Panax quinquefolium L. (Araliaceae), which grows in the United States and Canada, is known as American ginseng, and is commonly used as herbal medicine in the United States. The heat-processing method to strengthen the efficacy of Panax ginseng has been well defined in Korea based on the long history of ethnopharmacological evidence. It is possible, therefore, that the efficacy of American ginseng may also increase by heat-processing as in Panax ginseng, and this was experimentally studied by us. Based upon chemical and biological activity tests, the scientific evidence underlying the therapeutic potential of heat-processed American ginseng against oxidative stress and related tissue damage was elucidated. The free radical-scavenging active components such as less-polar ginsenosides and Maillard reaction products in American ginseng were significantly increased in a heat-processing temperature-dependent manner, as in Panax ginseng. From animal experiments related to oxidative tissue damage, heat-processed American ginseng showed a renoprotective effect by ameliorating renal dysfunction and reducing elevated nuclear factor-kappa B, N^ε e-(carboxymethyl)lysine, and receptor for advanced glycation endproducts protein expressions in the diabetic rat kidney. This investigation of specified bioactive constituents is important for the development of scientific ginseng-derived drugs from ethnomedicine. The results of the present study call for further testing involving human subjects to clarify the efficacy of dietary heat-processed American ginseng supplementation in diabetics.

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In China, rhubarb is processed by several methods to enhance particular desirable effects and reduce side effects. One of the resultant products is known as 'Jyuku-daiou' (JD) in Japanese (Shu-dahuang in Chinese). In ancient times, there were two methods for preparing JD, steaming and steaming after processing with liquor (liquor-steaming). At present, JD refers to liquor-steamed rhubarb; therefore, the medicinal effect of JD may have changed. In this report, we elucidated the medicinal effects of steamed (St) rhubarb and liquor-steamed rhubarb by searching the Chinese medical literature from ancient times. Next, we compared the contents of the principal compounds in St rhubarb and two types of liquor-steamed rhubarb, rhubarb sprayed with 16% ethanol (as a substitute for huangjiu) before being steamed (LSp + St) and rhubarb soaked in 16% ethanol before being steamed (LSo + St).
In herbological study, we found that JD was used as a remedy for poison, improving blood stasis, and moistening the bowel in ancient times. Furthermore, in chemical study, we found that St and LSp + St had decreased sennoside contents, while LSo + St had an increased anthraquinone content and a decreased sennoside content. Therefore, LSo + St is the only process that increases the contents of anthraquinones, which have anti-bacterial and anti-inflammatory effects that have been linked to detoxification effect, and we think that all processed rhubarbs may have relatively strong blood stasis improving effects due to their decreased sennoside contents. However, we could not confirm that processed rhubarb moistens the bowel.

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Daikenchuto, a Japanese herbal medicine, has been used to treat the gastrointestinal disorder, and it has been recently suggested that one of the mechanisms for the empirical effect of daikenchuto involves humoral changes in the gastrointestinal peptides. We examined daikenchuto's effect on the symptoms of gastrointestinal obstructions and the plasma levels of various gastrointestinal peptides [motilin, calcitonin gene-related peptide (CGRP), vasoactive intestinal polypeptide (VIP), somatostatin, and substance P] in seven patients having obstructions of morphine-induced gastrointestinal motility (constipation). Blood samples were taken before, and on 1, 3, and 7, day after administration, followed by the extracting procedure, and submitted to a highly sensitive enzyme immunoassay system for gastrointestinal peptide-like immunoreactive substances (IS). A clinical efficacy of daikenchuto was achieved in 4 of the 7 patients. Plasma motilin-IS levels in the responder group significantly increased on day 7 after oral administration of daikenchuto compared with the nonresponder group and were closer to the levels of normal subjects. These results suggest that the pharmacological effects of daikenchuto in improvement of morphine-induced constipation are closely related to changes in plasma motilin-IS levels.

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Phase 2 drug-metabolizing enzymes (DMEs), such as glutathione S-transferase (GST) and NAD(P)H:quinone oxidoreductase 1 (NQO1), play a major role in the cellular detoxification of pharmaceutical agents and carcinogens. Previously, we reported the inhibitory effects of human liver microsomal cytochrome P450 3A4 and 2D6, phase 1 DMEs, by extracts from 78 herbal medicines. In the present study, we investigated whether phase 2 DME activity in mammalian cells was affected by the herbal extracts. Among the herbal extracts tested, GST and NQO1 activities in Clone 9 cells, a cultured cell line from normal rat liver, were increased more than 1.5-fold by treatment with Incised Notopterygium Rhizome, Magnolia Bark, Saussurea Root, and Magnolia Flower extracts. On the other hand, both of those activities were decreased to less than one-fifth by treatment with Cassia Bark and Rhubarb extracts. Pretreatment of Clone 9 cells with the former four extracts that induced phase 2 DMEs resulted in protection against the cytotoxicities of the electrophiles menadione and 1-chloro-2,4-dinitrobenzene. In contrast, GST and NQO1 activities in human lung cancer A549 cells, which are known to have a high metabolism and show resistance to anticancer drugs, was significantly decreased by treatment with the Cassia Bark extract. These results suggest that phase 2 DME activity may be modulated by herbal medicines, and the modulation of phase 2 DMEs by herbal medicines might affect the action of concomitant drugs and the detoxification of carcinogens.

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The incidence of immunological disorders, especially autoimmune bullous diseases, is reported to be increasing in number in Japan after World War II. The reason is still unknown, however, change in dietary habits, namely traditional Japanese diet into western one may be one of reasons; western diet typically contains higher calory, and much richer lipid and protein than Japanese food. We report a case of 54-year-old Japanese woman with western lifestyle habits who had recalcitrant, steroid- and diaminodiphenyl sulfone-resistant linear IgA bullous dermatosis, which was corrected by a change to a traditional Japanese diet combined with intraoral saireito, which has been reported to have steroid-sparing effects. Clinically, her lesions consisted of pruritic annular erythema and bullae on the trunk and extremities. Histopathological specimen showed subepidermal blisters, including many neutrophils. Direct immunohistochemistry specimen showed linear deposition of IgA and C3 at the basement membrane. Indirect immunohistochemistry specimen using patient sera onto normal human skin split by 1 mol/l sodium chloride produced no detectable signal. Immunoelectron microscopy specimen using normal human skin and patient sera showed positive diaminobenzidine deposition on the epidermal side of the lamina lucida. Immunoblot using patient sera onto normal human epidermis showed a 97-kD band. We diagnosed this patient as lamina lucida-type IgA bullous dermatosis targeted to the 97-kD linear IgA antigen. Although a combination of betamethasone and diaminodiphenyl sulfone, well-established conventional therapy, did not control the skin symptoms, the patient was well controlled after the addition of this combination of Japanese diet and the Kampo herb therapy, saireito.

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