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Inchin-ko-to prevents medium-term liver fibrosis in postoperative biliary atresia patients

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Abstract

The oriental herbal formulation inchin-ko-to (ICKT) inhibits liver cell apoptosis induced by transforming growth factor-beta 1 (TGF-β1). This study evaluated the effect of ICKT on serum markers of liver function and liver fibrosis in postoperative biliary atresia (BA) patients. Twenty-one postoperative BA patients with elevated GOT, GPT and γ-GTP, but normal serum total bilirubin levels, were divided into two groups arbitrarily; an ICKT group (= 12), and a no-ICKT group (n = 9). Serum markers of liver function [GOT, GPT, γ-GTP, total bile acids (TBA)], and serum markers of liver fibrosis [hyaluronic acid (HA), type IV collagen (C-IV)], were measured in both groups at the beginning of the study, and at 1, and 3 years after the beginning of the study and the results compared statistically. All patients tolerated ICKT well, and there were no side effects. In the ICKT group, mean serum HA levels were significantly decreased at 1 year (P < 0.012), and at 3 years, both mean serum HA and C-IV were significantly decreased (P < 0.001 and P < 0.003, respectively). However, mean serum levels of GOT, GPT, γ-GTP, and TBA did not change significantly following ICKT use for any length of time (all P > 0.05). Administration of ICKT in postoperative BA patients appears to lower the serum levels of markers of fibrosis in the medium-term. Whether this in fact correlates with prevention cannot be determined from this paper, but ICKT would appear to protect against liver fibrosis. Long-term studies are required to determine the exact role ICKT plays in prognosis of BA patients.

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References

  1. Altman RP, Lilly JR, Greenfeld J, et al (1997) A multivariable risk factor analysis of the portoenterostomy (Kasai) procedure for biliary atresia: twenty-five years of experience from two centers. Ann Surg 226:348–355

    Article  PubMed  CAS  Google Scholar 

  2. Kobayashi H, Horikoshi K, Yamataka A, et al (2001) Are stable postoperative biliary atresia patients really stable? Pediatr Surg Int 17:104–107

    Article  PubMed  CAS  Google Scholar 

  3. Nittono H, Tokita A, Hayashi M, et al (1988) Ursodeoxycholic acid in biliary atresia. Lancet 1(8584):528

    Article  PubMed  CAS  Google Scholar 

  4. Kiso Y, Ogasawara Y, Hirota K, et al (1984) Antihepatotoxic principles of Artemisia capillaris buds. Planta Med 1:81–85

    Article  Google Scholar 

  5. Takeda S, Endo T, Aburada M (1981) Pharmacological studies on iridoid compounds. III: the choleretic mechanism of iridoid compounds. J Pharmaobiodyn 4:612–623

    CAS  Google Scholar 

  6. Okuno I, Uchida K, Nakamura M, et al (1988) Studies on choleretic constituents in Artemisia capillaris THUNB. Chem Parmacol Bull 36:769–775

    CAS  Google Scholar 

  7. Komiyama T, Tsukui M, Oshiro H (1976) Studies of ‘Inchinkoto’. I. Capillarisin, a new choleretic substances. Yakugaku Zassi 96:841–854

    Google Scholar 

  8. Yamamoto M, Ogawa K, Morita M, et al (1996) The herbal medicine Inchin-ko-to inhibits liver cell apoptosis induced by transforming growth factor beta 1. Hepatology 23:552–559

    PubMed  CAS  Google Scholar 

  9. Kosai K, Matsumoto K, Nagata S, et al (1988) Abrogation of fas-induced fulminant hepatic failure in mice by hepatocye growth factor. Biochem Biophys Res Commun 244: 683–690

    Article  Google Scholar 

  10. Yamamoto M, Miura N, Ohtake N, et al (2000) Genipin, a metabolite derived from the herbal medicine Inchin-ko-to, and suppression of Fas-induced lethal liver apoptosis in mice. Gastroenterology 118:380–389

    Article  PubMed  CAS  Google Scholar 

  11. Kobayashi H, Horikoshi K, Yamataka A, et al (2001) Beneficial effect of a traditional herbal medicine (inchin-ko-to) in postoperative biliary atresia patients. Pediatr Surg Int 17:386–389

    Article  PubMed  CAS  Google Scholar 

  12. Inao M, Mochida S, Matsui A, et al (2004) Japanese herbal medicine Inchin-ko-to as a therapeutic drug for liver fibrosis. J Hepatol 41:584–591

    Article  PubMed  Google Scholar 

  13. Muraji T, Nio M, Ohhama Y et al (2004) Postoperative corticosteroid therapy for bile drainage in biliary atresia—a nationwide survey. J Pediatr Surg 39:1803–1805

    Article  PubMed  Google Scholar 

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Correspondence to Hiroyuki Kobayashi.

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Tamura, T., Kobayashi, H., Yamataka, A. et al. Inchin-ko-to prevents medium-term liver fibrosis in postoperative biliary atresia patients. Pediatr Surg Int 23, 343–347 (2007). https://doi.org/10.1007/s00383-007-1887-9

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