吉川 哲史

ABSTRACT Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE‐HS) is an intractable form of epilepsy involving the hippocampus, and temporal lobectomy remains an effective treatment. Human herpesvirus 6B (HHV‐6B) establishes latency in the hippocampus and may contribute to MTLE‐HS pathogenesis by altering host gene expression; however, transcriptomic data from healthy controls remain limited. This study investigated the role of HHV‐6B to MTLE‐HS pathogenesis by analyzing gene expression in resected hippocampal tissues. Samples were collected from 12 to 43 HHV‐6 DNA‐positive and ‐negative patients, respectively, and three controls. RNA sequencing was performed on eight representative samples, followed by RT‐qPCR validation of nine selected genes in 58 samples. RNA sequencing identified 600 differentially expressed genes (210 upregulated, 390 downregulated) between HHV‐6B‐positive MTLE‐HS and controls. Pathway enrichment analysis revealed involvement of synaptic signaling and inflammatory responses, with prostaglandin biosynthesis specifically upregulated in HHV‐6B‐positive tissues. Two genes were significantly upregulated in HHV‐6B‐positive compared with HHV‐6B‐negative samples. RT‐qPCR confirmed elevated cholesterol 25‐hydroxylase and interleukin 1 beta expression in HHV‐6 DNA‐positive samples (both p  = 0.031). These findings suggest that HHV‐6B may contribute to MTLE‐HS pathogenesis by modulating the expression of host inflammatory genes, supporting a role for neuroinflammation and the potential benefits of anti‐inflammatory therapies.

BACKGROUND: Biliary atresia (BA) is a severe infantile hepatobiliary disorder of unknown etiology. Perinatal rotavirus (RV) infection has been implicated in animal models of BA; however, supporting human data remains limited. The study investigated the serological evidence of recent RV infection in infants with BA using RV-specific immunoglobulin (Ig)-A, a marker of primary infection unaffected by maternal antibodies. METHODS: Serum samples from 17 infants with BA and 30 age-matched controls without gastrointestinal symptoms or prior RV vaccination were retrospectively analyzed. Anti-RV-IgA titers were measured by enzyme-linked immunosorbent assay using purified WA-strain virions. Cytomegalovirus (CMV)-IgM and Epstein-Barr virus (EBV)-viral capsid antigen (VCA)-IgM levels were assessed using commercial enzyme immunoassays. RESULTS: RV-IgA was detected in 70.6% (12/17) of the patients with BA versus 3.4% (1/29) of the controls (p < 0.001). RV-IgA titers were significantly higher in the BA group (median: interquartile range 28.0:26.0-210.0) than in the control group (23.5:22.0-24.8) (p = 0.004). Among patients diagnosed with BA after 14 days of age, 84.6% (11/13) were RV-IgA-positive. CMV-IgM was detected in three patients in the BA group and one individual in the control group, while EBV-VCA-IgM was negative in BA patients and positive in two controls; neither difference was statistically significant. CONCLUSIONS: The study findings support the potential association between RV infection and BA pathogenesis. However, the lack of an epidemiological reduction in BA following the introduction of the RV vaccine warrants caution in other studies. Further prospective multicenter studies are required to elucidate the causal role of RV infection in BA development.

Abstract Heart rate variability (HRV) is a well-established, noninvasive measure of autonomic nervous system activity and is associated with clinical outcomes. Although real-time monitoring of HRV is valuable in clinical practice, its effectiveness is often compromised by major challenges: high inter-individual variability and frequent data contamination from procedural artifacts. To address these challenges, we developed and validated a computational framework for robust and personalized real-time HRV analysis oriented toward clinical application. The framework performs simultaneous analysis and visualization of both time- and frequency-domain HRV indices and incorporates an adaptive alert algorithm that personalizes alert thresholds using the interquartile range of each patient’s own data. A workflow-integrated mechanism for manually annotating and excluding artifact-prone periods prevents procedural artifacts from skewing the statistical baselines, and a multi-scale visualization module provides a unified view of short-term fluctuations and long-term trends. While existing HRV tools are powerful for research or offline analysis, they often lack the integration of personalized alerting and workflow-oriented artifact management needed for bedside care. The proposed system uniquely combines personalized alerting, care-linked artifact exclusion, and multi-scale bedside visualization within a single real-time software package. The framework was validated using open-access electrocardiogram (ECG) databases and synthetic noise-contaminated signals, confirming robust R-wave detection across pediatric and adult recordings and under low signal-to-noise conditions. In addition, the framework was operationally validated at the bedside using ECG data from 24 newborn patients. By systematically addressing the core challenges of personalization and artifact management in a clinically integrated manner, this work represents a significant step toward translating real-time HRV analysis into routine vital sign management and, ultimately, improved patient outcomes.

Varicella-zoster virus (VZV) causes varicella in children, establishes lifelong latency and reactivates to cause herpes zoster later in life. Implementation of routine varicella vaccination in Japan since 2014 has reduced varicella cases, however, breakthrough varicella still occurs. This study aimed to clarify the current distribution of VZV clade among pediatric varicella patients and adults with VZV-associated central nervous system (CNS) infections in Japan. Skin swabs were collected from varicella patients (< 15 years) in Aichi Prefecture (September 2015-August 2017). Cerebrospinal fluid (CSF) samples were obtained from adult patients (> 15 years) with VZV-associated CNS infections (November 2014-June 2023). VZV DNA was detected by PCR, and its clade was determined by sequencing open reading frame (ORF) 22 and ORF37 regions. Wild-type and Oka vaccine strains were distinguished by loop-mediated isothermal amplification (LAMP) method. Of 124 pediatric swab samples and 62 adult CSF samples 94.4% belonged to clade 2 and 4.8% clade 1. No clade 1 samples were detected in CSF samples. No vaccine strain was detected. Clinical characteristics did not differ significantly among clades. Clade 2 VZV predominates in both pediatric varicella and adult VZV-related CNS infections in Japan with sporadic clade 1 varicella cases.