Effects of Juzentaihotoon immunological and haematopoietic systems
Clinical effects ofJuzentaihotoexpect that it may improve constitution of the
diseases related to immunological system. In vivo animal study suggests that
Juzentaihotohas potent immunomodulating activity, such as stimulation of
antibody production,^16 and the active ingredients were clarified to be 22
different pectic polysaccharides.^17 Helper T cells (Th) are known to separate
into two subsets: Th1, which produces interferon-c(IFN-c) and interleukin
(IL)-2, stimulates cellular immunity, and Th2, which produces IL-4 and IL-5,
stimulates humoral immunity depending on the pattern of cytokine formation.
Administration ofJuzentaihotopharmaceutical extract preparation (TJ-48)
increased IFN-cproduction remarkably, as well as IL-5 secretion from both
mesenteric lymph node (MLN) and Peyer’s patches (PPs), whereas IL-2 secre-
tion was plainly reduced.^16 The ratio IFN-c:IL-4 was shifted to Th1 domina-
tion in MLN and PPs relating to gastric mucosal immune system; however,
little changed in the spleen relating to systemic immune system.^16 These obser-
vations indicate thatJusentaihoto regulates Th1:Th2 balance in gastric
mucosal immune system. As kampo medicines have generally been taken
orally, active ingredients may not only act by absorption from the intestine but
also affect the mucosal immune system. Oral administration of TJ-48 activates
T cells in PP cells, and stimulates the production of the haematopoietic factors
such as IL-6 and GM-CSF (granulocyte–macrophage colony-stimulating
factor) to proliferate bone marrow cells.^16 Oral administration of TJ-48 also
regulates cytokine production from stimulated hepatic lymphocytes, and
increases the population of NKT cells that are able to prevent cancer metas-
tasis and autoimmune diseases.^16 NKT cells are a heterogeneous group of T
cells that share properties of both Tcells and natural killer (NK) cells. NKT cells
seem to be essential for several aspects of immunity.
The effect of the active ingredients of Juzentaihotoon intestinal immune
system-modulating activities was linked to a lignin–carbohydrate complex
and a polysaccharide-containing arabinogalactan.18,19Although Juzentaihoto
consists of two kampo formulae, Shimotsuto and Shikunshito with
Cinnamomi cortex and Astragari radix, the activity appeared in the
lignin–carbohydrate complex fraction of the decoction, which was prepared
by combining Shikunshito(Atractylodis lanceae rhizoma,Ginseng radix,
Poria andGlycyrrhizae radix) with Cinnamomi cortexand Astragari radix.^20
Therefore the intestinal immunity-modulating activity of Juzentaihotois due
to the combination effect of the component herbs.
Juzentaihotoalso enhances peripheral blood counts in cancer patients
who have been administered phase-specific drugs and/or have received radi-
ation therapy. Oral administration of Juzentaihotoprolongs the survival of
tumour-bearing mice injected with mitomycin C, and enhances proliferation
of bone marrow stem cells, which may induce recovery from anaemia and
reduce side effects of anti-cancer agents caused by bone marrow injury.^21
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