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Kanda H, Yang Y, Duan S, Kogure Y, Wang S, Iwaoka E, Ishikawa M, Takeda S, Sonoda H, Mizuta K, Aoki S, Yamamoto S, Noguchi K, Dai Y. Atractylodin Produces Antinociceptive Effect through a Long-Lasting TRPA1 Channel Activation. Int J Mol Sci 2021; 22:3614. [PMID: 33807167 PMCID: PMC8036394 DOI: 10.3390/ijms22073614] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/27/2021] [Accepted: 03/27/2021] [Indexed: 12/11/2022] Open
Abstract
Atractylodin (ATR) is a bioactive component found in dried rhizomes of Atractylodes lancea (AL) De Candolle. Although AL has accumulated empirical evidence for the treatment of pain, the molecular mechanism underlying the anti-pain effect of ATR remains unclear. In this study, we found that ATR increases transient receptor potential ankyrin-1 (TRPA1) single-channel activity in hTRPA1 expressing HEK293 cells. A bath application of ATR produced a long-lasting calcium response, and the response was completely diminished in the dorsal root ganglion neurons of TRPA1 knockout mice. Intraplantar injection of ATR evoked moderate and prolonged nociceptive behavior compared to the injection of allyl isothiocyanate (AITC). Systemic application of ATR inhibited AITC-induced nociceptive responses in a dose-dependent manner. Co-application of ATR and QX-314 increased the noxious heat threshold compared with AITC in vivo. Collectively, we concluded that ATR is a unique agonist of TRPA1 channels, which produces long-lasting channel activation. Our results indicated ATR-mediated anti-nociceptive effect through the desensitization of TRPA1-expressing nociceptors.
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Affiliation(s)
- Hirosato Kanda
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe 650-8530, Japan; (H.K.); (Y.Y.); (S.D.); (Y.K.); (S.W.); (E.I.); (M.I.); (S.T.); (H.S.); (K.M.); (S.A.); (S.Y.)
- Department of Anatomy and Neuroscience, Hyogo College of Medicine, Nishinomiya 663-8501, Japan;
- Traditional Medicine Research Center, Chinese Medicine Confucius Institute at Hyogo College of Medicine, Nishinomiya 663-8501, Japan
| | - Yanjing Yang
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe 650-8530, Japan; (H.K.); (Y.Y.); (S.D.); (Y.K.); (S.W.); (E.I.); (M.I.); (S.T.); (H.S.); (K.M.); (S.A.); (S.Y.)
- Department of Pathophysiology, Shenyang Medical College, Shenyang 110034, China
| | - Shaoqi Duan
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe 650-8530, Japan; (H.K.); (Y.Y.); (S.D.); (Y.K.); (S.W.); (E.I.); (M.I.); (S.T.); (H.S.); (K.M.); (S.A.); (S.Y.)
| | - Yoko Kogure
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe 650-8530, Japan; (H.K.); (Y.Y.); (S.D.); (Y.K.); (S.W.); (E.I.); (M.I.); (S.T.); (H.S.); (K.M.); (S.A.); (S.Y.)
| | - Shenglan Wang
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe 650-8530, Japan; (H.K.); (Y.Y.); (S.D.); (Y.K.); (S.W.); (E.I.); (M.I.); (S.T.); (H.S.); (K.M.); (S.A.); (S.Y.)
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Emiko Iwaoka
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe 650-8530, Japan; (H.K.); (Y.Y.); (S.D.); (Y.K.); (S.W.); (E.I.); (M.I.); (S.T.); (H.S.); (K.M.); (S.A.); (S.Y.)
| | - Miku Ishikawa
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe 650-8530, Japan; (H.K.); (Y.Y.); (S.D.); (Y.K.); (S.W.); (E.I.); (M.I.); (S.T.); (H.S.); (K.M.); (S.A.); (S.Y.)
| | - Saki Takeda
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe 650-8530, Japan; (H.K.); (Y.Y.); (S.D.); (Y.K.); (S.W.); (E.I.); (M.I.); (S.T.); (H.S.); (K.M.); (S.A.); (S.Y.)
| | - Hidemi Sonoda
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe 650-8530, Japan; (H.K.); (Y.Y.); (S.D.); (Y.K.); (S.W.); (E.I.); (M.I.); (S.T.); (H.S.); (K.M.); (S.A.); (S.Y.)
| | - Kyoka Mizuta
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe 650-8530, Japan; (H.K.); (Y.Y.); (S.D.); (Y.K.); (S.W.); (E.I.); (M.I.); (S.T.); (H.S.); (K.M.); (S.A.); (S.Y.)
| | - Shunji Aoki
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe 650-8530, Japan; (H.K.); (Y.Y.); (S.D.); (Y.K.); (S.W.); (E.I.); (M.I.); (S.T.); (H.S.); (K.M.); (S.A.); (S.Y.)
| | - Satoshi Yamamoto
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe 650-8530, Japan; (H.K.); (Y.Y.); (S.D.); (Y.K.); (S.W.); (E.I.); (M.I.); (S.T.); (H.S.); (K.M.); (S.A.); (S.Y.)
| | - Koichi Noguchi
- Department of Anatomy and Neuroscience, Hyogo College of Medicine, Nishinomiya 663-8501, Japan;
| | - Yi Dai
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe 650-8530, Japan; (H.K.); (Y.Y.); (S.D.); (Y.K.); (S.W.); (E.I.); (M.I.); (S.T.); (H.S.); (K.M.); (S.A.); (S.Y.)
- Department of Anatomy and Neuroscience, Hyogo College of Medicine, Nishinomiya 663-8501, Japan;
- Traditional Medicine Research Center, Chinese Medicine Confucius Institute at Hyogo College of Medicine, Nishinomiya 663-8501, Japan
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Gyejigachulbutang (Gui-Zhi-Jia-Shu-Fu-Tang, Keishikajutsubuto, TJ-18) in Degenerative Knee Osteoarthritis Patients: Lessons and Responders from a Multicenter Randomized Placebo-Controlled Double-Blind Clinical Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:2376581. [PMID: 33178309 PMCID: PMC7647757 DOI: 10.1155/2020/2376581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/19/2020] [Accepted: 10/14/2020] [Indexed: 02/07/2023]
Abstract
Background Gyejigachulbutang (GUI-ZHI-JIA-SHU-FU-TANG, GCB) is an herbal formula widely prescribed in traditional East Asian medicine practice for arthritis and muscle pain. We evaluated the efficacy and safety of GCB for degenerative knee osteoarthritis (KOA). Methods Eighty patients with KOA were randomly assigned to the GCB group or the placebo group in a 1 : 1 ratio in two Korean medicine hospitals. Patients took GCB or placebo three times a day for 4 weeks. Primary outcome was the change in the visual analogue scale (VAS) score for knee pain from baseline to 4th week. Secondary outcomes were the change in the VAS score from baseline to 2nd week and 8th week, Korean Western Ontario and McMaster Universities Osteoarthritis Index (K-WOMAC), European Quality of Life Five Dimensions questionnaire (EQ-5D), and safety. Results There was no significant difference between the compared indicators of the GCB and placebo groups. However, in subgroup analysis, GCB was effective for subjects with a BMI lower than 25 kg/m2. The dose of pain medication was significantly lower in the GCB group than in the placebo group after four weeks (p=0.016). There were no serious adverse events in the GCB group. Conclusions GCB was not effective in primary outcome analysis. In exploratory subgroup analysis, GCB might be effective for individuals with BMI lower than 25 kg/m2 for the treatment of degenerative KOA. GCB may also help reduce the consumption of pain medication. Furthermore, research is required for our hypothesis. This trial is registered with KCT0003024.
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Sul JU, Kim MK, Leem J, Jo HG, Yoon SH, Kim J, Lee EJ, Yoo JE, Park SJ, Kim YI, Kim E, Jung IC, Jeon JH, Park YC. Efficacy and safety of gyejigachulbutang (Gui-Zhi-Jia-Shu-Fu-Tang, Keishikajutsubuto, TJ-18) for knee pain in patients with degenerative knee osteoarthritis: a randomized, placebo-controlled, patient and assessor blinded clinical trial. Trials 2019; 20:140. [PMID: 30782208 PMCID: PMC6381693 DOI: 10.1186/s13063-019-3234-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 01/29/2019] [Indexed: 01/04/2023] Open
Abstract
Background Degenerative knee osteoarthritis is a leading cause of disability in the elderly. If patients do not respond to pharmacological or nonpharmacological intervention, total knee replacement surgery is recommended. However, owing to the contraindications and adverse effects of surgery, the need for a new treatment strategy is emerging. Traditional herbal medicine is a widely used intervention in east Asia to treat knee osteoarthritis. Gyejigachulbutang is one of the frequently prescribed herbal formulae. The aim of our study is to evaluate the efficacy and safety of gyejigachulbutang for knee osteoarthritis. Methods This study is a randomized, placebo-controlled, patient and assessor blinded, superiority clinical trial. A total of 80 patients with knee osteoarthritis will be enrolled. The participants will be randomly assigned to the gyejigachulbutang or placebo group in a 1:1 ratio in two Korean medical hospitals. Every participant will take gyejigachulbutang or placebo at a dose of 2.5 g three times a day for 4 weeks. Additional follow-up will be conducted 4 weeks after treatment completion. Any concomitant treatment to relive knee pain will not be allowed except for rescue medicine (acetaminophen). The primary outcome will be a comparison of the change in the visual analogue scale score for knee pain from baseline to visit 3 (week 4) for both the treatment and placebo groups. Secondary outcomes include clinical relevance, minimal clinically important difference, disability, quality of life, and safety. Discussion This protocol presents a research methodology for clinical trials of gyejigachulbutang for knee osteoarthritis. Various secondary outcomes make this trial more informative. Our trial will provide fundamental evidence for knee osteoarthritis management via herbal medicine treatment. Trial registration Clinical Research Information Service (CRIS), KCT0003024. Registered on 25 July 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3234-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jae-Uk Sul
- Chung-Yeon Central Institute, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea.,Chung-Yeon Korean Medicine Hospital, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea
| | - Myung Kwan Kim
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, South Korea
| | - Jungtae Leem
- Chung-Yeon Central Institute, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea.,Dongshin Korean Medicine Hospital, 351, Omok-ro, Yangcheon-gu, Seoul, 07999, South Korea
| | - Hee-Geun Jo
- Chung-Yeon Central Institute, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea.,Chung-Yeon Korean Medicine Hospital, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea
| | - Sang-Hoon Yoon
- Chung-Yeon Central Institute, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea.,Chung-Yeon Korean Medicine Hospital, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea
| | - Jeeyong Kim
- Chung-Yeon Central Institute, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea.,Chung-Yeon Korean Medicine Hospital, 64, Sangmujungang-ro, Seo-gu, Gwangju, 61949, South Korea
| | - Eun-Jung Lee
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, South Korea
| | - Jeong-Eun Yoo
- Department of Korean Medicine Obstetrics & Gynecology, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, South Korea
| | - So Jung Park
- East West Cancer Center, Dunsan Korean Medicine Hospital of Daejeon University, 75, 176 Bun-gil, Daedeok-daero, Seo-gu, Daejeon City, 35235, South Korea
| | - Young Il Kim
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, South Korea
| | - Eunseok Kim
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, South Korea
| | - In Chul Jung
- Department of Neuropsychiatry, Dunsan Korean Medicine Hospital of Daejeon University, 75, Daedeok-daero 176 beon-gil, Seo-gu, Daejeon, 35235, South Korea
| | - Ju-Hyun Jeon
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, South Korea.
| | - Yang-Chun Park
- Department of Internal Medicine, Dunsan Korean Medicine Hospital of Daejeon University, 75, Daedeok-daero 176 beon-gil, Seo-gu, Daejeon, 35235, South Korea.
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Nakanishi M, Arimitsu J, Kageyama M, Otsuka S, Inoue T, Nishida S, Yoshikawa H, Kishida Y. Efficacy of traditional Japanese herbal medicines-Keishikajutsubuto (TJ-18) and Bushi-matsu (TJ-3022)-against postherpetic neuralgia aggravated by self-reported cold stimulation: a case series. J Altern Complement Med 2012; 18:686-92. [PMID: 22830970 DOI: 10.1089/acm.2010.0745] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES It has been reported that postherpetic neuralgia (PHN) in patients over 60 years of age is aggravated under cold stimulation and is often difficult to treat. Keishikajutsubuto (TJ-18) and Bushi-matsu (TJ-3022) are traditional Japanese herbal medicines and have long been used to treat neuralgia and arthralgia, which are aggravated following cold stimulation. This study was designed to evaluate the effectiveness of combined TJ-18 and TJ-3022 therapy in cases of PHN aggravated by self-reported cold stimulation. DESIGN Fifteen (15) PHN patients aged 60 years and over were examined. Patients were aware of the persistent pain despite other treatments; pain was generally aggravated following exposure to cold stimulation. First, TJ-18 (7.5 g/day) was administered to patients, and then TJ-3022 (1.0 g/day) was also administered and progressively increased by 0.5-1.0 g increments every 2-4 weeks, until stable improvement was achieved, which was rated using the visual analogue scale (VAS). Analgesic effects were evaluated using the VAS during each patient visit. OUTCOME MEASURES Background variables, responses to treatment (time course of VAS rating, VAS improvement rate), the amount of additional TJ-3022 administered, and adverse reactions were analyzed. RESULTS Twelve (12) of the 15 patients completed the entire trial. Patient ages were 61-85 years, the male-to-female ratio was 4:8, and length of time after onset of herpes zoster was 2-92 months. In 3 patients, oral TJ-18 treatment was not possible due to hot flash or gastric discomfort. The VAS improvement rate for patients being orally administered both TJ-18 and TJ-3022 was 76.5±27.7% (mean±standard deviation). The additional TJ-3022 dose was 1.0-5.0 g/day. Twelve (12) patients have been treated without serious adverse reactions. CONCLUSIONS TJ-18 and TJ-3022 combination treatment is a promising means of treating intractable PHN, which has a self-reported tendency to aggravate pain under cold stimulation.
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Affiliation(s)
- Miho Nakanishi
- Department of Kampo Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
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Kogure T, Tatsumi T, Shigeta T, Fujinaga H, Sato T, Niizawa A. Effect of kampo medicine on pain and range of motion of osteoarthritis of the hip accompanied by acetabular dysplasia: case report and literature review. INTEGRATIVE MEDICINE INSIGHTS 2011; 6:13-7. [PMID: 22174570 PMCID: PMC3236006 DOI: 10.4137/imi.s7884] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We report a 52-year-old female with end-stage osteoarthritis of the hip accompanied by acetabular dysplasia in whom quality of life (QOL) was improved by Kampo treatment. When she was 42 years old, she developed pain in the left hip joint, and early-stage OA of the hip was diagnosed by hip joint x-ray. Therefore, she took NSAIDs, and received conservative therapies such as diet and muscle training. However, pain in the hip joint increased and her activity of daily life (ADL) decreased at the age of 50, although she continued to receive the conservative therapies. At the age of 52, she consulted our department requesting Japanese Oriental (Kampo) Medicine. Kampo formulae; Keishikaryojutsubuto (12Tab/day: Kuracie Co. Ltd. Japan), and Boiougito (7.5 g/day: Kuracie Co. Ltd. Japan), were administered. Treatment for 3 months resulted in a decrease in the left hip joint pain using visual analogue scale (VAS) and improvement of her ADL. One year later, her joint symptoms have not increased, and both the Harris hip score and the clinical evaluation criteria of osteoarthritis of the hip have improved. The course of this disease varies depending on the lifestyle of the patient, and Kampo formulations may offer safe, potent supplemental treatment.
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Affiliation(s)
- Toshiaki Kogure
- Department of Japanese oriental medicine, Gunma Central and General Hospital
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