京都大学 · Medicine
나오토 타나베 교수의 연구실은 만성 폐쇄성 폐질환(COPD)의 병태생리적 기전을 고해상도 영상 및 체계적 조직학적 분석을 통해 규명하고 있습니다. 특히 소기능 기도의 병변, 병변이 보이지 않는 미세 기도의 변화, 그리고 폐의 복잡한 기하학적 구조(프랙탈 특성)에 초점을 맞추고 있으며, CT 영상 기반 생체지표 개발을 통해 질환 진행을 정량적으로 평가하는 데 기여하고 있습니다. 특히 기도-폐 상호작용의 비율 불균형, 병변의 분포 패atters 등이 FEV1 저하에 미치는 영향을 밝혀내는 데 핵심적인 연구를 수행하고 있습니다.
표시된 성과는 수집된 데이터 기준으로 산출되며, 일부 차이가 있을 수 있습니다.
This is the first longitudinal study to demonstrate that exacerbations are involved in emphysema progression in patients with chronic obstructive pulmonary disease. Emphysema progression should be evaluated as part of the outcomes of exacerbations in the management of chronic obstructive pulmonary disease.
The small conducting airways are the major site of obstruction in chronic obstructive pulmonary disease (COPD). This study examined small airway pathology using a novel combination of multidetector row computed tomography (MDCT), micro-computed tomography (microCT) and histology.Airway branches visible on specimen MDCT were counted and the dimensions of the third- to fifth-generation airways were computed, while the terminal bronchioles (designated TB), preterminal bronchioles (TB-1) and pre-pre
These results provide new information about small airways pathology in centrilobular and panlobular emphysema and show that these changes affect airways that are not visible with thoracic multidetector computed tomography scans but located proximal to the terminal bronchioles in chronic obstructive pulmonary disease.
A disproportionally small airway tree with a relatively large lung could lead to airflow obstruction and gas trapping in COPD. AWV% is an easily measured CT biomarker that may elucidate the clinical impacts of the airway-lung interaction in COPD.
A more homogeneous distribution of emphysema contributed to an accelerated decline in FEV1 independently of baseline pulmonary function, whole-lung emphysema severity, and smoking status. In addition to whole-lung analysis of emphysema, CT assessment of the cranial-caudal distribution of emphysema might be useful for predicting rapid, progressive disease and for developing a targeted strategy with which to prevent disease progression.
Chest CT is often used for localizing and quantitating pathologies associated with chronic obstructive pulmonary disease (COPD). While simple measurements of areas and volumes of emphysema and airway structure are common, these methods do not capture the structural complexity of the COPD lung. Since the concept of fractals has been successfully applied to evaluate complexity of the lung, this review is aimed at describing the fractal properties of airway disease, emphysema, and vascular abnormal
<b>Rationale:</b> Although centrilobular emphysema (CLE) and paraseptal emphysema (PSE) are commonly identified on multidetector computed tomography (MDCT), little is known about the pathology associated with PSE compared with that of CLE.<b>Objectives:</b> To assess the pathological differences between PSE and CLE in chronic obstructive pulmonary disease (COPD).<b>Methods:</b> Air-inflated frozen lung specimens (<i>n</i> = 6) obtained from patients with severe COPD treated by lung transplantati
The concept that the small airway is a primary pathological site for all COPD phenotypes has been challenged by recent findings that the disease starts from the central airways in COPD subgroups and that a smaller central airway tree increases COPD risk. This study aimed to examine whether the computed tomography (CT)-based airway disease-dominant (AD) subtype, defined using the central airway dimension, was less associated with small airway dysfunction (SAD) on CT, compared to the emphysema-dom
Susceptibility to parenchymal destruction induced by continuous smoking is not uniform over the lung, but might be higher in local regions of relatively advanced emphysema. These could result in the spatially heterogeneous progression of emphysema in current smokers.
Using a mouse model of COPD exacerbation, we demonstrated that thioredoxin-1 ameliorated neutrophilic inflammation by suppressing GM-CSF release, which prevented emphysema progression. Our findings deepen understanding of the mechanisms underlying the regulation of neutrophilic inflammation by thioredoxin-1 and indicate that thioredoxin-1 could have potential as a drug to counteract COPD exacerbation.
Multiple CT indices are associated with disease progression and mortality in patients with COPD, but which indices have the strongest association remain unestablished. This longitudinal 10-year observational study (n=247) showed that the emphysema severity on CT is more closely associated with the progression of airflow limitation and that a reduction in the cross-sectional area of erector spinae muscles (ESM<sub>CSA</sub>) on CT is more closely associated with mortality than the other CT indice
Chest computed tomography (CT) is used to screen for lung cancer and evaluate pulmonary and extra-pulmonary abnormalities such as emphysema and coronary artery calcification, particularly in smokers. In real-world practice, lung abnormalities are visually assessed using high-contrast thin-slice images which are generated from raw scan data using sharp reconstruction kernels with the sacrifice of increased image noise. In contrast, accurate CT quantification requires low-contrast thin-slice image