小林哲郎

**小林 哲郎**（こばやし てつろう、1948年（昭和23年）10月23日 - ）は、日本の医師、医学者。緩徐進行1型糖尿病(Slowly progressive insulin-dependent diabetes mellitus: SPIDDM)を発見し、成因や治療法について研究を続けている。冲中記念成人病研究所 所長、山梨大学名誉教授。専門は糖尿病学、内科学。

## 経歴
長野県木曽福島町生まれ。1967年長野県松本深志高等学校卒業。1974年金沢大学医学部医学科卒業。1974年虎の門病院内科研修医に着任。

虎の門病院内分泌代謝科医員時代、緩徐進行1型糖尿病患者を発見。1型糖尿病の新しい病型として1982年発表。1989年虎の門病院内分泌代謝科医長。1993年東京大学より医学博士の学位を取得。

2001年山梨医科大学第3内科教授（合併改組により山梨大学院医薬薬学総合研究部）。2004年山梨大学医学部付属病院副院長、第3内科教授を歴任。2014年山梨大学医学部第3内科教授定年退職。

緩徐進行1型糖尿病(SPIDDM)の発見と原因研究に加え、膵島に直接接する細胞群である膵島外分泌腺様細胞群(Acinar-like cell cluster Touching Langerhans islets with Thin Interstitial Surrounding: ATLANTIS)を発見。冲中記念成人病研究所 所長として研究活動をつづけている。

## 主な発表論文
# Kobayashi T, Sawano S, Itoh T, Sugimoto T, Takahashi S, Tanaka T, Suwa S :  Islet-cell antibodies in Insulin-dependent and non-insulin dependent diabetics in Japan : their prevalence and clinical significance. Clinico-genetic genesis of diabetes mellitus. Mimura G, Baba S, Goto Y, Kobberling J, Eds. Amsterdam, Excerpta Med p.150-160, 1982 (ICS No. 597)
# Kobayashi T, Sugimoto T, Itoh T, Kosaka K, Tanaka T, Suwa S, Satoh K, Tsuji K: The prevalence of islet cell antibodies in Japanese insulin-dependent and non-insulin-dependent diabetic patients studied by indirect immunofluorescence and by a new method. Diabetes 35 : 335-340, 1986
# Kobayashi T, Itoh T, Kosaka K, Sato K, Tsuji K: Time course of islet cell antibodies and beta-cell function in non-insulin-dependent stage of type 1 diabetes. Diabetes 36 : 510-517, 1987
# Kobayashi T, Nakanishi K, Sugimoto T, Itoh T, Murase T, Kosaka K, Tsuji K:  Maleness as risk factor for slowly progressive IDDM. Diabetes Care 12 : 7-11, 1989
# Kobayashi T: Immunology and Immunogenetics of type I diabetes in Japan. IDF Bulletin 35 : 34-37, 1990
# Kobayashi T, Tamemoto K, Nakanishi K, Kato N, Okubo M, Kajio H, Sugimoto T, Murase T, Kosaka K: Immunogenetic and clinical characterization of slowly progressive IDDM. Diabetes Care 16 : 780-788, 1993
# Oka Y, Katagiri H, Yazaki Y, Murase T, Kobayashi T: Mitochondria gene mutation in islet-cell-antibody-positive patients who were initially non-insulin-dependent diabetics. Lancet 342 : 527-528, 1993
# Nakanishi K, Kobayashi T, Miyashita H, Okubo M, Sugimoto T, Murase T, Hashimoto M, Fukuchi S, Kosaka K: Exocrine pancreatic ductgrams in insulin-dependent diabetes mellitus. Am J Gastroenterol 89 : 762-766, 1994
# Kobayashi T: Subtype of insulin-dependent diabetes mellitus (IDDM) in Japan : slowly progressive IDDM-the clinical characteristics and pathogenesis of the syndrome. Diabetes Res Clin Pract 24 (Suppl) : S95-S99, 1994
# Kobayashi T, Nakanishi K, Murase T, Kosaka K: Small doses of subcutaneous insulin as a strategy for preventing slowly progressive -cell failure in islet cell antibody-positive patients with clinical features of NIDDM.Diabetes 45 : 622-626, 1996
# Kobayashi T, Nakanishi K, Okubo M, Murase T, Kosaka K: GAD antibodies seldom disappear in slowly progressive IDDM. Diabetes Care 19: 1031, 1996
# Tanaka S, Kobayashi T, Momotsu T: A novel subtype of Type 1 diabetes mellitus. N Engl J Med 342 : 1835-1837, 2000
# Tanaka S, Kobayashi T, Nakanishi K, Okubo M, Murase T, Hashimoto M,  Takeuchi K: Corticosteroid-responsive diabetes mellitus associated with autoimmune pancreatitis. Lancet 356 : 910-911, 2000
# Kobayashi T, Tanaka S, Okubo M, Nakanishi K, Murase T, Lernmark Å: Unique epitopes of glutamic acid decarboxylase autoantibodies in slowly progressive type 1 diabetes. J Clin Endocrinol Metab 88 : 4768-4775, 2003
# Tanaka S, Endo T, Aida K, Shimura H, Yokomori N, Kaneshige M, Furuya F, Amemiya S, Mochizuki M, Nakanishi K, Kobayashi T: Distinct diagnostic criteria of fulminant type 1 diabetes based on serum C-peptide response and HbA1c levels at onset. Diabetes Care 27: 1936-1941, 2004
# Maruyama T, Tanaka S, Shimada A, Funae O, Kasuga A, Kanatsuka A, Takei I, Yamada S, Harii N, Shimura H, Kobayashi T: Insulin intervention in slowly progressive insulin- dependent (type 1) diabetes mellitus. J Clin Endocrinol Metab 93: 2115-2121, 2008
# Endo T, Takizawa S, Tanaka S, Takahashi M, Fujii H, Kamisawa T, Kobayashi T: Amylase α-2A autoantibodies :  Novel marker of autoimmune pancreatitis and fulminant type 1 diabetes. Diabetes 58: 732-737, 2009
# Tanaka S, Nishida Y, Aida K, Maruyama T, Shimada A, Suzuki M, Shimura H, Takizawa S, Takahashi M, Akiyama D, Arai-Yamashita S, Furuya F, Kawaguchi A, Kaneshige M, Katoh R, Endo T, Kobayashi T: Enterovirus infection, CXC chemokine ligand 10 (CXCL10), and CXCR3 circuit: A mechanism of accelerated -cell failure in fulminant type 1 diabetes. Diabetes 58 : 2285-2291, 2009
# Aida K, Nishida Y, Tanaka S, Maruyama T, Shimada A, Awata T, Suzuki M, Shimura H, Takizawa S, Ichijo M, Akiyama D, Furuya F, Kawaguchi A, Kaneshige M, Itakura J, Fujii H, Endo T, Kobayashi T :  RIG-I- and MDA5-initiated innate immunity linked with adaptive immunity accelerates T-cell death in fulminant type 1 diabetes. Diabetes 60: 884-889, 2011
# Furuya F, Shimura H, Asami K, Ichijo S, Takahashi K, Kaneshige M, Oikawa Y, Aida K, Endo T, Kobayashi T : Ligand-bound thyroid hormone receptor contributes to reprogramming of pancreatic acinar cells into insulin-producing cells. J Biol Chem 288 : 16155-16166, 2013
# Aida K, Saitoh S, Nishida Y, Yokota S, Ohno S, Mao X, Akiyama D, Tanaka S, Awata T, Shimada A, Oikawa Y, Shimura H, Furuya F, Takizawa S, Ichijo M, Ichijo S, Itakura J, Fujii H, Hashiguchi A, Takasawa S, Endo T, Kobayashi T: Distinct cell clusters touching islet cells induce islet cell replication in association with over-expression of regenerating gene (REG) protein in fulminant type 1 diabetes. PLoS ONE 9: e95110, 2014.
# Nishida Y, Aida K, Kihara M, Kobayashi T. Antibody-validated proteins in inflamed islets of fulminant type 1 diabetes profiled by laser-capture microdissection followed by mass spectrometry. PLoS ONE 9: e107664, 2014.
# Tanaka S, Ohmori M, Awata T, Simada A, Mrrao S, Maruyama T, Kamoi K, Kawasaki E, Nakanishi K, Nagata M, Fujii S, Ikegami H, Imagawa A, Uchigata Y, Okubo M, Osawa H, Kajio H, Kawaguchi A, Kawabata Y, Satoh J, Shimizu I, Takahashi K, Makino H, Iwahashi H, Mirra J, Yasuda K, Hanafusa T, Kobayashi T, Committee on Type 1 Diabetes. Diagnostic criteria for slowly progressive insulin-dependent (type 1) diabetes ellitus (SPIDDM) (2012): report by the Committee on Slowly Progressive Insulin-Dependent (Type 1) Diabetes Mellitus of the Japan Diabetes Society. Diabetol Int 6: 1-7, 2015.
# Kobayashi T, Aida K, Fukui T, Jimbo E, Shimada A, Mori Y, Fujii T, Yagihashi S. Pancreatic ductal hyperplasia/dysplasia with obstructive chronic pancreatitis: an association with reduced pancreatic weight in type 1 diabetes. Diabetologia 59: 865-867, 2016.
# Tanaka S, Okubo M, Nagasawa K, Takizawa S, Ichijo M, Ichijo S, Kaneshige M, Aida K, Shimura H, Mori Y, Kobayashi T. Predictive value of titer of GAD antibodies for further progression of beta cell dysfunction in slowly progressive insulin-dependent (type 1) diabetes (SPIDDM). Diabetol Int 7: 42–52, 2016.
# Awata T, Shimada A, Maruyama T, Oikawa Y, Yasukawa N, Kurihara S, Miyashita Y, Hatano M, Ikegami Y, Matsuda M, Niwa M, Kazama Y, Tanaka S, Kobayashi T. Possible long-term efficacy of sitagliptin, a dipeptidyl peptidase-4 inhibitor, for slowly progressive type 1 diabetes (SPIDDM) in the stage of non-insulin-dependency: an open-label randomized controlled pilot trial (SPAN-S). Diabetes Ther 8:1123–1134, 2017.
# Aida K, Kobayashi T, Takeshita A, Jimbo E, Nishida Y, Yagihashi S, Hosoi M, Fukui T, Sugawara A, Takasawa S. Crucial role Reg 1 from acinar-like cell cluster touching with islets (ATLANTIS) on mitogenesis of beta cells in EMC virus-induced diabetic mice. Biochem Biophys Res Commu 503(2): 963-969, 2018.
# Aida K, Fukui T, Jimbo E, Yagihashi S, Shimada A, Oikawa Y, Mori Y, Fujii T, Nishida Y, Koyama R, Kobayashi T. Distinct Inflammatory Changes of the Pancreas of Slowly Progressive Insulin-dependent (Type 1) Diabetes. Pancreas 47(9): 1101-1109, 2018.

## 著書
*Diabetes in the New Millennium. ed by John R Turtle et al., 1999.
*臨床糖尿病マニュアル 小林哲郎編著 南江堂1996年2月第1版
*臨床糖尿病マニュアル改定第2版 小林哲郎編著 南江堂2004年6月第2版
*インスリンポンプ療法マニュアル-CSII療法導入・管理のための手引き 小林哲郎、難波光義編集 南江堂 2009年3月第1版
*インスリンポンプ療法マニュアル-CSII療法導入・管理のための手引き 改定第2版 小林哲郎、難波光義編集 南江堂 2014年6月第1版

## 脚注・出典