西村 知泰 (ニシムラ トモヤス)

Nishimura, Tomoyasu

写真a

所属(所属キャンパス)

研究所・センター等 保健管理センター (日吉)

職名

准教授

外部リンク

経歴 【 表示 / 非表示

  • 2000年05月
    -
    2002年04月

    慶應義塾大学医学部, 内科学, 研修医

  • 2002年05月
    -
    2004年05月

    慶應義塾大学医学部, 内科学, 専修医

  • 2004年06月
    -
    2010年01月

    慶應義塾大学医学部, 内科学(呼吸器), 助手

  • 2007年01月
    -
    2010年01月

    慶應義塾大学医学部, 微生物学・免疫学, 研究員

  • 2008年07月
    -
    2010年01月

    佐野厚生総合病院, 内科, 医員

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学歴 【 表示 / 非表示

  • 2000年03月

    慶應義塾大学, 医学部, 医学科

    大学, 卒業

学位 【 表示 / 非表示

  • 博士, 慶應義塾大学, 論文, 2008年06月

免許・資格 【 表示 / 非表示

  • 医師免許, 2000年04月

 

研究分野 【 表示 / 非表示

  • ライフサイエンス / 呼吸器内科学

  • ライフサイエンス / 感染症内科学

研究キーワード 【 表示 / 非表示

  • 抗酸菌症

 

著書 【 表示 / 非表示

  • EBM呼吸器疾患の治療2016-2017

    西村 知泰, 中外医学社, 2016年01月

    担当範囲: Interferon Gamma Release Assayの有用性は?

  • 新 呼吸器専門医テキスト

    西村 知泰, 南江堂, 2015年04月

    担当範囲: 肺結核症

  • 内科研修マニュアル 改訂第2版

    西村 知泰, 南江堂, 2006年07月

    担当範囲: 市中肺炎/院内肺炎

論文 【 表示 / 非表示

  • Longitudinal significance of six-minute walk test in patients with nontuberculous mycobacterial pulmonary disease: an observational study

    Morita A., Yagi K., Asakura T., Namkoong H., Sato Y., Ogawa T., Kusumoto T., Suzuki S., Tanaka H., Lee H., Okamori S., Azekawa S., Nakagawara K., Kaji M., Nagao G., Funatsu Y., Kimizuka Y., Kamata H., Nishimura T., Ishii M., Fukunaga K., Hasegawa N.

    BMC Pulmonary Medicine (BMC Pulmonary Medicine)  23 ( 1 )  2023年12月

     概要を見る

    Background: The long-term exercise tolerance changes in patients with nontuberculous mycobacterial pulmonary disease (NTM-PD) are of great interest because of its chronic course. This study aimed to characterize the associations between changes over time in six-minute walking test (6MWT) parameters and clinical parameters in patients with NTM-PD. Methods: Overall, 188 patients with NTM-PD, visiting outpatient clinics at Keio University Hospital from April 2012 to March 2020 were included in the study. Data were collected using the St. George’s Respiratory Questionnaire (SGRQ), pulmonary function test (PFT), blood tests, and the 6MWT at registration and at least once after that. The association of the anchors and clinical indicators with the 6MWT parameters was assessed. Results: The median age [interquartile range] of the patients was 67 [63–74] years. The median baseline six-minute walk distance (6MWD) and final Borg scale (FBS) were 413 [361–470] m and 1 [0–2], respectively. In the correlation analysis, ΔSGRQ total/year (yr), Δforced vital capacity (FVC, % predicted)/yr, Δforced expiratory volume in 1 s (FEV1, % predicted)/yr, and Δdiffusing capacity for carbon monoxide (DLCO, % predicted)/yr correlated with both Δ6MWD/yr and ΔFBS/yr in the longitudinal analysis (|Rho| > 0.20). When stratified into three quantiles of changes in each anchor, the 6MWT parameters worsened over time in the bottom 25% group by mixed-effects model. Specifically, Δ6MWD was affected by SGRQ activity, SGRQ impacts, PFT (FVC, FEV1, and DLCO), and C-reactive protein (CRP). ΔFBS was affected by all SGRQ components, total score, and PFT. Anchor scores and variables at baseline that worsened Δ6MWD were higher SGRQ scores, lower FVC (% predicted), lower DLCO (% predicted), higher Krebs von den Lungen-6, old age, and undergoing treatment at registration. Similarly, these clinical parameters and elevated CRP, excluding undergoing treatment at registration, worsened ΔFBS. Conclusions: The decreased walking distance and exacerbation of dyspnea on exertion over time in patients with NTM-PD may reflect a deterioration of health-related quality of life and pulmonary function. Thus, the change in 6MWT over time can be used as an indicator to accurately assess the patient’s condition and tailor their healthcare environment.

  • Inactivation of nontuberculous mycobacteria by gaseous ozone treatment

    Misawa K., Nishimura T., Kashimura S., Hasegawa N.

    Journal of Infection and Chemotherapy (Journal of Infection and Chemotherapy)  29 ( 6 ) 628 - 630 2023年06月

    ISSN  1341321X

     概要を見る

    Nontuberculous mycobacteria (NTM) are environmental bacteria resistant to many common disinfectants and ultraviolet radiation. Inhalation of aerosols generated from NTM-containing water and soil causes NTM lung disease, especially in people with underlying lung diseases and decreased immunity. To prevent healthcare-acquired NTM infections, it is important to eradicate NTM living in hospital environments. Therefore, we evaluated the efficacy of gaseous ozone for the inactivation of NTM, namely Mycobacterium (M.) avium, M. intracellulare, M. kansasii, M. abscessus subsp. abscessus and M. abscessus subsp. massiliense. Gaseous ozone treatment at 1 ppm for 3 h reduced the bacterial number of all strains by more than 97%. Gaseous ozone treatment could be a practical, effective and convenient disinfection method for NTM living in hospital environments.

  • Characterization of DNA Gyrase Activity and Elucidation of the Impact of Amino Acid Substitution in GyrA on Fluoroquinolone Resistance in Mycobacterium avium

    Thapa J., Chizimu J.Y., Kitamura S., Akapelwa M.L., Suwanthada P., Miura N., Toyting J., Nishimura T., Hasegawa N., Nishiuchi Y., Gordon S.V., Nakajima C., Suzuki Y.

    Microbiology Spectrum (Microbiology Spectrum)  11 ( 3 )  2023年05月

     概要を見る

    Mycobacterium avium, a member of the M. avium complex (MAC), is the major pathogen contributing to nontuberculous mycobacteria (NTM) infections worldwide. Fluoroquinolones (FQs) are recommended for the treatment of macrolide-resistant MACs. The association of FQ resistance and mutations in the quinolone resistance-determining region (QRDR) of gyrA of M. avium is not yet clearly understood, as many FQ-resistant clinical M. avium isolates do not have such mutations. This study aimed to elucidate the role of amino acid substitution in the QRDR of M. avium GyrA in the development of FQ resistance. We found four clinical M. avium subsp. hominissuis isolates with Asp-to-Gly change at position 95 (Asp95Gly) and Asp95Tyr mutations in gyrA that were highly resistant to FQs and had 2- to 32-fold-higher MICs than the wild-type (WT) isolates. To clarify the contribution of amino acid substitutions to FQ resistance, we produced recombinant WT GyrA, GyrB, and four GyrA mutant proteins (Ala91Val, Asp95Ala, Asp95Gly, and Asp95Tyr) to elucidate their potential role in FQ resistance, using them to perform FQ-inhibited DNA supercoiling assays. While all the mutant GyrAs contributed to the higher (1.3- to 35.6-fold) FQ 50% inhibitory concentration (IC50) than the WT, Asp95Tyr was the most resistant mutant, with an IC50 15- to 35.6-higher than that of the WT, followed by the Asp95Gly mutant, with an IC50 12.5- to 17.6-fold higher than that of the WT, indicating that these amino acid substitutions significantly reduced the inhibitory activity of FQs. Our results showed that amino acid substitutions in the gyrA of M. avium contribute to FQ resistance. IMPORTANCE The emergence of fluoroquinolone (FQ) resistance has further compounded the control of emerging Mycobacterium avium-associated nontuberculous mycobacteria infections worldwide. For M. avium, the association of FQ resistance and mutations in the quinolone resistance-determining region (QRDR) of gyrA is not yet clearly understood. Here, we report that four clinical M. avium isolates with a mutation in the QRDR of gyrA were highly resistant to FQs. We further clarified the impact of mutations in the QRDR of GyrA proteins by performing in vitro FQ-inhibited DNA supercoiling assays. These results confirmed that, like in Mycobacterium tuberculosis, mutations in the QRDR of gyrA also strongly contribute to FQ resistance in M. avium. Since many FQ-resistant M. avium isolates do have these mutations, the detailed molecular mechanism of FQ resistance in M. avium needs further exploration.

  • Single-cell analyses and host genetics highlight the role of innate immune cells in COVID-19 severity

    Edahiro R., Shirai Y., Takeshima Y., Sakakibara S., Yamaguchi Y., Murakami T., Morita T., Kato Y., Liu Y.C., Motooka D., Naito Y., Takuwa A., Sugihara F., Tanaka K., Wing J.B., Sonehara K., Tomofuji Y., Wang Q.S., Hasegawa T., Saiki R., Hyugaji T., Shimizu E., Katayama K., Kanai M., Naito T., Sasa N., Yamamoto K., Takahashi K., Harada N., Naito T., Hiki M., Matsushita Y., Takagi H., Ichikawa M., Nakamura A., Harada S., Sandhu Y., Kabata H., Masaki K., Kamata H., Ikemura S., Chubachi S., Okamori S., Terai H., Morita A., Asakura T., Sasaki J., Morisaki H., Uwamino Y., Nanki K., Uchida S., Uno S., Nishimura T., Ishiguro T., Isono T., Shibata S., Matsui Y., Hosoda C., Takano K., Nishida T., Kobayashi Y., Takaku Y., Takayanagi N., Ueda S., Tada A., Miyawaki M., Yamamoto M., Yoshida E., Hayashi R., Nagasaka T., Arai S., Kaneko Y., Sasaki K., Tagaya E., Kawana M., Arimura K., Takahashi K., Anzai T., Ito S., Endo A., Uchimura Y., Miyazaki Y., Honda T., Tateishi T., Tohda S., Ichimura N., Sonobe K., Sassa C.T., Nakajima J., Nakano Y., Nakajima Y., Anan R., Arai R., Kurihara Y., Harada Y., Nishio K., Ueda T., Azuma M., Saito R., Sado T.

    Nature Genetics (Nature Genetics)  55 ( 5 ) 753 - 767 2023年05月

    ISSN  10614036

     概要を見る

    Mechanisms underpinning the dysfunctional immune response in severe acute respiratory syndrome coronavirus 2 infection are elusive. We analyzed single-cell transcriptomes and T and B cell receptors (BCR) of >895,000 peripheral blood mononuclear cells from 73 coronavirus disease 2019 (COVID-19) patients and 75 healthy controls of Japanese ancestry with host genetic data. COVID-19 patients showed a low fraction of nonclassical monocytes (ncMono). We report downregulated cell transitions from classical monocytes to ncMono in COVID-19 with reduced CXCL10 expression in ncMono in severe disease. Cell–cell communication analysis inferred decreased cellular interactions involving ncMono in severe COVID-19. Clonal expansions of BCR were evident in the plasmablasts of patients. Putative disease genes identified by COVID-19 genome-wide association study showed cell type-specific expressions in monocytes and dendritic cells. A COVID-19-associated risk variant at the IFNAR2 locus (rs13050728) had context-specific and monocyte-specific expression quantitative trait loci effects. Our study highlights biological and host genetic involvement of innate immune cells in COVID-19 severity.

  • Humoral and cellular immune response dynamics in Japanese healthcare workers up to six months after receiving a third dose of BNT162b2 monovalent vaccine

    Uwamino Y., Yokoyama T., Sato Y., Shibata A., Kurafuji T., Tanabe A., Noguchi M., Arai T., Ohno A., Yokota H., Namkoong H., Nishimura T., Kosaki K., Hasegawa N., Wakui M., Murata M., Matsushita H.

    Vaccine (Vaccine)  41 ( 9 ) 1545 - 1549 2023年02月

    ISSN  0264410X

     概要を見る

    Longitudinal data on the immune response from the first dose to several months after the third dose of COVID-19 vaccine are limited. We analyzed the immune response in 406 Japanese healthcare workers who received at least three doses of vaccine. The geometric mean anti-receptor binding domain IgG antibody titers and antigen-stimulated T-cell interferon-gamma levels after 6 months after receiving a third dose were similar to those 8 weeks after receiving a second dose. Humoral and cellular immunity induced by the third dose was more durable than that induced by the second dose. UMIN Clinical Trials Registry ID: UMIN000043340.

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KOARA(リポジトリ)収録論文等 【 表示 / 非表示

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研究発表 【 表示 / 非表示

  • 外国人留学生を対象とした結核感染調査

    西村知泰,森正明,牧野伸司,広瀬寛,和井内由充子,横山裕一,武田彩乃,畔上達彦,後藤伸子,河邊博史

    第116回日本内科学会総会・講演会 (名古屋) , 

    2019年04月

    ポスター発表

  • 肺MAC症の新規検査法

    西村 知泰

    第101回日本細菌学会関東支部総会 (東京) , 

    2018年11月

    シンポジウム・ワークショップ パネル(指名)

  • アスペルギルス沈降抗体陽性である肺Mycobacterium avium complex症患者の臨床的特徴

    鈴木翔二, 朝倉崇徳, 南宮湖, 岡森慧, 八木一馬, 鎌田浩史, 舩津洋平, 中野泰, 西村知泰, 石井誠, 海老原全, 別役智子, 長谷川直樹.

    第58回日本呼吸器学会学術講演会 (大阪) , 

    2018年04月

    ポスター発表

  • 大学生における先天性心疾患の管理状況

    牧野伸司, 和井内由充子, 武田彩乃, 畔上達彦, 広瀬寛, 西村知泰, 横山裕一, 河邊博史, 森正明.

    第115回日本内科学会年次学術講演会 (京都) , 

    2018年04月

    ポスター発表

  • 当大学医学部留学生に対するImmunization Recordの運用と考察

    武藤志保, 横山裕一, 弦巻美保, 齋藤圭美, 西村知泰, 森正明, 河邊博史.

    第55回全国大学保健管理研究集会 (宜野湾) , 

    2017年11月

    ポスター発表

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競争的研究費の研究課題 【 表示 / 非表示

  • 肺MAC症の新規治療法開発に向けた菌細胞壁脂質の解析

    2023年04月
    -
    2026年03月

    文部科学省・日本学術振興会, 科学研究費補助金, 補助金,  研究代表者

  • 肺非結核性抗酸菌症患者の宿主疾患感受遺伝子の機能解析による新規治療基盤の創出

    2023年04月
    -
    2026年03月

    文部科学省・日本学術振興会, 科学研究費補助金, 補助金,  研究分担者

  • 個細胞空間的degradome解析に基づくプロテアーゼを介したがん免疫制御の解明

    2022年04月
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    2026年03月

    文部科学省・日本学術振興会, 科学研究費補助金, 補助金,  研究分担者

  • 末梢気道病変に着目した肺NTM症の新たな治療標的の創出

    2022年04月
    -
    2025年03月

    国立研究開発法人日本医療研究開発機構, 新興・再興感染症研究基盤創生事業, 受託研究,  研究分担者

  • ムチン異常集積に着目した肺非結核性抗酸菌症の病態解明

    2021年10月
    -
    2024年03月

    文部科学省・日本学術振興会, 科学研究費補助金, 補助金,  研究分担者

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担当授業科目 【 表示 / 非表示

  • 現代社会と医学Ⅱ

    2023年度

  • 感染症学

    2023年度

  • 感染症学

    2022年度

  • 感染症学

    2021年度

  • 感染症学

    2020年度

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担当経験のある授業科目 【 表示 / 非表示

  • 感染症学

    慶應義塾

    2018年04月
    -
    2019年03月

    通年, その他, 講義, 兼担

  • 現代社会と医学Ⅱ

    慶應義塾

    2018年04月
    -
    2019年03月

    通年, その他, 講義, 専任

 

社会活動 【 表示 / 非表示

  • 平成27年度外務省巡回医師団

    2016年02月
    -
    2016年03月
  • 平成26年度外務省巡回医師団

    2015年01月
    -
    2015年02月

所属学協会 【 表示 / 非表示

  • 日本免疫学会

     
  • 日本内科学会

     
  • 日本呼吸器学会

     
  • 日本呼吸器内視鏡学会

     
  • 日本感染症学会

     

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委員歴 【 表示 / 非表示

  • 2016年04月
    -
    継続中

    評議員, 日本感染症学会