医学部 薬理学講座

桂田 健一

カツラダ ケンイチ  (Kenichi Katsurada)

基本情報

所属
自治医科大学 医学部 薬理学講座臨床薬理学部門 講師
学位
医学博士(2015年3月 自治医科大学)

研究者番号
70598630
ORCID ID
 https://orcid.org/0000-0002-0567-1458
J-GLOBAL ID
202001005844700723
researchmap会員ID
R000009616

学歴

 2

論文

 36
  • Yukako Ogoyama, Makiko Abe, Keisuke Okamura, Kazuhiro Tada, Kenichi Katsurada, Shigeru Shibata, Hisashi Kai, Hiromi Rakugi, Koichi Node, Hiroyoshi Yokoi, Kazuomi Kario, Hisatomi Arima
    Hypertension research : official journal of the Japanese Society of Hypertension 2024年6月3日  
    The efficacy of renal denervation (RDN) has been controversial, but recent randomized sham-controlled trials demonstrated significant blood pressure reductions after RDN in patients with hypertension. We conducted a systematic review and updated meta-analysis to evaluate the effects of RDN on ambulatory and office blood pressures in patients with hypertension. Databases were searched up to 15 November 2023 to identify randomized, sham-controlled trials of RDN. The primary endpoint was change in 24 h ambulatory systolic blood pressure (SBP) with RDN versus sham control. The secondary endpoints were changes in 24 h ambulatory diastolic blood pressure, daytime and nighttime blood pressure (BP), office BP, and home BP. A sub-analysis determined outcomes by medication, procedure, and device. From twelve trials, 2222 patients with hypertension were randomized to undergo RDN (n = 1295) or a sham procedure (n = 927). At 2-6 months after treatment, RDN significantly reduced 24 h ambulatory SBP by 2.81 mmHg (95% confidence interval: -4.09, -1.53; p < 0.001) compared with the sham procedure. RDN also reduced daytime SBP by 3.17 mmHg (- 4.75, - 1.58; p < 0.001), nighttime SBP by 3.41 mmHg (- 4.69, - 2.13; p < 0.001), office SBP by 4.95 mmHg (- 6.37, - 3.54; p < 0.001), and home SBP by 4.64 mmHg (- 7.44, - 1.84; p = 0.001) versus the sham control group. There were no significant differences in the magnitude of BP reduction between first- and second-generation trials, between devices, or between with or without medication. These data from randomized sham-controlled trials showed that RDN significantly reduced all blood pressure metrics in medicated or unmedicated patients with hypertension, including resistant/uncontrolled hypertension.
  • Kenichi Katsurada, Kaushik P Patel
    Hypertension research : official journal of the Japanese Society of Hypertension 2024年4月17日  
  • Kenichi Katsurada
    Hypertension research : official journal of the Japanese Society of Hypertension 2024年2月13日  
  • Masaki Mogi, Atsushi Tanaka, Koichi Node, Naoko Tomitani, Satoshi Hoshide, Keisuke Narita, Yoichi Nozato, Kenichi Katsurada, Tatsuya Maruhashi, Yukihito Higashi, Chisa Matsumoto, Kanako Bokuda, Yuichi Yoshida, Hirotaka Shibata, Ayumi Toba, Takahiro Masuda, Daisuke Nagata, Michiaki Nagai, Keisuke Shinohara, Kento Kitada, Masanari Kuwabara, Takahide Kodama, Kazuomi Kario
    Hypertension research : official journal of the Japanese Society of Hypertension 2023年9月15日  
    Total 276 manuscripts were published in Hypertension Research in 2022. Here our editorial members picked up the excellent papers, summarized the current topics from the published papers and discussed future perspectives in the sixteen fields. We hope you enjoy our special feature, 2023 update and perspectives in Hypertension Research.
  • Kenichi Katsurada, Kazuomi Kario
    Hypertension research : official journal of the Japanese Society of Hypertension 46(6) 1462-1470 2023年6月  
    Inappropriate sympathetic activation is closely associated with the development and progression of hypertension. Renal denervation (RDN) is a neuromodulation therapy performed using an intraarterial catheter in patients with hypertension. Recent randomized sham-operated controlled trials have shown that RDN has significant antihypertensive effects that last for at least 3 years. Based on this evidence, RDN is nearly ready for general clinical application. On the other hand, there are remaining issues to be addressed, including elucidation of the precise antihypertensive mechanisms of RDN, the appropriate endpoint of RDN during the procedure, and the association between reinnervation after RDN and the long-term effects of RDN. This mini review focuses on studies implicating anatomy of the renal nerves, which consist of afferent or efferent and sympathetic or parasympathetic nerves, the response of blood pressure to renal nerve stimulation, and reinnervation of renal nerves after RDN. A comprehensive understanding of the anatomical and functional aspects of the renal nerves and the antihypertensive mechanisms of RDN, including its long-term effects, will enhance our ability to incorporate RDN into strategies to treat hypertension in clinical practice. This mini review focuses on studies implicating anatomy of the renal nerves, which consist of afferent or efferent and sympathetic or parasympathetic nerves, the response of blood pressure to renal nerve stimulation, and reinnervation of renal nerves after renal denervation. Whether the ablation site is sympathetic dominant or parasympathetic dominant, and afferent dominant or efferent dominant, would in turn determine the final output of renal denervation. BP: blood pressure.

MISC

 48
  • 田中 裕郷, 澤城 大悟, 桂田 健一, 原田 顕治, 関島 良樹, 松浦 徹, 苅尾 七臣
    日本内科学会関東地方会 688回 26-26 2023年7月  
  • 桂田 健一, 苅尾 七臣
    医学のあゆみ 285(6) 557-564 2023年5月  
    遠心性腎交感神経の活性化は,レニン分泌促進,Na再吸収促進,腎血流低下による抗利尿作用の亢進に加え,さまざまなストレス・ホルモン・薬剤に対する利尿反応の変化やNa・水再吸収に関わる腎チャネル・トランスポーター発現の変化に関与している.他方で,求心性腎神経のシグナルは視床下部室傍核(PVN)へ入力し,全身への交感神経の出力を調整している.遠心性および求心性腎神経の不適切な活性化は血圧上昇や体液貯留をもたらし,交感神経活性化を背景とした高血圧や心不全病態を助長している.これらの神経性調節はノルエピネフリンのカテコールアミン受容体への直接作用に加え,レニン-アンジオテンシン-アルドステロン系や脳内炎症免疫系,一酸化窒素を介した作用機序などが含まれる.腎除神経(腎デナベーション)は,中枢から腎臓への遠心路(出力)および腎臓から中枢への求心路(入力)を遮断することで交感神経活性化の悪循環を断ち,高血圧や心不全病態を改善することが期待される.(著者抄録)
  • 桂田 健一, 今井 靖
    細胞 55(4) 231-234 2023年4月  
    SGLT2阻害薬は心不全診療に欠かせない治療薬として汎用されているが,心不全改善の作用機序については不明な点も多い。心不全では慢性的な腎交感神経活性化によりノルエピネフリンを介したSGLT2の膜輸送が促進され,SGLT2の発現が亢進し,ナトリウム再吸収による体液貯留病態が助長される。SGLT2阻害薬はSGLT2の発現レベルを是正し,容量負荷時の利尿反応を正常化することが示されており,その作用機序として腎交感神経活性の抑制が示唆される。心不全では求心性腎神経の活性化が中枢を介した遠心性腎交感神経の過剰な活性化に結び付いており,SGLT2阻害薬は腎組織の低酸素や炎症,酸化ストレスなどの環境変化を介して求心性腎神経活動を抑制することで,中枢を介して全身の交感神経出力を抑制する可能性が考えられる。本稿では心不全における,これらのSGLT2-腎神経の双方向性の連関について概説する。(著者抄録)
  • Kenichi Katsurada
    JOURNAL OF HYPERTENSION 41 E163-E164 2023年1月  
  • Kenichi Katsurada, Shyam S. Nandi, Kaushik P. Patel, Kazuomi Kario
    JOURNAL OF HYPERTENSION 41 E112-E113 2023年1月  

共同研究・競争的資金等の研究課題

 6