title: Inchin-ko-to prevents medium-term liver fibrosis in postoperative biliary atresia patients.
abstract: The oriental herbal formulation inchin-ko-to (ICKT) inhibits liver cell apoptosis induced by transforming growth factor-beta 1 (TGF-beta1). 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 gamma-GTP, but normal serum total bilirubin levels, were divided into two groups arbitrarily; an ICKT group (n = 12), and a no-ICKT group (n = 9). Serum markers of liver function [GOT, GPT, gamma-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, gamma-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.
authors.affiliation: Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Tamura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Yamataka
authors.forename: Geoffrey J
authors.initials: GJ
authors.lastname: Lane
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Koga
authors.forename: Takeshi
authors.initials: T
authors.lastname: Miyano
mesh_terms: D017209:Apoptosis / Q000187:drug effects; D001656:Biliary Atresia / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D002675:Child, Preschool; D002756:Cholagogues and Choleretics / Q000627:therapeutic use*; D024141:Collagen Type IV / Q000097:blood; D018450:Disease Progression; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D011183:Postoperative Complications; D011379:Prognosis; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D015415:Biomarkers; D002756:Cholagogues and Choleretics; D024141:Collagen Type IV; D004365:Drugs, Chinese Herbal; C078038:inchinko-to; D006820:Hyaluronic Acid