Mechanism of choreito, a formula from Japanese Kampo medicine, for hemorrhagic cystitis

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K19311
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: General internal medicine(including psychosomatic medicine)
• Research Institution: Nagoya University
• Principal Investigator: KAWASHIMA NOZOMU 名古屋大学, 医学部附属病院, 助教 (30772264)
• Research Collaborator: OKUNO Yusuke ; ITO Masafumi
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 漢方医学 / 猪苓湯 / 小児血液・悪性腫瘍 / 造血細胞移植 / 出血性膀胱炎 / BKウイルス / アデノウイルス / アルキル化剤

Outline of Final Research Achievements

Hemorrhagic cystitis is a severe, intractable complication in children treated with alkylating agents for hematological and solid malignancies or for posttransplant infections, such as BK virus or adenovirus. Choreito, a Japanese Kampo medicine prescription, can significantly shorten the interval from the start of treatment to hemostasis of macroscopic hematuria. Evidence from imaging studies indicates that choreito promotes hemostasis by reducing inflammation in the bladder and perivesical connective tissue. The Kampo pattern also indicates decreased inflammation in the urinary system after taking choreito. Based on the clinical findings, animal models were established to investigate the mechanism of action of choreito. Unfortunately, the hemostatic effects of choreito were not observed, which precluded further investigation of the mechanism.

Free Research Field

漢方医学

Academic Significance and Societal Importance of the Research Achievements

アルキル化剤誘発性あるいは造血細胞移植後ウイルス性出血性膀胱炎には確立した治療法がなく対症療法がおこなわれるのみであるため、その治療選択として安価で安全性の高い猪苓湯がその原因を問わず広く出血性膀胱炎に有効であることが証明されたのは社会に貢献したものと思われる。猪苓湯治療による漢方医学的投与目標の改善は客観的画像所見では膀胱周囲組織の炎症所見の改善として表現できうるということが示され、伝統医学と現代医学を結びつける学術的な新知見が得られたことでも意義深いと考えられる。