Shosaiko-to (TJ-9), a drug-extract preparation comprised of 7 kinds of herbal components, is one of the most commonly used Kampo medicines being mainly indicated for chronic liver injury in Japan. Recently, over 200 cases of interstitial pneumonia have been reported resulting from TJ-9 therapy.2,3) The cases of interstitial pneumonia have been noted to increase when treated with interferon (IFN)-a and TJ-9 at the same time.4) Accordingly, the combination has been contraindicated in Japan since 1994; however, the mechanisms of interstitial pneumonia induced by TJ-9 and IFN-a are not fully understood. It was observed that TJ-9 and IFN-a inhibited the proliferation of lung fibroblasts and increased the production of interleukin-6 (IL-6) by fibroblasts from healthy subjects and patients with idiopathic pulmonary fibrosis (IPF) in vitro.5) Although interstitial pneumonia induced by TJ-9 and/or IFN-a has been suggested to be caused by an allergic-immunological mechanism rather than toxicity, 4) other possible explanations remain to be investigated.Identification of the biologically active compounds might be a solution in clarifying the serious side effect of this crude drug. As possible candidates, 7 phenolic compounds have been found in human urine after administration of TJ-9 (Fig. 1). 6) They include medicarpin and liquiritigenin derived from Glycyrrhiza glabra; baicalin, baicalein, oroxylin A and wogonin from Scutellaria baicalensis; and davidigenin, a hydrogenated metabolite of liquiritigenin. Since these compounds are actually absorbed into the body and excreted in the urine as free and glucuronide conjugate forms, 7) we hypothesized that they would play an important role for the clinical effects of TJ-9. Therefore, in the current study, we investigated the effects of these 7 compounds and IFN-a on inducing apoptosis in human lung fibroblasts and peripheral Shosaiko-to is a Kampo medicine used for the treatment of chronic hepatitis in Japan. Lately, over 200 cases of interstitial pneumonia have been reported resulting from Shosaiko-to therapy, and the number of cases increased when patients were administrated interferon (IFN)-a a at the same time. However, the mechanisms of this Shosaiko-to implicated interstitial pneumonia are not fully understood. In this study, we examined by flow cytometry analysis the in vitro effects of 7 phenolic compounds (lignans and flavonoids), which were detected from human urine after administration of Shosaiko-to, and IFN-a a on inducing apoptosis in human lung fibroblasts and peripheral blood mononuclear cells (PBMCs). Among the 7 compounds, baicalein and medicarpin (10 m mg/ml) showed significant apoptosis-inducing effects on human PBMCs. In human lung fibroblasts, medicarpin exhibited a significantly higher activity to induce apoptosis compared to the control, and the percentage of cells undergoing apoptosis showed time-and dose-dependent increases. Baicalein (0.1 and 1 m mg/ml), liquiritigenin (10 m mg/ml) and davidigenin (10 m mg/ml) also showed significant effects after 96 h...