Abstract
Purpose
To examine the effect of preoperative administering of a Japanese traditional herbal medicine, Hochu-ekki-to (TJ-41), on immunosuppression induced by surgical stress in patients with gastrointestinal malignancies.
Methods
To monitor the immune functions, the mitochondrial membrane potential (MMP) and natural killer (NK) cell activity prior to and following operation were measured in peripheral blood lymphocytes (PBL) in patients with (n = 20) or without (n = 27) the preoperative administering of TJ-41 for 7 days. The plasma catecholamine and interleukin (IL)-6 levels were also analyzed prior to and following the operation.
Results
The numbers of MMP-high CD56-positive cells (NK cells) and NK cell activities in the TJ-41-treated group were significantly higher than those in the control group (P = 0.026 and P = 0.037, respectively). An elevation of plasma noradrenaline and IL-6 following surgery was also inhibited by the preoperative administering of TJ-41 (P = 0.023 and P = 0.039, respectively). A positive correlation between MMP-high CD56-positive cell numbers and NK cell activity in PBL treated with carbonyl cyanide m-chlorophenyl hydrazone (CCCP) in vitro suggested that MMP measurement in CD56-positive cells can serve as a convenient alternative to evaluate the NK cell activity.
Conclusion
Our findings suggest that the preoperative administering of TJ-41 prevents surgical stress-induced immunosuppression by maintaining the NK cell activity and inhibiting the elevation of stress mediators.
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References
Hirai T, Matsumoto H, Yamashita K, Urakami A, Ikai K, Yamamura M, et al. Surgical oncotaxis &3-excessive surgical stress and postoperative complications contribute to enhancing tumor metastasis, resulting in a poor prognosis for cancer patients. Ann Thorac Cardiovasc Surg 2005;11:4–6.
Shakhar G, Ben-Eliyahu S. Potential prophylactic measures against postoperative immunosuppression: could they reduce recurrence rates in oncological patients? Ann Surg Oncol 2003; 10:972–992.
Ben-Eliyahu S, Page GG, Yirmiya R, Shakhar G. Evidence that stress and surgical interventions promote tumor development by suppressing natural killer cell activity. Int J Cancer 1999;80:880–888.
Shakhar G, Ben-Eliyahu S. In vivo beta-adrenergic stimulation suppresses natural killer activity and compromises resistance to tumor metastasis in rats. J Immunol 1998;160:3251–3258.
Takabayashi A, Kanai M, Kawai Y, Iwata S, Sasada T, Obama K, et al. Change in mitochondrial membrane potential in peripheral blood lymphocytes, especially in natural killer cells, is a possible marker for surgical stress on the immune system. World J Surg 2003;27:659–665.
Kuroiwa A, Liou S. Hochu-ekki-to. J Integr Med 2005;15:79–81.
Nishida S. Effect of Hochu-ekki-to on asymptomatic MRSA bacteriuria. J Infect Chemother 2003;9:58–61.
Tokura Y, Sakurai M, Yagi H, Furukawa F, Takigawa M. Systemic administration of Hochu-ekki-to (Bu-Zhong-Yi-Qi-Tang), a Japanese-Chinese herbal medicine, maintains interferon-gamma production by peripheral blood mononuclear cells in patients with mycosis fungoides. J Dermatol 1998;25:131–133.
Kumazawa Y, Takimoto H, Miura S, Nishimura C, Yamada A, Kawakita T, et al. Activation of murine peritoneal macrophage by intraperitoneal administration of traditional Chinese herbal medicine, Xiao-Chai-Hu-Tang (Japanese name: Shosaiko-To). Int J Immunopharmacol 1998;10:395–403.
Li XY, Takimoto H, Miura S, Yoshikai Y, Matsuzaki G, Nomoto K. Effects of a traditional Chinese medicine, bu-zhong-yi-qi-tang (Japanese name: Hochu-ekki-to) on the protection against Listeria monocytogenes infection in mice. Immunopharmacol Immunotoxicol 1992;14:383–402.
Hossain MS, Takimoto H, Hamano S, Yoshida H, Ninomiya T, Minamishima Y, et al. Protective effects of Hochu-ekki-to, a Chinese traditional herbal medicine against murine cytomegalovirus infection. Immunopharmacology 1999;41:169–181.
Mori K, Kido T, Daikuhara H, Sakakibara I, sakata T, Shimizu K, et al. Effect of Hochu-ekki-to (TJ-41): a Japanese herbal medicine, on the survival of mice infected with influenza virus. Antiviral Res 1999;44:103–111.
Abe S, Tansho S, Ishibashi H, Akagawa G, Komatsu Y, Yamaguchi H. Protection of immunosuppressed mice from lethal Candida infection by oral administration of a kampo medicine, Hochu-ekki-to. Immunopharmacol Immunotoxicol 1999;21:331–342.
Utsuyama M, Seidlar H, Kitagawa M, Hirokawa K. Immunological restoration and anti-tumor effect by Japanese herbal medicine in aged mice. Mech Ageing Dev 2001;122:341–352.
Saiki I. A Kampo medicine “Juzen-taiho-to” prevention of malignant progression and metastasis of tumor cells and the mechanism of action. Biol Pharm Bull 2000;23:677–688.
Cho JM, Sato N, Kikuchi K. Prophylactic anti-tumor effect of Hochu-ekki-to (TJ41) by enhancing natural killer cell activity. In Vivo 1991;5:389–391.
Ohtake N, Nakai Y, Yamamoto M, Sakakibara I, Takeda S, Amagaya S, et al. Separation and isolation methods for analysis of the active principles of Sho-saiko-to (SST) oriental medicine. J Chromatogr B Analyt Technol Biomed Life Sci 2004;812;135–48.
Iwata S, Taki Y, Kawai Y, Kanai M, Takabayashi A. Mitochondrial membrane potential is reduced in peripheral natural killer cells following partial hepatectomy. Immunol Lett 2002;82:225–233.
Rottenberg H, Wu S. Quantitative assay by flow cytometry of the mitochondrial membrane potential in intact cells. Biochem Biophys Acta 1998;1404;393–404.
Pross HF, Baines MG. Spontaneous human lymphocyte-mediated cytotoxicity against target cell. I: The effect of malignant disease. Int J Cancer 1976;18:593–601.
Bryant J, Day R, Whiteside TL, Herberman RB. Calculation of lytic units for the expression of cell-mediated cytotoxicity. J Immunol Methods 1992;146:91–103.
Kim S, Iizuka K, Aguila HL, Weissman IL, Yokoyama WM. In vivo natural killer cell activities revealed by natural killer cell-deficient mice. Proc Natl Acad Sci 2000;97:2731–2736.
Tönnesen E, Wahlgreen C. Influence of extradural and general anaesthesia on natural killer cell activity and lymphocyte subpopulations in patients undergoing hysterectomy. Br J Anaesth 1988;60:500–507.
Tanabe H. Study of effect of surgical stress on immunity in patients with gastrointestinal cancer. Arch Jpn Chir 1993;62:145–152.
Vallejo R, Hord ED, Barna SA, Santiago-Palma J, Ahmed S. Perioperative immunosuppression in cancer patients. J Environ Pathol Toxicol Oncol 2003;22:139–146.
Li T, Tamada K, Abe K, Tada H, Onoe Y, Tatsugami K, et al. The restoration of the antitumor T cell response from stress-induced suppression using a traditional Chinese herbal medicine Hochu-ekki-to (TJ-41:Bu-Zhong-Yi-Qi-Tang). Immunopharmacology 1999;43:11–21.
Kuroiwa A, Liou S, Yan H, Eshita A, Naitoh S, Nagayama A. An effect of a traditional Japanese herbal medicine: Hochu-ekki-to (Bu-Zhong-Yi-Qi Tang), on immunity in elderly persons. Int Immunopharmacol 2004;4:317–324.
Weissman C. The metabolic response to stress: an overview and update. Anesthesiology 1990;73:308–327.
Blalock JE. The syntax of immune-neuroendocrine communication. Immunol Today 1994;15:504–511.
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Kimura, M., Sasada, T., Kanai, M. et al. Preventive effect of a traditional herbal medicine, Hochu-ekki-to, on immunosuppression induced by surgical stress. Surg Today 38, 316–322 (2008). https://doi.org/10.1007/s00595-007-3631-4
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DOI: https://doi.org/10.1007/s00595-007-3631-4