Ginseng (the root of Panax ginseng C. A. MEYER, Araliaceae) is frequently used in Asian countries as a traditional medicine. The major components of ginseng are ginsenosides.1,2) These ginsenosides have been reported to show various biological activities including antiinflammatory activity 3) and antitumor effects. 4,5) The pharmacological actions of these ginsenosides have been explained by the biotransformation of ginsenosides by human intestinal bacteria. [6][7][8][9][10][11] Transformed 20-O-b-D-glucopyranosyl-20(S)-protopanaxadiol (IH-901, compound K) from ginsenosides R b1 , R b2 and R c induces an antimetastatic or anticarcinogenic effect. [12][13][14] However, studies on the metabolism of ginsenoside R c by human intestinal bacteria and its related biological activities are not complete.We therefore investigated the human intestinal bacteria capable of metabolizing ginsenoside R c and its related antiallergic activity. MATERIALS AND METHODSInstrument Melting points were determined on an electrothermal digital melting point apparatus.1 H-and 13 C-NMR spectra were recorded on a Bruker-AM 500 with tetramethylsilane (TMS) as an internal standard. The TLC chromatogram of metabolites was quantitatively analyzed with Shimadzu model CS-9301PC (Japan).Materials and Bacterial Strains Sodium thioglycolate, ascorbic acid and disodium cromoglycate (DSCG) were purchased from Sigma Co. (U.S.A.). General anaerobic medium (GAM) was purchased from Nissui Pharmaceutical Co., Ltd. (Japan). Tryptic soy broth was purchased from Difco Co. (U.S.A.). Ginsenoside R c was isolated by the previous method.15) The other chemicals were of analytical reagent grade.Isolation of Metabolites of Ginsenoside R c by Human Intestinal Microflora The reaction mixture containing 100 mg of 20(S)-ginsenoside R c and 500 mg of fresh fecal suspension (Bifidobacterium K-103 or K-506) was incubated for 24 h at 37°C. The reaction mixture was extracted with ethyl acetate, evaporated to dryness, and applied to silica gel column chromatography; solvent, CHCl 3 -MeOH-H 2 O (65 : 35 : 10 v/v, lower phase). From the reaction mixture, we isolated ginsenoside M c , compound K and 20(S)-protopanaxadiol (5 mg). Ginsenosides R d (12 mg) and F 2 (10 mg) were isolated as metabolites by Bifidobacterium K-103, and ginsenoside M b (15 mg) was isolated as a metabolite by Bifidobacterium K-506.Ten grams of fresh feces were suspended with 100 ml of anaerobic diluted media and centrifuged at 200ϫg for 5 min, and the precipitate was discarded. The supernatant was centrifuged at 10000ϫg for 30 min. The precipitate was washed twice with saline and used in the experiment.Ginsenoside Screening of Bacteria Metabolizing Ginsenoside R cThe bacteria (Bacteroides HJ-15, Bacteroides JY-6, Eubacterium A-44, Bifidobacterium K-110, and Fusobacterium K-60) previously isolated from human intestinal microflora were cultured in 50 ml of tryptic soy broth containing 0.01% sodium thioglycolate and 0.1% ascorbic acid (TSTA), and then each cultured cell was centrifuged at 3000ϫg for 10 min an...

Ginseng (the root of Panax ginseng C. A. MEYER, family Araliaceae) is frequently used as a traditional medicine, taken orally, in China, Korea, Japan and other Asian countries.1) The major components of ginseng, the ginsenosides, are glycosides that contain an aglycone with a dammarane skeleton.2,3) These ginsenosides have been reported to show various biological activities, including immunomodulatory effect, anti-inflammatory activity and antitumor effects. 4-7)To explain these pharmacological actions, it is thought that ginseng saponins must be metabolized by human intestinal bacteria after their oral administration. [8][9][10][11][12] For example, ginsenoside Rb1, Rb2 and Rc are transformed to 20-O-b-D-glucopyranosyl-20(S)-protopanaxadiol (compound K) by human intestinal bacteria, with ginsenoside Re transformed to protopanaxatriol.Akao et al. reported that compound K was detected in the blood after the oral administration of ginsenoside Rb1 to rats. 8,10) We also reported that compound K was detected in the urine when ginsenoside Rb1 was orally administered to rats.13) Tawab et al. reported that ginsenoside F1, compound K and ginsenoside Rh1 were detected in the urine and blood when ginseng extract was orally administered to humans. 14)These results suggest that protopanaxadiol ginsenosides may be metabolized, mainly to compound K, and protopanaxatriol ginsenosides to ginsenoside Rh1 and ginsenoside F1. Thus, these findings are in contrast with the report of Hasegawa et al. who suggested that ginsenoside Re was metabolized mainly to protopanaxatriol by human intestinal microflora.15) Therefore, to clarify the metabolism of the ginsenoside Re by human intestinal microflora, the ginsenoside Re-metabolizing intestinal bacteria were isolated from human feces, their metabolic activity measured and the estrogenic effect of ginsenoside Re, as well as its main metabolites, investigated. MATERIALS AND MEHTODS Materials The, sulforhodamine B (SRB), NP40, 17b-estradiol, Dulbecco's modified Eagles medium (DMEM), fetal bovine serum (FBS) and charcoal dextran stripped FBS (CD-FBS) were purchased from Sigma Chem. Co. (U.S.A.). The general anaerobic medium (GAM) was purchased from Nissui Pharmaceutical Co., Ltd., (Tokyo, Japan). The tryptic soy broth (TS) and other media were purchased from Difco Co. (U.S.A.). The protein assay reagent was purchased from Bio-Rad Laboratories (U.S.A.). The enhanced chemiluminescence (ECL) kit was purchased from Amersham Co. (U.S.A.). The progesterone receptor (PR) was purchased from Santa Cruz Co. (U.S.A.). The protease inhibitor cocktail was purchased from Roche Co. (Germany). The poncirin, poncirenin and ponciretin were isolated as previously described.16) The ginsenosides Re and Rg2 were isolated according to the previously described method.3,15) All other chemicals were of analytical reagent grade, and all solutions used after redistillation.Isolation of Ginsenoside Re-hydrolyzing Bacteria from Human Intestinal Bacteria A suspension of the fresh feces of a healthy Korean man was diluted ...

PurposeDrug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is characterized by prolonged clinical symptoms even after the withdrawal of the culprit drug. Different criteria to diagnose DRESS syndrome have been proposed; however, there have been limited studies on prognostic factors. We investigated appropriate criteria for the diagnosis of DRESS syndrome in practice and with associated prognostic factors.MethodsA total of 48 patients with DRESS syndrome that satisfied RegiSCAR possible (or more) criteria were retrospectively recruited. They were also analyzed according to Bocquet's criteria and Japanese drug-induced hypersensitivity syndrome (DIHS) criteria. The duration of clinical manifestations, requirement for steroids, and fatalities determined the severity of DRESS syndrome. Blood tests were performed at initial presentation to our hospital.ResultsA total of 60.4% of patients satisfied RegiSCAR definite criteria and 77.1% satisfied Bocquet's criteria. Only 18.8% satisfied atypical DIHS criteria from the Japanese group. A total of 96.6% patients who fit the RegiSCAR definite criteria, 96.6% also satisfied Bocquet's criteria; reciprocally, 75.7% of patients who met Bocquet's criteria also satisfied RegiSCAR definite criteria. The duration of clinical symptoms positively correlated with leukocyte, lymphocyte, and eosinophil counts in non-fatal cases. Lymphocyte counts were higher in patients who used steroids compared to steroid-naïve patients. Fatal cases showed higher serum creatinine and ferritin levels compared to non-fatal cases.ConclusionsBocquet's criteria is efficient and appropriate to diagnose DRESS syndrome in clinical practice. Lymphocyte and eosinophil counts as well as creatinine and ferritin levels could be useful early prognostic factors.

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