Difficulties and Perspectives of Immunomodulatory Therapy with Mistletoe Lectins and Standardized Mistletoe Extracts in Evidence-Based Medicine

Viscum album preparations are aqueous mistletoe plant extracts used in complementary and alternative medicine as immunomodulators in cancer therapy. However, evidence of immunological efficacy of mistletoe extracts (MEs) used in clinical trials is often lacking. Mechanisms involved in anti-tumor pro...

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Bibliographic Details
Published in:Evidence-based complementary and alternative medicine 2011-01, Vol.2011 (2011), p.1-6
Main Authors: Hajtó, Tibor, Fodor, Krisztina, Perjési, Pál, Németh, Pèter
Format: Article
Language:English
Subjects:
Alternative medicine
Amino acid sequence
Amino acids
Angiogenesis
Apoptosis
Biochemistry
Cancer
Cell cycle
Clinical trials
Dendritic cells
Evidence-based medicine
Immune system
Immunology
Immunomodulation
Immunomodulators
Immunotherapy
Interleukin 12
Lectins
Macrophages
Medical prognosis
Medical research
Medicinal plants
Plant extracts
Post-translation
Review
Standardization
Viscum album
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Summary:Viscum album preparations are aqueous mistletoe plant extracts used in complementary and alternative medicine as immunomodulators in cancer therapy. However, evidence of immunological efficacy of mistletoe extracts (MEs) used in clinical trials is often lacking. Mechanisms involved in anti-tumor properties of ME and mistletoe lectins (MLs) modify both innate and adaptive immune systems, according to animal model experiments. In the background of these effects, a selective binding of ML on CD75 ganglioside receptors of interleukin 12 (IL-12)-producing macrophages or dendritic cells can play an important role. Immunological effects of ME correlate with their lectin activity, showing a bell-shaped dose-response curve of efficacy. Therefore, a correct determination of MLs for the standardization of commercial ME is essential. However, plant MLs exhibit heterogeneity, which most likely results from post-translational processing. In addition, amino acid analysis of ML has revealed numerous conservative substitutions along their amino acid sequence. Consequently, ML research needs new perspectives, and the advantages and disadvantages of purified and biologically better defined ML preparations are also discussed in this article.
ISSN:1741-427X
1741-4288
DOI:10.1093/ecam/nep191