時間がかかっても将来的に患者さんに還元できる基礎研究

Conducting basic research that can be returned to patients in the future, despite the time it may take

●研究の概要を教えてください

皮膚科は皮疹を伴う全ての疾患を扱う診療科です。当科で行う研究は皮疹の解析から始まりますが、扱う疾患の幅は非常に広く、皮膚疾患のみでなく多臓器病変を伴う全身性疾患も扱っています。特に全身性疾患の研究においては、皮膚を免疫臓器として捉え、皮膚免疫が臓器病変を制御・修飾するメカニズムに注目して研究を進めています。
現在取り組んでいる領域として、膠原（こうげん）病（全身性強皮症、全身性エリテマトーデス、皮膚筋炎）、皮膚腫瘍（メラノーマ、血管肉腫）、炎症性皮膚疾患（乾癬（かんせん）、アトピー性皮膚炎）、色素性疾患（白斑）が挙げられます。膠原病では特に全身性強皮症の研究に力を入れており、「転写因子FLI1の発現異常に基づく強皮症病態一元化仮説」をテーマに複数のモデルマウスを活用して、皮膚、肺、心臓、消化管など多臓器の病態解析と新規治療薬開発を目指した研究を進めています。皮膚腫瘍の研究では腫瘍関連マクロファージに着目し、腫瘍微小環境における免疫応答の制御と、免疫チェックポイント阻害薬や新規抗腫瘍薬によって修飾される免疫環境に注目して研究を行っています。
当科のモットーは「時間がかかっても将来的に患者さんに還元できる基礎研究」ですが、この意識を研究室全体で共有し、常に臨床応用を意識した議論を重ねています。こうして培われたリサーチマインドは、実臨床において「皮疹を診る解像度」を上げる効果もあり、臨床医として過ごす時間の豊かさの向上にもつながっています。

●What is the outline of your research?

Dermatology is a department that treats all diseases with skin rash. Our research begins with the analysis of skin rashes, but the range of diseases we treat is very broad, and we deal not only with skin diseases but also with systemic diseases involving multiple organ dysfunction. In particular, our research on systemic diseases focuses on the skin as an immune organ and studies the mechanisms by which skin immunity regulates and modifies organ dysfunctions.
Currently, we are working on collagen diseases (systemic sclerosis, systemic lupus erythematosus, dermatomyositis), skin tumors (melanoma, angiosarcoma), inflammatory skin diseases (psoriasis, atopic dermatitis), and pigmentary diseases (vitiligo). In the area of collagen diseases, we are particularly focusing on systemic sclerosis, and are conducting research on the “hypothesis of unification of scleroderma pathology based on the abnormal expression of transcription factor FLI1” utilizing multiple mouse models to analyze the pathology of multiple organs including skin, lung, heart, and gastrointestinal tract and to develop new therapeutic agents. In the study of skin tumors, we focus on tumor-associated macrophages, and our research focuses on the regulation of immune responses in the tumor microenvironment and the immune environment modified by immune checkpoint inhibitors and novel anti-tumor drugs.
The motto of our department is “basic research that can be returned to patients in the future, despite the time it may take,” and we share this awareness throughout the entire laboratory and constantly hold discussions with an awareness of clinical applications. The research mindset fostered in this way has the effect of raising the “resolution of skin rash diagnosis” in actual clinical practice and leads to an enrichment of the time spent as a dermatologist.

独自のライフワークを見つけ、思う存分自己表現を

Find your own life’s work and express yourself to the fullest

●研究室はどのような雰囲気ですか？

1学年2〜5人ほどの大学院生が入学しており、研究室全体で常に10人前後の大学院生が在籍しています。医学部卒業後5〜7年目で入学する大学院生が多く、平均年齢は30代前半で出身大学はさまざまです。研究グループは膠原病、皮膚腫瘍、炎症性皮膚疾患、色素性疾患がありますが、グループ間の垣根はなく、複数グループにまたがる研究テーマもあり、お互い協力し合う雰囲気があります。また、4つの研究グループとは独立した研究テーマの選択も可能で、そのようなケースでは各グループの指導教官が協力し合いながら新しいテーマの指導を行っています。
このように非常に風通しが良い雰囲気で、大学院生は自分の興味に従って自由に研究テーマを選ぶことができます。研究室全体で定期的なリサーチカンファを行い、さまざまな視点から情報交換できる環境の中で大学院生をしっかりとサポートし、研究成果の発表や論文化を進めています。研究への取り組み方については個々の大学院生のビジョンを尊重し、性別を問わずライフイベントと研究の両立を研究室全体でサポートしています。基礎研究は「自己表現の場」であるという意識を研究室全体で共有し、お互いの強みを尊重し合い、自己効力感を高めながら、建設的な雰囲気の中で切磋琢磨（せっさたくま）できる環境を整えています。

●How would you describe the work environment in your laboratory?

There are about 2 to 5 graduate students enrolled each academic year, and there are always about 10 graduate students in the entire laboratory. Many graduate students enter the laboratory 5 to 7 years after graduation from medical school, their average age is around early 30s, and they come from a variety of universities. The research groups include collagen diseases, skin tumors, inflammatory skin diseases, and pigmentary diseases, but there are no barriers between groups, and some research themes span multiple groups, creating an atmosphere of mutual cooperation. It is also possible to choose a research theme independent of the four research groups, and in such cases, the supervisors of each group cooperate with each other to guide the new theme.
In this very open atmosphere, graduate students are free to choose their research themes according to their own interests. The entire laboratory holds regular research conferences to provide graduate students with solid support in an environment where information can be exchanged from a variety of perspectives and research results can be presented and published. We respect the visions of individual graduate students in terms of how they approach their research, and the entire laboratory supports them in balancing life events with research, regardless of gender. The entire laboratory shares the awareness that basic research is “a place for self-expression,” and we respect each other’s strengths and create an environment where students can encourage each other in a constructive atmosphere while enhancing their sense of self-efficacy.

●学生にどのようなことを期待しているかなども含め、進学希望者へのメッセージをお願いします

当研究室では、研究活動を「自己表現の場」と捉えています。その時々に考えたこと、感じたことを皮膚科医として生きた足跡として残すことは、何らかの形で医学の発展に寄与するはずです。先人が敷いたレールの上を全力で駆け抜けることができた皆さんなら、きっと未来の皮膚科医が走るレールを敷くことができるはずです。若い先生方にはぜひとも研究活動を通じて独自のライフワークを見つけ、思う存分自己表現してほしいと思います。当研究室は、そのような情熱を持った大学院生を全力でサポートします。

●Would you give a message to prospective students, including what you expect from them?

Our laboratory regards research activities as “a place for self-expression”. Leaving behind a footprint of your thoughts and feelings as a dermatologist should contribute to the development of medical science in some way. Those of you who were able to run as fast as you could on the rails laid by your predecessors will surely be able to lay down the rails on which the dermatologists of the future will run. I hope that young doctors will find their own unique life work through research activities and express themselves to the fullest. Our laboratory will do its utmost to support graduate students with such passion.

修了後はリサーチマインドを持った指導医として活躍

After completion of the program, you will be active as a supervising physician with a research mindset

●修了後はどのような進路がありますか？また、修了生はどのように活躍していますか？

当教室では、専攻医3〜5年目に大学院に入学するケースが多いです。ですので、大学院修了後は皮膚科医として、関連病院の臨床現場に戻るのが一般的です。一方、大学院修了後も大学に残り、あるいは一度関連病院に出て臨床の研さんを積んだ後に大学に戻り、研究を続けながら診療のスキルアップや研究留学（国内外）を目指す場合もあります。いずれの場合も研究の経験を生かし、リサーチマインドを持った指導医として活躍してくれています。

●What kind of career paths are available after completion of the program, and how will the graduates be active in their careers?

In our department, many graduates enter graduate school in their third to the fifth year of medical specialty. Therefore, it is common for graduates to return to clinical practice as dermatologists at affiliated hospitals after completing graduate school. On the other hand, there are cases in which the graduate student remains at the university after completing graduate school, or goes to an affiliated hospital for clinical training and then returns to the university to continue research while improving their medical skills or aiming to study abroad for research (in Japan or abroad). In both cases, they make the most of their research experience and serve as research-minded supervisors.

●病院や企業に勤務しながらの修学は可能でしょうか？

社会人大学院生の受け入れ制度があります。時間的な制約から、病院や企業に勤務しながらの修学は多大な努力を要しますが、希望者は受け入れていますのでご相談ください。

●Is it possible to study while working at a hospital or company?

We have a system for accepting working graduate students. Due to time constraints, it takes a great deal of effort to study while working at a hospital or company, but we accept those who wish to do so, so please consult with us.

多様性尊重し、一人一人が自分の軸を確立していく教室に

A department where diversity is respected, and each student establishes his/her own axis

●東北大学の良いところは？

東北大学は建学以来、「研究第一」の理念を掲げ、2017年には東京大学・京都大学と並んで日本で最初の指定国立大学法人に指定されています。指定国立大学とは、世界最高水準の教育研究活動が展開できると、その実力と潜在能力を認められた国立大学のことです。事実、研究者の養成をサポートするシステムや学内の連携体制などが十分に確立されており、世界の第一線で活躍する研究者も多数在籍しています。異分野の研究者と連携することでより質の高い共同研究を進めることも可能です。当教室も、ゲノム・生体試料情報を用いた皮膚免疫疾患の病態解析に取り組むとともに、ICTやAI技術を駆使した皮膚科領域における未来型医療の創成を目指し、技術開発に取り組むなど、東北大学ならではの分野横断的な研究に取り組んでいます。
また、教育研究活動を発展させていく上で「人材の多様性」は不可欠です。東北大学建学以来の伝統である「門戸開放」の理念に基づき、出身大学の異なる先生方がそれぞれの目的・目標を持って和気あいあいと教育・研究・診療に従事しているのも良い点です。当教室も、さまざまな得意分野と個性を持つ人材が互いの多様性を尊重し合い、切磋琢磨する中で自己肯定感を育み、一人一人が未来の自分を支える軸を確立していくような教室を目指しています。

●What is the best thing about Tohoku University?

Since its founding, Tohoku University has upheld the philosophy of “research first,” and in 2017 was designated as the first designated national university corporation in Japan, along with the University of Tokyo and Kyoto University. Designated national universities are national universities that have been recognized for their ability and potential to develop world-class educational and research activities. In fact, Tohoku University has well-established systems to support the training of researchers and intra-university collaboration, and many of our researchers are active at the forefront of their fields around the world. It is also possible to promote higher quality collaborative research by working with researchers in different fields. Our department is also engaged in the pathological analysis of skin immune diseases using genome and biospecimen information, as well as in cross-disciplinary research unique to Tohoku University, such as technological development aimed at creating future-oriented medicine in the field of dermatology using ICT and AI technologies.
In addition, diversity of human resources is essential for the development of education and research activities. Based on the “open-door” philosophy, which has been a tradition at Tohoku University since its founding, it is good that professors from different universities are engaged in education, research, and medical treatment in a friendly atmosphere, each with their own goals and objectives. Also in our department, we respect the diversity of people with various specialties and personalities, and through mutual encouragement, we aim to nurture a sense of self-affirmation, thereby empowering each individual to establish their own axis that will underpin their future selves.

24年間東京大学医学部附属病院に勤務し、2022年2月に東北大学に着任しました。着任日に「強皮症オンライン相談 in 東北」をホームページ上に開設し、早速多くの患者さんに受診していただいています。2カ月を過ぎた頃、東京に比べると患者さんの訴えが少なく、待ち時間に対する苦情もほとんどないことに気付きました。医局員の話によると、東北人は口数が少なく、多少のことは我慢する性格の人が多いとのこと。振り返ってみると、東大病院時代、東北地方から受診される患者さんには確かにそのような傾向があったことに今更ながら思い至りました。実はその傾向は医局員にもあるように感じています。余計な口出しはせず、謙虚で遠慮しがちな東北人とのことですが、教室運営においては医局員が内に秘めているものに目を向ける努力を怠らないように日々心がけたいと思います。

I arrived at Tohoku University in February 2022 after 24 years of working at the University of Tokyo Hospital. On the day of my arrival, I launched "Scleroderma Online Consultation in Tohoku" on our website, and many patients immediately visited our clinic. 2 months later, I noticed that patients complained less than in Tokyo, and there were few complaints about waiting time. According to a member of the medical staff, many people in the Tohoku region are not talkative and are willing to be patient with a few problems. Looking back, I now realize that during my time at the University of Tokyo Hospital, there was indeed such a tendency among patients from the Tohoku region. In fact, I feel that this tendency also exists among the members of the medical staff. Although it is said that Tohoku people tend to be humble and reserved, and do not meddle unnecessarily, I would like to make a daily effort not to neglect to pay attention to what the members of the medical staff have inside themselves in the management of the department.

「強皮症オンライン相談 in 東北」

“Scleroderma Online Consultation in Tohoku”

http://www.derma.med.tohoku.ac.jp/patient/online.html