Mantani Naoki, Sakai Shinya, Kogure Toshiaki, Goto Hirozo, Shibahara Naotoshi, Kita Toshiaki, Shimada Yutaka, Terasawa Katsutoshi
Department of Japanese Oriental (Kampo) Medicine, Faculty of Medicine, Toyama Medical and Pharmaceutical University, 2630 Sugitani, Toyama 930-0194, Japan.
Yakugaku Zasshi. 2002 Jun;122(6):399-402. doi: 10.1248/yakushi.122.399.
In vitro mitogenic activity of 16 herbs and 3 Kampo (herbal medicine) formulae have been reported in experimental studies. It is not known how many herbs and Kampo formulae in total have mitogenic activity. Lymphocyte transformation test (LTT) is generally utilized to diagnose drug-induced liver injury. In LTT, mitogenic activity is assessed by measuring 3H-thymidine incorporation. The objective of the present study was to determine which herbs and which Kampo formulae caused false-positivity on LTT. We examined 2496 summaries of all admission records from 1979 to 1999 in our department. We selected patients in whom liver injuries were diagnosed as definitely unrelated to Kampo medication. In these patients, LTT was performed for some herbs contained in the suspect Kampo medicines, resulting in positive LTT for 17 herbs: Evodiae Fructus (Goshuyu), Zizyphi Fructus (Taiso), Ginseng Radix (Ninjin), Zingiberis Rhizoma (Shokyo), Hoelen (Bukuryo), Aconiti Tuber (Bushi), Angelicae Radix (Toki), Cnidii Rhizoma (Senkyu), Rehmanniae Radix (Jio), Ephedrae Herba (Mao), Anemarrhenae Rhizoma (Chimo), Cinnamomi Cortex (Keihi), Bupleuri Radix (Saiko), Artemisiae Capillari Spica (Inchinko), Persicae Semen (Tonin), Moutan Cortex (Botanpi) and Paeoniae Radix (Shakuyaku). These results were considered false-positive, because the results were observed in the "definitely unrelated" patients. Mitogenic activity inherent to some herbs and Kampo formulae may sometimes cause false-positivity on LTT in clinical situations. These examples suggest that LTT for Kampo formulae may be unreliable as a diagnostic method for drug-induced liver injury.
实验研究已报道了16种草药和3种汉方（草药配方）制剂的体外促有丝分裂活性。目前尚不清楚总共还有多少草药和汉方制剂具有促有丝分裂活性。淋巴细胞转化试验（LTT）通常用于诊断药物性肝损伤。在LTT中，通过测量3H-胸腺嘧啶核苷掺入来评估促有丝分裂活性。本研究的目的是确定哪些草药和哪些汉方制剂会导致LTT出现假阳性。我们检查了本部门1979年至1999年所有入院记录的2496份摘要。我们选择了诊断为与汉方用药明确无关的肝损伤患者。在这些患者中，对可疑汉方药物中含有的一些草药进行了LTT检测，结果显示17种草药的LTT呈阳性：吴茱萸（吴茱萸）、酸枣仁（酸枣）、人参（人参）、干姜（生姜）、茯苓（茯苓）、附子（附子）、当归（当归）、川芎（川芎）、生地黄（地黄）、麻黄（麻黄）、知母（知母）、肉桂（桂皮）、柴胡（柴胡）、茵陈蒿（茵陈）、桃仁（桃仁）、牡丹皮（牡丹皮）和白芍（芍药）。这些结果被认为是假阳性，因为这些结果是在“明确无关”的患者中观察到的。某些草药和汉方制剂固有的促有丝分裂活性有时可能会在临床情况下导致LTT出现假阳性。这些例子表明，作为药物性肝损伤的诊断方法，汉方制剂的LTT可能不可靠。
