Lymphocyte Transformation Test is unreliable for the diagnosis of kampo-medicine-induced liver injury.

为了解汉方药物促分裂活性对淋巴细胞转化试验(LTT)的实际影响，我们对一生中未服用汉方药物的患者进行了4种中药的淋巴细胞转化试验，并首次咨询了我科。14例患者入选当归、黄芩，4例患者入选柴胡、甘草。正在接受皮质类固醇或免疫抑制药物治疗或经历过药物过敏的患者被排除在外。每种草药(5g)加入600毫升水中，煮30分钟。浓缩后的提取物与从入选患者身上获得的血液样本一起被提交给生物医学实验室(BML，Inc.)。为了验证中药在临床情况下LTT的实际情况下的效果，采用BML，Inc.进行了LTT的测量，其中12例Toki和Ogon的LTT均为阳性。4例Saiko的LTT均阳性，3例Kanzo的LTT阳性。患者未见嗜酸性粒细胞增多或肝损伤。在本研究中，我们对一生中没有服用过坎布族药物的患者进行了LTT。这些发现表明，中草药的LTT有可能产生假阳性结果，LTT对Kampo药物所致肝损伤的诊断是不可靠的。

To examine actual impact of mitogenic activity by Kampo medicine on the lymphocyte transformation test(LTT), we conducted LTT for four herbs in patients who had taken no Kampo medicine in their life and consulted our department for the first time. Fourteen patients were enrolled for Toki (Angelicae Radix) and Ogon (Scutellariae Radix), and 4 patients were enrolled for Saiko (Bupleuri Radix) and Kanzo (Glycyrrhizae Radix). Patients who were being treated with corticosteroids or immunosuppresive drugs or who had experienced drug allergy were excluded. Each herb (5g) was added to 600 ml of water and boiled for 30 min. The boiled-down extract was submitted to Bio Medical Laboratories (BML, Inc.Japan), along with blood samples obtained from the enrolled patients. To examine the effects of herbs under the actual conditions of the LTT in the clinical situation, measurement of LTTs were performed as described previously ^<2)>by BML, Inc.LTT for both Toki and Ogon were positive in 12 of 14 patients. LTT for Saiko was positive in all 4 patients and LTT for Kanzo was positive in 3 of 4 patients. No eosinophilia or liver injury was observed in the patients. In the present study, we conducted LTT for these herbs in patients who had taken no Kampo medicine in their life. These findings suggests that LTT for the herbs are likely to yield false-positive results and LTT is unreliable for the diagnosis of Kampo-medicine-induced liver injury.