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Hodges RE, Lamotte AV. Impact of Diet and Lifestyle on Vaccine Efficacy in Adults Aged 55 and Older: A Review. Integr Med (Encinitas) 2022; 21:32-52. [PMID: 36644599 PMCID: PMC9542930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Context Age-related declines in immune system function, including vaccine responsiveness, are well established. Dietary and lifestyle factors have been investigated in human clinical trials and observational studies for their effects on vaccine response. Objective The review intended to assess dietary and lifestyle factors that can modulate vaccine response in a population aged 55 years or older or in a population with an average age of 55 years or older. Design The research team performed a narrative review of studies occurring up until May 2021 by searching electronic PubMed databases. Results The review findings suggest that two factors may have clinically relevant effects on vaccine response: regular aerobic exercise and psychological environmental stressors, in particular caregiving stress, which studies have consistently found can have a positive and negative effect or association, respectively. In addition, micronutrients used in combination as well as microbiome-targeted interventions show mostly promising results. Other factors may yet be relevant but very few studies have been done. Conclusions Heterogeneity of study design, small sample sizes, and other challenges mean that strong conclusions remain elusive. Further study is needed as well as improvements in study design. However, there are indications that certain dietary and lifestyle factors influence vaccine effectiveness.
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Affiliation(s)
| | - Amy V. Lamotte
- Managing Director, Vallotte Nutrigenomics Limited, Hong Kong
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Japanese Kampo Medicine Juzentaihoto Improves Antiviral Cellular Immunity in Tumour-Bearing Hosts. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:6122955. [PMID: 35996405 PMCID: PMC9392631 DOI: 10.1155/2022/6122955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/05/2022] [Accepted: 06/07/2022] [Indexed: 12/05/2022]
Abstract
Global and antigen-independent immunosuppression by growing tumours can cause life-threating damage when concurrent with an infection in tumour-bearing hosts. In the present study, we investigated whether the oral administration of the Japanese traditional herbal (Kampo) medicine, juzentaihoto (JTT), plays a role in the improvement of antiviral cellular immunity in tumour-bearing hosts. Female BALB/c mice subcutaneously injected with murine colorectal cancer CT26 cells fed a control or JTT diet were inoculated with recombinant vaccinia virus expressing human immunodeficiency virus-1 glycoprotein 160 (vSC25). At 7 days postinfection, anti-vSC25 cellular immunity was evaluated by measuring the abundance of splenic virus-specific CD8+ T cells. JTT had no impact on CT26 tumour growth in vivo. Surprisingly, JTT augmented anti-vSC25 cellular immunity in CT26-bearing mice. Depletion of either CD25+ regulatory T (Treg) cells or myeloid-derived suppressor cells (MDSCs) also enhanced anti-vSC25 cellular immunity in tumour-bearing mice but had no therapeutic benefit against tumour growth. However, JTT had no impact on the abundance of these immunosuppressive cells. Overall, our data indicates that JTT contributes to the improvement of anti-vSC25 cellular immunity in tumour-bearing hosts possibly via a mechanism independent of CD25+ Treg cells and MDSCs, suggesting that this Kampo medicine can act as a promising antiviral adjuvant in an immunosuppressive state caused by tumours.
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Immunostimulatory properties of heat-resistant RNA in a decoction of Glycyrrhizae Radix. Biomed Pharmacother 2021; 145:112457. [PMID: 34864611 DOI: 10.1016/j.biopha.2021.112457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 11/21/2022] Open
Abstract
Research on the bioactive components of herbal medicines have been conducted mainly on the secondary metabolites of herbal plants. Accordingly, limited information is available on primary metabolites (carbohydrates, amino acids, lipids, and nucleic acids) and their biological effects. Here, we focused on the heat-resistant RNA of a decoction of Glycyrrhizae Radix and showed its immunostimulatory effects. The RNA activated NF-κB/AP-1 and induced TNF-α production in murine macrophages. Further analysis revealed that the RNA was around 90 nucleotides long. RNA sequencing (RNA-Seq) by next generation sequencing (NGS) showed that approximately 30% of the NGS reads were mapped to the genome of Glycyrrhiza uralensis, which is plant material of Glycyrrhizae Radix. Further analysis of the other 70% of reads indicated that the RNA contained RNA sequences that could be mapped to various microorganisms. Together, these results propose nucleic acids as a new research field in the bioactive components of herbal medicines.
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Immunological Differences in Human Peripheral Blood Mononuclear Cells Treated with Traditional Japanese Herbal Medicines Hochuekkito, Juzentaihoto, and Ninjin'yoeito from Different Pharmaceutical Companies. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:7605057. [PMID: 34589133 PMCID: PMC8476247 DOI: 10.1155/2021/7605057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 09/06/2021] [Indexed: 01/13/2023]
Abstract
Hochuekkito (HET), Juzentaihoto (JTT), and Ninjin'yoeito (NYT) have been used as Hozai, a group of traditional Japanese herbal medicines, to treat physically and mentally weak cancer patients. Their compositions are quite different, and Japanese pharmaceutical companies have been using different types or quantities of herbs for formulations with the same name. Here, we compared the immunological differences between HET, JTT, and NYT with respect to the induced T cell subsets and cytokines. Peripheral blood mononuclear cells (PBMCs) were isolated from healthy volunteers and treated with 0 (control), 25, 50, 100, 200, or 400 μg/mL HET, JTT, or NYT (manufactured by Tsumura [TJ], Kracie [KR], and Kotaro [KO]). PBMC proliferation, CD4+ T cell, CD8+ T cell, and regulatory T cell (Treg) proportions and interleukin (IL) concentrations (IL-6, IL-10, IL-17A, interferon-γ, tumor necrosis factor-α, and transforming growth factor (TGF)-β) secreted by PBMCs were measured using Cell Counting Kit-8 or flow cytometry bead analysis. PBMC proliferation and CD4+ T cell percentages were similar in the HET, JTT, NYT, and control groups; however, the percentage of CD8+ T cells tended to increase after treatments. Tregs were suppressed by HET, JTT, and NYT, and TJ-JTT significantly decreased Treg numbers (compared with control). The concentrations of all cytokines except TGF-β were increased in a concentration-dependent manner (p < 0.05); particularly, KR-HET induced IL-6 secretion (compared with the control, TJ-HET, and KO-HET; 37-, 7-, and 17-fold, respectively; p < 0.05). The TGF-β concentration was decreased in a concentration-dependent manner by HET, JTT, and NYT (compared with the control). These results suggest that, compared with TJ-HET and KO-HET, KR-HET should be administered with caution. Although HET, JTT, and NYT belong to the same Hozai group and have the same names among companies, their differing effects on immune activity must be considered and they must be administered with caution.
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Lee JY, Kim EH, Yoon JH, Eo W, Yoon SW. Traditional Herbal Medicine, Sipjeondaebo-Tang, for Cancer-Related Fatigue: A Randomized, Placebo-Controlled, Preliminary Study. Integr Cancer Ther 2021; 20:15347354211040830. [PMID: 34672230 PMCID: PMC8543707 DOI: 10.1177/15347354211040830] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/01/2021] [Accepted: 08/03/2021] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Sipjeondaebo-tang (SDT) is a widely used traditional herbal medicine for relieving fatigue. This randomized, placebo-controlled, preliminary study evaluated SDT for cancer-related fatigue, which is the most common symptom experienced by patients with cancer. PATIENTS AND METHODS Patients with a Brief Fatigue Inventory (BFI) score of at least 4 were randomly assigned in a double-blinded manner to receive SDT (3 g 3 times daily) or placebo orally for 3 weeks. The BFI was the primary outcome measure and secondary outcome measures included the Hospital Anxiety and Depression Scale (HADS), the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC QLQ-C30), immunoregulatory tests, and safety. RESULTS A total of 50 participants were randomly assigned and 48 patients completed the trial. Based on intention-to-treat analysis, fatigue, which was the primary outcome, was improved in both arms compared with the baseline, and was significantly better in the SDT group than in the placebo group at week 3 (3.56 ± 1.18 vs 4.63 ± 1.83, P = .019). Secondary outcomes, including anxiety, depression, and immunoregulatory tests, did not improve significantly in either group. However, quality of life measured using the EORTC QLQ-C30 improved in both arms compared with the baseline, and the global health subscale was significantly better in the SDT group than in the placebo group (P = .02). No significant toxicities were observed. CONCLUSION SDT may improve cancer-related fatigue and quality of life in patients with cancer. A further randomized clinical trial with large sample size is warranted.
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Affiliation(s)
- Jee Young Lee
- Kyung Hee University Hospital at
Gangdong, Seoul, Republic of Korea
- Jaseng Medical Foundation, Seoul,
Republic of Korea
| | - Eun Hye Kim
- Kyung Hee University Hospital at
Gangdong, Seoul, Republic of Korea
| | - Jee-Hyun Yoon
- Kyung Hee University Hospital at
Gangdong, Seoul, Republic of Korea
| | - Wankyu Eo
- Kyung Hee University Hospital at
Gangdong, Seoul, Republic of Korea
| | - Seong Woo Yoon
- Kyung Hee University Hospital at
Gangdong, Seoul, Republic of Korea
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Iitsuka H, Koizumi K, Suzaki M, Otsuka Y, Jo M, Shibahara N. Immunostimulatory effects of cell wall-based nanoparticles in boiled Glycyrrhizae radix water extracts involves TLR4. Biomed Rep 2020; 12:303-308. [PMID: 32346474 PMCID: PMC7184953 DOI: 10.3892/br.2020.1294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 12/31/2019] [Indexed: 01/21/2023] Open
Abstract
A number of immunostimulant effects of herbal medicines have been reported; however, the underlying mechanisms of their immunostimulatory effects have not been elucidated in detail. Our previous study showed that sugar-based nanoparticles derived from cell walls acted as the immunostimulatory component of boiled Glycyrrhizae radix water extracts. Therefore, the aim of the present study was to clarify the molecular mechanisms by which these cell wall-based nanoparticles functioned as immunostimulants. Mouse macrophage RAW-blue cells were stimulated by these nanoparticles and several immunological effects were investigated. When phosphorylation of nuclear factor-κB (NF)-κB p65 subunit was increased, the expression of the inflammatory cytokines interleukin-6 and tumor necrosis factor-α were induced via NF-κB. On the other hand, Toll-like receptor 4 recognizes cell wall components of bacteria and fungi. In the present study, it was also shown that these cell wall-based nanoparticles serve an immunostimulatory role as ligands of Toll-like receptor 4 by RNA interference experiments. The results of the present study suggested that the signaling pathway of nanoparticles obtained from boiled Glycyrrhizae radix water extracts, at least partially involved TLR4 and downstream signaling from this receptor, resulting in the immunostimulatory effects of these nanoparticles in RAW-blue cells.
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Affiliation(s)
- Hirofumi Iitsuka
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Keiichi Koizumi
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Mikiko Suzaki
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Yoshiki Otsuka
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Michiko Jo
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Naotoshi Shibahara
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
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Ko Y, Sun SH, Han IS, Go HY, Kim TH, Lee JM, Jang JB, Park KS, Song YK, Lee KY, Jeon CY, Ko SG. The efficacy and safety of Sipjeondaebo-tang in Korean patients with cold hypersensitivity in the hands and feet: a protocol for a pilot, randomized, double-blind, placebo-controlled, parallel-group clinical trial. Trials 2019; 20:217. [PMID: 30987667 PMCID: PMC6466777 DOI: 10.1186/s13063-019-3286-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 03/11/2019] [Indexed: 01/25/2023] Open
Abstract
Background Cold hypersensitivity in the hands and feet (CHHF) is frequent in Asian countries including Korea. The quality of life can be degraded by the symptoms of CHHF. In particular, gynecological disorders such as menstrual pain, infertility, leucorrhea, and irregular bleeding may be related to CHHF. Sipjeondaebo-tang (SDT) is widely used in the treatment of various diseases including CHHF by balancing Yin and Yang, restoring the deterioration of physiological function, and improving immunity. However, the efficacy of SDT in the treatment of CHHF has not been assessed in clinical trials. Therefore, we aimed to investigate the feasibility of a full randomized clinical trial of SDT for the treatment of CHHF in Korean women through this trial. Methods This study will be a pilot, randomized, double-blind, two-arm, placebo-controlled, parallel-group, multicenter clinical trial. Women aged 19–59 years who present with CHHF will be recruited from five university hospitals. A total of 60 subjects will be randomly assigned to a treatment group (SDT) or a placebo group at a 1:1 ratio. The subjects will receive 3 g of either SDT or placebo three times daily for 8 weeks. The primary outcome measures will be the Visual Analogue Scale scores of CHHF. The secondary outcome measures will be changes in body temperature in both the hands and the feet as measured using a thermometer and the Korean version of the World Health Organization Quality of Life Scale Abbreviated Version. Discussion This will be the first trial to investigate the efficacy and safety of SDT in the treatment of CHHF. This study will provide basic clinical information regarding Korean herbal medicine treatment of CHHF and a clinical basis for designing a full randomized clinical trial. Trial registration ClinicalTrials.gov, NCT03374345. Registered on 15 February 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3286-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Youme Ko
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea
| | - Seung-Ho Sun
- Department of Korean Internal Medicine, College of Korean Medicine, Sangji University, 80 Sangjidae-gil, Wonju-si, Gangwon-do, 26339, Republic of Korea
| | - In-Sik Han
- Department of Korean Internal Medicine, College of Korean Medicine, Sangji University, 80 Sangjidae-gil, Wonju-si, Gangwon-do, 26339, Republic of Korea
| | - Ho-Yeon Go
- Department of Korean Internal Medicine, College of Korean Medicine, Semyung University, 65 Semyeong-ro, Jecheon-si, Chungcheongbuk-do, Republic of Korea
| | - Tae-Hun Kim
- Korean Medicine Clinical Trial Center, College of Korean Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea
| | - Jin-Moo Lee
- Department of Korean Gynecology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea
| | - Jun-Bok Jang
- Department of Korean Gynecology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea
| | - Kyoung Sun Park
- Department of Korean Gynecology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea
| | - Yun-Kyung Song
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Gachon University, 1342 Seongnamdae-ro, Sujeong-gu, Gyeonggi-do, Republic of Korea
| | - Kyou-Young Lee
- Department of Ophthalmology, Otolaryngology, Dermatology, College of Korean Medicine, Sangji University, 80 Sangjidae-gil, Wonju-si, Gangwon-do, 26339, Republic of Korea.
| | - Chan-Yong Jeon
- Department of Korean Internal Medicine, College of Korean Medicine, Gachon University, 1342 Seongnamdae-ro, Sujeong-gu, Gyeonggi-do, 13120, Republic of Korea.
| | - Seong-Gyu Ko
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea
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Assessment of Age-Related Decline of Immunological Function and Possible Methods for Immunological Restoration in Elderly. HANDBOOK OF IMMUNOSENESCENCE 2019. [PMCID: PMC7121363 DOI: 10.1007/978-3-319-99375-1_73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The immune system plays an important role in protection against infection and cancer, and in the maintenance of the internal environment of the body. However, such important immune functions are known to decline with age in many mammals, including humans. It is a matter of clinical importance that the incidence of various age-associated diseases such as infections, cancer, and vascular disorders increases with a decrease in immunological vigor. The extent of immunologic decline is variable and exhibits wide interindividual variations. Thus, it is important to assess the extent of immunologic decline in both patients suffering from various diseases and in healthy people in order to maintain healthy conditions. To this end, we have developed a scoring system that analyzes immune parameters according to a database of known age-associated immune changes obtained from a healthy population. Using this scoring system, we can combine several different immunological parameters and express the immune status of individuals as a simple numeral. Several methods of immunological restoration were introduced and the magnitude of restoration was evaluated by the quantitative assessment of immunological level.
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Iitsuka H, Koizumi K, Inujima A, Suzaki M, Mizuno Y, Takeshita Y, Eto T, Otsuka Y, Shimada R, Liu M, Ikeda K, Nakano M, Suzuki R, Maruyama K, Zhou Y, Sakurai H, Shibahara N. Discovery of a sugar-based nanoparticle universally existing in boiling herbal water extracts and their immunostimulant effect. Biochem Biophys Rep 2018; 16:62-68. [PMID: 30338298 PMCID: PMC6186954 DOI: 10.1016/j.bbrep.2018.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 08/20/2018] [Indexed: 01/21/2023] Open
Abstract
Herbal medicine is mainly prepared from boiling herbal water extracts. Many epoch-making immunosuppressant drugs, such as glycyrrhizic acid (old example) and FTY720 (current example), were developed from herbal secondary metabolites in the boiling water extract by partition with organic solvents. However, few immunostimulants have been discovered by this method. Instead of the usual method, we aimed to find a novel immunostimulant component by two unique methods in the research of herbal medicine: ultracentrifugation and electron microscopy. The immunostimulant was not a secondary metabolite, as expected, but the structure was a nanoparticle formed by a polysaccharide. In addition, we clarified the immune effect of the nanoparticle. Intake of the nanoparticle by phagocytosis resulted in immunostimulant effects by increasing the genes and proteins of inflammatory cytokines in macrophage cells. The immunostimulant effects were inhibited by a phagocytosis inhibitor, cytochalasin D. To the best of our knowledge, this study is the first to describe the discovery of a nanoparticle in boiling herbal water extracts and its immunostimulant properties. This study will provide additional understanding of the efficacy of herbal medicine, in that the immunostimulant nanoparticle universally exists in boiling herbal water extracts. Thus, traditional herbal medicine may be an oldest known nanomedicine. Furthermore, this study suggests that the immunostimulant nanoparticle simply can be obtained from herbal medicine only by ultracentrifugation. We hope that this simple strategy will substantially contribute to drug development, including vaccine adjuvant, in the future. Nanoparticles are universally present in boiling herbal water extracts. Nanoparticles are obtained from these extracts by ultracentrifugation. Nanoparticles are mainly composed of polysaccharides. Nanoparticles have an immunostimulatory effect on macrophage cells. This effect is exhibited by the phagocytosis of exogenous nanoparticles.
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Affiliation(s)
- Hirofumi Iitsuka
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Keiichi Koizumi
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Akiko Inujima
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Mikiko Suzaki
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Yusuke Mizuno
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Yoshiki Takeshita
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Takeshi Eto
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Yoshiki Otsuka
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Ryo Shimada
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Mengxin Liu
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Keisuke Ikeda
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan
| | - Minoru Nakano
- Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan
| | - Ryo Suzuki
- Laboratory of Drug Delivery System, Faculty of Pharma-Science, Teikyo University, Tokyo 173-8605, Japan
| | - Kazuo Maruyama
- Laboratory of Drug Delivery System, Faculty of Pharma-Science, Teikyo University, Tokyo 173-8605, Japan
| | - Yue Zhou
- Department of Cancer Cell Biology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan
| | - Hiroaki Sakurai
- Department of Cancer Cell Biology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan
| | - Naotoshi Shibahara
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
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Japanese Herbal Kampo Hochu-Ekki-To or Juzen-Taiho-To after Surgery for Hip Fracture Does Not Reduce Infectious Complications. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:8620198. [PMID: 29853976 PMCID: PMC5949155 DOI: 10.1155/2018/8620198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/08/2018] [Accepted: 04/12/2018] [Indexed: 12/17/2022]
Abstract
Background Infectious complications after hip fracture surgery are common in the elderly. Although experimental studies have suggested that kampo medicine, Hochu-ekki-to and Juzen-taiho-to, can prevent infectious complications, only a few small clinical studies have been published to date. Primary Study Objective The aim of the present study is to investigate the impact of Hochu-ekki-to or Juzen-taiho-to on postoperative infectious complications in patients undergoing surgery for hip fracture. Methods and Design In this retrospective cohort study using a nationwide inpatient database in Japan, we performed propensity score matching to compare patients who did or did not receive kampo medicine after surgery for hip fracture. Settings A nationwide inpatient database. Participants Patients who did or did not receive kampo medicine after surgery for hip fracture. Intervention Kampo medicine after surgery for hip fracture. Primary Outcome Measures Infectious complications. Results The proportions of postoperative infectious complications were not significantly different between the 424 propensity-matched pairs with and without kampo medicine (11 versus 8, P = 0.644). Conclusion The present study suggests that Hochu-ekki-to or Juzen-taiho-to postoperatively is not associated with decreased occurrence of infectious complications in patients who underwent surgery for hip fracture.
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Tackenberg B, Schneider M, Blaes F, Eienbröker C, Schade-Brittinger C, Wellek A, Deschauer M, Eickmann M, Klenk HD, Müller HH, Sommer N. Acetylcholine Receptor Antibody Titers and Clinical Course after Influenza Vaccination in Patients with Myasthenia Gravis: A Double-Blind Randomized Controlled Trial (ProPATIent-Trial). EBioMedicine 2018; 28:143-150. [PMID: 29337134 PMCID: PMC5835557 DOI: 10.1016/j.ebiom.2018.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 01/04/2018] [Accepted: 01/05/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND It is a continuous matter of discussion whether immune activation by vaccination in general and Influenza vaccination in particular increases the risk for clinical deterioration of autoimmune diseases. This prospective study investigated the serological and clinical course of autoimmune Myasthenia gravis (MG) after a seasonal influenza vaccination. METHODS This randomized, placebo-controlled, double-blind study enrolled MG patients with antibodies against acetylcholine-receptors (AChR-ab). They were allocated to receive seasonal influenza vaccine or placebo. The primary endpoint was the relative change of AChR-ab-titer over 12weeks. A relative increase of 20% was set as non-inferiority margin. Secondary endpoints were clinical changes in the modified Quantitative Myasthenia Gravis Score (QMG), increase of anti-influenza-ELISA-antibodies, and changes of treatment. The study is registered with Clinicaltrialsregister.eu, EudraCT number 2006-004374-27. FINDINGS 62 patients were included. Mean±standard deviation (median) in the vaccine and placebo group were AChR-ab-titer changes of -6.0%±23.3% (-4.0%) and -2.8%±22.0% (-0.5%) and QMG score changes of -0.08±0.27 (0.17) and 0.11±0.31 (0.00), respectively. The difference between groups (Hodges-Lehmann estimate with 95% CI) was - for the AChR-ab-titer change 4·0% [-13.3%, 4.5%] (p=0.28 for testing a difference, p<0.0001 for testing non-inferiority) and for the QMG change 0·00 [-0.17, 0.00] (p=0.79 for testing a difference). The occurrence of 74 adverse events (AE) was comparable between groups. The most common AE was flu-like symptoms. One serious AE (hospitalisation following gastrointestinal haemorrhage) in the verum group was not related to the vaccine. INTERPRETATION Influenza vaccination in MG is safe. Uprating the potential risk of a severe course of MG exacerbation during influenza infection compared to the 95% CI differences for the endpoints, vaccination is principally indicated in this patient population.
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Affiliation(s)
- Björn Tackenberg
- Klinik für Neurologie, Philipps-Universität und Universitätsklinikum Marburg, Baldingerstr. 1, Marburg 35043, Germany.
| | - Maximilian Schneider
- Klinik für Neurologie, Philipps-Universität und Universitätsklinikum Marburg, Baldingerstr. 1, Marburg 35043, Germany
| | - Franz Blaes
- Klinik für Neurologie, Klinikum Oberberg, Am Hüttenberg 1, Gummersbach 51643, Germany
| | - Christian Eienbröker
- Klinik für Neurologie, Philipps-Universität und Universitätsklinikum Marburg, Baldingerstr. 1, Marburg 35043, Germany
| | - Carmen Schade-Brittinger
- Koordinierungszentrum für Klinische Studien (KKS), Philipps-Universität, Karl-von-Frisch-Str. 4, Marburg 35043, Germany
| | - Anne Wellek
- Klinik für Neurologie, Philipps-Universität und Universitätsklinikum Marburg, Baldingerstr. 1, Marburg 35043, Germany
| | - Marcus Deschauer
- Klinik für Neurologie, Technische Universität München (TUM), Ismaninger Str. 22, München 81675, Germany
| | - Markus Eickmann
- Institut für Virologie, Philipps-Universität, Hans-Meerwein-Str. 2, Marburg 35043, Germany
| | - Hans-Dieter Klenk
- Institut für Virologie, Philipps-Universität, Hans-Meerwein-Str. 2, Marburg 35043, Germany
| | - Hans-Helge Müller
- Institut für Medizinische Biometrie und Epidemiologie (IMBE), Philipps-Universität, Bunsenstr. 3, Marburg 35037, Germany
| | - Norbert Sommer
- Klinik für Neurologie, Philipps-Universität und Universitätsklinikum Marburg, Baldingerstr. 1, Marburg 35043, Germany; Klinik für Neurologie, Klinikum Christophsbad, Faurndauer Str. 6, Göppingen 73035, Germany
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12
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Takaku S, Shimizu M, Takahashi H. Japanese Kampo medicine ninjin'yoeito synergistically enhances tumor vaccine effects mediated by CD8 + T cells. Oncol Lett 2017; 13:3471-3478. [PMID: 28529575 PMCID: PMC5431575 DOI: 10.3892/ol.2017.5937] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 02/28/2017] [Indexed: 12/14/2022] Open
Abstract
Although Japanese traditional herbal medicine (Kampo) has been widely applied to the treatment of various diseases, including cancer, their mechanisms of action have not yet been elucidated in detail, particularly regarding their role in tumor immunology. The present study investigated the antitumor effects of the Japanese Kampo medicine, ninjin'yoeito (NYT; Ren-Shen-Yang-Rong-Tang in Chinese), which was orally administered with or without an irradiated tumor cell vaccine to a subcutaneous CT26 colon carcinoma tumor model. The irradiated tumor cell vaccine in a prophylactic setting significantly delayed tumor growth in mice fed a control diet, whereas a diet containing NYT alone did not exert any antitumor effects in vivo. However, the inhibition of tumor growth was significantly greater in vaccinated mice fed the NYT diet compared with in vaccinated mice given the control diet. These results suggest that NYT synergistically enhances the effects of the antitumor vaccine. The depletion of cluster of differentiation (CD)8+ T cells abrogated these effects, indicating that antitumor activity required CD8+ T cells. Furthermore, reductions in CD4+ CD25+ and forkhead box protein 3+ T regulatory cell numbers were more apparent between vaccinated mice fed the NYT diet and non-vaccinated mice fed the control diet than between vaccinated mice and non-vaccinated mice fed the control diet, suggesting that the weaker impact of T regulatory cells contributes to the augmentation of antitumor immunity by CD8+ T cells in vaccinated mice fed with NYT. Overall, these results indicate that NYT synergistically enhances the effects of the prophylactic tumor vaccine mediated by CD8+ T cells and that this Japanese Kampo medicine has potential as a useful adjuvant agent for cancer immunotherapy.
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Affiliation(s)
- Shun Takaku
- Department of Microbiology and Immunology, Nippon Medical School, Tokyo 113-8602, Japan
| | - Masumi Shimizu
- Department of Microbiology and Immunology, Nippon Medical School, Tokyo 113-8602, Japan
| | - Hidemi Takahashi
- Department of Microbiology and Immunology, Nippon Medical School, Tokyo 113-8602, Japan
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13
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Kampo Medicines for Infectious Diseases. JAPANESE KAMPO MEDICINES FOR THE TREATMENT OF COMMON DISEASES: FOCUS ON INFLAMMATION 2017. [PMCID: PMC7150106 DOI: 10.1016/b978-0-12-809398-6.00014-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Numerous Kampo medicines and Oriental herbs have been used for the treatment of infectious diseases for several reasons, such as genetic background, economical reasons, fewer adverse effects, and so on. This chapter describes Kampo medicines and related Oriental herbs that are effective or promising in the treatment of infectious diseases at the clinical level and/or in animal models. In addition, effective Kampo medicines tested in vitro in cultured-cell studies are also included in this chapter. Each section is categorized by infectious disease and according to the popularity of the Kampo medicine.
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14
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Young B, Zhao X, Cook AR, Parry CM, Wilder-Smith A, I-Cheng MC. Do antibody responses to the influenza vaccine persist year-round in the elderly? A systematic review and meta-analysis. Vaccine 2016; 35:212-221. [PMID: 27939013 DOI: 10.1016/j.vaccine.2016.11.013] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 09/19/2016] [Accepted: 11/04/2016] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The influenza vaccine is less immunogenic in older than younger adults, and the duration of protection is unclear. Determining if protection persists beyond a typical seasonal epidemic is important for climates where influenza virus activity is year-round. METHODS A systematic review protocol was developed and registered with PROSPERO [CRD42015023847]. Electronic databases were searched systematically for studies reporting haemagglutination-inhibition (HI) titres 180-360days following vaccination with inactivated trivalent seasonal influenza vaccine, in adults aged ⩾65years. Geometric mean titre (GMT) and seroprotection (HI titre ⩾1:40) at each time point was extracted. A Bayesian model was developed of titre trajectories from pre-vaccination to Day 360. In the meta-analysis, studies were aggregated using a random-effects model to compare pre-vaccination with post-vaccination HI titres at Day 21-42 ('seroconversion'), Day 180 and Day 360. Potential sources of bias were systematically assessed, and heterogeneity explored. RESULTS 2864 articles were identified in the literature search, of which nineteen met study inclusion/exclusion criteria. Sixteen studies contained analysable data from 2565 subjects. In the Bayesian model, the proportion of subjects seroprotected increased from 41-51% pre-vaccination to 75-78% at seroconversion. Seroprotection subsequently fell below 60% for all serotypes by Day 360: A/H1 42% (95% CI 38-46), A/H3 59% (54-63), B 47% (42-52). The Bayesian model of GMT trajectories revealed a similar pattern. By Day 360, titres were similar to pre-vaccination levels. In the meta-analysis, no significant difference in proportion of subjects seroprotected, 0 (-0.11, 0.11) or in log2GMT 0.30 (-0.02, 0.63) was identified by Day 360 compared with pre-vaccination. The quality of this evidence was limited to moderate on account of significant participant dropout. CONCLUSIONS The review found consistent evidence that HI antibody responses following influenza vaccination do not reliably persist year-round in older adults. Alternative vaccination strategies could provide clinical benefits in regions where year-round protection is important.
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Affiliation(s)
- Barnaby Young
- Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, 308433 Singapore, Singapore.
| | - Xiahong Zhao
- Saw Swee Hock School of Public Health, Tahir Foundation Building, National University of Singapore, 12 Science Drive 2, #09-01, 117549 Singapore, Singapore
| | - Alex R Cook
- Saw Swee Hock School of Public Health, Tahir Foundation Building, National University of Singapore, 12 Science Drive 2, #09-01, 117549 Singapore, Singapore; Yale-NUS College, National University of Singapore, 16 College Avenue West #01-220, 138527 Singapore, Singapore
| | - Christopher M Parry
- School of Tropical Medicine and Global Health, Nagasaki University Institute of Tropical Medicine, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Annelies Wilder-Smith
- Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, 308433 Singapore, Singapore; Lee Kong Chian School of Medicine, 11 Mandalay Road, 308232 Singapore, Singapore
| | - Mark Chen I-Cheng
- Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, 308433 Singapore, Singapore; Saw Swee Hock School of Public Health, Tahir Foundation Building, National University of Singapore, 12 Science Drive 2, #09-01, 117549 Singapore, Singapore
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15
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Fermented Sipjeondaebo-tang Alleviates Memory Deficits and Loss of Hippocampal Neurogenesis in Scopolamine-induced Amnesia in Mice. Sci Rep 2016; 6:22405. [PMID: 26939918 PMCID: PMC4778044 DOI: 10.1038/srep22405] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 02/12/2016] [Indexed: 12/15/2022] Open
Abstract
We investigated the anti-amnesic effects of SJ and fermented SJ (FSJ) on scopolamine (SCO)-induced amnesia mouse model. Mice were orally co-treated with SJ or FSJ (125, 250, and 500 mg/kg) and SCO (1 mg/kg), which was injected intraperitoneally for 14 days. SCO decreased the step-through latency and prolonged latency time to find the hidden platform in the passive avoidance test and Morris water maze test, respectively, and both SCO effects were ameliorated by FSJ treatment. FSJ was discovered to promote hippocampal neurogenesis during SCO treatment by increasing proliferation and survival of BrdU-positive cells, immature/mature neurons. In the hippocampus of SCO, oxidative stress and the activity of acetylcholinesterase were elevated, whereas the levels of acetylcholine and choline acetyltransferase were diminished; however, all of these alterations were attenuated by FSJ-treatment. The alterations in brain-derived neurotrophic factor, phosphorylated cAMP response element-binding protein, and phosphorylated Akt that occurred following SCO treatment were protected by FSJ administration. Therefore, our findings are the first to suggest that FSJ may be a promising therapeutic drug for the treatment of amnesia and aging-related or neurodegenerative disease-related memory impairment. Furthermore, the molecular mechanism by which FSJ exerts its effects may involve modulation of the cholinergic system and BDNF/CREB/Akt pathway.
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Takeno N, Inujima A, Shinohara K, Yamada M, Shibahara N, Sakurai H, Saiki I, Koizumi K. Immune adjuvant effect of Juzentaihoto, a Japanese traditional herbal medicine, on tumor vaccine therapy in a mouse model. Int J Oncol 2015; 47:2115-22. [PMID: 26496932 DOI: 10.3892/ijo.2015.3208] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 08/10/2015] [Indexed: 11/06/2022] Open
Abstract
Japanese traditional herbal medicine (Kampo) have been used to improve the general physical condition after surgery and to mitigate the side effects of radiation and chemotherapy in tumor patients. Juzentaihoto (JTT) consists of ten medical herbs, and is also called Shi-Quan-Da-Bu-Tang in Chinese herbal medicine. Among Kampo medicines, JTT has especially gained attention as a biological response modifier. Currently, clinical trials of various tumor vaccine therapies are being performed world-wide. However, tumor antigens that are inoculated as vaccines do not have high immunogenicity; thus, it is difficult to obtain an effective therapeutic effect. Thus, it is necessary to develop a tumor vaccine adjuvant that is more potent and very safe. In the present study, we examined the efficacy of JTT as an oral adjuvant when given together with tumor vaccines. As a result, JTT enhanced the phagocytic ability of OVA antigen and the presentation ability of OVA antigen in dendritic cells in vitro. Furthermore, tumor growth was markedly decreased, and the survival period was significantly prolonged in mice inoculated with mouse lymphoma, which is expressed with tumor model antigen. In conclusion, these findings suggest that JTT can be used with tumor vaccines as an immune adjuvant.
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Affiliation(s)
- Nobuhiro Takeno
- Division of Pathogenic Biochemistry, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Akiko Inujima
- Division of Pathogenic Biochemistry, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Kanna Shinohara
- Division of Pathogenic Biochemistry, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Miyuki Yamada
- Division of Pathogenic Biochemistry, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Naotoshi Shibahara
- Division of Kampo Diagnostics, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Hiroaki Sakurai
- Division of Pathogenic Biochemistry, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Ikuo Saiki
- Division of Pathogenic Biochemistry, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Keiichi Koizumi
- Division of Pathogenic Biochemistry, Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
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