Innovation is the practical implementation of ideas that result in the introduction of new goods or services or the improvement in them (Schumpter, 1983). Innovation is closely related to invention as innovation is more on involving the practical implementation of a new or improved invention to make a meaningful impact in a market or society (Schumpter, 1939). On the other hand, innovative design is a process of identifying, pinpointing, and understanding the needs of the user or audience (Shaulis, 2021). Previously, Dixon (1966) defined innovative design as any design that is: new or different, or elegant or uses new ideas, or is an improvement over its peers. Once the market need has been identified, a solution can then be designed. In our proposed innovative design method, we introduced and investigated a method that is able to be applied in designing an intergrated system that could be a valuable solution to the society. This method starts with directly observe activities of things and real people in real trouble in the real field. Then, we think about the value of "I wish there were such things as…", visualize the story, draw a clear sketch to accomplish the story concretely. Next, we solidify the functions and specifications while investigating needs and competition. Then, we create a prototype that able to show and test your ideas, demonstrate to the people who need it, let them experience it, and gain feedback. Lastly, we evaluate the value of product design and development and plan methods for implementing it as an organization, and plan ways to improve and expand globally. All of the steps in this method are important for innovative design, however, in this research this time we focused on co-designing value, big idea, and considering as integrated steps for identifying latent needs of the consumers. It is because identifying needs is an important part in the product development process. Latent needs are those that many consumers recognize as important in a final product but unable to articulate in advance (Ulrich, 2015). The latent needs addressed in this study was focusing on identifying consumer requirements in product development in the innovative design method. The challenge in identifying latent needs is finding the method to elicit from consumers the needs which are not addressed by any inventors yet in the present market but would delight the consumers if delivered tomorrow. The purpose of this study is to propose and verify the method in the elicitation of latent needs from consumer needs by introducing a working prototype to the consumers, interviewing, and analyzing responses from the consumers. This research was conducted during the year the start of the COVID-19 pandemic. As the pandemic spread, most countries were forced to go into lockdown or declare an emergency state. The school was closed and business organizations needed to switch to working from home to prevent the spread. The parents were unable to work from home efficiently as they were worried their children will involve in dangerous incidents if the children were left by themselves. Based on this situation, this study was conducted in finding the latent needs of the parents, childcare workers, and children in order to assist them in going through their problems during this COVID-19 pandemic. The working prototype was used as material to prepare presentation slides for the consumers' interviews. The first presentation slides were focused on the background problems and ideas for the solutions while the second presentation slides provided consumers with a prototype and story of the product that was believed would be one of the solutions to the problems. Interviews were conducted after both slide presentations. Consumers' responses were obtained and interpreted into consumers' needs in terms of product functions. In the first study, consumers' interpreted needs from Problem-based interviews and Prototype and Story-based interviews were compared. Based on the results, latent needs interpreted from interviewees' responses and the categories of the needs obtained from the Prototype-based interviews are more than from the Problem-based interview. The latent needs that we were able to obtain from this research were for example, “The device is able to detect small changes in a child while watching he/she sleeping” which could lead into the prevention of unwanted incident such as sudden infant death syndrome (SIDS). This supports our assumption that showing working prototype-based materials with story descriptions can be effective in uncovering potential latent needs. In the second study, it is assumed that experience, empathy, and knowledge of working prototype is essential elements in product development, therefore, new additional guidelines which are “to write a statement with empathy”, “to write a statement as a designer”, and “to write a statement as someone with experience” were proposed during consumers' needs interpretation to see whether these new guidelines will influence the process of identifying latent needs of consumers. From the result, it is concluded that the number of interpreted needs increased when we applied the new proposed guideline. Although the number is small, the needs might not be interpreted if the new guidelines were not considered. We were also able to obtain a few important latent needs when we applied these new guidelines. A latent need collected from applying the guideline "to write a statement as someone with experience" is “The device is not for teaching love and humanity but for monitoring by watching facial expression, posture, and vital signals such as temperature and heart rate”. We could conclude that including these guidelines upon interpreting raw data from the consumers’ interviews might lead into discovering important and critical latent needs of the consumers. In the third study, a quantitative evaluation method for identifying latent needs was introduced. The consumers' interpreted needs were rated according to a basis of rating from the three perspectives of importance, latent-ness, and technological feasibility. The Degree of Latent Needs (DLN) was calculated by multiplying these three metrics. Based on the result for the average and variance of DLN mean value for each evaluator which is sufficiently small, it indicates that the basis of rating for three metrics of the DLN is effective. The results also indicate that the 20 highest DLN points of the interpreted needs contain attractive features in terms of design. However, we had gotten some pushback on the average of each interpreted need and its variance which indicates opposing opinions among evaluators. As it is possible that attractive needs are hidden and may lead to the discovery of latent needs through individual pinpoint interviews, the interviews with the minority evaluators were conducted. The interview results indicate that the latent needs with low DLN rates but valuable might be able to be discovered by conducting follow-up interviews such as “The device is able to recognize items (food or not) that a child wants to put in the mouth”. From the results in all three studies, we could conclude that a number of important latent needs are able to be elicited from consumers’ needs by applying the proposed method. In our fourth study, a decision-making method based on the patent analysis between the conceptual design stage and the prototyping stage in the innovative design method was introduced. Conducting a patent strategy was assumed to support how to select the right concept precisely. In this study, by conducting a patent search in this stage by the designer who understood best the product functions and working principles, a supporting method was introduced to assist the designer in their decision-making process. Based on the result, the method was able to observe whether there are dominating companies or not for our concept design. If there is a dominating company, the possibility of not being able to produce our concept becomes bigger. This method may be applied as an indicator to support decisionmaking in the concept design stage in the innovative design method, whether to proceed with the concept design or not and to reduce the possibility of product failure in the future. From the results of all the studies, we could conclude that these above methods may be applied as assistive tools to support designers’ understanding of consumers’ requirements and selecting the right concept design.

Aldosterone is a steroid hormone synthesized in the adrenal cortex and is part of the renin-angiotensin-aldosterone system (RAAS). It accelerates renal sodium retention and elimination of potassium through its action on the mineralocorticoid receptor (MR), and has a major role in regulating body fluid volume and blood pressure. Excessive secretion of aldosterone and activation of the MR cause cardiovascular inflammation, fibrosis and remodeling, and tubulointerstitial fibrosis and glomerular injury in the kidney. There are several reports on plasma aldosterone concentration (PAC) in healthy, chronic kidney disease (CKD), systemic hypertension, and chronic heart failure in cats and dogs. Measurement of urinary aldosterone/creatinine ratio has also been reported in cats and dogs. However, it has been suggested that measuring aldosterone in feline urine using the available methodology has limited or no utility in investigating feline hypertension associated with CKD. It may be important to evaluate PAC in cats and dogs with CKD associated with the activation of RAAS. On the other hand, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers suppress the RAAS during hypertensive, renal, and cardiac diseases in cats. The Randomized Aldactone Evaluation Study in humans showed that the aldosterone antagonist, spironolactone, reduced the mortality of patients with chronic heart failure who received ACEI and loop diuretics. Spironolactone also reportedly reduced the mortality rate in cats with congestive heart failure secondary to cardiomyopathy. Another selective aldosterone antagonist, eplerenone, not only antagonizes MR but also blocks the nongenomic effects of aldosterone in vascular tissues not susceptible to spironolactone. These effects of eplerenone may be more effective than spironolactone in treating hypertension due to vasoconstriction. Although eplerenone reduces mortality and hospitalization in human patients with chronic heart failure, there are no available reports on eplerenone’s use in feline practice. Since elevated PAC is a risk factor for kidney injury in humans, and MR antagonists are beneficial in rodent models of CKD and human patients, it was hypothesized that if an elevated PAC is detectable in the early stages of the disease in cats, the use of eplerenone may prolong lifespan. However, the relationship between PAC and the survival time in cats and dogs with CKD has not been investigated. Therefore, this study aimed to investigate PAC in cats and dogs with CKD, and evaluate the influence of high PAC on the survival time of CKD animals and the effect of treatment with eplerenone in CKD cats with high PAC. In chapter 1, PAC in cats with CKD was investigated retrospectively, and the survival time of cats with high PAC was evaluated. Furthermore, the effect of treatment with eplerenone on survival time in CKD cats with high PAC was examined prospectively. The eplerenone study was conducted including both cats with CKD only and CKD cats complicated cardiac disease or systemic hypertension. The PAC was measured retrospectively in blood samples obtained from 156 client-owned cats that visited a veterinary hospital. The cats were designated into 2 groups: clinically healthy (n = 101) and CKD (n = 55). The PAC was measured by solid-phase radioimmunoassay. Median (minimum–maximum) PAC in healthy cats was 97 (10–416) pg/mL and the upper limit (95th percentile) was 243 pg/mL. In the CKD group, PAC [126 (10–981) pg/mL] was significantly higher than in the clinically healthy group. In the CKD group as classified by the International Renal Interest Society (IRIS) stage, the PACs were higher in IRIS stage 2 than in the healthy group. Similarly, PACs in IRIS stage 3 and 4 cats were higher than in the healthy group. In cats with CKD, the survival time of those with high PAC (n = 16) (> 243 pg/mL) was significantly shorter than that of those (n = 39) with normal PAC. In cats with high PAC and CKD, eplerenone administration (2.5 to 5 mg/kg body weight; n = 8) prolonged significantly the survival compared to cats not receiving eplerenone (n = 18). These results indicated that PAC could be a prognostic marker of CKD in cats and that eplerenone may prolong the survival in cats with CKD and high PAC complicated with cardiac disease or hypertension. In chapter 2, PAC in dogs with CKD was investigated retrospectively, and the survival time of CKD dogs with high PAC was evaluated. PAC was measured in blood samples obtained from 145 client-owned dogs. The dogs were divided into two groups: clinically healthy (n = 106) and CKD (n = 39). In clinically healthy group, median (minimum–maximum) PAC was 56 (10–250) pg/mL, and the upper limit (95th percentile) was 182 pg/mL. PAC (median 69 pg/mL; range 10–553 pg/mL) in CKD group was significantly higher than in the healthy group. In the CKD group as classified by IRIS stage, PAC (median 97 pg/mL) in IRIS stage 2 and 3 was significantly higher than in the healthy group. A significant positive correlation between PAC and IRIS stage was observed in CKD dogs, suggesting that the lower survival rate in high PAC group may be related to severity of CKD. In dogs with CKD, the survival time of those with high PAC (n = 10) (> 182 pg/mL) was significantly shorter than that of those with normal PAC (n = 24). These results suggested that high PAC might indicate shorter survival time in dogs with CKD. In conclusion, this study revealed that both cats and dogs with CKD had significantly higher PAC than clinically healthy animals. In CKD, the survival time of cats and dogs with high PAC was significantly shorter than those with normal PAC. The use of eplerenone also significantly prolonged the survival of cats with high PAC in CKD complicated with cardiac disease or hypertension. This study proposes PAC as a prognostic marker of cats or dogs with CKD. Eplerenone may be useful in prolonging cats’ survival with high PAC in CKD complicated with cardiac disease or hypertension. However, further study on PAC level in CKD progression and treatment response in a larger population may be required. This study provided new information on the relationship between PAC and the survival of cats or dogs with CKD, and the effect of eplerenone treatment for the survival time of cats with high PAC and CKD.

The objective of Chapter 1 of the present study was to evaluate the effect of heat-killed Lactobacillus sakei HS-1 (HK-LS HS-1) on the health and fecal bacteriological change of suckling Japanese Black calves as a supplement in milk replacers. To this end, they were randomly assigned to an HK-LS HS-1 supplement or a control without HK-LS HS-1 group in milk replacers. HK-LS HS-1 was administered from separation day to 3 weeks. Blood and fecal samples were examined. The result is glucose and vitamin A levels on day 7 were significantly higher in the supplement group than in the control group. No significant differences were observed in haptoglobin or serum amyloid A between the groups. The number of Escherichia coli in feces was lower in the control group than in the supplement group on day 21. No difference was observed in the number of Bifidobacteria, but that of lactic acid bacteria was significantly higher in the supplement group on day 21. The number of medications administered was significantly lower in the supplement group than in the control group during the experimental period. The results indicated that HK-LS HS-1 is potentially beneficial for improving intestinal microbes and reducing the number of medical treatments. In the second study, we evaluated the effects of supplementing cattle feed with difructose anhydride III (DFA III) by measuring urinary sterigmatocystin (STC) concentrations using 20 Japanese Black cattle aged 9–10 months from one herd. DFA III was supplemented for 2 weeks for 10 animals, and non-treated animals served as controls. STC concentration in the dietary feed was 0.06 mg kg−1(mixture of roughage and concentrate) at the beginning of the study (Day 0). The urine STC concentration was measured using liquid chromatography with tandem mass spectrometry 1 d prior to DFA 2 III administration, 9 and 14 d thereafter, and 9 d following supplementation cessation, concomitant with the measurement of serum amyloid A (SAA). The number of heifers in which STC was detected in the urine was low in the DFA III group compared to that in the control group on Day 9. After 9 d following supplementation cessation (Day 23), STC concentrations were significantly lower (P = 0.032) in the DFA III group than in the control group, although there was no difference in the number of heifers in which urinary STC was detected or in SAA concentrations between the two groups. Our findings demonstrate the effect of DFA III on reducing the urinary concentration of STC in Japanese Black cattle.

間葉系幹細胞（MSC）は、再生医療において有用な細胞である。MSCの培養工程の初期に、組織から抽出した単核球を培養容器に播種し、MSCの単離を行う。単離工程において、単核球の播種密度を最適化することで、単離後のMSCの収量や分化能が向上することが報告されている。しかし、単核球の播種密度がMSCの品質に影響する機構は明らかになっていない。 我々はその機構を明らかにする為、ヒト骨髄単核球を様々な播種密度（4.0×104、1.25×105、2.5×105、6.3×105、1.25×106cells/cm2）で培養し、単核球の播種密度とMSCのコロニー形成過程との関係を解析した。播種密度が高い条件（6.3×105、1.25×106cells/cm2）では、培養容器に接着したMSC同士の距離が小さく、互いの増殖スペースが制限される為、早期に高密度に達した。一方、低い播種密度（4.0×104、1.25×105 cells/cm2）では、MSCは単一細胞由来のコロニーを形成し、コロニーの直径や密度は様々な形態を示した。コロニーを継時観察したところ、高い増殖能力を持つMSCは、培養時間の経過に伴い、全体におけるその割合が増加した。それに対して、増殖能力が低いMSCは肥大化し、老化が進行した。老化細胞は剥離処理の時間を調整することで除去できることを見出した。単核球の播種密度が低い条件で、上記機構により、増殖能が高いMSCの純度が向上することが明らかになった。この機構をもとに単離工程のパラメータを最適化し、得られたMSCの増殖能と分化能を評価した。単核球の播種密度が高い条件（1.25×106cells/cm2）と比較し、最適化した条件（播種密度：1.25×105cells/cm2）から得られたMSCは、高い増殖能を示し、骨以外の脂肪や軟骨への分化能が有意に上昇した。 本研究により、高品質なMSCの純度を向上させる方法として、（1）単一細胞由来のコロニーを形成させる為に単核球の播種密度を最適化すること、（2）高い増殖能を持つMSCの割合を増やす為に培養期間を調整すること、（3）老化細胞を除去できる剥離処理の時間を設定することを提案する。

方法： 本研究は圧縮センシングを用いた自由呼吸下での多相ダイナミックEOB-MRIを撮像された96人の患者を対象とした。多相ダイナミック撮像として自由呼吸下で11秒毎に1相を5分間、脂肪抑制T1強調画像を撮像し、単純1相と造影28相を撮像した。造影剤投与後20分後に肝細胞相を撮像し、30相目とした。ROI: region of intensityを肝右葉に2つ、左葉に1つを脈管を避けながら可能な限り大きく設定した。3つのROIの信号強度の平均値をそれぞれの時相の信号強度とした。 以下の増強効果のパラメータについて評価した。 CER (contrast enhancement ratio) CERy-x: (SIy -SIx)/SIx (x相目からy相目)とし、 CER4-pre：動脈相 CER7-5：門脈相から動脈相にかけて CER7-pre：門脈相 CER28-pre：5分早期肝細胞相 CER28-7：門脈相から5分早期肝細胞相 CERHBP-pre：20分肝細胞相 GRL (gradient of regression line)：回帰曲線の傾き GRLy-x: x相目からy相目とし、 GRL4-2：動脈相での傾き GRL7-4 ：門脈相での傾き GRL 7-2 ：動脈相、門脈相にかけての傾き GRL 28-7：門脈相から早期肝細胞相での傾き 先行研究によると、肝実質の線維化の重症度(F0-F2 vs F3-F4)に基づいてCERHBP-preでcut off値を0.703として肝細胞相での増強効果がinsufficient HBP enhancement groupとsufficient HBP enhancement groupに分けれるとしている。CERHBP-pre<0.703またはCERHBP-pre>0.703により患者を2群に分け、CERy-x、GRLy-xについて検討した。 上記に加えて年齢、性別、総ビリルビン、プロトロンビン時間、アルブミン、eGFRについても、この2群間で比較した(ウィルコクソンの順位和検定)。 肝細胞相の増強効果に対する影響の大きさを調べるためにノンパラメトリック検定も用いられた(スピアマンの順位相関係数)。 結果： 動脈相(CER4-pre、GRL4-2)に関する結果として、これらはsufficient HBP enhancement groupがinsufficient HBP enhancement groupの間に有意差を認めなかった。 動脈門脈相(1相目～7相目)に関する結果としては、CER7-preはsufficient HBP enhancement groupがinsufficient HBP enhancement groupより有意に高い値となった(0.55 vs 0.44, p<0.001)。CER4-pre、GRL4-2、Gradient7-4、Gradient7-2では2群間に有意差は見られなかった。 5分後の早期肝細胞相(1相目～28相目)に関する結果としては、CER28-pre、CER28-7、GRL28-7においてsufficient HBP enhancement groupがinsufficient HBP enhancement groupより有意に高い値となった(0.64 vs 0.47, 0.10 vs 0.03, 1.27 vs 0.27、すべてp<0.001)。 血液データ(総ビリルビン、プロトロビン時間、アルブミン、eGFR)においても2群間で有意差が認められた(p=0.004-0.049)。CER7-pre、CER28-pre、CER28-7、GRL28-7の各パラメータは血液データのパラメータよりも相関係数が高かった。 CER28-preが最も相関係数が高かった(0.838)。 考察： 動脈相では2群間(sufficient HBP enhancement groupとinsufficient HBP enhancement group)に有意差を認めず、門脈相のパラメータでは有意差が見られた。機序としては推測になってしまうが、肝の線維化の進行に伴い門脈血流は低下しやすいが、動脈血流は比較的保たれることが原因であろうか。 また、肝細胞相の信号強度は、血液データなどによって得られた肝機能を示す数値と相関することはこれまでにも報告されてきた。肝機能が良好であるほど、肝細胞がEOBを取り込みやすいためとされる。 本研究では腎機能と肝細胞相の信号強度とにも相関が見られたが、腎機能が低い症例の方がより肝排泄の割合が増えるからと思われた。 本研究のように、ダイナミック撮像中に得られるパラメータが肝細胞相における肝実質の信号強度と相関することを報告した研究はこれまでになかった。 CER7-pre、CER28-pre、CER28-7、GRL28-7の各パラメータは、いずれも血液データのパラメータよりも相関係数が高かった。 本研究のようにダイナミック撮像中に得られたパラメータを用いれば、血液データよりも高い精度で肝実質の信号強度を予測することができる。 これにより、肝細胞相の撮像タイミングを症例により短縮できることが期待される。 結語： 圧縮センシングを用いた自由呼吸下でのEOB-MRIのダイナミック撮像おいて、肝実質の信号強度の変化を連続データとして捉えることにより得られたパラメータは、肝細胞相での肝実質の信号強度と強い相関を示す。これにより、肝細胞相の撮像タイミングを症例により短縮できることが期待される。

背景：糖尿病患者における聴覚障害の有病率は有意に高く、その予防法の開発が望まれている。 目的：本研究では、糖尿病マウスに対するエイコサペンタエン酸（EPA）投与による早期難聴の予防効果を検討した。 方法：糖尿病モデルとしてTSOD（Tsumura, Suzuki, Obese Diabetes）マウスを、コントロールとしてTSNO（Tsumura, Suzuki, Non Obesity）マウスを使用した。TSNO群とTSOD（EPA-）群（ひまわり油投与）、TSOD（EPA＋）群（EPA投与）の3 群に分けた。聴性脳幹反応（ABR）を測定し、蝸牛を組織学的に評価した。 結果：TSOD（EPA＋）群はTSOD（EPA-）群に比べ、閾値の上昇が小さい傾向を認めた。TSOD（EPA+）群では、生後11 ヶ月から14 ヶ月にかけて、4kHzでのABR 閾値がTSOD（EPA-）群よりも有意に低かった。TSOD（EPA-）群では、血管条の毛細血管内腔の狭小化と蝸牛軸における血管壁の肥厚が観察された。 結論：TSOD マウスに対するEPA 投与による蝸牛血管の動脈硬化の抑制は、加齢に伴う早期難聴を抑制することが示唆された。

角膜の剛性を表す生体力学的指標の一つとして角膜ヒステリシス（CH）があり，CHは眼圧（IOP）や中心角膜厚（CCT）などの影響を受け，眼球全体の剛性も反映することから，CH低下が緑内障の進行リスクとして注目される。一方で，硝子体は眼球を外力から保護する緩衝材としての作用があり，眼球の剛性に影響するが，硝子体とCHとの関連は明らかになっていない。本研究では硝子体切除がCHに与える影響を評価することを目的に，白内障単独手術と白内障手術併施硝子体切除術の術後早期のCHを比較した。白内障手術（PEA+IOL）を施行した18例20眼（PEA+IOL群），黄斑上膜あるいは黄斑円孔に対してPEA+IOL併施の経毛様体扁平部硝子体切除術（PPV）を施行した27例28眼（PPV triple群）を対象とした。術前，術後2週，術後3か月のCH，IOP，CCTおよびCHとCCTの相関関係について後ろ向きに検討した。CHは術前，術後2週，術後3か月で，PEA+IOL群において11.1±1.1mmHg，10.4±1.1 mmHg，11.0±1.0 mmHgであり，PPV triple群において11.0±1.4mmHg，9.8±1.4 mmHg，10.6±1.6 mmHgであった。CHはPEA+IOL群で術前後に有意差は認めなかったが，PPV triple群の術後2週で有意に低下していた。IOPおよびCCTは両群とも術前後に有意な変化は認めなかった。PEA+IOL群の全時点とPPV triple群の術前にはCHとCCTの正の相関関係を認めたが，PPV triple群の術後には相関関係を認めなかった。以上より，PPV triple手術ではIOPやCCT以外による要因で術後にCHが低下することが示され，硝子体切除が眼球の剛性変化をもたらしCH低下に寄与した可能性が考えられた。CHの低下は，外力や眼圧の影響を受けやすい眼球構造であると言えることから，PPV 術後のCH評価は眼圧管理の指標や緑内障の発症，進行リスクを反映する可能性がある。

本研究では、特定の遺伝子型と表現型との関連を明らかにするために、EDAR遺伝子の潜性（劣性）変異に着目し、その特徴を詳細に検討した。具体的には、過去にEDARのDD内に同定された潜性（劣性）遺伝形式を示す4 種類のミスセンス変異（p.R358Q、p.G382S、p.I388T、p.T403M）について、培養細胞での過剰発現系で一連の解析を実施した。これらの変異の中で、p.R358QはEDARADDとの結合能を失い、下流のNF-κB活性を低下させることが知られており、機能喪失の陽性対照として用いた。 まず、細胞溶解液を用いたwestern blot法では、p.R358Qおよびp.T403M変異型EDAR蛋白は野生型EDAR蛋白よりも発現量が減衰し、より大きい分子量を示した。一方で、p.G382Sおよびp.I388T変異型EDAR蛋白は野生型EDAR蛋白と同様の発現パターンを示した。また、各EDAR蛋白の細胞内での局在を解析するために実施した蛍光免疫染色法では、野生型EDAR蛋白と同様にp.G382Sおよびp.I388T変異型EDAR蛋白は細胞質内に局在が認められたが、p.R358Qとp.T403M変異型EDAR蛋白は細胞膜に発現していた。これらの結果から、変異型蛋白間で発現パターンが異なることが示された。続いて行ったNF-κBレポーターアッセイでは、すべての変異型EDAR蛋白がNF-κBの活性化を抑制したが、p.R358Qとp.T403M変異型EDAR蛋白に比べ、p.G382Sとp.I388T変異型EDAR蛋白による抑制効果は軽微であった。EDARとEDARADDの結合を検討した共免疫沈降法では、p.R358Qとp.T403M変異型EDAR蛋白はEDARADDとの結合能を完全に喪失していたが、p.G382Sとp.I388T変異型EDAR蛋白は、ある程度結合能を維持した。これらの解析で、p.G382S変異型EDARの機能喪失の程度は最も軽度と考えられた。 過去の研究で、野生型EDARはTRAF6とは直接結合しないことが報告されており、本研究で実施した野生型EDARとTRAF6間の共免疫沈降法でも同様の結果が得られた。しかしながら、驚くべきことに、本研究で解析した全ての変異型EDAR蛋白はTRAF6と直接結合する性質を示した。 培養細胞での過剰発現系においては、機序は不明だがEDAR蛋白を含む種々のTNF受容体が細胞質内に発現する傾向を示すことが知られていたことから、p.R358Qおよびp.T403M変異型EDAR蛋白の細胞膜への局在は異常な発現パターンと考えられる。NF-κBレポーターアッセイおよび共免疫沈降法の結果から、各変異型EDAR蛋白とEDARADDの親和性はNF-κB活性低下の程度と強く相関することが示唆された。今回解析した4 種類のミスセンス変異は、いずれもEDARの機能や構造に重大な影響を与えると複数のデータベースで推測されていたが、各データベースのスコアは4つの変異の間で非常に類似していた。すなわち、現在の予測ツールの解析能力には限界があり、本研究のように実際に発現・機能解析を行う重要性がハイライトされたといえる。 4種類の変異型EDAR蛋白に共通する唯一の現象は、野生型EDAR蛋白がEDARADDを介して間接的にTRAF6と相互作用するのに対し、TRAF6と直接結合することである。これは、変異型EDAR蛋白がEDAR、DARADD、TRAF6からなる正しい蛋白複合体を形成できないことを示唆しており、EDAR遺伝子変異に起因するHEDの鍵となっている可能性があるが、本現象の病的意義を解明するためには今後のさらなる検討を要する。 本研究で得られた結果に基づき、各変異を機能喪失の度合いで評価した。R358QとT403Mを「重度」、p.I388Tを「中等度」、p.G382Sを「軽度」とした。各変異を報告した文献に提示されていた表現型と比較検討した結果、EDAR遺伝子変異の機能喪失の程度がHEDの重症度と相関している可能性が示唆された。

自動車事故に際しシートベルトに沿って生じる帯状の皮下出血斑はシートベルト兆候（seat belt sign：SBS）と呼ばれている。特に腹部SBS が上前腸骨棘（anterior superior iliac spine：ASIS）よりも上方に位置する場合、腹部臓器損傷の危険性が高い。本研究の目的は、腹部SBS 位置に関連するシートベルト腹部部分（ラップベルト）の位置に影響を与える因子について解析することである。本研究は、健康な成人100名（男性50名、女性50名）の身体所見と、カーシート座位時のラップベルト位置との関係を前向きに検討したものである。身体所見は、年齢、身長、Body Mass Index（BMI）、腹囲を測定した。それぞれ平均年齢37.9歳、平均身長164.9cm、平均BMI 23.9kg/m2、平均腹囲83.4cmであった。X線学的所見は、腰椎前弯（lumbar lordosis：LL）、仙骨傾斜（sacral slope：SS）を測定し、ラップベルト位置は運転席側のラップベルトの中央とASIS相当の位置に鉛テープでマーキングすることで計測した。側面X線撮影を行い、ASISから中央マーカーまでの水平距離（X値）、垂直距離（Z値）を計測した。ラップベルト角度は、2つのマーカーの上端を結ぶ直線と水平線とのなす角度を計測することで求めた。これらの身体所見とX線学的所見との関係を統計学的に解析した。X値とZ値は体重（X値r = 0.73、Z値r = 0.56）、BMI（X値r = 0.77、Z値r = 0.56）、腹囲（X値r = 0.74、Z値r = 0.52）と正の相関があり、ラップベルト角度は体重（r = -0.33）、BMI（r = -0.35）、腹囲（r = -0.37）と負の相関があった。これらの結果からは、BMIの高い乗員ではラップベルトがASISより高い位置にあるため、シートベルト損傷を引き起こす可能性が高い。この解析は、より安全なシートベルトの開発に役立つと思われる。