Yamashiki M, Nishimura A, Watanabe J, Nakano T, Kosaka Y
Department of Laboratory Medicine, Mie University School of Medicine, Tsu, Japan.
J Clin Lab Immunol. 1992;38(4):153-60.
The herbal medicine "Sai-rei-to" has been used in the treatment of swellings and edemas for about 3000 years in China. Recently, this drug has been prescribed as an adjuvant in the treatment of rheumatoid arthritis (RA) among Japan's western medicine doctors. It is thought to possess regulatory effects on the immune system, although its mode of action is not yet fully described. In the present in vitro study, we at first induced interferon-gamma (IFN-gamma) in the cultures of peripheral blood mononuclear cells of healthy volunteers by adding pokeweed mitogen (PWM), phytohemagglutinin (PHA), recombinant interleukin-2 (IL-2), or control medium. We then added "Sai-rei-to" to these cultures and investigated the effects of this drug on IFN-gamma production levels. The results demonstrated that "Sai-rei-to" had 2 different effects: (i) it inhibited the IFN-gamma production in cultures with PWM or PHA (which induced large volumes of IFN-gamma), and (ii) it increased IFN-gamma production in the cultures with IL-2 (IL-2 induced only small volumes of IFN-gamma). These findings indicate that "Sai-rei-to" possesses regulatory effects on the IFN-gamma production. IFN-gamma is an important cytokine in the immune system, and it has also attracted attention as a factor related to the pathogeneses of RA. Therefore, concomitant administration of such a medicine which can appropriately control IFN-gamma production in vivo could be beneficial for RA patients from the immunological viewpoint. Clinical experience in the past has shown that "Sai-rei-to" has a very low incidence of side effects, and can be administered orally for long periods. We expect that concomitant administration of "Sai-rei-to" with current therapy could be clinically useful in the management of RA patients.
草药“柴苓汤”在中国用于治疗肿胀和水肿已有约3000年历史。最近，日本的西医医生已将这种药物作为类风湿性关节炎（RA）治疗的辅助药物开出处方。尽管其作用方式尚未完全阐明，但人们认为它对免疫系统具有调节作用。在目前的体外研究中，我们首先通过添加商陆有丝分裂原（PWM）、植物血凝素（PHA）、重组白细胞介素-2（IL-2）或对照培养基，在健康志愿者外周血单个核细胞培养物中诱导γ-干扰素（IFN-γ）。然后我们将“柴苓汤”添加到这些培养物中，并研究该药物对IFN-γ产生水平的影响。结果表明，“柴苓汤”有两种不同的作用：（i）它抑制了用PWM或PHA（可诱导大量IFN-γ）培养时的IFN-γ产生，（ii）它增加了用IL-2（IL-2仅诱导少量IFN-γ）培养时的IFN-γ产生。这些发现表明“柴苓汤”对IFN-γ的产生具有调节作用。IFN-γ是免疫系统中的一种重要细胞因子，并且它作为与RA发病机制相关的一个因素也已引起关注。因此，从免疫学角度来看，同时给予一种能够在体内适当控制IFN-γ产生的药物可能对RA患者有益。过去的临床经验表明，“柴苓汤”副作用发生率非常低，并且可以长期口服给药。我们期望“柴苓汤”与目前的治疗方法联合应用在RA患者的管理中可能具有临床实用性。
