Questions and Answers About Iscador M/P/Qu
1. WHAT IS MISTLETOE (VISCUM ALBUM)?
2. HOW ARE MISTLETOE EXTRACTS GIVEN?
3. WHAT LABORATORY OR ANIMAL STUDIES HAVE BEEN DONE USING MISTLETOE EXTRACTS?
4. HAVE ANY STUDIES OF MISTLETOE EXTRACTS BEEN DONE IN PEOPLE?
Questions and Answers
Mistletoe is a semiparasitic plant that grows on trees, such as apple, oak, maple, elm, pine, and birch. It has been used for hundreds of years to treat medical conditions such as epilepsy, hypertension, headaches, menopausal symptoms, infertility, arthritis, and rheumatism. Mistletoe is one of the most widely studied complementary and alternative medicine therapies for cancer. In Europe, mistletoe extracts are among the most prescribed therapies for cancer patients.
Mistletoe products vary, depending on the following factors:
* The type of host tree on which the mistletoe grows.
* The species of mistletoe.
* The type of extract used and if it is made with homeopathicmethods.
* The time of year the plant is picked.
Mistletoe extracts are made in water-based solutions or solutions of water and alcohol. Mistletoe products may be named according to the type of tree on which the plant grows. For example, IscadorM is from apple trees, IscadorP comes from pine trees, IscadorQu is from oak trees, and IscadorU comes from elm trees.
2. HOW ARE MISTLETOE EXTRACTS GIVEN? (Top ↑(
Mistletoe extracts are usually given by an injection under the skin (subcutaneous). Less common ways to give mistletoe include by mouth, into a vein (intravenous or IV), into the pleural cavity, or into a tumor.
3. WHAT LABORATORY OR ANIMAL STUDIES HAVE BEEN DONE USING MISTLETOE EXTRACTS? (Top ↑(
In laboratory studies, tumor cells are used to test a substance to find out if it is likely to have any anticancer effects. In animal studies, tests are done to see if a drug, procedure, or treatment is safe and effective in animals. Laboratory and animal studies are done before a substance is tested in people.
Laboratory and animal studies have tested the effects of mistletoe extracts in laboratory experiments. In the following some of these studies had been mentioned:
Extracts of Viscum album (mistletoe) are widely used as complementary cancer therapies in Europe. The mistletoe lectins have been identified as the main active principle of mistletoe extracts. They have been shown to exhibit cytotoxic effects as well as immunomodulatory activities. The latter is exemplified by induction of cytokine secretion and increased activity of natural killer cells. Recent reports however, indicated possible tumor growth stimulation by mistletoe extracts. Therefore, the three aqueous mistletoe extracts (Iscador M special, Iscador Qu special and Iscador P) were evaluated for anti proliferative and/or stimulatory effects in a panel of 16 human tumor cell lines in vitro using a cellular proliferation assay. The results show no evidence of stimulation of tumor growth by any of the three Iscador preparations, comprising central nervous system, gastric, non-small cell lung, mammary, prostate, renal and uterine cancer cell lines, as well as cell lines from hematological malignancies and melanomas. On the contrary, Iscador preparations containing a high lectin concentration (Iscador M special and Iscador Qu special) showed antitumor activity in the mammary cancer cell lineMAXF4 01NL at the 15 lg/ml dose level with a more than 70% growth inhibition compared to untreated control cells. In addition, a slight anti tumor activity (growth inhibition 30^70%) was found in three tumor cell lines for Iscador M special and in seven tumor cell lines for Iscador Qu special, respectively. Iscador P, which contains no mistletoe lectin I, showed no anti proliferative activity (Gerhard Maier et al, 2002).
To further investigate the immunological prerequisites of the differences in the VA-E susceptibilities, an analysis was carried out of the pre-existing differences in the tumor patients’ lymphocyte subsets, and of whether the LR pattern (none, moderate, strong) might be associated with distinct aspects of the patients’ quality of life. Patients and Methods: Seventy-one cancer patients were subcutaneously treated with VA-E (Iscador®) at increasing concentrations and their lymphocyte subsets measured by flow cytometry during a 6 month observation period; quality of life was assessed with the HLQ questionnaire. The occurrence of stronger LR was associated with a primarily higher level of T-cells and their CD4+ T-helper/inducer subset, and CD25+ respectively HLA-DR+ (activated) T-cells. Moreover, counts or proportions of T-cells, CD4+ T-helper/inducer cells and CD8+ CD28+ cytotoxic cells were lower, while the relative proportions of CD8+ CD28– suppressor cells, B- and NK cells were the highest in the group with moderate LR. In particular, this latter group had a significantly higher quality of life. Our results indicate that the induction of moderate LR in response to VA-E application was associated with better T cell function and quality of life (A. Bussing et al, 2008).
Mistletoe lectins have been identified as main active components and exhibit cytotoxic effects as well as immunomodulatory activity. Since it is still not elucidated in detail how mistle toe extracts such as ISCADOR communicate their effects, we analyzed the mechanisms that might be responsible for their antitumoral function on a molecular and functional level. ISCADOR-treated glioblastoma (GBM) cells down-regulate central genes involved in glioblastoma progression and malignancy such as the cytokine TGF-β and matrix-metalloproteinases. Using in vitro glioblastoma/immune cell co-cultivation assays as well as measurement of cell migration and invasion, we could demonstrate that in glioblastoma cells, lectin-rich ISCADOR M and ISCADOR Q significantly enforce NK-cell-mediated GBM cell lysis. Beside its immune stimulatory effect, ISCADOR reduces the migratory and invasive potential of glioblastoma cells. In a syngeneic as well as in a xenograft glioblastoma mouse model, both pretreatment of tumor cells and intratumoral therapy of subcutaneously growing glioblastoma cells with ISCADOR Q showed delayed tumor growth. In conclusion, ISCADOR Q, showing multiple positive effects in the treatment of glioblastoma, may be a candidate for concomitant treatment of this cancer (Oliver Podlech et al, 2012).
Human breast carcinoma cell lines HCC1937 and HCC1143 were treated with doxorubicin hydrochloride, pancreas adenocarcinoma cell line PA-TU-8902 with gemcitabine hydrochloride, prostate carcinoma cell line DU145 with docetaxel and mitoxantrone hydrochloride and lung carcinoma cell line NCI-H460 was treated with docetaxel and cisplatin. Each dose of the respective chemotherapeutic drug was combined with Viscum album extract (VAE) in clinically relevant concentrations and proliferation and apoptosis were measured. VAE did not inhibit chemotherapy induced cytostasis and cytotoxicity in any of our experimental settings. At higher concentrations VAE showed an additive inhibitory effect. Our in vitro results suggest that no risk of safety by herb drug interactions has to be expected from the exposition of cancer cells to chemotherapeutic drugs and VAE simultaneously (Ulrike Weissenstein et al, 2014).
The Her-2 positive human breast carcinoma cell line SK-BR-3 was treated with Trastuzumab. Different doses of the drug were combined with Viscum album extract (VAE) in clinically relevant doses. Proliferation, apoptosis, cell cycle and the secretion of vascular endothelial growth factor (VEGF) were analyzed. No inhibition of antitumor efficacy of Trastuzumab by VAE was detected. VAE and Trastuzumab, either alone or in combination, inhibited proliferation of SK-BR-3 cells in vitro. At higher concentrations VAE induced apoptosis, which was not observed for Trastuzumab. Cells treated with Trastuzumab underwent a G0/G1 cell cycle arrest and cells treated with VAE a G2/M arrest. After application of the two drugs in combination both G0/G1 and G2/M arrest was observed. VEGF secretion of SK-BR-3 cells was significantly inhibited by sole treatment with Trastuzumab or VAE. Combined treatment of Trastuzumab and VAE at clinically relevant doses showed additive inhibitory effects on VEGF secretion. VAE did not interfere with cytostatic effects of Trastuzumab on SK-BR-3 cells in vitro. Our in vitro results suggest that no risk of safety by herb drug interactions has to be expected from the exposition of cancer cells to Trastuzumab and VAE simultaneously. In contrast, VAE and Trastuzumab seem to exhibit complementary anti-cancer effects in vitro (U. Weissenstein et al, 2016).
4. HAVE ANY STUDIES OF MISTLETOE EXTRACTS BEEN DONE IN PEOPLE? (Top ↑(
Most clinical trials using mistletoe extracts to treat cancer have been done in Europe. Many studies use mistletoe as adjuvant therapy in patients with cancer.