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No Significant Effect of Daikenchuto (TJ-100) on Peritoneal IL-9 and IFN-γ Levels After Pancreaticoduodenectomy

Authors Maeda H, Okada K, Fujii T, Oba MS, Kawai M, Hirono S, Kodera Y, Sho M, Akahori T, Shimizu Y, Ambo Y, Kondo N, Murakami Y, Ohuchida J, Eguchi H, Nagano H, Sakamoto J, Yamaue H

Received 27 May 2020

Accepted for publication 12 September 2020

Published 19 October 2020 Volume 2020:13 Pages 461—466

DOI https://doi.org/10.2147/CEG.S262082

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Prof. Dr. Everson L.A. Artifon


Hiromichi Maeda,1,* Ken-ichi Okada,2,* Tsutomu Fujii,3 Mari S Oba,4 Manabu Kawai,2 Seiko Hirono,2 Yasuhiro Kodera,5 Masayuki Sho,6 Takahiro Akahori,6 Yasuhiro Shimizu,7 Yoshiyasu Ambo,8 Naru Kondo,9 Yoshiaki Murakami,9 Jiro Ohuchida,10 Hidetoshi Eguchi,11 Hiroaki Nagano,12 Junichi Sakamoto,13 Hiroki Yamaue2

1Department of Surgery, Kochi Medical School, Nankoku, Kochi 780-8505, Japan; 2Second Department of Surgery, Wakayama Medical University, Wakayama 641-8510, Japan; 3Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan; 4Department of Medical Statistics Faculty of Medicine, Toho University, Ota-ku, Tokyo 143-8540, Japan; 5Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Showa-ku, Nagoya 466-8560, Japan; 6Department of Surgery, Nara Medical University, Kashihara, Nara 634-8521, Japan; 7Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan; 8Department of Surgery, Teine-Keijinkai Hospital, Sapporo, Hokkaido 006-8555, Japan; 9Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan; 10Department of Surgery, Miyazaki Prefectural Miyazaki Hospital, Miyazaki 889-1692, Japan; 11Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan; 12Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan; 13Tokai Central Hospital, Kakamigahara, Gifu 504-8601, Japan

*These authors contributed equally to this work

Correspondence: Hiroki Yamaue
Second Department of Surgery, Wakayama Medical University, Kimiidera, Wakayama 641-8510, Japan
Tel +81-73-441-0613
Email yamaue-h@wakayama-med.ac.jp

Aim and Background: TJ-100 is a traditional Japanese medicine that affects inflammation and gastrointestinal motility, and is used as a preventive and treatment for paralytic ileus. This study aims at determining the effect of TJ-100 on the peritoneal levels of IFN-γ/IL-9, cytokines related to ileus, after pancreaticoduodenectomy (PD) in a clinical setting.
Methods: This was a subsidiary study of the clinical trial investigating the effect of TJ-100 on postoperative bowel function. Ascites was collected from 180 patients using an abdominal drainage tube on postoperative day 1 and 3 after PD (POD 1 or POD 3) and used to measure 27 cytokines. We performed univariate and multivariate analyses using several perioperative variables and administration of TJ-100/placebo to determine the effect of TJ-100 on the levels of IFN-γ and IL-9.
Results: Peritoneal levels of IL-9 and IFN-γ decreased between POD 1 and 3 (Wilcoxon signed-rank test p< 0.001). Multivariate analysis was performed after univariate analysis to select the variables and patients with a body mass index of ≥ 22 kg/m2, older age, use of epidural anesthesia, and longer surgery correlated with the levels of IL-9 and IFN-γ. However, we could not detect a correlation between the use of TJ-100 and cytokine levels in ascites either on POD 1 or 3.
Conclusion: TJ-100 did not affect peritoneal IL-9 and IFN-γ levels after PD. This was in accordance with published clinical findings showing no improvement in bowel function after PD and TJ-100 treatment.

Keywords: TNF, Kampo, Daikenchuto, herbal medicine, pancreatic cancer

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