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

为考察汉布药对有丝分裂活性对淋巴细胞转化试验（LTT）的实际影响，我们对从未服用过汉布药的患者进行了4种中草药的LTT试验，并首次咨询了我科。Toki（当归）和Ogon（黄芩）组14例，Saiko（柴胡）和Kanzo（甘草）组4例。正在接受皮质类固醇或免疫抑制药物治疗或有药物过敏经历的患者被排除在外。每种草药（5g）加入600毫升水，煮沸30分钟。将煮沸的提取物连同从入组患者获得的血液样本一起提交给生物医学实验室（BML, Inc.Japan）。为了检验中草药在临床实际情况下对LTT的影响，我们按照前面所述的^<2)>由BML， inc .进行了LTT测量。14例患者中，Toki和Ogon的LTT均为阳性，其中12例为阳性。Saiko的LTT在所有4例患者中均呈阳性，Kanzo的LTT在4例患者中有3例呈阳性。患者未见嗜酸性粒细胞增多或肝损伤。在本研究中，我们对生活中没有服用过汉布药的患者进行了这些草药的LTT。这些发现表明，LTT对中草药可能产生假阳性结果，LTT对康坡药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.