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Radiation therapy has been shown to be adaptable for various stages of hepatocellular carcinoma

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World Journal of Gastroenterology 2015年第1期21卷 94-101页

作者： yasuteru kondo Osamu Kimura Tooru Shimosegawa Division of Gastroenterology Tohoku University HospitalSendai 980-8574Japan

In addition to surgical procedures, radiofrequency ablation is commonly used for the treatment of hepatocellular carcinomas(HCCs) of limited size and number. Transcatheter arterial chemoembolization(TACE), using iodized poppy seed oil, Lipiodol and anticancer drugs, has been actively performed for the treatment of unresectable HCC, particularly in Asian countries. Recently, Sorafenib become available for advanced HCCs when the liver is still sufficiently functional. Sorafenib is an oral multikinase inhibitor with antiproliferative and antiangiogenic effects. However, the effect of sorafenib seems to be inadequate to control the progression of HCC. Radiation therapy(RT)for HCC has a potential role across all stages of HCC. However, RT is generally not considered an option in HCC consensus documents or national guidelines, primarily because of insufficient supporting evidence. However, the method of RT has much improved because of advances in technology. Moreover, combined treatment of RT plus other treatments(TACE, sorafenib and chemotherapy etc.) has become one of the alternative therapies for HCC. Therefore, we should understand the various kinds of RT available for HCC. In this review, we focus on various kinds of external beam radiation therapy.

关键词： Hepatocellular carcinoma Radiofrequency ablation T

Direct effects of hepatitis C virus on the lymphoid cells

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World Journal of Gastroenterology 2013年第44期19卷 7889-7895页

作者： yasuteru kondo Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine Sendai City Miygai 980-0873 Japan

It has been reported that the direct binding of hepatitis C virus(HCV)and/or the replication of HCV in the extrahepatic organs and,especially,lymphoid cells,might affect the pathogenesis of extrahepatic diseases with HCV *** than one decade ago,several reports described the existence of HCV-RNA in peripheral blood mononuclear ***,many reports describing the existence of HCV in B lymphocytes and B cell lymphoma have been *** addition to B lymphocytes,it was reported that HCV replication could be detected in T lymphocytes and T cell *** the extrahepatic diseases with HCV infection,mixed cryoglobulinemia-related diseases and autoimmunerelated diseases are important for understanding the immunopathogensis of HCV persistent ***,HCV persistent infection can cause malignant *** biological significance of lymphotropic HCV has not yet become ***,several candidates have been considered for a long *** is that lymphotropic HCV is an HCV reservoir that might contribute to the recurrence of HCV infection and difficultto-treat disease *** other important issue is the carcinogenesis of the lymphoid cells and disturbances of the immune ***,the extrahepatic diseases might be induced by direct interaction between HCV and lymphoid *** this article,we summarize various studies showing the direct effect of HCV on lymphoid cells and discuss the biological significance of lymphotropic HCV.

关键词： Hepatitis C virus Lymphotropism T cell B cell Immunology

Mechanism of T cell hyporesponsiveness to HBcAg is associated with regulatory T cells in chronic hepatitis B

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World Journal of Gastroenterology 2006年第27期12卷 4310-4317页

作者： yasuteru kondo Koju Kobayashi Yoshiyuki Ueno Masaaki Shiina Hirofumi Niitsuma Noriatsu Kanno Tomoo Kobayashi Tooru Shimosegawa Tohoku University Graduate School of Medicine 1-1 Seiryo-machiAoba-kuSendai 980-8574Japan Tohoku University School of Health Sciences 2-1 Seiryo-machiAoba-kuSendai 980-8575Japan Department of Gastroenterology Sendai Medical Center2-8-8 MiyaginoMiyagino-kuSendai 983-0045Japan Department of Internal Medicine Furukawa City HospitalSenjujimae-machiFurukawa 919-6183Japan

AIM： To study the mechanisms of hyporesponsiveness of HBV-specific CD4^＋ T cells by testing TH1 and TH2 commitment and regulatory T cells. METHODS： Nine patients with chronic hepatitis B were enrolled. Peripheral blood mononuclear cells were stimulated with HBcAg or HBsAg to evaluate their potential to commit to TH1 and TH2 differentiation. HBcAg-specific activity of regulatory T cells was evaluated by staining with antibodies to CD4, CD25, CTLA-4 and interleukin-10. The role of regulatory T cells was further assessed by treatment with anti-interleukin-10 antibody and depletion of CD4^＋CD25^＋ cells. RESULTS： Level of mRNAs for T-bet, IL-12R β2 and IL-4 was significantly lower in the patients than in healthy subjects with HBcAg stimulation. Although populations of CD4^＋CD25^highCTLA-4^＋ T cells were not different between the patients and healthy subjects, IL-10 secreting cells were found in CD4^＋ cells and CD4^＋CD25^＋ cells in the patients in response to HBcAg, and they were not found in cells which were stimulated with HBsAg. Addition of anti-IL-10 antibody recovered the amount of HBcAgspecific TH1 antibody compared with control antibody （P 〈 0.01, 0.34% ± 0.12% vs 0.15% ± 0.04%）. Deletion of CD4^＋CD25^＋ T cells increased the amount of HBcAgspecific TH1 antibody when compared with lymphoo/tes reconstituted using regulatory T cells （P 〈 0.01, 0.03% ± 0.02% vs 0.18% ± 0.05%）.CONCLUSION： The results indicate that the mechanism of T cell hyporesponsiveness to HBcAg includes activation of HBcAg-induced regulatory T cells in contrast to an increase in TH2-committed cells in response to HBsAg.

关键词： Hepatitis B virus Regulatory T cells IL-10 FOXP3 TH1

Pegylated interferon plus ribavirin for genotype Ib chronic hepatitis C in Japan

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World Journal of Gastroenterology 2008年第47期14卷 7225-7230页

作者： Takayuki Kogure Yoshiyuki Ueno Koji Fukushima Futoshi Nagasaki yasuteru kondo Jun Inoue Yasunori Matsuda Eiji Kakazu Takeshi Yamamoto Hiroyoshi Onodera Yutaka Miyazaki Hiromasa Okamoto Takehiro Akahane Tomoo Kobayashi Yutaka Mano Takao Iwasaki Motoyasu Ishii Tooru Shimosegawa Division of Gastroenterology Tohoku University HospitalSendai 980-8574Japan Department of Gastroenterology Tohoku Rosai HospitalSendai 980-8574Japan Department of Gastroenterology Miyagi Cancer CenterNatori 981-1293Japan Department of Internal Medicine Tohoku Kosai HospitalSendai 980-0803Japan Department of Internal Medicine Shirakawa Kosei General HospitalShirakawa 961-0005Japan Department of Gastroenterology Ishinomaki Municipal HospitalIshinomaki 986-0835Japan Department of Gastroenterology Osaki Citizen HospitalFurukawa 989-6183Japan Department of Gastroenterology Sendai Medical CenterSendai 983-8520Japan Department of Internal Medicine Miyagi Social Insurance HospitalSendai 981-1103Japan

AIM:To evaluate the efficacy of pegylated interferon α-2b(peg-IFNα-2b) plus ribavirin(RBV) therapy in Japanese patients with chronic hepatitis C(CHC) genotype Ib and a high viral ***:One hundred and twenty CHC patients(58.3% male) who received peg-IFNα-2b plus RBV therapy for 48 wk were *** virological response(SVR) and clinical parameters were ***:One hundred(83.3%) of 120 patients completed 48 wk of treatment.53 patients(44.3%) achieved *** virological response(EVR) and end of treatment response(ETR) rates were 50% and 73.3%,*** clinical parameters(SVR vs non-SVR) associated with SVR,ALT(108.4 IU/L vs 74.5 IU/L,P = 0.063),EVR(76.4% vs 16.4%,P 56 years),SVR in females was significantly lower than that in males(17% vs 50%,P = 0.0262).EVR and adherence to Peg-IFN were demonstrated to be the main factors associated with ***:Peg-IFNα-2b plus RBV combination therapy demonstrated good tolerability in Japanese patients with CHC and resulted in a SVR rate of 44.3%.Treatment of elderly female patients is still challenging and maintenance of adherence to peg-IFNα-2b is important in improving the SVR rate.

关键词： Chronic hepatitis C Pegylated interferon Ribavirin