Before the modern use of synthetic drugs, many medicines worldwide were derived from natural plant sources, including the nuts, roots and leaves. In Asian countries, especially in ancient China, many botanical materials had been adapted into medicines and these compositions have been described in old medicical encyclopedias.
Kampo originally means “Chinese style”, not only in medicine, but also for other Japanese words describing life styles. Kampo these days has come to mean “ethnical traditional medicine”. The principles of Kampo drugs were originally based on old Chinese traditional medicines and comprise about one hundred and fifty kinds of compositions of natural herbs and other natural products. Kampo medicine is generally characterized by its low frequency of severe adverse effects and is used in current clinical practice all over Japan and other countries.
Kampo products, for example, herbal extract granules for ethical use, were first included under the coverage of the Japanese public health insurance system in 1976 and currently, many clinical doctors in Japan apply these Kampo medicines along with Western chemically synthesized drugs [1
Kampo traditional medicine is based on the long experience with its use in China and other oriental countries. The main theory of this medicine is based on the concept that diseases are caused from a disharmony of bodily flow and the aim of therapy is treating the patient as a body, not the disease. Consequently there can many ways to treat individual patients with the same disease.
“Sho”, the term of traditional Kampo medicine, refers to a particular pathological status of a patient evaluated by Kampo diagnosis, and is patterned according to the patient'sconstitution and symptoms, among other considerations [1
]. Kampo preparations, including Japanese traditional botanical medicines, should be used after confirmation that it is suitable for the identified Sho of the patient.
Based on the particular diagnosis for Sho, some herbs and other natural materials should be compound into drugs. Originally they were taken as soluble extract in hot water just like tea, but now it can easily be taken as granular essence style drugs controlled under the Japanese Pharmacopoeia. Over ten pharmaceutical companies in Japan produce these granular style Kampo drugs for increased patient convenience [1
Recently the use of alternative and complementary medicines in the Western countries has become more popular and some Kampo medicines can now be used in these countries. The use of Kampo style medicines is evolving how comprehensive medicine is practiced with established Western medical drugs.
Juzentaihoto (JTT), one of the Kampo Japanese herbal medicines was first described as SiQuan-Da-Bu-Tang in Daipinghuimin-Hejijufang (the Drug text book in Song Dynasty, 1151 A.D. in ancient China) and introduced into Japan in the Kamakura dynasty, about eight hundred years ago. The name of this drug originates from its Han–letters. This is composed with four parts of characters in the name, “Juzen” means perfect, “tai” means great, “ho” means supplement, and “to” means water drug, respectively, and it consists from ten crude components obtained from natural herbs (shown in from the 2006 Japanese Pharmacopoeia) [2
Botanical origins of ten crude drugs of JTT from the 2006 Japanese Pharmacopoeia.
It has been mainly administrated to patients depressed or weakened by long illness to improve their general condition. The intended effect of this drug is to treat weakened conditions after illness, pale complexion, general fatigue, loss of appetite, night sweats, cold extremities, dry skin, dry mouth and anemia. Recently there have been some reports that JTT has anti-tumor effects and may prolong the survival of cancer patients [3
]. Other reports describe that decreased occurrence of secondary carcinogenesis [7
These pharmacological mechanisms by which JTT exerts its effects have not yet been clarified. One study reports JTT cause the induction of interleukin (IL)-12 and subsequent activation of natural killer T (NKT) lymphoid cells [12
]. Other work mentions IL-18 induction as a possible result of JTT.
NKT cells are a type of lymphocyte characterized by their morphology which displays large granules in the plasma and has T cell receptors (TCR) with NK receptors, such as NK1.1. These cells have a role in both innate and adaptive immune responses [14
]. Cytokines, such as IL-12 and IL-18, are important activators of NKT cells [15
In this paper we describe experiments in designed to determine the ability of JTT to induce IL-12 and IL-18 and subsequent activation of NKT cells.