retrospective Studies ; Interferon Type I ; Dermatitis ; Lupus Erythematosus, Systemic/diagnosis ; Lupus Erythematosus, Systemic/drug therapy
    Chemical Substances Interferon Type I
    Language English
    Publishing date 2023-01-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 2078157-X
    ISSN 1439-7609 ; 1439-7595
    ISSN (online) 1439-7609
    ISSN 1439-7595
    DOI 10.1093/mr/road015
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    Zs.B 2982: Show issues Location:
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  10. Article: [Interleukin-2(IL-2) and its receptor].

    Niiro, Hiroaki

    Nihon rinsho. Japanese journal of clinical medicine

    2010  Volume 68 Suppl 7, Page(s) 69–71

    MeSH term(s) Humans ; Immunoenzyme Techniques ; Interleukin-2/blood ; Receptors, Interleukin-2/blood
    Chemical Substances Interleukin-2 ; Receptors, Interleukin-2
    Language Japanese
    Publishing date 2010-07
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 390903-7
    ISSN 0047-1852
    ISSN 0047-1852
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