Prognostic value of PSA bounce after definitive radiotherapy revisited.

BACKGROUND: Prostate-specific antigen (PSA) bounce after definitive radiotherapy has been reported as a predictor of improved biochemical recurrence-free survival (BCRFS). We revisited this phenomenon to confirm its clinical impact on oncological outcomes in patients with long-term follow-up who were free of biochemical recurrence (BCR) at least 3 years after treatment. MATERIALS AND METHODS: A total of 541 patients with localized, intermediate-risk prostate cancer underwent low-dose rate brachytherapy with iodine-125 seeds with or without supplemental external beam radiotherapy in combination. Neoadjuvant hormonal therapy was administered to 273 patients (50.5%) with a median duration of 3 months (range 1-108 months). PSA bounce was defined as ≥ 0.2 ng/ml increase above the interval PSA nadir, followed by a decrease below that value. RESULTS: The median age was 69 years (range 49-90 years). The median follow-up duration was 102 months (range 36-205 months). One-hundred and fifty patients (27.7%) had PSA bounce with a median magnitude of 0.47 ng/ml (range 0.2-3.19 ng/ml). Age was significantly associated with the occurrence of PSA bounce [age: hazard ratio (HR) 0.95, 95% confidence interval (CI) 0.93-0.98]. It was found to be independently associated with a decreased risk for BCR (HR 0.29; 95% CI 0.12-0.69) and clinical progression (HR 0.44; 95% CI 0.95-0.98). CONCLUSION: PSA bounce indicated a favorable BCRFS and clinical progression-free survival in patients who had been free of BCR for at least 3 years after definitive radiotherapy.

Trimodal therapy with high-dose-rate brachytherapy and hypofractionated external beam radiation combined with long-term androgen deprivation for unfavorable-risk prostate cancer.

PURPOSE: To assess the outcomes of high-dose-rate (HDR) brachytherapy and hypofractionated external beam radiation therapy (EBRT) combined with long-term androgen deprivation therapy (ADT) in very-high-risk (VHR) versus high-risk (HR) prostate cancer (PCa), as defined in the National Comprehensive Cancer Network (NCCN) criteria. METHODS: Data from 338 consecutive HR or VHR PCa patients who had undergone this tri-modal therapy between 2005 and 2018 were retrospectively analyzed. Biochemical recurrence (BCR)-free, progression-free, overall, and cancer-specific survival (BCRFS/PFS/OS/CSS) rates were analyzed using the Kaplan-Meier method and Wilcoxon test. Cox regression models were used to evaluate candidate prognostic factors for survival. C­indexes were used to assess model discrimination. RESULTS: Within a median follow-up of 84 months, 68 patients experienced BCR, 58 had disease progression including only 3 with local progression, 27 died of any cause, and 2 died from PCa. The 5­year BCRFS, PFS, OS, and CSS rates were 82.2% (HR 86.5%; VHR 70.0%), 90.0% (HR 94.3%; VHR 77.6%), 95.7% (HR, 97.1%; VHR, 91.8%), and 99.6% (HR, 100%; VHR, 98.0%), respectively. In multivariable analyses that adjusted for standard clinicopathologic features, the risk subclassification was associated both PFS and OS (p = 0.0003 and 0.001, respectively). Adding the risk subclassification improved the accuracy of models in predicting BCRFS, PFS, and OS. CONCLUSION: While the outcome of this trimodal approach appears favorable, VHR PCa patients had significantly worse oncological outcomes than those with HR PCa. The NCCN risk subclassification should be integrated into prognostic tools to guide risk stratification, treatment, and follow-up for unfavorable PCa patients receiving this trimodal therapy.

Lutein plus Water Chestnut (Trapa bispinosa Roxb.) Extract Inhibits the Development of Cataracts and Induces Antioxidant Gene Expression in Lens Epithelial Cells.

Age-related cataract (ARC) is the major cause of blindness worldwide. The most significant factors are the maximal exposure of the eye lens to environmental stressors, including oxidative and glycative load. The administration of antioxidant and antiglycative supplements may reduce the risk of cataract progression. In this study, the effects of lutein (LU) and water chestnut (Trapa bispinosa Roxb.) extract (TBE) on cataracts and the expression of antioxidant-related genes were assessed in Shumiya cataract rats (SCRs). LU+TBE or castor oil (COil) as a control was administered to 6- or 9-week-old cataractous SCRs and noncataractous SCRs via a feeding needle for 3 or 4 weeks. Five-week-old SCRs were provided ad libitum access to solid regular chow containing LU, TBE, LU+TBE, or the same chow without LU and/or TBE for 3 weeks. Lenses from all rats were then extracted and photographed. The right eyes of the rats were processed for histological observation, and the left eyes were used for total RNA extraction from lens epithelial cells (LEC). The mRNA levels of antioxidant proteins, peroxiredoxin 6, and catalase were examined using real-time quantitative polymerase chain reaction. Lens opacity appeared in all cataractous SCRs that began receiving LU+TBE at 9 weeks of age. However, compared to the COil group, lens opacity was decreased in the cataractous LU+TBE SCRs in all experiments. The mRNA expression levels of peroxiredoxin 6 and catalase in LECs of cataractous SCRs and cultured human LECs increased after the administration of LU+TBE. Collectively, our results highlight the anticataract and antioxidative effects of LT+TBE in SCRs. LT+TBE supplementation may, thus, be useful in delaying cataract progression.

Prospective comparison of the efficacy of caudal versus periprostatic nerve block, both with intrarectal local anesthesia, during transrectal ultrasonography-guided prostatic needle biopsy.

OBJECTIVE: The aim of this study was to compare the effectiveness of caudal block (CB) versus periprostatic nerve block (PPNB), both with intrarectal local anesthesia (IRLA), in reducing pain during transrectal ultrasonography (TRUS)-guided prostatic biopsy. MATERIALS AND METHODS: This study included 532 patients: 266 patients received CB with IRLA and 266 patients PPNB with IRLA. A visual analogue scale (VAS) was applied to prospectively evaluate pain (1) at induction of anesthesia, (2) at insertion of the TRUS probe, (3) at needle penetration to the prostate, and (4) throughout the biopsy procedure. Pain scores were compared to evaluate differences between groups. The secondary endpoint of serious complication rate was also evaluated. As a subanalysis, the pain scores were compared in patients with high body mass index (BMI ≥25 kg/m²). RESULTS: Overall, the pain score in the PPNB group was significantly lower than in the CB group at induction of anesthesia (mean ± SD: 2.0 ± 1.9 vs 2.9 ± 2.1, p = .0001) but higher at insertion of the TRUS probe (2.7 ± 2.5 vs 1.9 ± 1.7, p = .009). The pain score did not differ significantly between groups at needle penetration or throughout the biopsy. Univariate analyses indicated no significant association between VAS scores and patient demographics. Overall rates of serious complications did not differ between the two groups (5.6% vs 5.3%, p = .85). In patients with high BMI, the pain score was significantly lower in the PPNB group than in the CB group throughout the procedure (2.5 ± 2.0 vs 3.5 ± 2.5, p = .03). CONCLUSIONS: Both procedures were equally effective in reducing pain, and the incidence of serious complications was similar. PPNB with IRLA may be more applicable than CB with IRLA in obese patients.

Do androgen deprivation and the biologically equivalent dose matter in low-dose-rate brachytherapy for intermediate-risk prostate cancer?

The objective of this study was to investigate the impact of the biologically equivalent dose (BED) on treatment outcomes after iodine-125 low-dose-rate brachytherapy (LDR-BT) with or without supplemental external beam radiotherapy (EBRT) and androgen deprivation therapy (ADT) for intermediate-risk prostate cancer (PCa). We retrospectively evaluated 292 Japanese patients. The impact of the BED and ADT on treatment outcomes was investigated. Cox proportional hazard models were used for univariate and multivariate analysis with biological progression-free survival (bPFS) and clinical progression-free survival (cPFS) as the primary outcome measures. The median follow-up was 66 months. The bPFS and cPFS rates at 5-/7-years were 91.6/87.7% and 95.9/94.0%, respectively. When stratified by BED levels, the bPFS rates at 5-/7-years were 92.1/89.3% for <178.0 Gy2, and 91.2/86.0% for ≥178.0 Gy2 , respectively (P > 0.05). Based on ADT duration, the bPFS rates at 5-/7-years were 89.8/83.5%, 89.7/89.7%, and 97.5/97.5% for none, 1-3 months, and 4-12 months, respectively (P = 0.03). For the univariate analysis, the use of ADT and its duration were significant predictors for bPFS, whereas BED was not significant. A multivariate analysis did not indicate the use of ADT itself was significant, however, when covariates were accounted for by the duration of ADT, the longer use of ADT was found to significantly improve bPFS. Although cPFS was associated neither with the BED levels nor ADT duration (P > 0.05), ADT duration had a trend of improving cPFS (P = 0.053). The higher levels of BED did not significantly impact bPFS for intermediate-risk PCa after LDR-BT with or without supplemental EBRT and ADT. The longer duration of ADT could provide an additional benefit in the context of high-dose irradiation generated by LDR-BT.

Capsaicin: a novel radio-sensitizing agent for prostate cancer.

INTRODUCTION: Radio-sensitizing agents sensitize tumor cells to the lethal effects of radiotherapy (RT) allowing for use of lower doses of radiation to achieve equivalent cancer control, while minimizing adverse effects to normal tissues. Given their limited toxicity and ability to easily integrate into the diet, compounds occurring naturally in the diet make ideal potential radio-sensitizing agents. In this study, we have examined whether capsaicin, the active compound in chilli peppers, can modulate the response to RT in preclinical models of prostate cancer (PCa). METHODS: The effects of RT (1-8 Gy) and/or capsaicin (1-10 µM) on colony formation rates in human PCa cells were assessed using clonogenic assays. Mechanistic studies were performed by Western Blot, immunocytochemistry, and flow cytometry. Athymic mice (n = 40) were inoculated with human LNCaP cells. Once tumors reached 100 mm(3) , animals were randomized into four groups: control, capsaicin alone (5 mg/kg/d), RT alone (6 Gy), and capsaicin and RT. RESULTS: Capsaicin reduced colony formation rates and radio-sensitized human PCa cells (Sensitizer enhancement ratio = 1.3) which corresponded to the suppression of NFκB, independent of TRP-V1 receptor. Cell cycle modulation occurred following RT and capsaicin treatment independently. In vivo, oral administration of capsaicin with RT resulted in a 'greater than additive' growth delay and reduction in the tumor growth rate greater than capsaicin (P < 0.001) or RT (P < 0.03) alone. Immunohistochemical analysis revealed a reduction in proliferation and NFκB expression, and increase in DNA damage. DISCUSSION: Our findings suggest that capsaicin acts as a radio-sensitzing agent for PCa through the inhibition of NFκB signalling.

[Liver injury and hepatic encephalopathy induced by the herbal medicine Hochuekkito].

A 57-year-old man was admitted with pruritus and jaundice following treatment for fatigue with the herbal medicine Hochuekkito. The patient was prescribed prednisolone and ursodeoxycholic acid, but he developed progressive cholestasis that required intravenous methylprednisolone pulse therapy. After treatment with plasma exchange for prolonged prothrombin time, the patient recovered; however, his liver function deteriorated because of liver injury induced by trimethoprim-sulfamethoxazole for pneumocystis pneumonia. After reduction of trimethoprim-sulfamethoxazole, his liver function almost returned to normal by day 130 of admission. It has remained normal for 10 months since then. Therefore, when prescribing Hochuekkito, the possibility of drug-induced liver injury should be taken in account.

Mid-term outcome of permanent prostate iodine-125 brachytherapy in Japanese patients.

OBJECTIVES: To analyze mid-term oncological outcomes of low-dose rate brachytherapy in Japanese patients. METHODS: Between 2003 and 2010, 604 consecutive patients with clinically localized prostate cancer were treated with low-dose rate brachytherapy at Jikei University Hospital in Tokyo, Japan. Median follow up was 48 months. Of these patients, 260 (43%) were treated with neoadjuvant therapy, 45 (7.5%) with adjuvant hormonal therapy and 75 (12.4%) with supplemental external beam radiation therapy. Biochemical recurrence was defined as the prostate-specific antigen nadir plus 2 ng/mL. RESULTS: Of the 604 patients, 219 (36.2%) were low risk, 361 (59.8%) were intermediate risk and 24 (4.0%) had high-risk disease. The median biologically effective dose was 174.4 Gy2. At 8 years, biochemical recurrence-free survival, cancer-specific survival, and overall survival were 82.2%, 100% and 95.6%, respectively. Biochemical recurrence-free survival at 8 years was 89.9%, 79.4% and 52.5%, for the low-, intermediate-, and high-risk groups, respectively. Biochemical recurrence-free survival for the high-risk group was significantly lower than the low- and intermediate-risk groups (P < 0.001). Biochemical recurrence-free survival did not differ significantly by biologically effective dose stratification. In multivariate analysis, younger age (P = 0.045), higher prostate-specific antigen (P = 0.004), higher Gleason score (P = 0.006) and higher clinical T stage (P = 0.008) were significant covariates associated with biochemical recurrence. The addition of hormonal therapy or external beam radiation therapy was associated with significantly better outcomes than low-dose rate brachytherapy monotherapy (P = 0.0021 and 0.010). Just four patients experienced G3 genitourinary or gastrointestinal toxicity. CONCLUSIONS: Low-dose rate brachytherapy results in excellent mid-term oncological outcomes and acceptable toxicity in Japanese patients. In our experience, biologically effective dose does not represent a significant predictor for biochemical recurrence.

Pre-clinical validation of orthotopically-implanted pulmonary tumor by imaging with 18F-fluorothymidine-positron emission tomography/computed tomography.

The development of positron-emission tomography (PET) and X-ray computed tomography (CT) imaging has improved the detection of tumor burden and, in turn, pre-clinical drug development and clinical treatment. In pre-clinical drug development, clinically-relevant murine cancer models, such as orthotopic models of lung cancer, have provided an accurate representation of tumor burden in humans. However, evidence demonstrating the capability of imaging-guided evaluation of these clinically-relevant models is limited. Here, we combined (18)F-fluorothymidine (FLT)-PET/CT imaging and a murine model of human non-small cell lung cancer (NSCLC) to improve the accuracy of anticancer drug evaluation in pre-clinical studies. We found that FLT-PET/CT imaging enabled the progression of pulmonary tumors to be longitudinally monitored rather than FDG-PET/CT. Furthermore, in an efficacy study of a standard treatment of docetaxel in a murine lung cancer model, FLT-PET imaging detected the anticancer response earlier than volumetric analysis by CT imaging. We, thus, observed a relationship between the alteration of FLT signals and Ki-67 index in the pulmonary tumor during the period of chemotherapy. These results indicate that the combination of FLT-PET/CT imaging and an orthotopic NSCLC model is an effective strategy for evaluating clinical efficacy and potential of an anticancer agent during pre-clinical development.

Transperineal prostate brachytherapy, using I-125 seed with or without adjuvant androgen deprivation, in patients with intermediate-risk prostate cancer: study protocol for a phase III, multicenter, randomized, controlled trial.

BACKGROUND: The optimal protocol for 125I-transperineal prostatic brachytherapy (TPPB) in intermediate-risk prostate cancer (PCa) patients remains controversial. Data on the efficacy of combining androgen-deprivation therapy (ADT) with 125I-TPPB in this group remain limited and consequently the guidelines of the American Brachytherapy Society (ABS) provide no firm recommendations. METHODS/DESIGN: Seed and Hormone for Intermediate-risk Prostate Cancer (SHIP) 0804 is a phase III, multicenter, randomized, controlled study that will investigate the impact of adjuvant ADT following neoadjuvant ADT and 125I-TPPB. Prior to the end of March, 2011, a total of 420 patients with intermediate-risk, localized PCa will be enrolled and randomized to one of two treatment arms. These patients will be recruited from 20 institutions, all of which have broad experience of 125I-TPPB. Pathological slides will be centrally reviewed to confirm patient eligibility. The patients will initially undergo 3-month ADT prior to 125I-TPPB. Those randomly assigned to adjuvant therapy will subsequently undergo 9 months of adjuvant ADT. All participants will be assessed at baseline and at the following intervals: every 3 months for the first 24 months following 125I-TPPB, every 6 months during the 24- to 60-month post-125I-TPPB interval, annually between 60 and 84 months post-125I-TPPB, and on the 10th anniversary of treatment.The primary endpoint is biochemical progression-free survival (BPFS). Secondary endpoints are overall survival (OS), clinical progression-free survival, disease-specific survival, salvage therapy non-adaptive interval, acceptability (assessed using the international prostate symptom score [IPSS]), quality of life (QOL) evaluation, and adverse events. In the correlative study (SHIP36B), we also evaluate biopsy results at 36 months following treatment to examine the relationship between the results and the eventual recurrence after completion of radiotherapy. DISCUSSION: These two multicenter trials (SHIP0804 & SHIP36B) are expected to provide crucial data regarding the efficacy, acceptability and safety of adjuvant ADT. SHIP36B will also provide important information about the prognostic implications of PSA levels in intermediate-risk PCa patients treated with 125I-TPPB. TRIAL REGISTRATION: NCT00664456, NCT00898326, JUSMH-BRI-GU05-01, JUSMH-TRIGU0709.

Effects of single and cyclical local injections of basic fibroblast growth factor on cancellous bone defects in rabbits.

BACKGROUND: Local administration of basic fibroblast growth factor (bFGF) has anabolic effects on bone formation. A delivery system for local treatment is required to increase efficacy because of its short half-life. However, little is known about the effects of cyclical local injection of bFGF. We evaluated the effects of single and cyclical local injection of bFGF at a cancellous bone defect in the femoral condyle in rabbits. METHODS: Using the "vehicle only" as a control, a single low dose (40 microg), single high dose (120 microg), or cyclical low dose (40 microg, three times) of bFGF was injected percutaneously into a bone defect implanted with a gelatin sponge. The rabbits were killed at 4 weeks after surgery and the femurs were harvested for evaluation. RESULTS: Both single and cyclical administration of bFGF dose-dependently increased the amount of new bone formation in the bone defect using radiographs (P < 0.01) and bone mineral density (BMD) measurements (P < 0.01) compared to controls. However, only high-dose bFGF injection significantly increased the cancellous bone volume at the bone defect (P < 0.05) compared to controls, using bone histomorphometry. Cyclical injection of bFGF significantly increased the number of runt-related transcription factor-2 (Runx2)-positive cells compared to single low- and high-dose bFGF administration (P < 0.01 and P < 0.05, respectively), and single high-dose and cyclical administration significantly increased the number of osteopontin-positive cells compared to controls (P < 0.01), based on immunohistochemical analysis. CONCLUSIONS: These results suggest that high-dose injection of bFGF, at the very early stage of cancellous bone healing, is more effective in increasing cancellous bone volume, and cyclical injection of bFGF may stimulate osteoprogenitor cells.

pH-dependence of selenate removal from liquid phase by reductive Fe(II)-Fe(III) hydroxysulfate compound, green rust.

Removal of selenate ion from the liquid phase by hydroxysulfate green rust (GR(SO4)) was investigated in the pH range from 7.5 to 10.0. Batch tests showed that the total selenium concentration decreased more rapidly with increasing pH. However, the amount of selenium removed from the liquid phase increased as the pH decreased. X-ray absorption spectrometric analysis demonstrated that the Se(VI) in the selenate ion was reduced to elemental selenium Se(0) at pH 9.0, whereas the existence of small amount of intermediate Se(IV) was detected at pH 7.5. Comparing the mass balance of the amount of consumed ferrous iron in GR(SO4), [DeltaFe(II)], and the amount of Se(VI) removed from the liquid phase, [DeltaSe(VI)], [DeltaFe(II)] is approximately six times larger than [DeltaSe(VI)] in mol units. This is also indirect but convincing evidence that the oxidation of Fe(II) in GR(SO4) leads to the simultaneous reduction of Se(VI) to Se(0). Powder X-ray diffraction analysis showed that the end product of GR(SO4) depends on the pH: magnetite for pH>9.0, goethite for pH<8.0, and their mixture at pH 8.5. These results indicate that the solution pH has a significant effect on the reaction path of selenate removal by GR(SO4).

Indoor cultivation and cultural characteristics of Wolfiporia cocos sclerotia using mushroom culture bottles.

We newly developed an indoor cultivation technique for Wolfiporia cocos (Wolf) Ryvarden et Gilbertson (Syn. Poria cocos Wolf), not with soil, but using mushroom culture bottles with pine logs, and clarified some cultural characteristics of sclerotia in the laboratory. To determine the optimum conditions for sclerotia growth, the weight of sclerotia and concentration of CO2 in three different air filters; cloth, paper and urethane resin, and closed bottles were tested. When the cloth air filter was used, the growth rate was the fastest and the yield was maximal. These results suggested that the aeration was an important environmental factor for cultivation. To clarify the characteristics of culture in the cloth air filtered and closed bottles, the weight of sclerotia, the compositions of pine logs and the contents of pachymic acid and dehydropachymic acid were examined during 24 weeks. The growth of scleroia and the wood decaying efficiency in the cloth air filtered bottles were better than those in the closed bottles. Also, it was found that W. cocos was a brown rot fungus due to the alkaline solubility of pine logs in the wood decay process. In addition, the contents of pachymic acid and dehydropachymic acid and the TLC pattern between the cultivated and commercial sclerotia did not differ remarkably.

Identification of medicinal Atractylodes based on ITS sequences of nrDNA.

Dried rhizomes of five species of Atractylodes (A. japonica, A. macrocephala, A. lancea, A. chinensis, and A. koreana), Compositae, have been used as crude drugs mainly for the treatment of stomach disorders and for their diuretic properties in Chinese and Japanese traditional medicines. The identification of the botanical origins of these crude drugs is generally difficult from their morphological and chemical features only. In this study, for identification with more reliable, nuclear ribosomal DNA (nrDNA), internal transcribed spacer (ITS) regions of five species of medicinal Atractylodes were sequenced. As a result, specific ITS genotypes were recognized by each species. The four species (A. japonica, A. macrocephala, A. lancea, and A. chinensis) prescribed in Chinese and Japanese Pharmacopoeias as botanical origins of crude Atractylodes drugs could be distinguished by their ITS sequences because they had difference genotypes on the ITS sequences. However, the genotype of A. koreana was the same as that of A. chinensis. Additionally, hybrids between A. lancea and A. chinensis were also recognized as nucleotide additives on their ITS sequences. In this study, several morphological characteristics were researched by their genotype, too. As this result, the hybrids recognized from the genetic analysis had intermediate morphological characteristics between A. lancea and A. chinensis. It was also recognized that A. lancea and A. chinensis except for their hybrids were significant differences. It is therefore suggested that ITS sequences of nrDNA would be useful for the identification of the crude drugs derived from Atractylodes species and their interspecific hybridizations.

[Clinical studies on TUR-P using clinical path: report of 50 cases and review of literature].

PURPOSE: This study was undertaken to clarify the usefulness and problems involved in the clinical path of transurethral prostatectomy (TUR-P) in hospital. PATIENTS AND METHODS: The subjects consisted of 50 patients, for whom the Department of Urology, Jikei Medical University Hospital introduced its own clinical path and performed TUR-P during a period of 9 months from July 1999 to March 2000. The mean length of hospital stay, rate of postoperative complications, and the medical insurance claims made by these patients were clarified and compared with those of 73 patients before introduction of the clinical path. RESULTS: With the introduction of the clinical path, the length of hospital stay decreased by an average of 3.4 days and the total medical insurance claims decreased by an average of 18.5%. The rate of postoperative complications before and after introduction was almost equal. CONCLUSION: Our clinical path for TUR-P was well accepted by both patients and comedicals. However, the present medical treatment system in Japan is not as yet prepared to promote the introduction of this clinical path, and it will take some time before this clinical path is introduced on a full scale.

Effect of the rhizomes of Atractylodes lancea and its constituents on the delay of gastric emptying.

The effect of rhizomes of Atractylodes lancea on gastric disorders, in particular, the delay in gastric emptying induced by N(G)-nitro-L-arginine in rats, was investigated. Intragastric treatment with an aqueous extract (250 mg/kg) and its lipophilic fractions (4 mg/kg) significantly improved delayed gastric emptying. The major constituents of the lipophilic fraction were two sesquiterpens, hinesol and beta-eudesmol, and four known polyacetylenic compounds, atractylodin, atractylodinol, acetylatractylodinol and 4,6,12-tetradecatriene-8,10-diyne-1,3,14-triol. The activity was found in the four polyacetylenic compounds at a similar potency, but not in the two sesquiterpens. To clarify the effect of the four polyacetylenic compounds in this extract, we attempted to evaluate the activity of atractylodin, as representative, at a dose of 0.2 mg/kg based on the total amounts (0.2 mg/250 mg aqueous extract) of the four polyacetylenic compounds. In addition, atractylodin improved the delay in gastric emptying at between 0.1 and 0.3 mg/kg in a dose-dependent manner. These results suggest that the aqueous extract improved the delayed gastric emptying, and polyacetylenic compounds contributed to its activity.

Components of Panax ginseng that improve accelerated small intestinal transit.

We previously clarified that Dai-kenchu-to, a Chinese prescription, was useful for improving carbachol-induced hyperperistalsis of the small intestine in vivo, and the efficacy of Ginseng Radix, a crude drug component of Dai-kenchu-to, was also confirmed. Ginseng Radix, the root of Panax ginseng C.A. Meyer, showed significant ameliorative effects on both the carbachol-induced and the BaCl(2)-induced accelerated small intestinal transit model in mice, suggesting that both an inhibitory effect on the cholinergic nervous system and direct suppressive effect on muscles were involved in the ameliorative effect of Ginseng Radix on the accelerated small intestinal transit. Ginsenoside Rb1 (4) and ginsenoside Rd (7), major components of Ginseng Radix, improved both animal models. These results suggest that ginsenoside Rb1 (4) and ginsenoside Rd (7) were representative compounds of Ginseng Radix for improving the accelerated movement of the small intestine and that these compounds partly contribute to the action of Dai-kenchu-to on small intestinal transit.

Possible involvement of suppression of Th2 differentiation in the anti-allergic effect of Sho-seiryu-to in mice.

The clinical effectiveness of the Kampo medicine Sho-seiryu-to (SST) has recently been demonstrated in a double-blind randomized study of allergic asthma and rhinitis. We investigated the effect of SST on a type 1 allergic model in mice. Ovalbumin (OVA)-induced sneezing and the total and OVA-specific IgE levels were significantly suppressed with SST at 1.0 g/kg, but that of OVA-specific IgG(2a) was not. In the splenocytes isolated from SST-administered mice, OVA-induced interleukin (IL)-4 production decreased while interferon (IFN)-gamma production was not. The co-culture experiments using purified CD4(+)T cells and antigen-presenting cells (APCs) suggested that SST influenced both cell types. Flow-cytometric analysis showed that SST suppressed the number of IL-4 producing CD4(+)T cells but not the number of IFN-gamma producing CD4(+)T cells. The CD86(+) major histocompatibility complex class II(+) (MHC II)(+) cells and CD28(+)CD4(+)T cells were decreased by SST treatment, while CD80(+)MHC II(+) cells, CD40(+)MHC II(+) cells and CD154(+)CD4(+)T cells showed no change. These data suggested that SST may suppress IL-4 production in CD4(+)T cells via influencing CD28-CD86 interaction. In addition to the previously reported inhibitory activity on histamine release, suppression of Th2 differentiation at the stage of APC-CD4(+)T cell interaction may be involved in the anti-allergic effects of SST.

Pharmacological characteristics of Ryokan-kyomi-shinge-nin-to, an antiallergic Kampo medicine.

The pharmacological characteristics of Ryokan-kyomi-shinge-nin-to (RKS), a traditional oriental herbal (Kampo) medicine which has been used for the treatment of allergic asthma and rhinitis, were investigated. The number of sneezes by actively sensitized mice after a topical antigen challenge was significantly reduced by pretreatment with RKS (300 and 1000 mg/kg, p.o.). Although RKS did not inhibit the antigen-induced histamine release from rat peritoneal exudate cells (PEC), it significantly inhibited an increase in vascular permeability induced by histamine and serotonin. These results suggest that RKS has antiallergic activity in animals, and the functional antagonism of a histamine response may be one of the mechanisms of its effect. In addition, RKS prevented histamine hypersensitivity in actively sensitized mice. Because RKS did not affect sleeping time induced by pentobarbital in mice and did not inhibit gastric emptying in rats, the drug appears to be useful for treating allergic patients suffering from classical antihistamines side effects such as stomach discomfort or relative drowsiness.

Saiko-ka-ryukotsu-borei-to, an herbal medicine, prevents chronic stress-induced disruption of glucocorticoid negative feedback in rats.

Exposure to stress is known to precipitate or exacerbate many neuropsychiatric disorders such as depression. Abnormality of the neuroendocrine system, as shown by increased adrenal weight and attenuated glucocorticoid negative feedback, is frequently seen in depression. The aim of the present study is to clarify the usefulness of saiko-ka-ryukotsu-borei-to, an herbal medicine, in the treatment of abnormality of the neuroendocrine system using an experimental stress-depression model. Rats were subjected to water immersion and restraint for 2 h daily for 4 weeks (chronic stress), followed by recovery for 10 days. Saiko-ka-ryukotsu-borei-to was administered during the stress and recovery periods (100, 300, or 1000 mg/kg daily, p.o.) or only during the recovery period (1000 mg/kg). After the recovery period, the adrenal weight was measured, and glucocorticoid feedback ability was evaluated by a dexamethasone suppression test using 30 microg/kg dexamethasone. The administration of saiko-ka-ryukotsu-borei-to during the stress and recovery periods prevented the stress-induced increase in adrenal weight or the attenuated negative feedback in a dose-dependent manner. The administration of saiko-ka-ryukotsu-borei-to during the recovery period alone also ameliorated the abnormality of the neuroendocrine system. These results indicate that saiko-ka-ryukotsu-borei-to is effective against chronic stress-induced abnormality of the neuroendocrine system. Because some symptoms and symptomatic relapses in depressives are attributed to dysfunction of the hypothalamo-pituitary-adrenal axis, the present findings provide information important for prevention and treatment of depression.