Induction of maturation and activation of human dendritic cells: A mechanism underlying the beneficial effect of Viscum albumas complimentary therapy in cancer

Elluru, Sri Ramulu; Huyen, Jean–Paul Duong Van; Delignat, Sandrine; Kazatchkine, Michel D.; Friboulet, Alain; Kaveri, Srini V.; Bayry, Jagadeesh

doi:10.1186/1471-2407-8-161

Cited by 41 publications

(40 citation statements)

References 27 publications

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“…Immunological parameters were analyzed in 23 [93,94]. This review article presents the current knowledge from clinical trials about the influence of treatment with the mistletoe preparation Iscador ® on patients NK lymphocytes.…”

Section: Subcutaneous Adjuvant Therapymentioning

confidence: 99%

“…However, NK cell cytokine and cytotoxic responses not only depend on the cytokine milieu, but also on the interaction with other immune cells, such as T cells, macrophages, and dendritic cells [48,131,132]. Recently, Iscador ® has been shown to stimulate the maturation of dendritic cells [24] enabling them to stimulate CD4 + T cells and CD8 + T cells [23] and, therefore, it might be possible that mistletoe extracts favor the cross talk between NK cells and dendritic cells [45].…”

Section: Acknowledgment and Conflicts Of Interestmentioning

confidence: 99%

“…In vitro studies and animal tumor models demonstrated mistletoe-mediated activation of monocytes, macrophages [19,20], granulocytes, natural killer (NK) cells [21,22], dendritic cells (DC) [23,24], and T cells [20,25,26] as well as the induction of various cytokines [8].…”

Section: Cd3mentioning

confidence: 99%

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Immunomodulatory Effects of <i>Viscum album</i> Extracts on Natural Killer Cells: Review of Clinical Trials

Braedel-Ruoff¹

2010

Forsch Komplementmed

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Extracts produced from Viscum album L. (mistletoe) are widely used in complementary medicine for the treatment of cancer. In many preclinical and clinical studies, Viscum album extracts were shown to exert immunomodulatory functions. Natural killer (NK) cells play an important role in cell-mediated immune responses against tumor cells. This article reviews clinical trials that address the influence of the mistletoe extract Iscador^® on NK cells and discusses the results with regard to the NK cell functions assayed, to putative underlying mechanisms, and to the role of different mistletoe components. Conclusion: Although many trials demonstrated a positive effect of Iscador^® treatment on NK cell function, further dedicated studies with optimized treatment schedules and comparable mistletoe doses are necessary to confirm these results regarding involvement of NK cells on the immunomodulatory functions of Iscador^® therapy and to investigate the clinical relevance of these findings.

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Section: Subcutaneous Adjuvant Therapymentioning

confidence: 99%

Section: Acknowledgment and Conflicts Of Interestmentioning

confidence: 99%

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Immunomodulatory Effects of <i>Viscum album</i> Extracts on Natural Killer Cells: Review of Clinical Trials

Braedel-Ruoff¹

2010

Forsch Komplementmed

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“…Finally, the adjunctive treatment with mistletoe extracts might have contributed to the favorable outcome of this patient. In line with this, previous smaller-scale studies have suggested a potential benefit of such treatment in patients with various tumorentities,includingbreastcancerandgallbladdercancer [5,6].Thepotentialmechanismsbywhichmistletoeextracts may exert their antiproliferative activity have not yet been exploredindetail [7][8][9],butrecentstudieshavesuggestedan activationofdendriticcells,whichmayfacilitateantitumoral immune responses [10]. Whether mistletoe extracts exert …”

Section: Discussionmentioning

confidence: 71%

Sustained Partial Remission of Metastatic Pancreatic Cancer Following Systemic Chemotherapy with Gemcitabine and Oxaliplatin plus Adjunctive Treatment with Mistletoe Extract

Ritter

Tischoff²,

Uhl³

et al. 2010

Onkologie

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Background: The clinical prognosis of metastatic pancreatic cancer is very poor, with a median survival time of such patients ranging from 3 to 6 months. Current chemotherapy regimens include the combination of oxaliplatin and gemcitabine. Case Report: A 43-year-old woman was diagnosed with pancreatic adenocarcinoma spreading into the regional lymph nodes and into multiple liver segments (pT3, pN1, pM1). Upon diagnosis, she underwent a pylorus-preserving pancreatic head resection, including dissection of regional lymph nodes and atypical resection of a single liver segment, followed by 9 cycles of palliative chemotherapy with gemcitabine and oxaliplatin. 37 weeks after surgery, the patient demonstrated a sustained partial remission, and the chemotherapy was stopped. Surprisingly, 10 months later, she still showed no evidence of tumor progression. Since the time of pancreatic surgery, the patient had taken mistletoe extracts and this adjunctive treatment has been continued until now. Conclusions: Cases of sustained long-term remission of metastatic pancreatic cancer are extremely rare. Although this single case observation does not allow for firm conclusions regarding potential mechanisms, the adjunctive therapy with mistletoe extracts might have played a role. Therefore, the clinical effects of such treatment in patients with pancreatic cancer warrant further investigation.

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“…In German-speaking countries, there is a high prevalence of complementary and alternative medicine, 41,42 and European mistletoe extracts (Viscum album L.) are the mostly frequently prescribed herbal remedies. [43][44][45][46][47][48] An overview on the mode of action of mistletoe extracts is given by Bar-Sela 49 and has been well summarized by Zänker et al 50 In vitro, it showed antitumoral effects, such as induction of apoptosis, [44][45][46][47][48]51 inhibition of cell proliferation, 47,48,52 potentiating anticancer effects of TNF-alpha, 53,54 activation of immunocompetent cells, [54][55][56][57] decreasing angiogenesis, 50,53 and retention of chemotherapeutic agents in cancer cells by modulating the transport of cell-toxifying substances. 58 Whereas systemic mistletoe therapy primary aims to stimulate the immune system, intratumoral application focuses on the local cytotoxic effect.…”

Section: Discussionmentioning

confidence: 99%

Intratumoral Mistletoe (Viscum album L) Therapy in Patients With Unresectable Pancreas Carcinoma

et al. 2013

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Pancreatic carcinoma remains one of the main causes for cancer-related death. Intratumoral application of anticancer agents is discussed as a promising method for solid tumors such as pancreatic cancer. Endoscopic ultrasound provides a good tool to examine and treat the pancreas. European mistletoe (Viscum album L) is a phytotherapeutic commonly used in integrative oncology in Central Europe. Its complementary use seeks to induce immunostimulation and antitumoral effects as well as alleviate chemotherapeutic side effects. Intratumoral mistletoe application has induced local tumor response in various cancer entities. This off-label use needs to be validated carefully in terms of safety and benefits. Here we report on 39 patients with advanced, inoperable pancreatic cancer, who received in total 223 intratumoral applications of mistletoe, endoscopic ultrasound guided or under transabdominal ultrasound control. No severe procedure-related events were reported. Adverse drug reactions were mainly increased body temperature or fever in 14% and 11% of the applications, respectively. Other adverse drug reactions, such as pain or nausea, occurred in less than 7% of the procedures. No severe adverse drug reaction was recorded. Patients received standard first-and second-line chemotherapy and underwent adequate palliative surgical interventions as well as additive subcutaneous and partly intravenous mistletoe application. A median survival of 11 months was observed for all patients, or 11.8 and 8.3 months for stages III and IV, respectively. Due to the multimodal therapeutic setting and the lack of a control group, the effect of intratumoral mistletoe administration alone remains unclear. This retrospective analysis suggests that intratumoral-applicated mistletoe might contribute to improve survival of patients with pancreatic cancer. In conclusion, the application is feasible and safe, and its efficacy should be evaluated in a randomized controlled trial.

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Induction of maturation and activation of human dendritic cells: A mechanism underlying the beneficial effect of Viscum albumas complimentary therapy in cancer

Cited by 41 publications

References 27 publications

Immunomodulatory Effects of <i>Viscum album</i> Extracts on Natural Killer Cells: Review of Clinical Trials

Immunomodulatory Effects of <i>Viscum album</i> Extracts on Natural Killer Cells: Review of Clinical Trials

Sustained Partial Remission of Metastatic Pancreatic Cancer Following Systemic Chemotherapy with Gemcitabine and Oxaliplatin plus Adjunctive Treatment with Mistletoe Extract

Intratumoral Mistletoe (Viscum album L) Therapy in Patients With Unresectable Pancreas Carcinoma

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