Clinical Gastroenterology Vol.33 No.11(3-1)

Theme Kampo Medicine for Gastrointestinal Diseases -- Theory and Practice
Title The Action Mechanism of Rikkunshito as a Ghrelin Enhancer
Publish Date 2018/10
Author Hiroshi Takeda Hokkaido University Graduate School of Pharmaceutical Sciences
Author Naoto Okubo Hokkaido University Graduate School of Pharmaceutical Sciences
Author Koji Nakagawa Hokkaido University Graduate School of Pharmaceutical Sciences
Author Shunsuke Ohnishi Third Department of Internal Medicine (Gastroenterology and Hematology), Hokkaido University Graduate School of Medicine
Author Naoki Fujitsuka Tsumura " Co.
Author Tomohisa Hattori Tsumura " Co.
[ Summary ] Rikkunshito has been used in Japan for treatment of upper gastrointestinal (GI) symptoms of patients with functional dyspepsia (FD), gastroesophageal reflux disease (GERD), postoperative dyspeptic symptoms of patients who have undergone GI surgery, and chemotherapy-induced dyspepsia in cancer patients. Recently, a novel mechanism of Rikkunshito was reported: oral administration of Rikkunshito potentiated orexigenic action of ghrelin through several mechanisms. In addition, several lines of evidence obtained from both animal and human studies indicated that Rikkunshito is an attractive and promising therapeutic option for patients' anorectic conditions including cisplatin-induced dyspepsia, anorexia of aging, stress-induced hypophagia, cancer cachexia-anorexia syndrome, and drug-related anorexia. This review highlighted our current understanding of the orexigenic action of Rikkunshito with special focus on its interaction with the ghrelin signaling system.
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