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Current state of yusho and prospects for therapeutic strategies

  • PCBs Risk Evaluation and Environmental Protection
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Abstract

The mass food poisoning incident yusho occurred in Japan in 1968. It was caused by the ingestion of rice bran oil contaminated with polychlorinated biphenyls and various dioxins and dioxin-like compounds including polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDFs). Notably, PCDFs were found to contribute to approximately 65% of the total toxicity equivalent in the blood of yusho patients. Lipophilic dioxins are retained in the body for a longer period than previously estimated. Victims suffered from characteristic skin manifestations associated with non-specific systemic symptoms, neurological symptoms, and respiratory symptoms. The severe symptoms seen in the initial phase subsequently faded, but recently, improvements have scarcely been observed. The Yusho Group has been researching treatments for this condition. Several clinical trials with chelating agents or dietary fibers aimed at accelerating the excretion of compounds. While some treatments increased dioxin excretion, none provided satisfactory symptom relief. Concurrently, various phytochemicals and herbal extracts have been found to possess biological activities that suppress dioxin-induced toxicity via aryl hydrocarbon receptor or activate the antioxidant nuclear factor-erythroid 2-related factor-2 (NRF2) signal pathway, making them promising therapeutic candidates. Here, we summarize the current status of yusho and findings of clinical trials for yusho patients and discuss the treatment prospects.

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Acknowledgement

We very much appreciate the contribution and participation of the patients in health examinations for follow-up of yusho each year. We also deeply thank all of the members of the study group for their efforts to help and support patients’ health and well-being.

Funding

This work was supported by a grant-in-aid for scientific research from the Japanese Ministry of Health, Labor, and Welfare (Research on Food Safety; H27-Designated Research-017).

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Authors and Affiliations

  1. Research and Clinical Center for Yusho and Dioxin, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Chikage Mitoma & Masutaka Furue

  2. Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan

    Hiroshi Uchi & Masutaka Furue

  3. Department of Obstetrics, Fukuoka Children’s Hospital, Fukuoka, 813-0017, Japan

    Kiyomi Tsukimori

  4. Kitakyushu Life Science Center, Public Interest Incorporated Foundation, Fukuoka, 804-0003, Japan

    Takashi Todaka

  5. Fukuoka Institute of Health and Environmental Sciences, Fukuoka, 818-0135, Japan

    Jumboku Kajiwara

  6. Clinical Research Support Center Kyushu, Fukuoka, 812-8582, Japan

    Takayuki Shimose

  7. Department of Public Health, Health Management and Policy, Nara Medical University School of Medicine, Nara, 634-8521, Japan

    Manabu Akahane & Tomoaki Imamura

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  1. Chikage Mitoma
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  2. Hiroshi Uchi
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  3. Kiyomi Tsukimori
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  7. Manabu Akahane
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  8. Tomoaki Imamura
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  9. Masutaka Furue
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Correspondence to Chikage Mitoma.

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The study project of Keishibukuryogan was approved by the institutional ethics committee of Kyushu University Hospital (reference 27010). The participants received sufficient explanation and agreed in a written consent form.

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The authors declare that they have no conflict of interest.

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Responsible editor: Philippe Garrigues

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Mitoma, C., Uchi, H., Tsukimori, K. et al. Current state of yusho and prospects for therapeutic strategies. Environ Sci Pollut Res 25, 16472–16480 (2018). https://doi.org/10.1007/s11356-017-0833-1

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