Honma, Koichiro

写真a

Affiliation

School of Medicine, Department of Emergency and Critical Care Medicine (Shinanomachi)

Position

Associate Professor
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Academic Degrees 【 Display / hide 】

  • 医学博士, 慶應義塾大学

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Papers 【 Display / hide 】

  • Early intubation and decreased in-hospital mortality in patients with coronavirus disease 2019

    Yamamoto R., Kaito D., Homma K., Endo A., Tagami T., Suzuki M., Umetani N., Yagi M., Nashiki E., Suhara T., Nagata H., Kabata H., Fukunaga K., Yamakawa K., Hayakawa M., Ogura T., Hirayama A., Yasunaga H., Sasaki J.

    Critical Care (Critical Care)  26 ( 1 )  2022.12

    ISSN  13648535

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    Background: Some academic organizations recommended that physicians intubate patients with COVID-19 with a relatively lower threshold of oxygen usage particularly in the early phase of pandemic. We aimed to elucidate whether early intubation is associated with decreased in-hospital mortality among patients with novel coronavirus disease 2019 (COVID-19) who required intubation. Methods: A multicenter, retrospective, observational study was conducted at 66 hospitals in Japan where patients with moderate-to-severe COVID-19 were treated between January and September 2020. Patients who were diagnosed as COVID-19 with a positive reverse-transcription polymerase chain reaction test and intubated during admission were included. Early intubation was defined as intubation conducted in the setting of ≤ 6 L/min of oxygen usage. In-hospital mortality was compared between patients with early and non-early intubation. Inverse probability weighting analyses with propensity scores were performed to adjust patient demographics, comorbidities, hemodynamic status on admission and time at intubation, medications before intubation, severity of COVID-19, and institution characteristics. Subgroup analyses were conducted on the basis of age, severity of hypoxemia at intubation, and days from admission to intubation. Results: Among 412 patients eligible for the study, 110 underwent early intubation. In-hospital mortality was lower in patients with early intubation than those with non-early intubation (18 [16.4%] vs. 88 [29.1%]; odds ratio, 0.48 [95% confidence interval 0.27–0.84]; p = 0.009, and adjusted odds ratio, 0.28 [95% confidence interval 0.19–0.42]; p < 0.001). The beneficial effects of early intubation were observed regardless of age and severity of hypoxemia at time of intubation; however, early intubation was associated with lower in-hospital mortality only among patients who were intubated later than 2 days after admission. Conclusions: Early intubation in the setting of ≤ 6 L/min of oxygen usage was associated with decreased in-hospital mortality among patients with COVID-19 who required intubation. Trial Registration None.

  • Extracorporeal cardiopulmonary resuscitation in adult patients with out-of-hospital cardiac arrest: a retrospective large cohort multicenter study in Japan

    Inoue A., Hifumi T., Sakamoto T., Okamoto H., Kunikata J., Yokoi H., Sawano H., Egawa Y., Kato S., Sugiyama K., Bunya N., Kasai T., Ijuin S., Nakayama S., Kanda J., Kanou S., Takiguchi T., Yokobori S., Takada H., Inoue K., Takeuchi I., Honzawa H., Kobayashi M., Hamagami T., Takayama W., Otomo Y., Maekawa K., Shimizu T., Nara S., Nasu M., Takahashi K., Hagiwara Y., Kushimoto S., Fukuda R., Ogura T., Shiraishi S.i., Zushi R., Otani N., Kikuchi M., Watanabe K., Nakagami T., Shoko T., Kitamura N., Otani T., Matsuoka Y., Aoki M., Sakuraya M., Arimoto H., Homma K., Naito H., Nakao S., Okazaki T., Tahara Y., Kuroda Y., Senda A., Suzuki H., Tanimoto A., Kitagawa K., Katayama Y., Igarashi N., Kawano M., Kuroki Y., Umehara T., Sasaki Y., Tominaga N., Hamaguchi T., Sakai T., Abe T., Hanafusa H., Yamaoka Y., Kakizaki Y., Sakato S., Kashiwabara S., Kadoya T., Misumi K., Kobayashi T., Yamada S., Kobayashi M., Akashi N., Kuno M., Maruyama J., Kobata H., Soh M., Shirasaki K., Shiba D., Isokawa S., Uchida M., Sakurai A., Tatsukawa H., Nishikawa M., Kojima M., Kosaki R., Shimazui T., Kinoshita H., Sawada Y., Yamamoto R., Masuzawa Y., Matsumura K., Shimazaki J.

    Critical Care (Critical Care)  26 ( 1 )  2022.12

    ISSN  13648535

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    Background: The prevalence of extracorporeal cardiopulmonary resuscitation (ECPR) in patients with out-of-hospital cardiac arrest (OHCA) has been increasing rapidly worldwide. However, guidelines or clinical studies do not provide sufficient data on ECPR practice. The aim of this study was to provide real-world data on ECPR for patients with OHCA, including details of complications. Methods: We did a retrospective database analysis of observational multicenter cohort study in Japan. Adult patients with OHCA of presumed cardiac etiology who received ECPR between 2013 and 2018 were included. The primary outcome was favorable neurological outcome at hospital discharge, defined as a cerebral performance category of 1 or 2. Results: A total of 1644 patients with OHCA were included in this study. The patient age was 18–93 years (median: 60 years). Shockable rhythm in the initial cardiac rhythm at the scene was 69.4%. The median estimated low flow time was 55 min (interquartile range: 45–66 min). Favorable neurological outcome at hospital discharge was observed in 14.1% of patients, and the rate of survival to hospital discharge was 27.2%. The proportions of favorable neurological outcome at hospital discharge in terms of shockable rhythm, pulseless electrical activity, and asystole were 16.7%, 9.2%, and 3.9%, respectively. Complications were observed during ECPR in 32.7% of patients, and the most common complication was bleeding, with the rates of cannulation site bleeding and other types of hemorrhage at 16.4% and 8.5%, respectively. Conclusions: In this large cohort, data on the ECPR of 1644 patients with OHCA show that the proportion of favorable neurological outcomes at hospital discharge was 14.1%, survival rate at hospital discharge was 27.2%, and complications were observed during ECPR in 32.7%.

  • Intestinal Epithelial NAD<sup>+</sup>Biosynthesis Regulates GLP-1 Production and Postprandial Glucose Metabolism in Mice

    Nagahisa T., Yamaguchi S., Kosugi S., Homma K., Miyashita K., Irie J., Yoshino J., Itoh H.

    Endocrinology (United States) (Endocrinology (United States))  163 ( 4 )  2022.04

    ISSN  00137227

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    Obesity is associated with perturbations in incretin production and whole-body glucose metabolism, but the precise underlying mechanism remains unclear. Here, we tested the hypothesis that nicotinamide phosphoribosyltransferase (NAMPT), which mediates the biosynthesis of nicotinamide adenine dinucleotide (NAD+), a key regulator of cellular energy metabolism, plays a critical role in obesity-associated intestinal pathophysiology and systemic metabolic complications. To this end, we generated a novel mouse model, namely intestinal epithelial cell-specific Nampt knockout (INKO) mice. INKO mice displayed diminished glucagon-like peptide-1 (GLP-1) production, at least partly contributing to reduced early-phase insulin secretion and postprandial hyperglycemia. Mechanistically, loss of NAMPT attenuated the Wnt signaling pathway, resulting in insufficient GLP-1 production. We also found that diet-induced obese mice had compromised intestinal NAMPT-mediated NAD+ biosynthesis and Wnt signaling pathway, associated with impaired GLP-1 production and whole-body glucose metabolism, resembling the INKO mice. Finally, administration of a key NAD+ intermediate, nicotinamide mononucleotide (NMN), restored intestinal NAD+ levels and obesity-associated metabolic derangements, manifested by a decrease in ileal Proglucagon expression and GLP-1 production as well as postprandial hyperglycemia in INKO and diet-induced obese mice. Collectively, our study provides mechanistic and therapeutic insights into intestinal NAD+ biology related to obesity-associated dysregulation of GLP-1 production and postprandial hyperglycemia.

  • Hydrogen gas with extracorporeal cardiopulmonary resuscitation improves survival after prolonged cardiac arrest in rats

    Yin T., Becker L.B., Choudhary R.C., Takegawa R., Shoaib M., Shinozaki K., Endo Y., Homma K., Rolston D.M., Eguchi S., Ariyoshi T., Matsumoto A., Oka K., Takahashi M., Aoki T., Miyara S.J., Nishikimi M., Sasaki J., Kim J., Molmenti E.P., Hayashida K.

    Journal of Translational Medicine (Journal of Translational Medicine)  19 ( 1 )  2021.12

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    Background: Despite the benefits of extracorporeal cardiopulmonary resuscitation (ECPR) in cohorts of selected patients with cardiac arrest (CA), extracorporeal membrane oxygenation (ECMO) includes an artificial oxygenation membrane and circuits that contact the circulating blood and induce excessive oxidative stress and inflammatory responses, resulting in coagulopathy and endothelial cell damage. There is currently no pharmacological treatment that has been proven to improve outcomes after CA/ECPR. We aimed to test the hypothesis that administration of hydrogen gas (H2) combined with ECPR could improve outcomes after CA/ECPR in rats. Methods: Rats were subjected to 20 min of asphyxial CA and were resuscitated by ECPR. Mechanical ventilation (MV) was initiated at the beginning of ECPR. Animals were randomly assigned to the placebo or H2 gas treatment groups. The supplement gas was administered with O2 through the ECMO membrane and MV. Survival time, electroencephalography (EEG), brain functional status, and brain tissue oxygenation were measured. Changes in the plasma levels of syndecan-1 (a marker of endothelial damage), multiple cytokines, chemokines, and metabolites were also evaluated. Results: The survival rate at 4 h was 77.8% (7 out of 9) in the H2 group and 22.2% (2 out of 9) in the placebo group. The Kaplan–Meier analysis showed that H2 significantly improved the 4 h-survival endpoint (log-rank P = 0.025 vs. placebo). All animals treated with H2 regained EEG activity, whereas no recovery was observed in animals treated with placebo. H2 therapy markedly improved intra-resuscitation brain tissue oxygenation and prevented an increase in central venous pressure after ECPR. H2 attenuated an increase in syndecan-1 levels and enhanced an increase in interleukin-10, vascular endothelial growth factor, and leptin levels after ECPR. Metabolomics analysis identified significant changes at 2 h after CA/ECPR between the two groups, particularly in d-glutamine and d-glutamate metabolism. Conclusions: H2 therapy improved mortality in highly lethal CA rats rescued by ECPR and helped recover brain electrical activity. The underlying mechanism might be linked to protective effects against endothelial damage. Further studies are warranted to elucidate the mechanisms responsible for the beneficial effects of H2 on ischemia–reperfusion injury in critically ill patients who require ECMO support.

  • The real-time reverse transcription-polymerase chain reaction threshold cycle values for severe acute respiratory syndrome coronavirus 2 predict the prognosis of coronavirus disease 2019 pneumonia

    Fukushima T., Kabata H., Yamamoto R., Suhara T., Uwamino Y., Kondo Y., Masaki K., Kamata H., Nagata H., Homma K., Kaneko Y., Ishii M., Sasaki J., Morisaki H., Hasegawa N., Fukunaga K.

    Respiratory Investigation (Respiratory Investigation)  59 ( 3 ) 360 - 363 2021.05

    ISSN  22125345

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    The clinical course of coronavirus disease 2019 (COVID-19) varies from mild to critical. We retrospectively examined whether clinical and laboratory findings on admission could predict COVID-19 prognosis. Among various factors associated with COVID-19 severity, our results indicated that the real-time reverse transcription-polymerase chain reaction (RT-PCR) threshold cycle (Ct) values for severe acute respiratory syndrome coronavirus 2 were the most useful predictor of COVID-19 prognosis.

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Papers, etc., Registered in KOARA 【 Display / hide 】

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Presentations 【 Display / hide 】

  • アンジオテンシン抑制による蛋白尿減少作用の経時的比較検討

    Hayashi Kouichi，Honma Kouichirou，Kanda Takeshi，Saruta Takao

    第22回日本臨床薬理学会総会, 

    2001.12

  • 食塩感受性ラットの腎微小循環における酸化ストレスの役割

    Kanda Takeshi，Hayashi Kouichi，Honma Kouichirou，Ozawa Yuri，Ookubo Ken，Takamatsu Ichirou，Tatematsu Satoru，Saruta Takao

    第5回日本心血管内分泌代謝学会総会, 

    2001.11

  • 慢性腎炎におけるACE-IとARBの腎保護作用の長期比較検討

    Matsuda Hiroto，Honma Kouichirou，Hayashi Kouichi，Saruta Takao

    第5回日本心血管内分泌代謝学会総会, 

    2001.11

  • Direct evidence for impaired endothelial function in renal microcirculation of acute hyperhomocysteinemia in vivo

    Okubo Ken, Hayashi Koichi, Honda Masanori, Tokuyama Hirobumi, Takamatsu Ichiro, Ozawa Yuri, Homma Koichiro, Saruta Takao

    Annual Meeting of American Society of Nephrology (34th ; 2001 ; San Francisco, CA, USA), 

    2001.10

  • Enhanced intrarenal ACE- but not chymase-dependent angiotensin II generation in chronic renal failure

    Okubo Ken, Hayashi Koichi, Honda Masanori, Tokuyama Hirobumi, Takamatsu Ichiro, Ozawa Yuri, Homma Koichiro, Saruta Takao

    Annual Meeting of American Society of Nephrology (34th ; 2001 ; San Francisco, CA, USA), 

    2001.10

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Research Projects of Competitive Funds, etc. 【 Display / hide 】

  • NAD合成系を標的とした心停止後症候群に対する新規治療法開発と重症病態での役割解明

    2023.04
    -
    2026.03

    基盤研究(B), Principal investigator

  • iPS細胞とH2ガスを利用した網羅的アプローチよる急性腎障害への新規治療法の開発

    2019.04
    -
    2022.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (B), Principal investigator

  • リプログラミングによる皮下脂肪細胞から皮膚線維芽細胞への直接誘導法の開発

    2016.04
    -
    2019.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (B), Principal investigator

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Courses Taught 【 Display / hide 】

  • LECTURE SERIES, EMERGENCY MEDICINE

    2025

  • EMERGENCY MEDICINE AND NURSING

    2025

  • CLINICAL CLERKSHIP IN EMERGENCY MEDICINE

    2025

  • LECTURE SERIES, EMERGENCY MEDICINE

    2024

  • EMERGENCY MEDICINE AND NURSING

    2024

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