特別講演会要旨
雑誌名
東北医学雑誌
巻
129
号
1
ページ
153-154
発行年
2017-06
URL
http://hdl.handle.net/10097/00128692
特 別 講 演 会 東北医誌 129 : 153-154, 2017153
特 別 講 演 会 要 旨
2016 年 11 月から 2017 年 4 月までの間に東北医学会主催で行われた特別講演会は 次のとおりです． 1. 2016 年 11 月 15 日（火）高齢者高次脳医学寄附研究 部門担当Dr. Joe Verghese, MBBS, MS : Professor of
Neurol-ogy & Medicine, Chief, Integrated Divisions of Cognitive & Motor Aging （Neurology） and Geriatrics （Medicine）, Murray D Gross Memorial Faculty Scholar in Gerontol-ogy, Director, Montefiore-Einstein Center for the Aging Brain, Albert Einstein College of Medicine, Bronx, NY, USA
“Foot in Alzheimer world”
Summary : The recently described Motoric Cognitive Risk
syndrome will be described as an example of the expanded clinical spectrum of dementia syndromes that includes non -cognitive symptoms, which in turn offers new avenues of intervention. Pre-dementia syndromes are defined as a tran-sitional stage between normal aging and dementia that is char-acterized by cognitive problems that are more severe for age groups than considered normal, but without significant func-tional decline. The clinical relevance of diagnosing pre -dementia syndromes is to identify individuals at high risk of converting to dementia, which may provide a window to intro-duce preventive measures early in the course of the disease. Pre-dementia syndromes are typically diagnosed based on performance on cognitive tests, biomarkers, or neuroimaging. These approaches are important for gaining insights into the progression of dementia ; however access to these tools is limited. For example, much of the rise in dementia rates globally is attributable to increasing aging populations in low -and middle-income countries where accessibility of neuropsy-chological, laboratory and imaging tests is limited.
Increasingly, studies have indicated that slowing of gait may precede declines in cognitive tests indicating that motor func-tion may be a sensitive early marker of cognitive changes in aging. However, despite overwhelming evidence of the link between motor function and cognition, efforts to utilize motor function to define pre-dementia states in order to predict cog-nitive decline are limited. The Motoric Cogcog-nitive Risk Syn-drome （MCR） is a newly proposed pre-dementia syndrome that is characterized by presence of cognitive complaints and slow gait in older individuals without dementia or disability. MCR criteria developed upon those used to define MCI,
sub-stituting cognitive test performance criterion with gait speed and retaining the remaining operational criteria. Cognitive complaints are ascertained by responses to cognitive status items in standardized questionnaires, and slow gait is defined as walking speed one standard deviation below age and sex specific means. A global prevalence study involving almost 27 thousand older persons from 17 countries showed that MCR was common ; affecting almost 1 in 10 older adults liv-ing in the community. To further explain the epidemiology of MCR and gain insights into underlying causes, we examined the incidence and associated risk factors of MCR in a multi -center study of four U.S. based cohorts with 3,128 healthy older adults. The age- and sex-adjusted incidence of MCR syndrome was 65.2/1,000 person-years. This rate is similar to those reported in other pre-dementia syndromes such as MCI. Among the lifestyle factors examined, physical inactiv-ity, strokes, Parkinson’s disease, obesinactiv-ity, and depressive symp-toms predicted incident MCR. The MCR diagnosis provides clinicians with an opportunity to recommend preventative strategies that might be effective in reducing future risk of dementia. In addition, it offers patients a chance to change any harmful behaviors with the knowledge that they are at a higher risk for developing dementia in the future. This investigation supports an illustrative picture of the types of lifestyle behaviors that are harmful or beneficial in the context of cognitive decline in aging.
References for further reading :
1） Verghese, J., Annweiler, C., Ayers, E., et al. （2014） Motoric Cognitive Risk Syndrome : Multi-country Prevalence and Dementia Risk. Neurology, 83, 718 -726.
2） Verghese, J., Ayers, E., Barzilai, N., et al. （2014） Motoric Cognitive Risk Syndrome : Multi-center Inci-dence Study. Neurology, 83, 2278-2284. PMID : 25361778
（文責 : 目黒謙一） 2. 2016 年 11 月 29 日（火）運動学分野担当
Prof. Giuseppe De Vito : University College Dublin,
Ireland
“Determinants of neuromuscular function in older individuals the impact of exercise and nutrition”
特 別 講 演 会
154
3. 2016 年 11 月 29 日（火）運動学分野担当
Dr. Roberta Forte : University of Rome Foro Italico,
Italy
“Muscular and cognitive efficiency in relation to functional ability, health and quality of life percep-tion in healthy aging”
4. 2016 年 12 月 5 日（月）病理検査学分野担当
Prof. Debabrata Chakravarti : Northwestern
Univer-sity Feinberg School of Medicine Chicago, IL 60611, USA
“Targeting Nuclear Receptors and Epigenomic Sig-naling in Human Diseases”
要旨 : Nuclear hormone receptors are key regulators of normal physiology and human diseases. Epigenomic signaling is now established as a key component of all chromatin-based processes. Leiomyoma （Uterine fibroids） constitutes a major health problem worldwide and is characterized by excessive deposition of extracellular matrix （ECM） and tumorigenesis of uterine smooth muscle cells.
About 75-80% of women are affected by leiomyomas in their lifetime, yet leiomyomas remain shockingly understudied. We will present data demonstrating that targeting a family of nuclear receptors by chemical compounds significantly decreases pathological fibrotic development and thus provides newer therapeutic opportunities.
We have previously demonstrated a role for WDR5 and KAT8 transcriptional cofactors and epigenome signaling components in prostate cancer （Mol. Cell 2014, Mol. Endo 2016）. We will provide evidence that epigenome-cofactor interaction provides a viable platform to identify and characterize drugs for potential prostate cancer treatment.
（文責 : 鈴木 貴） 5. 2017 年 2 月 16 日（木）分子病態医工学分野担当
Dr. Jeffrey B. Kopp : Kidney Diseases Branch.
NIDDK/NIH
“Focal segmental glomerulosclerosis”
6. 2017 年 3 月 23 日（水）血液免疫病学分野担当
Dr. Prabhakar S Kedar : National Institute of
Immu-nohaematology
“Detection of new pathogenic mutations in unex-plained hemolytic anemia in India using cell tar-geted next generation sequencing panel”
要旨 : 赤血球の生体における最も重要な役割は，体組織 への酸素運搬である．赤血球は毎日約 2,000 億個産生され るが，その寿命は約 120 日であり，古くなると脾臓や肝臓 のマクロファージに補足され，分解される．しかし，赤血 球膜に病的変化が生じたり，血管壁の異常や赤血球に対す る自己抗体が生じたりすると，赤血球は寿命を全うする前 に崩壊する．この崩壊が，骨髄における産生能力を上回る と貧血を呈し，この病態を溶血性貧血と呼ぶ．溶血性貧血 は，発症時期と溶血原因の所在により，先天性と後天性に 分類される．先天性溶血性貧血は，赤血球膜や赤血球酵素， ヘモグロビンなどの赤血球に内在する異常である．一方， 後天性溶血性貧血は，赤血球外の環境要因により溶血を来 すことが大多数であるが，造血幹細胞自体の後天性の異常 に伴う発作性夜間血色素尿症も含まれる． 本邦では先天性溶血性貧血は比較的稀であるが，その大 多数は赤血球膜異常に起因する遺伝性球状赤血球症を占め ており，サラセミア・鎌状赤血球症に代表されるヘモグロ ビン異常症やグルコース-6-リン酸脱水素酵素（G6PD）異 常症に代表される赤血球酵素異常症は極めて稀である．一 方，インドにおいては，遺伝性球状赤血球症に加えてヘモ グロビン異常症や赤血球酵素異常に伴う先天性溶血性貧血 も非常に多く認められる．Prabhakar S Kedar 先生は，イン ド国内の先天性溶血性貧血患者の遺伝子診断をこれまでに 数多く行っており，その一連の研究成果が今回紹介された． Kedar先生によると，先天性溶血性貧血患者のうち約半 数近くは原因遺伝子が不明であるが，次世代シークエン サーを用いた網羅的な遺伝子解析を通じて，NADH- cyto-chrome b5 reductaseなどの新規原因遺伝子が次々と同定さ れており，溶血性貧血発症に寄与する新たな病態も明らか となりつつある現状をご紹介頂いた．今後，これらの成果 が，疾患の予防や新規治療法の開発に役立つことが期待さ れる． （文責 : 藤原 亨）
