Theoretical basis for herbal medicines, Tokishakuyaku-san and Sairei-to, in the treatment of autoimmunity-related recurrent abortion by correcting T helper-1/T helper-2 balance.
OBJECTIVE
To get insight into the basis for the empirical usage of herbal medicines in the treatment of recurrent abortion, we examined whether Tokishakuyaku-san (Toki) and Sairei-to (Sai) modulate T helper-1 (Th1) and T helper-2 (Th2) cytokine release from peripheral blood mononuclear cells (PBMCs). The effects of these medicines were investigated as related to human leukocyte antigen (HLA)-G, a non-classical HLA class I antigen expressed on trophoblasts and a putative crucial player involved in fetomaternal immune interplay.


RESULTS
Toki and Sai increased the release of Th1 group cytokines, tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma while preserving the inhibitory effect of HLA-G on the release of these cytokines. As for Th2 group cytokine release, Toki was without effect in modulating interleukin (IL)-4 release, regardless of the presence of HLA-G, whereas Sai nullified the effect of the presence of HLA-G to stimulate the release of IL-4 without affecting its release in the absence of HLA-G.


CONCLUSIONS
Toki and Sai may have therapeutic potential, particularly in autoimmunity-related recurrent abortion where Th2 response is pathologically enhanced, but not in recurrent abortion involving alloimmune fetomaternal derangement, a condition of, rather, an enhanced Thl response.
Fujii
T
T
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan. fujiit-tky@umin.ac.jp
Kanai
T
T
Kozuma
S
S
Hamai
Y
Y
Hyodo
H
H
Yamashita
T
T
Miki
A
A
Unno
N
N
Taketani
Y
Y
D000026:Abortion, Habitual / Q000628:therapy*; D000328:Adult; D015551:Autoimmunity / Q000187:drug effects*; D001565:Benzoates; D001952:Bridged-Ring Compounds; D020170:Caspase 1 / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism*; D004365:Drugs, Chinese Herbal / Q000494:pharmacology*; D005260:Female; D005960:Glucosides / Q000494:pharmacology*; D006680:HLA Antigens / Q000494:pharmacology; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I / Q000494:pharmacology; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D039821:Monoterpenes; D006377:T-Lymphocytes, Helper-Inducer / Q000187:drug effects*; D018417:Th1 Cells / Q000187:drug effects; D018418:Th2 Cells / Q000187:drug effects; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D006027:Glycosides
D001565:Benzoates; D001952:Bridged-Ring Compounds; D020170:Caspase 1; D016207:Cytokines; D004365:Drugs, Chinese Herbal; D005960:Glucosides; D006680:HLA Antigens; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I; D007371:Interferon-gamma; D039821:Monoterpenes; D014409:Tumor Necrosis Factor-alpha; C080903:sairei-to; C015423:peoniflorin; D006027:Glycosides