Treatment with Kampo medicine (Keigai-rengyo-to or Seijo-bofu-to) and Doxycycline for Chikungunya virus infection

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Chikungunya virus (CHIKV) is an arthritogenic alphavirus transmitted mainly by Aedes mosquitoes, causing acute high fever and severe polyarthralgia, with chronic joint pain persisting in some patients. Despite its growing global impact, no virus‑specific antiviral therapy is currently available, and management remains supportive. Although several compounds such as favipiravir and ribavirin show antiviral activity in experimental settings, none have advanced to clinical trials. Kampo medicines (KMs), traditional Japanese herbal formulations, have emerged as potential antiviral candidates. Among them, Keigai‑rengyo‑to (KRT) contains multiple plant‑derived components—such as baicalein, naringenin, hesperetin, berberine, luteolin, and apigenin—that have demonstrated inhibitory effects on CHIKV replication through suppression of viral RNA synthesis, protein expression, or intracellular proliferation. Because Seijo‑bofu‑to (SBT) shares many of these ingredients, it may also possess anti‑CHIKV potential. Doxycycline (DOX), a tetracycline antibiotic, additionally exhibits antiviral, anti‑inflammatory, and neuroprotective properties, suggesting possible benefits for CHIKV‑associated symptoms. Given these complementary mechanisms, combination therapy using KM (KRT or SBT) and DOX may offer therapeutic promise, although clinical studies are needed to confirm efficacy, safety, and optimal treatment conditions.