{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:52:52Z","timestamp":1786121572708,"version":"build-2736575974"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Low-dose computed tomography (CT) scans can induce DNA damage, including chromosomal aberrations (CAs) and DNA double-strand breaks, which may contribute to long-term cancer risk. D-limonene, a bioactive component present in several Kampo formulas, has shown radioprotective effects in preclinical studies; however, clinical evidence remains limited, and the gastrointestinal side effects associated with isolated D-limonene may restrict its clinical application. This single-arm observational pilot study aimed to evaluate whether Kampo formulas containing D-limonene could mitigate CT-induced cytogenetic damage and to generate preliminary data for designing a future definitive trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty-nine patients with functional dyspepsia received one of four D-limonene-containing Kampo formulas: bukuryoin, rikkunshito, heiisan, or nichinto. Peripheral blood lymphocytes were collected before and after Kampo treatment and exposed in vitro to CT radiation. Chromosomal aberrations were assessed using peptide nucleic acid fluorescence in situ hybridization (PNA-FISH), while DNA double-strand breaks were evaluated by \u03b3-H2AX immunofluorescence. Wilcoxon signed-rank tests and linear mixedeffects models were used to assess radiation effects and Kampo-related interactions, and intraclass correlation coefficients (ICCs) were calculated to compare assay reliability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CT exposure significantly increased CAs before Kampo treatment (p = 0.024), whereas this increase was attenuated after treatment (p = 0.417). However, neither the pre\u2013post difference-in-differences analysis (p = 0.428) nor the CT \u00d7 Kampo interaction in the mixed-effects model (\u03b2 = \u20130.72; 95% CI, \u20132.19 to 0.75; p = 0.343) reached statistical significance. \u03b3-H2AX showed a similar trend. PNA-FISH demonstrated higher measurement reliability than \u03b3-H2AX immunofluorescence (ICC = 0.89 vs. 0.65). Sample size estimation based on PNA-FISH indicated that 275\u2013295 evaluable participants per arm would be required for a future definitive trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Overall, Kampo formulas containing D-limonene showed a trend toward mitigating CT-induced cytogenetic injury, and PNA-FISH appeared to provide a more reliable endpoint than \u03b3-H2AX. These exploratory findings support further investigation in a randomized controlled trial to determine whether D-limonene-containing Kampo formulas can meaningfully mitigate CT-associated genotoxicity in humans.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1888108","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T05:28:32Z","timestamp":1786080512000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploratory assessment of the potential protective effects of Kampo treatment against low dose medical radiation: a single arm prospective observational study"],"prefix":"10.3389","volume":"17","author":[{"given":"Hongyang","family":"Li","sequence":"first","affiliation":[{"name":"Kampo Clinical Center, Hiroshima University Hospital, Kasumi","place":["Hiroshima, 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