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Background Methods Results Conclusion More than 500 randomized controlled trials (RCTs) were selected from various databases by the evidence‐based medicine committee of the Japan Society for Oriental Medicine (JSOM). Their structured abstracts have been published in Japanese and English in “Evidence Reports of Kampo Treatment.”From among these RCTs, “Kampo Best RCTs” were selected according to impact factor and number of Google Scholar citations.Four of the authors in this article presented their data at a symposium at the 74th Congress of the JSOM in June 2024. Kazunari Tominaga was elected as the No. 1 author among the best RCTs. His two articles described the effects of rikkunshito on functional dyspepsia and non‐erosive gastroesophageal reflux disease, respectively. Hidekazu Suzuki was elected as No. 2. His article described the effect of rikkunshito on functional dyspepsia. The No. 3 author, Toshimi Kaido, and No. 4 author, Chu Matsuda, described the effects of daikenchuto on adult gastrointestinal disorder following liver transplant and the effects of hangeshashinto on chemotherapy‐induced stomatitis, respectively. These four articles were all based on double‐blind RCTs. Although a range of hardships were encountered during the studies, these RCTs were reported in original articles, providing clinical evidence of high international reputation.Here, we describe the details and the hardships encountered by the authors, identify points to note in the interpretation of clinical trial results, and finally mention the current status and future prospects of Kampo RCTs. [ABSTRACT FROM AUTHOR]

Cardiomyocyte dysfunction and cardiovascular diseases (CVDs) can be classified as ischemic or non-ischemic. We consider the induction of cardiac tissue dysfunction by intracellular advanced glycation end-products (AGEs) in cardiomyocytes as a novel type of non-ischemic CVD. Various types of AGEs can be generated from saccharides (glucose and fructose) and their intermediate/non-enzymatic reaction byproducts. Recently, certain types of AGEs (Nε-carboxymethyl-lycine [CML], 2-ammnonio-6-[4-(hydroxymetyl)-3-oxidopyridinium-1-yl]-hexanoate-lysine [4-hydroxymethyl-OP-lysine, hydroxymethyl-OP-lysine], and Nδ-(5-hydro-5-methyl-4-imidazolone-2-yl)-ornithine [MG-H1]) were identified and quantified in the ryanodine receptor 2 (RyR2) and F-actin–tropomyosin filament in the cardiomyocytes of mice or patients with diabetes and/or heart failure. Under these conditions, the excessive leakage of Ca2+ from glycated RyR2 and reduced contractile force from glycated F-actin–tropomyosin filaments induce cardiomyocyte dysfunction. CVDs are included in lifestyle-related diseases (LSRDs), which ancient people recognized and prevented using traditional medicines (e.g., Kampo medicines). Various natural compounds, such as quercetin, curcumin, and epigallocatechin-3-gallate, in these drugs can inhibit the generation of intracellular AGEs through mechanisms such as the carbonyl trap effect and glyoxalase 1 activation, potentially preventing CVDs caused by intracellular AGEs, such as CML, hydroxymethyl-OP, and MG-H1. These investigations showed that bioactive herbal extracts obtained from traditional medicine treatments may contain compounds that prevent CVDs. [ABSTRACT FROM AUTHOR]

Lifestyle-related diseases (LSRDs), such as diabetes mellitus, cardiovascular disease, and nonalcoholic steatohepatitis, are a global crisis. Advanced glycation end-products (AGEs) have been extensively researched because they trigger or promote LSRDs. Recently, techniques such as fluorimetry, immunostaining, Western blotting, slot blotting, enzyme-linked immunosorbent assay, gas chromatography-mass spectrometry, matrix-assisted laser desorption-mass spectrometry (MALDI-MS), and electrospray ionization-mass spectrometry (ESI-MS) have helped prove the existence of intra/extracellular AGEs and revealed novel AGE structures and their modifications against peptide sequences. Therefore, we propose modifications to the existing categorization of AGEs, which was based on the original compounds identified by researchers in the 20th century. In this investigation, we introduce the (i) crude, (ii) diverse, and (iii) multiple AGE patterns. The crude AGE pattern is based on the fact that one type of saccharide or its metabolites or derivatives can generate various AGEs. Diverse and multiple AGE patterns were introduced based on the possibility of combining various AGE structures and proteins and were proven through mass analysis technologies such as MALDI-MS and ESI-MS. Kampo medicines are typically used to treat LSRDs. Because various compounds are contained in Kampo medicines and metabolized to exert effects on various organs or tissues, they may be suitable against various AGEs. [ABSTRACT FROM AUTHOR]

Aim: The Japanese government defined integrative/integrated medicine (IM) as "medical practice led by physicians, cooperating with other specialists." Therefore, the basics of comprehensive medical education should be provided in medical universities. We investigated the situation of IM with special reference to Kampo medicines in the national core curricula, national examination standards and the syllabuses for lectures published on the universities' websites. Methods: In the published documents regarding the core curriculum, national examination standards and syllabuses in the academic year 2018, we analyzed whether they include IM. Results: Four kinds of universities offered "Kampo medicine" (Japanese traditional herbal medicine) as their core curriculum. Pharmaceutical universities included "health food", and nursing universities included "alternative medicine". National examination standards for dentists and pharmacists included Kampo medicine, but those for doctors and nurses did not. In the syllabuses of medical universities, 85% included Kampo medicine, but the percentage for IMs was low. The situation was similar in dental universities. All pharmaceutical universities included Kampo medicines and health foods; other IMs were low. The number for all IMs in nursing universities was lower than half. Conclusion: Based on the definition of IM in this paper, we investigated the actual situation of IM education including Kampo in all universities. There were considerable differences between all the faculties. For medical doctor, the Kampo medicines listed in the model core curriculum that are not included in the national examination standard should be rectified. For pharmacists, it is important to deepen the educational contents in this field. [ABSTRACT FROM AUTHOR]

Kampo medicines are Japanese traditional medicines developed from Chinese traditional medicines. The action mechanisms of the numerous known compounds have been studied for approximately 100 years; however, many remain unclear. While components are normally affected through digestion, absorption, and metabolism, in vitro oral, esophageal, and gastric epithelial cell models avoid these influences and, thus, represent superior assay systems for Kampo medicines. We focused on two areas of the strong performance of this assay system: intracellular and extracellular advanced glycation end-products (AGEs). AGEs are generated from glucose, fructose, and their metabolites, and promote lifestyle-related diseases such as diabetes and cancer. While current technology cannot analyze whole intracellular AGEs in cells in some organs, some AGEs can be generated for 1–2 days, and the turnover time of oral and gastric epithelial cells is 7–14 days. Therefore, we hypothesized that we could detect these rapidly generated intracellular AGEs in such cells. Extracellular AEGs (e.g., dietary or in the saliva) bind to the receptor for AGEs (RAGE) and the toll-like receptor 4 (TLR4) on the surface of the epithelial cells and can induce cytotoxicity such as inflammation. The analysis of Kampo medicine effects against intra/extracellular AGEs in vitro is a novel model. [ABSTRACT FROM AUTHOR]