Kanzo-bushi-to (KBT) is a traditional Japanese herbal medicine (Kampo medicine), which is used in Japan to treat rheumatoid arthritis. In the present study, we investigated the suppressive effect of KBT on collagen-induced arthritis (CIA) and further studied the underlying mechanism. CIA was induced in male DBA/1J mice by immunization with bovine type II collagen, followed by a booster injection 21 d later. KBT was given at a dose of 430 mg/kg/d from three days before the first immunization to the end of the experiment. KBT suppressed CIA development effectively and further protected focal bone erosion and bone destruction as evidenced by the reduced histological score. Histochemical examination revealed that KBT decreased TRAP-positive cells at the synovium-bone interface and at the sites of focal bone erosion, coincident with the findings that RANKL/OPG mRNA ratio was significantly reduced by KBT treatment. KBT also decreased mRNA levels of M-CSF and iNOS in joints and of iNOS in peritoneal macrophages. In conclusion, KBT prevented osteoclast generation by decreasing RANKL/OPG ratio and M-CSF mRNA levels, resulting in reduction in bone erosion and destruction. In addition, KBT has anti-inflammatory effect such as the suppression of iNOS expression in peritoneal macrophages and joints of CIA mice. These finding suggests that KBT is a potential new therapeutic agent for the treatment of RA.Key words Kanzo-bushi-to; Kampo medicine; collagen-induced arthritis; bone destruction; osteoclast 1406Biol. Pharm. Bull. 27(9) 1406-1413 (2004 tis in an induced-arthritis model, CIA mice. 25) Especially, KBT decreased serum anti-type II collagen antibody levels significantly, 25) although such an effect was not seen in other Kampo medicines. These results suggest that the inhibition of arthritis by KBT is ascribed to anti-inflammatory and immunosuppressive effect. We therefore evaluated the effect of KBT on bone destruction in the joints of CIA model mice, as one of the most important aims of RA therapy is to block bone destruction. We provided here several lines of evidence that KBT effectively suppressed bone destruction in arthritic joints, accompaning the reduction of osteotropic factors.