Influenza A virus infection causes acute respiratory syndrome and leads to sometimes lethal diseases includ ing pneumonia. Identifying host factors involved in pathogenesis is important for the prevention and treatment of influenza. Type I interferons (IFNs) are essential to activating antiviral responses against influenza A virus. We show that the viral polymerase complex inhibited IFNβ promoter activation. Moreover, PB 2 inhibited the transcription of endogenous IFNβ gene induced after influenza A virus infection. The viral polymerase is critical for regulating host anti-viral response through binding to IPS-1 and inhibition of IFNβ production.
We also demonstrated that Siva-1 is crucial for apoptosis induction by influenza A virus and is involved in its viral replication. Expression of Siva-1 enhanced apoptosis induction after influenza A virus infection and knockdown of Siva-1 expression strongly inhibited it. Furthermore, the replication of influenza A virus was significantly suppressed by Siva-1 knockdown.
Recently, we examined the inhibitory effects of some herbal medicines on influenza A virus replication. Ex tracts of gingyosan and maoto had inhibitory effects for the replication of influenza A viruses. We analyzed the effect of fractions of these extracts and analyzed the main ingredients with a HPLC system.

We report the case of an 84-year-old woman with advanced biliary tract cancer and accompanying colonic invasion and hepatic metastasis, who was successfully treated with single-agent gemcitabine chemotherapy in combination with juzentaihoto (a traditional Japanese herbal medicine). Response to this combination chemo therapy was extremely good, and the patient's tumors disappeared. There have been no reports like our case until today. These findings suggest that combined treatment with juzentaihoto and gemcitabine is effective not only for reducing tumor size, decreasing the side effects of chemotherapy, and maintaining general condition but also for mediating immune antitumor activity.

We report a patient who was successfully treated with a herbal formulation of goreisan (Wu-ling-san) for recurrent vomiting associated with pyloric stenosis, with significant simultaneous improvement of congestive heart failure.
A 78-year-old woman was in a bedridden state after cerebral infarction and was being fed through a nasal tube. She often experience repeated vomiting and aspiration pneumonia. Cicatricial stenosis was found in the pyloric region and we performed an expansion operation with balloon endoscopy. However, symptoms did not improve and her heart failure worsened. Therefore, we administered goreisan. Urinary output volume increased, edematous changes gradually disappeared, and pleural effusion decreased. The stenosis-related lesion did not change, but the vomiting ceased, even after nasal tube feeding was resumed.
Goreisan is an herbal formula used to promote diuresis that is considered to correct water absorption in digestive organs. In this case, goreisan was effective for the improvement of many symptoms.

[Objectives] To investigate the long-term effect of Kampo medicine on the ocular manifestations of Behçet's disease based on 30-years of experience.
[Patients] The number of patients who consulted Yamamoto Eye Clinic on Kampo medicine over a 30-year period was 24, and we investigated and reviewed these patients.
[Results] Although 11 patients discontinued treatment within a few months and 2 patients left our clinic after a short time, we were able to continue Kampo treatment in 11 patients for more than 10 years, with the longest period being 26 years. Consequently, 8 patients recovered their visual acuity.
[Discussion] Our retrospective study indicates that continuous treatment using Kampo medicine reduces the frequency of uveitis attacks and disease activity. In addition, it may be possible to discontinue Kampo medicine if patients achieve and maintain a better condition despite there being several factors that deteriorate their condition. Our study also indicates the importance of more than 10-years follow up to evaluate the efficacy of any intervention for this chronic disease.
[Conclusions] Kampo medicine is effective for preventing the recurrence of uveitis in patients with Behçet's disease.

It is thought that meirouin was created by Toukaku Wada, originally. Although prescriptions were applied for ophthalmologic disease at first, such case reports have decreased recently. Here, we report that meirouinkakikuka was successful for serous retinal detachment complicated with an abnormal visual field during postpartum.
We present the case of a 34 year old Japanese woman. Tinnitus had appeared from 35 weeks of pregnancy. Blood pressure rose to 140/100 mmHg at 36 weeks of pregnancy, the patient was diagnosed with preeclampsia,and hospitalized. After hospitalization, blood pressure was rose further to 190/120 mmHg, and an emergency cesarean section was performed. On the 2 nd postpartum (post operation) day her field of view became yellowed and eyesight failure arose. She was diagnosed as hypertensive retinopathy and serous retinal detachment by an ophthalmologist. She stopped applying her eyewash treatment herself because she was feeling unwell. One week afterward, she desired Kampo treatments. Meirouinkakikuka was prescribed, the tinnitus disappeared in 2 weeks, furthermore, her retinal detachment was recovered from 4 weeks later. Thus we believe that Kampo treatments can be a viable alternative, as suggested by this case where application of an eyewash treatment was difficult.

We report a case of acute chronic obstructive pulmonary disease (COPD) exacerbation caused by bacterial pneumonia infection, which was successfully resolved using saikokeishito. An 86-year-old woman with COPD presented with fever. Chest radiography and computed tomography (CT) confirmed bacterial pneumonia and she was admitted. Antibiotic therapy was started, but it had to be discontinued shortly thereafter because the patient developed drug rash. Oral saikokeishito was administered, as an alternative medicine, after which the patient showed dynamic improvements in pneumonia, and other general complaints such as respiratory dysfunction, fever, delirium, and appetite loss.
Saikokeishito is known to trigger various biomedical effects such as stimulation of anti-inflammatory and antipsychotic functions and autoimmune regulation.
Although antibiotic therapy is, without doubt, the most efficient treatment for acute bacterial pneumonia, in cases where antibiotic treatment is not possible, Kampo therapy may be used as an alternative treatment method for improving the condition and other complaints.
In future, more sequential case reports showing the use of Kampo therapy in acute respiratory medicine would be necessary to establish conclusive evidence for the use of this therapy as an alternative treatment method.

In oriental medicine, when an exopathogen enters the body, the inner spirits (内精) and the exopathogen conflict with each other. Disease occurs in this deficient condition of inner spirits. In most classical formulary, such as the Shanghanlun (傷寒論), the cause of disease is regarded as the external circumstance, such as the cold, the wind or warmth. Here, the authors surveyed the significance of exopathogens and endogenous factors in medical books such as the Shanghanlun, as well as the Jinkuiyaolue (金匱要略), the Suwen (素問), the Lingsue (霊枢) and the others, to obtain the results herein. In the original pathology of a disease concurrent with both an exogenous and an endogenous factor, there is conflict between well-regulated seasonal Qi (四時正気) and unregulated inner spirits. Previous to the development of internal mechanisms for disease causes,this concurrent pathology thinking is concerned significantly with the external world and Shenxien (神仙) thought. Furthermore ambiguities arise from various relationships between exogenous factors and endogenous factors.

Tenmin NAMIKAWA (並河天民) thought the Shanghanlun (傷寒論) was an important text. He also taught his pupils the importance of prescribing Zhongjing ZHANG's (張仲景) medicines. Ryokyu ARIMA (有馬凉及) was a physician-teacher, who prescribed Chengqitang (承気湯) for the emperor without conferring with other doctors. His chengqitang formulary was derived from medical texts by Zhongjing ZHANG. Kyugo GODA (合田求吾) on the other hand, was a pupil of Ikkannsai MATSUBARA (松原一閑斎), who wrote in the Idokikigaki (医道聞書) : theKoho (古方) school started by Ryokyu ARIMA. He was a hero who was punished by the Goseiin (後西院) emperor. He taught Koho to Tenmin. This therefore reveals that Ryokyu ARIMA was a teacher who taught the importance of the Shanghanlun.

From around 1990, it has been suggested that our internal defense system is composed of two distinct elements ; local innate immunity principally arranged on surface areas to establish barriers against various pathogens, and systemic acquired immunity mainly seen in systemic compartments to survey and control internal damage and disorders. The former innate surface barrier is chiefly regulated via species-restricted CD 1 antigen-presenting molecules, through lipid/glycolipid antigens presented mainly by dendritic cells (DCs) and lacking antigen-specific memory through gene-rearrangements, while the latter acquired barrier is controlled by individually restricted MHC molecules and gains antigen-specific memory through gene-rearrangements. Surprisingly, it had been revealed more than 2,000 years before in the ancient Chinese medicine textbook, Ko-tei-nai-kei, that our defense system is also classified into two categories, named “defense-qi” and “nutritional-qi”, and shown that the former “defense-qi” is arranged at the surface of skin to control our sweat and interact with “muddy” substances, while the latter “nutritional-qi” is situated on and within blood vessels and produces purified nutrients from food, drink and other exogenous substances. In this review, based on our recent understanding of immunological progress and the modern concepts of immunity, the possible relationship between “defense-qi” and innate immunity as well as “nutritional-qi” and acquired immunity are discussed.

It has been popular to group various renal disorders under chronic kidney disease (CKD). And, angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB) drugs are used as the first choice for treatment of CKD with hypertension. Here, however, I review some Kampo treatments. To begin with, shichimotsukokato is a promising formula for the treatment of CKD in combination with ACE inhibitors/ARBs. The effects of hachimijiogan show promise for the inhibition of diabetic nephropathy through basic studies using experimental models. And, recent evaluations have revealed the efficacy and usefulness of saireito, in reducing steroid dose for the treatment of glomerulonephritis and primary nephrotic syndrome. Moreover, when considering disease backgrounds, saibokuto is useful in the patients with IgA nephropathy accompanied by frequent episodes of upper respiratory infection, while saireito is occasionally effective for nephrotic syndrome with allergic disorder. Saireito has also been reported to be effective in childhood IgA nephropathy in a prospective controlled study. The effects of onpito, on the other hand, are reported to prevent or postpone the introduction of dialysis in pre-dialysis patients with chronic renal failure. And furthermore, for the treatment of hemodialysis patients, goreisan efficacy has been reported for the difficulty of fluid removal, while saireito is promising for the treatment of peritoneal fibrosis due to peritoneal dialysis.