Zusammenfassung
Hintergrund
Immunstimulanzien aus der Naturheilkunde sind rezeptfrei erhältlich und werden durch viele Patienten zusätzlich zu der konventionellen onkologischen Therapie eingenommen.
Ziel der Arbeit
Darstellung von Immunstimulanzien aus der Naturheilkunde und deren Einsatz bei malignen Erkrankungen.
Material und Methoden
Narrative Übersichtsarbeit.
Ergebnisse
Zu den Immunstimulanzien, die häufig in der komplementären Medizin eingesetzt werden und die zu einer Aktivierung von unspezifischen Immunparametern führen, gehören Substanzen pflanzlichen Ursprungs wie Echinacin, Umckaloabo, Mistel und sog. Heilpilze. Zusätzlich gibt es Immunstimulanzien aus Thymus, also tierischen Ursprungs. Die Datenlage aus klinischen Studien zum Einsatz von naturheilkundlichen Immunstimulanzien bei malignen Erkrankungen ist limitiert. Vor allem gibt es keine belastbaren Daten, dass es zu einer Verbesserung von relevanten klinischen Parametern, also einer Aktivierung von Immunzellen gegen den Tumor selbst oder zu einer Verbesserung der Lebensqualität oder von Nebenwirkungen der Tumortherapie durch den zusätzlichen Einsatz von naturheilkundlichen Immunstimulanzien, kommt.
Schlussfolgerung
Es ergibt sich ein potenziell negatives Nutzen-Risiko-Verhältnis. Im Zuge der Patientenaktivierung sind Informationen zur Bedeutung eines gesunden Lebensstils, zur körperlichen Aktivität und ausgewogenen Ernährung besser geeignet.
Abstract
Background
Immunostimulants from naturopathy are available without a prescription and are taken by many patients in addition to the conventional oncological therapy.
Objectives
Presentation of evidence concerning immune stimulants from naturopathy which are used by patients with cancer.
Materials and methods
Narrative review.
Results
Immunostimulants, which have been shown to activate unspecific immune parameters, include echinacin, umckaloabo, mistletoe and medicinal mushrooms. In addition, there are stimulants from thymus, which are of animal origin. Data from clinical studies on the use of naturopathic immunostimulants in malignancies is limited. Above all, there is no reliable data that additional use of naturopathic immunostimulants lead to an improvement of relevant clinical parameters as tumor growth, survival, quality of life or side effects of tumor treatment.
Conclusions
There is a potentially negative benefit–risk ratio. With respect to patient activation, information about the importance of a healthy lifestyle, physical activity, and a balanced diet is more appropriate.
Literatur
Abreu P, Sánchez R, Mut T et al (2017) Homeopathic mistletoe adverse reaction mimics nodal involvement in 18F-FDG PET/CT performed for evaluation of response to chemotherapy in lymphoma. Rev Esp Med Nucl Imagen Mol 36:110–112. https://doi.org/10.1016/j.remn.2016.07.005
Bernengo MG, Appino A, Bertero M et al (1992) Thymopentin in Sézary syndrome. J Natl Cancer Inst 84:1341–1346. https://doi.org/10.1093/jnci/84.17.1341
Bernengo MG, Doveil GC, Meregalli M et al (1988) Immunomodulation and Sézary syndrome: experience with thymopentin (TP-5). Br J Dermatol 119:207–221. https://doi.org/10.1111/j.1365-2133.1988.tb03203.x
Borghardt J, Rosien B, Görtelmeyer R et al (2000) Effects of a spleen peptide preparation as supportive therapy in inoperable head and neck cancer patients. Arzneimittelforschung 50:178–184. https://doi.org/10.1055/s-0031-1300186
Bossaer JB, Odle BL (2012) Probable etoposide interaction with Echinacea. J Diet Suppl 9:90–95. https://doi.org/10.3109/19390211.2012.682643
Cichello SA, Yao Q, He XQ (2016) Proliferative activity of a blend of Echinacea angustifolia and Echinacea purpurea root extracts in human vein epithelial, HeLa, and QBC-939 cell lines, but not in Beas-2b cell lines. J Tradit Complement Med 6:193–197. https://doi.org/10.1016/j.jtcme.2015.01.002
Demidov LV, Manziuk LV, Kharkevitch GY et al (2008) Adjuvant fermented wheat germ extract (Avemar) nutraceutical improves survival of high-risk skin melanoma patients: a randomized, pilot, phase II clinical study with a 7-year follow-up. Cancer Biother Radiopharm 23:477–482. https://doi.org/10.1089/cbr.2008.0486
Eliza WLY, Fai CK, Chung LP (2012) Efficacy of Yun Zhi (Coriolus versicolor) on survival in cancer patients: systematic review and meta-analysis. Recent Pat Inflamm Allergy Drug Discov 6:78–87. https://doi.org/10.2174/187221312798889310
Freuding M, Keinki C, Kutschan S et al (2019) Mistletoe in oncological treatment: a systematic review: part 2: quality of life and toxicity of cancer treatment. J Cancer Res Clin Oncol 145:927–939. https://doi.org/10.1007/s00432-018-02838-3
Freuding M, Keinki C, Micke O et al (2019) Mistletoe in oncological treatment: a systematic review: part 1: survival and safety. J Cancer Res Clin Oncol 145:695–707. https://doi.org/10.1007/s00432-018-02837-4
Fritz H, Kennedy DA, Ishii M et al (2015) Polysaccharide K and Coriolus versicolor extracts for lung cancer: a systematic review. Integr Cancer Ther 14:201–211. https://doi.org/10.1177/1534735415572883
Fritz P, Dippon J, Müller S et al (2018) Is mistletoe treatment beneficial in invasive breast cancer? A new approach to an unresolved problem. Anticancer Res 38:1585–1593. https://doi.org/10.21873/anticanres.12388
Garami M, Schuler D, Babosa M et al (2004) Fermented wheat germ extract reduces chemotherapy-induced febrile neutropenia in pediatric cancer patients. J Pediatr Hematol Oncol 26:631–635
Gebbia V, Valenza R, Testa A et al (1994) A prospective randomized trial of thymopentin versus granulocyte—Colony stimulating factor with or without thymopentin in the prevention of febrile episodes in cancer patients undergoing highly cytotoxic chemotherapy. Anticancer Res 14:731–734
Goey AKL, Meijerman I, Rosing H et al (2013) The effect of Echinacea purpurea on the pharmacokinetics of docetaxel. Br J Clin Pharmacol 76:467–474. https://doi.org/10.1111/bcp.12159
Hansen TS, Nilsen OG (2008) In vitro CYP3A4 metabolism: inhibition by Echinacea purpurea and choice of substrate for the evaluation of herbal inhibition. Basic Clin Pharmacol Toxicol 103:445–449. https://doi.org/10.1111/j.1742-7843.2008.00307.x
Hayashi I, Ohotsuki M, Suzuki I, Watanabe T (2001) Effects of oral administration of Echinacea purpurea (American herb) on incidence of spontaneous leukemia caused by recombinant leukemia viruses in AKR/J mice. Nihon Rinsho Meneki Gakkai Kaishi 24:10–20. https://doi.org/10.2177/jsci.24.10
Hübner J, Phieler F (2009) Hypersensitivitätsreaktion auf Oxaliplatin – Wiederauftreten unter Misteltherapie ? TumorDiagn Ther 30:36–39. https://doi.org/10.1055/s-2008-1027982
Huebner J, Micke O, Muecke R et al (2014) User rate of complementary and alternative medicine (CAM) of patients visiting a counseling facility for CAM of a German comprehensive cancer center. Anticancer Res 34:943–948
Huntimer ED, Halaweish FT, Chase CCL (2006) Proliferative activity of Echinacea angustifolia root extracts on cancer cells: interference with doxorubicin cytotoxicity. Chem Biodivers 3:695–703. https://doi.org/10.1002/cbdv.200690071
Iaffaioli RV, Frasci G, Tortora G et al (1988) Effect of thymic extract „thymostimulin“ on the incidence of infections and myelotoxicity during adjuvant chemotherapy for breast cancer. Thymus 12:69–75
Itoh Y, Mizuno M, Ikeda M et al (2015) A randomized, double-blind pilot trial of Hydrolyzed rice bran versus placebo for radioprotective effect on acute gastroenteritis secondary to chemoradiotherapy in patients with cervical cancer. Evid Based Complement Alternat Med 2015:974390. https://doi.org/10.1155/2015/974390
Jakab F, Shoenfeld Y, Balogh Á et al (2003) A medical nutriment has supportive value in the treatment of colorectal cancer. Br J Cancer 89:465–469. https://doi.org/10.1038/sj.bjc.6601153
Kleeberg UR, Suciu S, Bröcker EB et al (2004) Final results of the EORTC 18871/DKG 80‑1 randomised phase III trial. rIFN-alpha2b versus rIFN-gamma versus ISCADOR M versus observation after surgery in melanoma patients with either high-risk primary (thickness 〉3 mm) or regional lymph node metastasis. Eur J Cancer 40:390–402. https://doi.org/10.1016/j.ejca .2003.07.004
Kovacs E (2004) Effects of viscum album extract therapy in patients with cancer: relation with interleukin‑6, soluble interleukin‑6 receptor, and soluble gp130. J Altern Complement Med 10:241–246. https://doi.org/10.1089/act.2004.10.241
Krege S, Hinke A, Otto T, Rübben H (2002) Bewertung des Komplementärtherapeutikums Factor AF2 als Supportivum in der Behandlung des fortgeschrittenen Urothelkarzinoms Prospektiv randomisierte Multicenterstudie. Urologe 41:164–168. https://doi.org/10.1007/s001200100129
Liang Y, He M, Fan X et al (2013) An abnormal elevation of serum CA72‑4 by ganoderma lucidum spore powder. Ann Clin Lab Sci 43:337–340
McDermott C, Richards SCM, Thomas PW et al (2006) A placebo-controlled, double-blind, randomized controlled trial of a natural killer cell stimulant (BioBran MGN-3) in chronic fatigue syndrome. QJM 99:461–468. https://doi.org/10.1093/qjmed/hcl063
Melchart D, Clemm C, Weber B et al (2002) Polysaccharides isolated from Echinacea purpurea herba cell cultures to counteract undesired effects of chemotherapy—A pilot study. Phytother Res 16:138–142. https://doi.org/10.1002/ptr.888
Mukai H, Watanabe T, Ando M, Katsumata N (2006) An alternative medicine, Agaricus blazei, may have induced severe hepatic dysfunction in cancer patients. Jpn J Clin Oncol 36:808–810. https://doi.org/10.1093/jjco/hyl108
Nichelatti M, Hidvégi M (2002) Experimental and clinical results with Avemar® (a dried extract from fermented weath germ) in animal cancer models and in cancer patients. Nog Oncol 7:180–185
Papadopoulos I, Wand H (1989) Reducing the side effects of aggressive chemotherapy (cisplatin and epirubicin) with xenogenic peptides (factor AF2) in patients with hormone refractory metastatic prostate cancer. A prospective, randomized study. Onkologie 12(Suppl 3):26–31. https://doi.org/10.1159/000216700
Piao BK, Wang YX, Xie GR et al (2004) Impact of complementary mistletoe extract treatment on quality of life in breast, ovarian and non-small cell lung cancer patients. A prospective randomized controlled clinical trial. Anticancer Res 24:303–309
Reddy BS, Hirose Y, Cohen LA et al (2000) Preventive potential of wheat bran fractions against experimental colon carcinogenesis: implications for human colon cancer prevention. Cancer Res 60:4792–4797
Romiti N, Pellati F, Nieri P et al (2008) P‑Glycoprotein inhibitory activity of lipophilic constituents of Echinacea pallida roots in a human proximal tubular cell line. Planta Med 74:264–266. https://doi.org/10.1055/s-2008-1034308
Safonova EA, Lopatina KA, Vychuzhanina AV et al (2016) Plant Polysaccharides attenuate fluorouracil toxicity for the small intestinal epithelium. Bull Exp Biol Med 161:308–311. https://doi.org/10.1007/s10517-016-3402-6
Sakamoto J, Morita S, Oba K et al (2006) Efficacy of adjuvant immunochemotherapy with polysaccharide K for patients with curatively resected colorectal cancer: a meta-analysis of centrally randomized controlled clinical trials. Cancer Immunol Immunother 55:404–411. https://doi.org/10.1007/s00262-005-0054-1
Tsai Y‑L, Chiu C‑C, Yi-Fu Chen J et al (2012) Cytotoxic effects of Echinacea purpurea flower extracts and cichoric acid on human colon cancer cells through induction of apoptosis. J Ethnopharmacol 143:914–919. https://doi.org/10.1016/j.jep.2012.08.032
Ulbricht C, Abrams TR, Bent S et al (2010) Reishi mushroom (Ganoderma lucidum): systematic review by the natural standard research collaboration. J Soc Integr Oncol 8:148–159. https://doi.org/10.2310/7200.2009.0029
Wesa KM, Cunningham-Rundles S, Klimek VM et al (2015) Maitake mushroom extract in myelodysplastic syndromes (MDS): a phase II study. Cancer Immunol Immunother 64:237–247. https://doi.org/10.1007/s00262-014-1628-6
Wolf E, Milazzo S, Boehm K et al (2011) Thymic peptides for treatment of cancer patients. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD003993.pub3
Yan B, Meng X, Shi J et al (2014) Ganoderma lucidum spore induced CA72‑4 elevation in gastrointestinal cancer: a five-case report. Integr Cancer Ther 13:161–166. https://doi.org/10.1177/1534735413510022
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J. Hübner, C. Stoll und C. Keinki geben an, dass kein Interessenkonflikt besteht.
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Hübner, J., Stoll, C. & Keinki, C. Immunstimulanzien aus der Naturheilkunde und ihr Einsatz bei Neoplasien. Onkologe 27, 1125–1130 (2021). https://doi.org/10.1007/s00761-021-01040-4
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DOI: https://doi.org/10.1007/s00761-021-01040-4