Neuroinflammation and Oxidative Stress in the Pathogenesis of Autism Spectrum Disorder.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder (NDD) characterized by impairments in social communication, repetitive behaviors, restricted interests, and hyperesthesia/hypesthesia caused by genetic and/or environmental factors. In recent years, inflammation and oxidative stress have been implicated in the pathogenesis of ASD. In this review, we discuss the inflammation and oxidative stress in the pathophysiology of ASD, particularly focusing on maternal immune activation (MIA). MIA is a one of the common environmental risk factors for the onset of ASD during pregnancy. It induces an immune reaction in the pregnant mother's body, resulting in further inflammation and oxidative stress in the placenta and fetal brain. These negative factors cause neurodevelopmental impairments in the developing fetal brain and subsequently cause behavioral symptoms in the offspring. In addition, we also discuss the effects of anti-inflammatory drugs and antioxidants in basic studies on animals and clinical studies of ASD. Our review provides the latest findings and new insights into the involvements of inflammation and oxidative stress in the pathogenesis of ASD.

Dispersion characteristics of oral microbial communities in a built environment

Advances in next‐generation sequencing (NGS) technologies since 2005 have revolutionized biological science. One particular application of NGS technologies is to elucidate microbiomes in built environments. We are currently conducting a series of studies on the elucidation and control of mass infection mechanisms based on dynamic measurement of environment microbiomes. The objective of this study is to clarify the dispersion characteristics of oral bacteria in the built environment. Bacterial communities from occupants’ hands and oral cavities, doorknobs, desk and keyboard surfaces, and air in laboratories were investigated in seven Japanese universities. The median relative abundances of Firmicutes, Proteobacteria, Actinobacteria, Bacteroidetes, and Fusobacteria were 41%, 31%, 12%, 7%, and 3%, respectively. Moreover, the main genera detected were Streptococcus (27.6%), Haemophilus (7.0%), Staphylococcus (5.6%), Neisseria (5.6%), Corynebacterium (4.7%), Rothia (3.2%), Prevotella (3.0%), Fusobacterium (2.6%), Veillonella (1.7%), Leptotrichia (1.7%), Enhydrobacter (1.7%), Lactobacillus (1.3%), Acinetobacter (1.3%), and Actinomyces (1.1%). The oral bacteria Actinomyces, Corynebacterium, Fusobacterium, Haemophilus, Leptotrichia, Neisseria, Prevotella, Rothia, and Streptococcus were observed in indoor air and on surfaces as well as in oral cavities. Furthermore, Prevotella melaninogenica and Rothia mucilaginosa were observed in all samples, including those from hands and oral cavities, doorknobs, desk and PC keyboard surfaces, and air in laboratories, in all seven universities.

Approach of Medical Excellence JAPAN to create platforms of collaboration in Asia.

Medical Excellence JAPAN (MEJ) is a general incorporated association established in 2011 in Japan. It aims to serve as a central hub and a platform to promote international health business jointly with governments, medical communities, academic organizations, and healthcare industries. This article introduces the works of MEJ in the broader context of Japan Revitalization Strategy. The Act on Promotion of Healthcare Policy (2014 Act No. 48) established the Headquarters for Healthcare Policy, chaired by the Prime Minister and supported by dedicated secretariats in the Cabinet Office. The Headquarters aimed at policy coordination across ministries but learned hard lessons from COVID-19, such as delay of domestic vaccine production. This highlights our systematic weakness of the trajectory from R&D to public availability, and this is the field in which MEJ can play further roles. The value and feasibility of developing MEJ-like mechanisms in Asia with a rapidly growing healthcare sector is discussed.

[Immune thrombocytopenia after BNT162b2 mRNA COVID-19 vaccination].

A 95-year-old male developed general subcutaneous petechiae, tongue hematoma, and melena two days after receiving the second BNT162b2 mRNA COVID-19 vaccine. Two days later, his platelet count decreased to below 1,000/µl. Laboratory testing was positive for a slight increase in D-dimer, Helicobacter pylori (H. pylori) immunoglobulin G (IgG) antibody, lupus anticoagulant, and anticardiolipin IgG antibody levels. There were no severe infections or symptomatic thrombosis. Platelet transfusions were transiently effective. He was diagnosed with newly developed immune thrombocytopenia (ITP). We administered prednisolone (PSL) at 0.5 mg/kg/day and intravenous immunoglobulin (IVIG) at 0.4 g/kg/day. From the following day, his platelet count rapidly increased, with an improvement in bleeding tendency. H. pylori was eradicated after platelet count recovery. Thrombocytopenia did not relapse although PSL was tapered three months later. Causes of thrombocytopenia after SARS-CoV-2 vaccination include ITP, vaccine-induced immune thrombotic thrombocytopenia, and thrombotic thrombocytopenic purpura. Differential diagnosis is important to determine the proper therapy. Case reports of newly diagnosed ITP after SARS-CoV-2 vaccination have been increasing recently. In these cases, including ours, the responses to steroids and IVIG were good. Further follow-up studies are needed to manage thrombocytopenia following SARS-CoV-2 vaccination.