Background: Viscum album L. extracts (VAE, European mistletoe) are a widely used medicinal plant extract in gynaecological and breast-cancer treatment.
Background: Major surgery suppresses natural killer (NK) cell cytotoxic
activity which is potentially harmful for cancer patients by
favouring haematogenic tumour cell dissemination. The influence
of a perioperative infusion of a standardized mistletoe extract (Iscador
®) on immune functions was tested in a prospective, sequential,
randomized clinical trial. Patients and Methods: Colorectal cancer
patients undergoing open tumour resection were randomly assigned
to either mistletoe infusion or no additional therapy. We hypothesized
that mistletoe infusion improves NK cell activity and
increases expression of MHC class II antigen HLA-DR on monocytes
24 h and 7 days after surgery, respectively. For statistical analysis
we used a sequential study design. The decision boundaries for the
two triangular tests were calculated for altogether 62 patients. Results:
The sequential study design allowed stopping the recruitment
prematurely. NK cell activity differed significantly between the therapy
groups 24 h after surgery (p = 0.027). The absolute number of
HLA-DR molecules on monocytes did not differ 7 days after surgery.
NK cell activity of patients treated with mistletoe extract did not
change significantly during the course of the study (-7.9% 24 h after
surgery), whereas HLA-DR expression changed significantly
(-38.5% at day 7 after surgery). For control patients both parameters
decreased significantly after surgery (NK cell activity: -44.4% at
24 h; HLA-DR expression: -32.9% at day 7 after surgery). Conclusion:
Perioperative infusion of mistletoe extracts can prevent a suppression
of NK cell activity in cancer patients. The impact of this
therapy on relapse and survival should be tested in further studies.
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