The efficacy of ma-huang-tang (maoto) against influenza

Saita, Mizue; Naito, Toshio; Boku, Soushin; Watanabe, Yukiko; Suzuki, Mai; Oka, Fukuko; Takahashi, Miki; Sakurai, Takako; Sogihara, Eiichiro; Haniu, Tomomi; Uehara, Yuki; Mitsuhashi, Kazunori; Fukuda, Hiroshi; Isonuma, Hiroshi; Lee, Keiko; Kobayashi, Hiroyuki

doi:10.4236/health.2011.35052

Cited by 15 publications

(10 citation statements)

References 4 publications

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“…We also found that maoto was the most common kampo formula used in the chills without sweating cluster, but in the other two clusters patients used two or more kampo formula medicines. Various reports have suggested that the kampo formula, maoto, decreases the length of the febrile period in influenza patients .…”

Section: Discussionmentioning

confidence: 99%

Classification of acute phase febrile upper respiratory tract infection: Retrospective chart review

Yoshino

Takada

Horiba

et al. 2017

Traditional & Kampo Medicine

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Aim: Acute upper respiratory tract infections (URI) are a common problem in primary care settings. In traditional East Asian medicine, URI are categorized into three major disorders: influenza-like; common cold; and warmth disorders. The categorization of acute febrile URI, however, is yet to be ascertained. Here, we conducted a single-center retrospective chart review and classification of the various symptoms of acute phase febrile URI. Methods: A retrospective chart review between December 2013 and May 2015 was performed. We included febrile (≥38 C) patients with upper respiratory symptoms within 48 h from the onset of fever. Patient profile and symptoms were investigated at the first consultation and clusters were constructed based on symptoms. Results: The study included 135 patients. Patients were divided into two groups, day 1 and day 2, according to the time from fever onset. The incidence rate of symptoms, such as general fatigue and muscle pain, were higher in day 1 visitors. Local symptoms, including cough, sore throat, and nasal symptoms, were more frequent in day 2 visitors. Three clusters were observed: chills without sweating (60.0%); chills with sweating (23.0%); and without chills (17.0%). Conclusion: Symptoms in acute fever vary. The present three clusters observed suggest that the classical classification of febrile disease is still true. Further studies are necessary to confirm the course of febrile URI described in classical textbooks.

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Section: Discussionmentioning

confidence: 99%

Classification of acute phase febrile upper respiratory tract infection: Retrospective chart review

Yoshino

Takada

Horiba

et al. 2017

Traditional & Kampo Medicine

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“…Clinical studies have shown that maoto has antipyretic 2 , 3 and anti-malaise effects 4 in children, and improves flu symptoms with efficacy comparable to that of neuraminidase inhibitors in adults infected with influenza A virus. 5 , 6 Experimentally, maoto has been shown to decrease viral titer, while exerting an antipyretic effect. 7 Furthermore, the herbal compounds in maoto have been reported to have various modulating effects on the host’s immune system, including Toll-like receptors (TLR) 8 – 14 and a direct inhibitory effect on viral growth.…”

Section: Introductionmentioning

confidence: 99%

Deconstructing the traditional Japanese medicine “Kampo”: compounds, metabolites and pharmacological profile of maoto, a remedy for flu-like symptoms

et al. 2017

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Pharmacological activities of the traditional Japanese herbal medicine (Kampo) are putatively mediated by complex interactions between multiple herbal compounds and host factors, which are difficult to characterize via the reductive approach of purifying major bioactive compounds and elucidating their mechanisms by conventional pharmacology. Here, we performed comprehensive compound, pharmacological and metabolomic analyses of maoto, a pharmaceutical-grade Kampo prescribed for flu-like symptoms, in normal and polyI:C-injected rats, the latter suffering from acute inflammation via Toll-like receptor 3 activation. In total, 352 chemical composition-determined compounds (CCDs) were detected in maoto extract by mass spectrometric analysis. After maoto treatment, 113 CCDs were newly detected in rat plasma. Of these CCDs, 19 were present in maoto extract, while 94 were presumed to be metabolites generated from maoto compounds or endogenous substances such as phospholipids. At the phenotypic level, maoto ameliorated the polyI:C-induced decrease in locomotor activity and body weight; however, body weight was not affected by individual maoto components in isolation. In accordance with symptom relief, maoto suppressed TNF-α and IL-1β, increased IL-10, and altered endogenous metabolites related to sympathetic activation and energy expenditure. Furthermore, maoto decreased inflammatory prostaglandins and leukotrienes, and increased anti-inflammatory eicosapentaenoic acid and hydroxyl-eicosapentaenoic acids, suggesting that it has differential effects on eicosanoid metabolic pathways involving cyclooxygenases, lipoxygenases and cytochrome P450s. Collectively, these data indicate that extensive profiling of compounds, metabolites and pharmacological phenotypes is essential for elucidating the mechanisms of herbal medicines, whose vast array of constituents induce a wide range of changes in xenobiotic and endogenous metabolism.

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“…Maoto (Ma-Huang-Tang in Chinese) is traditionally prescribed for acute febrile diseases or upper respiratory tract infection [9,10]. We and others previously reported in nonrandomized [11,12] and randomized controlled trials [13,14] that maoto has clinical efficacy for seasonal influenza, without severe adverse effects. In our study of adult patients randomly assigned maoto granules, oseltamivir, or zanamivir, analysis was done of the duration of fever, total symptom score, and viral shedding.…”

Section: Introductionmentioning

confidence: 99%

Maoto, a Traditional Japanese Herbal Medicine, Inhibits Uncoating of Influenza Virus

Masui

Nabeshima

Ajisaka

et al. 2017

Evidence-Based Complementary and Alternative Medicine

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We previously reported in randomized controlled trials that maoto, a traditional herbal medicine, showed clinical and virological efficacy for seasonal influenza. In this study, a culturing system for influenza was used to test the effect of maoto. A549 cells in the culture were infected with influenza virus A (PR8) and followed after treatment with maoto; the virus titers in the culture supernatant, intracellular viral proteins, and viral RNA were determined. When infected cells were cultured with maoto for 24 hr, the virus titer and protein were significantly reduced compared with medium only. Other subtypes, A/H3N2, H1N1pdm, and B, were also inhibited by maoto. Proliferation of viral RNA in a 6 hr culture was inhibited by maoto in the early phase, especially in the first 30 min. Focusing on the entry step of the influenza virus, we found that endosomal pH, regulated by vacuolar-type H+ ATPase (V-ATPase) located in the membrane, was increased when treated with maoto. We also found that uncoating of influenza viruses was also inhibited by maoto, resulting in the increase of the number of virus particles in endosomes. These results strongly suggest that the inhibition of endosomal acidification by maoto results in blocking influenza virus entry to cytoplasm, probably through the inhibition of V-ATPase. The present study provides evidence that supports the clinical use of maoto for the treatment of influenza.

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The efficacy of ma-huang-tang (maoto) against influenza

Cited by 15 publications

References 4 publications

Classification of acute phase febrile upper respiratory tract infection: Retrospective chart review

Classification of acute phase febrile upper respiratory tract infection: Retrospective chart review

Deconstructing the traditional Japanese medicine “Kampo”: compounds, metabolites and pharmacological profile of maoto, a remedy for flu-like symptoms

Maoto, a Traditional Japanese Herbal Medicine, Inhibits Uncoating of Influenza Virus

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