川上純 医師 かわかみあつし

「患者さんと協力して病気に対処することを心がけ、実地臨床に即した、患者さんに還元できる研究を進めて行きたいと思っています」(川上純医師)
川上純医師らは早期関節炎の患者を対象に、関節リウマチ(RA)の早期分類・診断基準案を2009年にNagasaki scoreとして報告した。これは関節MRI所見を取り入れたもの。2010年には新しいRA分類基準が2010 RA分類基準として米国リウマチ学会(ACR)/欧州リウマチ学会(EULAR)から発表された。川上医師らも関節超音波を新たに加え2010 RA分類基準と組み合わせたNagasaki scoreバージョン2を作成。これらは実地臨床にすぐに応用可能な研究成果と言える。また、長崎県はHTLV-1の高浸淫地域。
川上医師らは20年にわたり、HTLV-1感染とシェーグレン症候群(SS)やRAに関する研究も継続し、抗HTLV-1抗体陽性SSの特徴も明らかにしてきた。これも地域の特色を生かした研究内容であると言えるだろう。それ以外では、研究の進歩が著しい自己炎症症候群や皮膚筋炎、全身性エリテマトーデスに関しても、多施設共同研究の形式もとりながら、臨床ならびに基礎研究を進めている。
「その一方で、当科では長崎市内の診療所や開業医とのRAを中心とした連携医療にも力を入れています」(川上医師)
同院と地域の先生方とのネットワーク作りを通じて、長崎県のリウマチ膠原病疾患の医療レベルの向上にも貢献したいと考えているという。

リウマチ・膠原病内科の初診外来および再診外来は月曜・水曜・金曜。初診を受けられる場合は同院地域連携室に連絡。外来予約日時と担当医を15分ほどで決められる。

1985年3月　長崎大学医学部　卒業
1985年6月　長崎大学医学部附属病院第一内科研修医
1986年4月　日赤長崎原爆病院内科研修医
1987年4月　長崎大学大学院医学研究科内科学専攻博士課程入学(第一内科)
1991年3月　長崎大学大学院医学研究科内科学専攻博士課程終了(第一内科)
1991年4月　米国ハーバード大学ダナ・ファーバー癌研究所研究員
1994年1月　長崎大学医学部内科学第一研究生
2000年4月　長崎大学医学部内科学第一助手
2003年7月　長崎大学医学部・歯学部附属病院第一内科講師
2009年4月　長崎大学大学院医歯薬学総合研究科展開医療科学講座准教授
2010年11月　長崎大学大学院医歯薬学総合研究科展開医療科学講座教授
2016年4月　長崎大学大学院医歯薬学総合研究科先進予防医学共同専攻教授
2019年4月　長崎大学大学院医歯薬学総合研究科長

日本内科学会(会員・認定内科医・研修指導医)・日本リウマチ学会(理事)・アメリカリウマチ学会(International Member)・日本シェーグレン症候群学会(理事長)・日本脊椎関節炎学会(理事)・日本リウマチ財団(委員)・日本臨床免疫学会(会員・評議員)・日本臨床リウマチ学会(会員・評議員)・日本炎症・再生医学会(会員・評議員)・日本免疫学会(会員)・日本内分泌学会(会員)・日本糖尿病学会(会員)・日本甲状腺学会(会員)・日本医療マネジメント学会(会員)

受賞歴
・平成12年度日本リウマチ学会賞
「Inhibition of caspase cascade by HTLV-I Tax through induction of NF-kappaB nuclear translocation. Blood 94:3847-3854, 1999」
・平成13年度角尾学術賞
「アポトーシスの制御異常による自己免疫性疾患発症機序の解明」
・平成13年度日本炎症・再生医学会奨励賞
「Regulation of synovial cell apoptosis by proteasome inhibitior. Arthritis Rheum 42:2440-2448, 1999」
・平成16年度日本臨床免疫学会優秀ポスター賞
「シェーグレン症候群唾液腺組織におけるToll-like receptors (TLRs)発現の検討」

主な研究内容、著書・論文等
●Nakamura H, Shimizu T, Takatani A, Suematsu T, Nakamura T, Kawakami A. Initial human T-cell leukemia virus type 1 infection of the salivary gland epithelial cells requires a biofilm-like structure. Virus Research. 2019 Jun. [Epub ahead of print]
●Endo Y, Koga T, Kawashiri SY, Morimoto S, Nishino A, Okamoto M, Eguchi M, Tsuji S, Takatani A, Shimizu T, Sumiyoshi R, Igawa T, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Ueki Y, Yoshitama T, Eiraku N, Matsuoka N, Okada A, Fujikawa K, Hamada H, Tsuru T, Nagano S, Arinobu Y, Hidaka T, Tada Y, Kawakami A. Anti-citrullinated protein antibody titre as a predictor of abatacept treatment persistence in patients with rheumatoid arthritis: a prospective cohort study in Japan. Scand J Rheumatol. 2019 Jun. [Epub ahead of print]
●Kawashiri SY, Fujikawa K, Nishino A, Takatani A, Kawakami A, Shimizu T, Umeda M, Fukui S, Igawa T, Koga T, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Mizokami A. Combination of ultrasound power Doppler-verified synovitis and seropositivity accurately identifies patients with early rheumatoid arthritis. Int J Rheum Dis. 2019 May; 22(5):842-851.
●Ichinose K, Kitamura M, Sato S, Eguchi M, Okamoto M, Endo Y, Tsuji S, Takatani A, Shimizu T, Umeda M, Fukui S, Sumiyoshi R, Koga T, Kawashiri SY, Iwamoto N, Igawa T, Tamai M, Nakamura H, Origuchi T, Nishino T, Kawakami A. Complete renal response at 12 months after induction therapy is associated with the renal relapse-free rate in lupus nephritis ~ a single center retrospective cohort study. Lupus. 2019 Apr;28(4):501-509.
●Endo Y, Fujikawa K, Koga T, Mizokami A, Mine M, Tsukada T, Uetani M, Kawakami A. Observational Study Characteristics of late-onset spondyloarthritis in Japan: A retrospective cohort study. Medicine. 2019 Feb;98(7):e14431.
●Fukui S, Kuwahara-Takaki A, Ono N, Sato S, Koga T, Kawashiri SY, Iwanaga N, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Migita K, Arinobu Y, Niiro H, Tada Y, Akashi K, Maeda T, Kawakami A. Serum levels of fibroblast growth factor-2 distinguish Takayasu arteritis from giant cell arteritis independent of age at diagnosis. Scientific Reports. 24;9(1):688. 2019 Jan.
●Koga T, Sato T, Furukawa K, Morimoto S, Endo Y, Umeda M, Sumiyoshi R, Fukui S, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Origuchi T, Nakamura H, Kawakami A. Promotion of Calcium/calmodulin-dependent protein kinase 4 promotes GLUT1-dependent glycolysis in systemic lupus erythematosus. Arthritis Rheumatol. 2019 May;71(5):766-772.
●Endo Y, Koga T, Ishida M, Fujita Y, Tsuji S, Takatani A, Shimizu T, Sumiyoshi R, Igawa T, Umeda M, Fukui S, Nishino A, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Agematsu K, Yachie A, Masumoto J, Migita K, Kawakami A. Musculoskeletal manifestations occur predominantly in patients with later-onset familial Mediterranean fever: Data from a multicenter, prospective national cohort study in Japan. Arthritis Res. Ther. 2018 Nov 20;20(1):257.
●Fukui S, Iwamoto N, Takatani A, Igawa T, Shimizu T, Umeda M, Nishino A, Horai Y, Hirai Y, Koga T, Kawashiri SY, Tamai M, Ichinose K, Nakamura H, Origuchi T, Masuyama R, Kosai K, Yanagihara K, Kawakami A. M1 and M2 monocytes in rheumatoid arthritis: A contribution of imbalance of M1/M2 monocytes to osteoclastogenesis. Frontiers in Immunology. 2018 Jan 8;8: 1958.
●Suzuki T, Fukui S, Umekita K, Miyamoto J, Umeda M, Nishino A, Okada A, Koga T, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Fujikawa K, Aramaki T, Mizokami A, Matsuoka N, Ueki Y, Eguchi K, Sato S, Hidaka T, Origuchi T, Okayama A, Kawakami A, Nakamura H. Brief Report: Attenuated effectiveness of tumor necrosis factor inhibitors for anti-human T-lymphotropic virus type Ⅰ antibody-positive rheumatoid arthritis. Arthritis Rheumatol. 2018 Jul;70(7):1014-1021.
●Yamanashi H, Koyamatsu J, Nagayoshi M, Shimizu Y, Kawashiri SY, Kondo H, Fukui S, Tamai M, Sato S, Yanagihara K, Kawakami A, Maeda T. Human T-cell leukemia virus-1 infection is associated with atherosclerosis as measured by carotid intima-media thickness in Japanese community-dwelling older people. Clin Infect Dis. 2018 Jul 2;67(2):291-294.
●Umeda M, Koga T, Ichinose K, Igawa T, Sato T, Takatani A, Shimizu T, Fukui S, Nishino A, Horai Y, Hirai Y, Kawashiri SY, Iwamoto N, Aramaki T, Tamai M, Nakamura H, Yamamoto K, Abiru N, Origuchi T, Ueki Y, Kawakami A. CD4+ CD52lo T-Cell Expression Contributes to the Development of Systemic Lupus Erythematosus. Clinical Immunology. Clin Immunol. 2018 Feb; 187:50-57.
●Ichinose K, Ohyama K, Furukawa k, Higuchi O, Mukaino A, Satoh K, Nakane S, Shimizu T, Umeda M, Fukui S, Nishino A, Nakajima H, Koga T, Kawashiri SY, Iwamoto N, Tamai M, Nakamura H, Origuchi T, Yoshida N, Kuroda N, Kawakami A. Novel anti-suprabasin antibodies may contribute to the pathogenesis of neuropsychiatric systemic lupus erythematosus. Clin Immunol. 2018 Aug; 193:123-130.
●Koga T, Migita K, Sato T, Sato S, Umeda M, Nonaka F, Fukui S, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Ueki Y, Masumoto J, Agematsu K, Yachie A, Yoshiura KI, Eguchi K, Kawakami A. MicroRNA-204-3p inhibits the production of TLR4-related cytokines in familial Mediterranean fever by targeting the PI3Kγ signaling pathway. Rheumatology. 2018 Apr 1;57(4):718-726.
●Tsuboi H, Hagiwara S, Asashima H, Takahashi H, Hirota T, Noma H, Umehara H, Kawakami A, Nakamura H, Sano H, Tsubota K, Ogawa Y, Takamura E, Saito I, Inoue H, Nakamura S, Moriyama M, Takeuchi T, Tanaka Y, Hirata S, Mimori T, Matsumoto I, Sumida T. Comparison of performance of the 2016 ACR-EULAR classification criteria for primary Sj?gren's syndrome with other sets of criteria in Japanese patients. Ann Rheum Dis. 2017 Dec;76(12):1980-1985.
●Kawashiri, SY, Fujikawa K, Nishino A, Okada A, Aramaki T, Shimizu T, Umeda M, Fukui S, Suzuki T, Koga T, Iwamoto N, Ichinose K, Tamai M, Mizokami A, Nakamura H, Origuchi T, Ueki Y, Aoyagi K, Maeda T, Kawakami A. Ultrasound-detected bone erosion is a relapse risk factor after discontinuation of biologic disease-modifying antirheumatic drugs in rheumatoid arthritis patients whose ultrasound power Doppler synovitis activity and clinical disease activity are well controlled. Arthritis Research & Therapy. 2017 May 25;19(1):108.
●Koga T, Otomo K., Mizui M, Yoshida N, Umeda M, Ichinose K, Kawakami A, Tsokos GC. CaMK4 facilitates the recruitment of IL-17-producing cells to target organs through the CCR6/CCL20 axis in Th17-driven inflammatory diseases. Arthritis Rheumatol. 2016 Aug;68(8):1981-8.
●Koga T, Okada A, Fukuda T, Hidaka T, Ishii T, Ueki Y, Kodera T, Nakashima M, Takahashi Y, Honda S, Horai Y, Watanabe R, Okuno H, Aramaki T, Izumiyama T, Takai O, Miyashita T, Sato S, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Origuchi T, Nakamura H, Aoyagi K, Eguchi K, Kawakami A. Prognostic Factors Toward Clinically Relevant Radiographic Progression in Patients with Rheumatoid Arthritis in Clinical Practice: A Japanese Multicenter, Prospective Longitudinal Cohort Study for Achieving a Treat-to- Target Strategy. Medicine. 2016 Apr; 95(7): e3476.
●Ichinose K, Ushigusa T, Nishino A, Nakashima Y, Upra, Horai Y, Koga T, Kawashiri SY, Iwamoto N, Tamai M, Arima K, Nakamura H, Obata Y, Yamamoto K, Origuchi T, Nishino T, Kawakami A, Tsokos GC. Lupus Nephritis IgG Induction of Calcium/Calmodulin-Dependent Protein Kinase IV Expression in Podocytes and Alteration of Their Function. Arthritis Rheumatol. 2016 Apr;68(4):944-52.
●Koga T, Migita K, Sato S, Umeda M, Nonaka F, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Ueki Y, Masumoto J, Agematsu K, Yachie A, Yoshiura K, Eguchi K, Kawakami A. MultipleSerum Cytokine Profiling to Identify Combinational Diagnostic Biomarkers in Attacks of Familial Mediterranean Fever. Medicine. 2016 Apr; 95(16): e3449.
●Suzuki T, Iwamoto N, Yamasaki S, Nishino A, Nakashima Y, Horai Y, Kawashiri SY, Ichinose K, Arima K, Tamai M, Nakamura H, Origuchi T, Miyamoto C, Osaki M, Ohyama K, Kuroda N, Kawakami A. Upregulation of Thrombospondin 1 Expression in Synovial Tissues and Plasma of Rheumatoid Arthritis: Role of Transforming Growth Factor-beta1 toward Fibroblast-like Synovial Cells. J Rheumatol. 42(6): 943- 947, 2015.
●Kaneko N, Ito Y, Iwasaki T, Takeda H, Sawasaki T, Migita K, Agematsu K, Kawakami A, Morikawa S, Mokuda S, Kurata M, Masumoto J. Reconstituted AIM2 inflammasome in cell-free system. J Immunol Methods. 426: 76-81, 2015.
●Nakamura H, Takahashi Y, Yamamoto-Fukuda T, Horai Y,Nakashima Y, Arima K, Nakamura T, Koji T, and Kawakami A. Direct infection of primary salivary gland epithelial cells by HTLV-Ⅰ that induces the niche of the salivary glands of sjogren's syndrome patients. Arthritis Rheumatol. 2015 Apr;67(4):1096-106.
●Tamai M, Kita J, Nakashima Y, Suzuki T, Horai Y, Okada A, Koga T, Kawashiri SY, Iwamoto N, Ichinose K, Arima K, Yamasaki S, Nakamura H, Origuchi T, Uetani M, Fukushima A, Aoyagi K, Eguchi K, Kawakami A. Combination of MRI-detected bone marrow oedema with 2010 rheumatoid arthritis classification criteria improves the diagnostic probability of early rheumatoid arthritis. Ann Rheum Dis. 2014 Des;73(12):2219-20.
●Kawashiri SY, Suzuki T, Nakashima Y, Horai Y, Okada A, Nishino A, Iwamoto N, Ichinose K, Arima K, Tamai M, Nakamura H, Origuchi T, Uetani M, Aoyagi K, Eguchi K, Kawakami A. Synovial inflammation assessed by ultrasonography correlates with MRI-proven osteitis in patients with rheumatoid arthritis. Rheumatology (Oxford). 2014 Mar 22.
●Kawashiri SY, Suzuki T, Nakashima Y, Horai Y, Okada A, Iwamoto N, Ichinose K, Tamai M, Arima K, Nakamura H, Origuchi T, Uetani M, Aoyagi K, Eguchi K, Kawakami A. Ultrasonographic examination of rheumatoid arthritis patients who are free of physical synovitis: power Doppler subclinical synovitis is associated with bone erosion. Rheumatology (Oxford). 2014 Mar; 53(3): 562-9.
●Kawashiri SY, Suzuki T, Okada A, Yamasaki S, Tamai M, Nakamura H, Origuchi T, Mizokami A, Uetani M, Aoyagi K, Eguchi K, Kawakami A. Musculoskeletal ultrasonography assists the diagnostic performance of the 2010 classification criteria for rheumatoid arthritis. Mod Rheumatol. 2013 Jan;23(1):36-43.
●Ohyama K, Kawakami A, Tamai M, Baba M, Kishikawa N, Kuroda N. Serum immune complex containing thrombospondin-1: a novel biomarker for early rheumatoid arthritis. Annals of the rheumatic diseases 71 (11): 1916-1917, 2012.
●Koga T, Fujikawa K, Horai Y, Okada A, Kawashiri SY, Iwamoto N, Suzuki T, Nakashima Y, Tamai M, Arima K, Yamasaki S, Nakamura H, Origuchi T, Hamaguchi Y, Fujimoto M, Ishimatsu Y, Mukae H, Kuwana M, Kohno S, Eguchi K, Aoyagi K, Kawakami A. The diagnostic utility of anti-melanoma differentiation-associated gene 5 antibody testing for predicting the prognosis of Japanese patients with DM. Rheumatology (Oxford). 2012 Jul;51(7):1278-84.
●Iwamoto N, Kawakami A, Tamai M, Arima K, Nakamura H, Kawashiri SY, Kita J, Okada A, Koga T, Kamachi M, Yamasaki S, Ichinose K, Ida H, Origuchi T, Uetani M, Eguchi K. Magnetic resonance imaging of wrist and finger joints distinguishes secondary Sj?gren's syndrome with rheumatoid arthritis from primary Sj?gren's syndrome with articular manifestations. Clin Exp Rheumatol. 2011 Nov-Dec;29(6):1062-3.
●Koga T, Okada A, Kawashiri S, Kita J, Suzuki T, Nakashima Y, Tamai M, Satoh K, Origuchi T, Iwamoto N, Yamasaki S, Nakamura H, Migita K, Ida H, Ueki Y, Eguchi K, Kawakami A. Soluble urokinase plasminogen activator receptor as a useful biomarker to predict the response to adalimumab in patients with rheumatoid arthritis in a Japanese population. Clin Exp Rheumatol. 2011 Sep-Oct;29(5):811-5.
●Kawashiri SY, Kawakami A, Okada A, Koga T, Tamai M, Yamasaki S, Nakamura H, Origuchi T, Ida H, Eguchi K. CD4+CD25(high)CD127(low/-) Treg cell frequency from peripheral blood correlates with disease activity in patients with rheumatoid arthritis. J Rheumatol. 2011 Dec;38(12):2517-21.
●Arima K, Kinoshita A, Mishima H, Kanazawa N, Kaneko T, Mizushima T, Ichinose K, Nakamura H,Tsujino A, Kawakami A, Matsunaka M, Kasagi S, Kawano S, Kumagai S, Omura K, Mimori T, Hirano M, Ueno S, Tanaka M, Toyosima I, Sugino H, Yamakawa A, Tanaka K, Niikawa N, Furukawa F, Murata S, Eguchi K, Ida H, Yoshimura K. Proteasome assembly defect due to a proteasome subunit beta type8 (PSMB8) mutation causes the autoinflammatory disorder, Nakajo-Nishimura syndrome. Proc Natl Acad Sci U S A 108 (36); 14914-14919, 2011.
●Tamai M, Kawakami A, Iwamoto N, Kawashiri SY, Fujikawa K, Aramaki T, Kita J, Okada A, Koga T, Arima K, Kamachi M, Yamasaki S, Nakamura H, Ida H, Origuchi T, Takao S, Aoyagi K, Uetani M, Eguchi K. Comparative study of the detection of joint injury in early-stage rheumatoid arthritis by magnetic resonance imaging of the wrist and finger joints and physical examination. Arthritis Care Res 63 (3): 436- 439, 2011.
●Ohyama K, Ueki Y, Kawakami A, Kishikawa N, Tamai M, Osaki M, Kamihira S,Nakashima K, Kuroda N. Immune complexome analysis of serum and its application in screening for immune complex antigens in rheumatoid arthritis. Clin Chem. 2011 Jun;57(6):905-9.
●Iwamoto N, Kawakami A, Arima K, Nakamura H, Kawashiri SY, Tamai M, Kita J, Okada A, Koga T, Kamachi M, Yamasaki S, Ichinose K, Ida H, Origuchi T, Eguchi K. Regulation of disease susceptibility and mononuclear cell infiltration into the labial salivary glands of Sj?gren's syndrome by monocyte chemotactic protein-1. Rheumatology 49 (8): 1472-1478, 2010.
●Nakamura H, Kawakami A, Iwamoto N, Okada A, Yamasaki S, Tamai M, Ida H, Takagi Y, Hayashi T, Aoyagi K, Nakamura T, Eguchi K. A single centre　retrospective analysis of AECG classification criteria for primary sj?gren's　syndrome based on 112 minor salivary gland biopsies in a Japanese population.　Rheumatology (Oxford). 2010 Jul;49(7):1290-3.
●Tamai M, Kawakami A, Uetani M, Takao S, Arima K, Iwamoto N, Fujikawa K, Aramaki T, Kawashiri SY, Ichinose K, Kamachi M, Nakamura H, Origuchi T, Ida H, Aoyagi K, Eguchi K. A prediction rule for disease outcome in patients with undifferentiated arthritis using magnetic resonance imaging of the wrists and finger joints and serologic autoantibodies. Arthritis Rheum 61 (6): 772-778, 2009.
●Fujikawa K, Kawakami A, Kaji K, Fujimoto M, Kawashiri S, Iwamoto N, Aramaki T, Ichinose K, Tamai M, Kamachi M, Nakamura H, Ida H, Origuchi T, Ishimoto H, Mukae H, Kuwana M, Kohno S, Takehara K, Sato S, Eguchi K. Association of distinct clinical subsets with myositis-specific autoantibodies towards anti-155/140-kDa polypeptides, anti-140-kDa polypeptides, and anti-aminoacyl tRNA synthetases in Japanese patients with dermatomyositis: a single-centre, cross-sectional study. Scand J Rheumatol. 2009;38(4):263-7.
●Nakamura H, Kawakami A, Hayashi T, Nakamura T, Iwamoto N, Yamasaki S, Ida H, Eguchi K. Low prevalence of ectopic germinal centre formation in patients with HTLV-I-associated Sjogren's syndrome. Rheumatology (Oxford). 2009 Jul;48(7):854-5.
●Iwamoto N, Kawakami A, Tamai M, Fujikawa K, Arima K, Aramaki T, Kawashiri S, Ichinose K, Kamachi M, Nakamura H, Origuchi T, Ida H, Eguchi K. Determination of the subset of Sjogren's syndrome with articular manifestations by anticyclic citrullinated peptide antibodies. J Rheumatol. 2009 Jan;36(1):113-5.
●Nakamura H, Takagi Y, Kawakami A, Ida H, Nakamura T, Nakamura T, Eguchi K. HTLV-I infection results in resistance toward salivary gland destruction of Sj?gren's syndrome. Clin Exp Rheumatol. 2008 Jul-Aug;26(4):653-5.
●Tamai M, Kawakami A, Uetani M, Takao S, Rashid H, Tanaka F, Fujikawa K, Aramaki T, Nakamura H, Iwanaga N, Izumi Y, Arima K, Aratake K, Kamachi M, Huang M, Origuchi T, Ida H, Aoyagi K, Eguchi K. Early prediction of rheumatoid arthritis by serological variables and magnetic resonance imaging of the wrists and finger joints: results from prospective clinical examination. Ann Rheum Dis. 2006 Jan;65(1):134-5.