Investigations of Free Anthraquinones from Rhubarb Against alpha-Naphthylisothiocyanate-induced Cholestatic Liver Injury in Rats.

Basic Clin Pharmacol Toxicol. 2009 Mar 10; Zhao YL, Wang JB, Zhou GD, Shan LM, Xiao XHThe protective effects of anthraquinones from Rhubarb, a Chinese herbal medicine, consisting of the root and rhizome of Rheum palmatum L., R. tanguticum Maxim. Ex Balf., or R. officinale Baill. (family Polygonaceae) were investigated and compared in rats with liver injury induced by alpha-naphthylisothiocyanate. alpha-Naphthylisothiocyanate was given intragastrically in rats, liver injury with cholestasis developed within 36 hrs, as indicated by characteristic serum levels of glutamate-pyruvate transaminase, glutamic oxaloacetic transaminase, total bilirubin, direct bilirubin, alkaline phosphatase, gamma-glutamyltransferase and total bile acid. The intragastrical administration of rhein, aloe-emodin and physione to alpha-naphthylisothiocyanate-treated rats reduced significantly the serum level of both glutamate-pyruvate transaminase, glutamic oxaloacetic transaminase and the serum total bilirubin, direct bilirubin, alkaline phosphatase, gamma-glutamyltransferase and total bile acid. For all hepatic biochemical markers and cholestasis index, rhein was most efficient. By comparison, the administration of emodin and chrysophanol did not reduce the serum levels of hepatic enzymes glutamate-pyruvate transaminase and glutamic oxaloacetic transaminase but decreased the levels of serum total bilirubin, direct bilirubin, alkaline phosphatase, gamma-glutamyltransferase, and total bile acid, showing their partial protective effects on cholestatic liver injury. The liver in alpha-naphthylisothiocyanate-treated rats showed cholangiolitic hepatitis characterized by intrahepatic cholestasis, necrosis of hepatocytes and biliary epithelial cells and bile obstruction. The concurrent intragastrical administration of rhein reduced the severity of all morphological alteration, especially the neutrophil infiltration and sinusoid congestion. Rhein, aloe-emodin, and physione all exhibited protective effects on hepatocytes and cholangiocytes against alpha-naphthylisothiocyanate-induced damage, whereas emodin and chrystophanol provided partial protection.

Current status of Kampo (Japanese herbal) medicines in Japanese clinical practice guidelines.

Complement Ther Med. 2009 Jun; 17(3): 147-54Motoo Y, Arai I, Hyodo I, Tsutani KBACKGROUND AND AIMS: Kampo (Japanese herbal) medicines are often used in clinical practice in Japan. However, it is unclear how Kampo medicines are quoted and evaluated in current clinical practice guidelines (CPGs). Here, we systematically reviewed Japanese CPGs, and aimed to reveal how Kampo medicines are described in the CPGs. MATERIALS AND METHODS: We reviewed the quasi-comprehensive list of Japanese CPGs available from the Toho University Medical Media Center (TUMMC) having the largest data base on Japanese CPGs, and also used a hand search. CPGs containing Kampo products were classified into three types based on how Kampo was handled. CPGs that provided recommendations based on evidence were classified as "type A". Those which cited references but did not provide any recommendations were classified as "type B". Those which described the Kampo practice or Kampo-related terms without providing any relevant references were classified as "type C". RESULTS: By the end of March of 2007, 35 (10.1%) of 346 CPGs listed by TUMMC contained descriptions of Kampo products. We discovered one Kampo-related CPGs in a hand search process. Of these 36 CPGs, 6 were "type A", 13 were "type B", and 17 were "type C". Although results from pertinent randomized controlled trials (RCTs) were available, we noticed that some well-known RCTs studying Kampo medicines are missing in corresponding CPGs. CONCLUSIONS: We revealed that the citation rate of Kampo medicines in CPGs was approximately 10% and that some pivotal trials for Kampo medicines were not quoted in CPGs. Kampo medicines in CPGs should be assessed more comprehensively and scientifically.