Rheumatology

(1) Overview

The human body is equipped with an immune system, that works to protect the body from pathogens such as bacteria and viruses. If the immune system eliminates what is truly harmful to the body and does not react to what is harmless, there is no problem, but if the immune system has a “misunderstanding” and misidentifies what is harmless as being harmful, difficulties arise. In particular, if the immune systems sees your own body as something harmful and as an enemy and attacks it, the tissues become inflamed and are destroyed, and in extreme cases, the condition may become life-threatening. Illnesses that occur with this mechanism are known as autoimmune diseases.
Autoimmune diseases include those that affect only a single organ or organ system and those that damage organs throughout the entire body. In Japan, systemic autoimmune diseases are collectively called “connective tissue disease.” Connective tissue disease is classified into many types based on the characteristics of the illness, but the most common illness is rheumatoid arthritis. Our department specializes in the treatment of connective tissue diseases, including rheumatoid arthritis.

(2) Policy

As the diseases addressed by the department are caused by problems with immune function, suppression of immunity comprises the main axis of treatment. Signal substances (hormones) produced by the organ called the adrenal gland in the human body have the property of suppressing immunity, and have long been used as virtually the “only card to play” in the treatment of arthritis and connective tissue disease. Although many lives have been saved by steroid medications, long-term use of these drugs is known to cause side effects such as osteoporosis and diabetes. In the 1990’s, new methods using drugs with immunosuppressive properties such as methotrexate were developed, and in the 2000’s, drugs (biologics) became available, designed based on the latest research that elucidated the mechanism of immunity in the human body. Standards for the treatment of connective tissue disease have changed greatly over the last 10 to 20 years, and our department strives to provide safe, reliable medical care based on the latest research.

(3) Our Strengths

• Since connective tissue disease is a disease that can lead to systemic symptoms, collaboration with physicians in other clinical departments is essential. In addition, there are many patients who undergo treatment for extended periods of time, and we also strongly emphasize collaboration with practicing physicians who provide support in the community. Our department is a division of a general hospital, enabling us to respond to the diverse issues and needs of patients through this type of collaboration.
• Some patients feel unwell despite the fact that there are no signs of the worsening of their illness on tests. Perhaps this means that current medicine is not yet complete, and there are no means to detect this feeling of unwellness, and it may be an issue that cannot be resolved by adding or changing (or decreasing) drugs that suppress immunity. In such cases, incorporating treatment with Japanese traditional medicine, which perceives of physical issues from a completely different perspective, may bring us closer to a solution. In our department, patients can be treated by specialists in Japanese traditional medicine certified by the Japan Society for Oriental Medicine.
• In recent years, advances in the study and research on the mechanisms of immunity have progressed at remarkable speed, and as a result, drugs have been successively developed that have completely different properties from previous drugs. However, in order for these drugs to be used in an actual clinical setting, the safety and efficacy of the drugs must be scientifically demonstrated. Specifically, patients who are willing to cooperate will be recruited, and those who meet the conditions will be asked to use the drug, and data will be collected. At this time, a certain number of patients will be allocated the “placebo,” a drug which should have no effect, and it will not be revealed who was allocated which drug until the data is ultimately analyzed. Once it has been confirmed with the data that the new drug is safe and its efficacy exceeds the placebo, for the first time, the new drug can be made available to many patients. This series of verification tasks is called a “clinical trial,” and because massive amounts of time and effort are required, clinical trials are only conducted at a limited number of medical institutions. Our department actively undertakes “clinical trials” for the benefit of future patients suffering from the same illness.

Message for Our Patients

Connective tissue diseases include many diseases designated as so-called intractable diseases (specific diseases). For this reason, most of patients diagnosed with connective tissue disease are extremely worried and anxious about “having a difficult disease”. However, it cannot be unconditionally said that connective tissue diseases = “difficult diseases.” For example, in terms of whether they are illnesses where it is difficult to save the patient’s life, connective tissue diseases are on their way to no longer being “difficult diseases.” In the past, patients with arthritis or connective tissue disease were said to have a considerably shorter average lifespan compared with individuals without these diseases, but due to advances in treatment, this has significantly improved. It is now an age where many patients enjoy life in the same way as individuals without connective tissue disease, living out their lifespans to the fullest.
In this department, we seek to provide treatment not only for the symptoms of illness, but to also alleviate the anxiety and worries brought about by illness.