Skip to main content
Top
Published in: BMC Complementary Medicine and Therapies 1/2011

Open Access 01-12-2011 | Research article

Safety and effects of two mistletoe preparations on production of Interleukin-6 and other immune parameters - a placebo controlled clinical trial in healthy subjects

Authors: Roman Huber, Holger Lüdtke, Johannes Wieber, Christiane Beckmann

Published in: BMC Complementary Medicine and Therapies | Issue 1/2011

Login to get access

Abstract

Background

In Germany, Iscucin® Populi (IP), a preparation from mistletoe growing on the poplar tree, is used in cancer therapy while Viscum Mali e planta tota (VM), a preparation from mistletoe growing on the apple tree, is used in patients with osteoarthritis. Since mistletoe preparations are suspected to induce production of potentially tumor promoting cytokines like interleukin (IL)-6, further studies on the immunological effects are of interest.

Methods

In this 3-armed randomized, double blind clinical trial healthy volunteers received increasing doses of either IP (strength F, 0.0125%, G, 0.25% and H, 5%, each for 4 weeks), or VM (1:1000 [D3], 1:100 [D2] and 2% each for 4 weeks) or placebo (isotonic solution) subcutaneously twice per week over a period of 12 weeks. Physical examination was performed weekly. Routine laboratory parameters and immunological parameters (C-reactive protein (CRP), differential blood count, lymphocyte subsets, immunoglobulins, IL-6 and tumor necrosis factor (TNF)-α) were analysed every 4 weeks.

Results

71 subjects were included in the study (IP = 30, VM = 21, placebo = 20) of whom 69 concluded it according to protocol. Application of IP strengths G and H caused strong local reactions at the site of injection. In parallel, a distinct eosinophilia (p < 0.001 compared to placebo) occurred. Furthermore, application of all IP concentrations resulted in an increase of CD4 cell counts (p < 0.05) compared to placebo. Stimulation of IL-6 production, CRP or relevant deviations in other laboratory parameters were not observed. Because of local reactions, IP strengths G and H were considered less tolerable than placebo. VM 2% was slightly less tolerable than placebo, caused only mild local reactions and an only small increase in eosinophile counts.

Conclusion

Treatment with IP results in eosinophilia and an increase of CD4 cells but not in an increase of IL-6 or CRP. No safety concerns regarding the two mistletoe preparations have been raised by this study. EudraCT-Number 2007-002166-35.

Trial registration

ClinicalTrials.gov: NCT01378702
Appendix
Available only for authorised users
Literature
1.
go back to reference Büssing A: Biological and pharmacological properties of Viscum album L. Mistletoe. The Genus Viscum. Edited by: Büssing A. 2000, Amsterdam: Harwood Academic Publishers, 123-182. Büssing A: Biological and pharmacological properties of Viscum album L. Mistletoe. The Genus Viscum. Edited by: Büssing A. 2000, Amsterdam: Harwood Academic Publishers, 123-182.
2.
go back to reference van der Weg F, Streuli RA: Use of alternative medicine by patients with cancer in a rural area of Switzerland. Swiss Medical Weekly. 2003, 133 (15-16): 233-240.PubMed van der Weg F, Streuli RA: Use of alternative medicine by patients with cancer in a rural area of Switzerland. Swiss Medical Weekly. 2003, 133 (15-16): 233-240.PubMed
3.
go back to reference Horneber MA, Bueschel G, Huber R, Linde K, Rostock M: Mistletoe therapy in oncology. Cochrane Database Systematic Review. 2008, CD003297-2 Horneber MA, Bueschel G, Huber R, Linde K, Rostock M: Mistletoe therapy in oncology. Cochrane Database Systematic Review. 2008, CD003297-2
4.
go back to reference Gabius S, Gabius HJ: Immunomodulating mistletoe therapy by lectin standardization: a double-edged sword?. Versicherungsmedizin. 1999, 51 (3): 128-36.PubMed Gabius S, Gabius HJ: Immunomodulating mistletoe therapy by lectin standardization: a double-edged sword?. Versicherungsmedizin. 1999, 51 (3): 128-36.PubMed
5.
go back to reference Hallek M: Interleukin-6-mediated cell growth in multiple myeloma - a role for Viscum album extracts?. Onkologie. 2005, 28 (8-9): 387-10.1159/000087116.PubMed Hallek M: Interleukin-6-mediated cell growth in multiple myeloma - a role for Viscum album extracts?. Onkologie. 2005, 28 (8-9): 387-10.1159/000087116.PubMed
6.
go back to reference Hallek M, Bergsagel PL, Anderson KC: Multiple myeloma: increasing evidence for a multistep transformation process. Blood. 1998, 91 (1): 3-21.PubMedPubMedCentral Hallek M, Bergsagel PL, Anderson KC: Multiple myeloma: increasing evidence for a multistep transformation process. Blood. 1998, 91 (1): 3-21.PubMedPubMedCentral
7.
go back to reference Kelter G, Schierholz JM, Fischer IU, Fiebig HH: Cytotoxic activity and absence of tumor growth stimulation of standardized mistletoe extracts in human tumor models in vitro. Anticancer Research. 2007, 27 (1A): 223-233.PubMed Kelter G, Schierholz JM, Fischer IU, Fiebig HH: Cytotoxic activity and absence of tumor growth stimulation of standardized mistletoe extracts in human tumor models in vitro. Anticancer Research. 2007, 27 (1A): 223-233.PubMed
8.
go back to reference Kovacs E: Investigation of the proliferation, apoptosis/necrosis, and cell cycle phases in several human multiple myeloma cell lines. Comparison of Viscum album QuFrF extract with vincristine in an in vitro model. ScientificWorld Journal. 2010, 10: 311-220.CrossRefPubMed Kovacs E: Investigation of the proliferation, apoptosis/necrosis, and cell cycle phases in several human multiple myeloma cell lines. Comparison of Viscum album QuFrF extract with vincristine in an in vitro model. ScientificWorld Journal. 2010, 10: 311-220.CrossRefPubMed
9.
go back to reference Kovacs E, Link S, Toffol-Schmidt U: Comparison of Viscum album QuFrF extract with vincristine in an in vitro model of human B cell lymphoma WSU-1. Arzneimittelforschung. 2008, 58 (11): 592-597.PubMed Kovacs E, Link S, Toffol-Schmidt U: Comparison of Viscum album QuFrF extract with vincristine in an in vitro model of human B cell lymphoma WSU-1. Arzneimittelforschung. 2008, 58 (11): 592-597.PubMed
10.
go back to reference Stumpf C, Rosenberger A, Rieger S, Tröger W, Schietzel M: Mistletoe extracts in the therapy of malignant, hematological and lymphatic diseases--a monocentric, retrospective analysis over 16 years. Forschende Komplementärmedizin und Klassische Naturheilkunde. 2000, 7 (3): 139-146. 10.1159/000021330.CrossRefPubMed Stumpf C, Rosenberger A, Rieger S, Tröger W, Schietzel M: Mistletoe extracts in the therapy of malignant, hematological and lymphatic diseases--a monocentric, retrospective analysis over 16 years. Forschende Komplementärmedizin und Klassische Naturheilkunde. 2000, 7 (3): 139-146. 10.1159/000021330.CrossRefPubMed
11.
go back to reference Vogel HH: Richtlinien für die Malignom-Therapie mit Iscucin-Viscum-Präparaten. Edited by: WALA-Heilmittel GmbH. 1980 Vogel HH: Richtlinien für die Malignom-Therapie mit Iscucin-Viscum-Präparaten. Edited by: WALA-Heilmittel GmbH. 1980
12.
go back to reference Sommer M, Soldner G: Die Mistel und ihre Wirtsbäume. Der Merkurstab. 2000, 1 (53): 29-43. Sommer M, Soldner G: Die Mistel und ihre Wirtsbäume. Der Merkurstab. 2000, 1 (53): 29-43.
13.
go back to reference Gärtner C: Therapie der Arthrosen großer Gelenke. Der Merkurstab. 1999, 52: 48-51. Gärtner C: Therapie der Arthrosen großer Gelenke. Der Merkurstab. 1999, 52: 48-51.
14.
go back to reference Zuzak T, Rist L, Viviani A, Eggenschwiler J, Mol C, Riegert U, Meyer U: Das Mistelpräparat Iscucin® - Herstellung, Analytik, Wirkung in vitro. Der Merkurstab. 2004, 6: 467-473. Zuzak T, Rist L, Viviani A, Eggenschwiler J, Mol C, Riegert U, Meyer U: Das Mistelpräparat Iscucin® - Herstellung, Analytik, Wirkung in vitro. Der Merkurstab. 2004, 6: 467-473.
15.
go back to reference Investigator's Brochure Iscucin Populi, strength F, G, H and Viscum Mali e planta tota D3, D2 and 2%. 2007, WALA Heilmittel GmbH Investigator's Brochure Iscucin Populi, strength F, G, H and Viscum Mali e planta tota D3, D2 and 2%. 2007, WALA Heilmittel GmbH
16.
go back to reference Huber R, Klein R, Berg PA, Lüdtke R, Werner M: Effects of a lectin- and a viscotoxin-rich mistletoe preparation on clinical and hematologic parameters: a placebo-controlled evaluation in healthy subjects. Journal of Alternative and Complementary Medicine. 2002, 8 (6): 857-866. 10.1089/10755530260511847.CrossRefPubMed Huber R, Klein R, Berg PA, Lüdtke R, Werner M: Effects of a lectin- and a viscotoxin-rich mistletoe preparation on clinical and hematologic parameters: a placebo-controlled evaluation in healthy subjects. Journal of Alternative and Complementary Medicine. 2002, 8 (6): 857-866. 10.1089/10755530260511847.CrossRefPubMed
17.
go back to reference Stein GM, Stettin A, Schultze J, Berg PA: Induction of anti-mistletoe lectin antibodies in relation to different mistletoe extracts. Anticancer_Drugs. 1997, 8 (Suppl 1): S57-S59.PubMed Stein GM, Stettin A, Schultze J, Berg PA: Induction of anti-mistletoe lectin antibodies in relation to different mistletoe extracts. Anticancer_Drugs. 1997, 8 (Suppl 1): S57-S59.PubMed
18.
go back to reference Huber R, Rostock M, Goedl R, Lüdtke R, Urech K, Buck S, Klein R: Mistletoe treatment induces GM-CSF- and IL-5 production by PBMC and increases blood granulocyte- and eosinophil counts: a placebo controlled randomized study in healthy subjects. European Journal of Medical Research. 2005, 10 (10): 411-418.PubMed Huber R, Rostock M, Goedl R, Lüdtke R, Urech K, Buck S, Klein R: Mistletoe treatment induces GM-CSF- and IL-5 production by PBMC and increases blood granulocyte- and eosinophil counts: a placebo controlled randomized study in healthy subjects. European Journal of Medical Research. 2005, 10 (10): 411-418.PubMed
19.
go back to reference Thomas L, Editor: Labor und Diagnose. 2000, TH-Books Verlagsgesellschaft Frankfurt/Main, 5 Thomas L, Editor: Labor und Diagnose. 2000, TH-Books Verlagsgesellschaft Frankfurt/Main, 5
20.
go back to reference Bosma PJ, Chowdhury JR, Bakker C, Gantla S, de Boer A, Oostra BA, Lindhout D, Tytgat GN, Jansen PL, Oude Elferink RP: The genetic basis of the reduced expression of bilirubin UDP-glucuronosyltransferase 1 in Gilbert's syndrome. New England Journal of Medicine. 1995, 333 (18): 1171-1175. 10.1056/NEJM199511023331802.CrossRefPubMed Bosma PJ, Chowdhury JR, Bakker C, Gantla S, de Boer A, Oostra BA, Lindhout D, Tytgat GN, Jansen PL, Oude Elferink RP: The genetic basis of the reduced expression of bilirubin UDP-glucuronosyltransferase 1 in Gilbert's syndrome. New England Journal of Medicine. 1995, 333 (18): 1171-1175. 10.1056/NEJM199511023331802.CrossRefPubMed
21.
go back to reference Rostock M, Huber R: Randomized and double-blind studies - demands and reality as demonstrated by two examples of mistletoe research. Forschende Komplementärmedizin und Klassische Naturheilkunde. 2004, 1 (Suppl): 18-22.CrossRef Rostock M, Huber R: Randomized and double-blind studies - demands and reality as demonstrated by two examples of mistletoe research. Forschende Komplementärmedizin und Klassische Naturheilkunde. 2004, 1 (Suppl): 18-22.CrossRef
22.
go back to reference Melzer J, Iten F, Hostanska K, Saller R: Efficacy and safety of mistletoe preparations (Viscum album) for patients with cancer diseases. A systematic review. Forschende Komplementärmedizin. 2009, 16 (4): 217-226.CrossRefPubMed Melzer J, Iten F, Hostanska K, Saller R: Efficacy and safety of mistletoe preparations (Viscum album) for patients with cancer diseases. A systematic review. Forschende Komplementärmedizin. 2009, 16 (4): 217-226.CrossRefPubMed
24.
go back to reference Stein G: Untersuchungen zur Interaktion von Mistelantigenen mit dem Immunsystem. 1995, Doctorate thesis University Tuebingen, Germany Stein G: Untersuchungen zur Interaktion von Mistelantigenen mit dem Immunsystem. 1995, Doctorate thesis University Tuebingen, Germany
25.
go back to reference Stein G, Henn W, von Laue H, Berg P: Modulation of the cellular and humoral immune responses of tumor patients by mistletoe therapy. Eur J Med Res. 1998, 3 (4): 194-202.PubMed Stein G, Henn W, von Laue H, Berg P: Modulation of the cellular and humoral immune responses of tumor patients by mistletoe therapy. Eur J Med Res. 1998, 3 (4): 194-202.PubMed
26.
go back to reference Kaiser G, Büschel M, Horneber M, Smetak M, Birkmann J, Braun W, Fischer S, v. Laue HB, Scheer R, Gallmaier WM: Studiendesign und erste Ergebnisse einer prospektiven placebokontrollierten, randomisierten Studie mit AbnobaViscum Mali 4. Die Mistel in der Tumortherapie. Grundlagenforschung und Klinik. Edited by: Scheer R, Bauer R, Becker H, Berg PA, Fintelmann V. 2001, Essen: KVC publisher, 485-505. Kaiser G, Büschel M, Horneber M, Smetak M, Birkmann J, Braun W, Fischer S, v. Laue HB, Scheer R, Gallmaier WM: Studiendesign und erste Ergebnisse einer prospektiven placebokontrollierten, randomisierten Studie mit AbnobaViscum Mali 4. Die Mistel in der Tumortherapie. Grundlagenforschung und Klinik. Edited by: Scheer R, Bauer R, Becker H, Berg PA, Fintelmann V. 2001, Essen: KVC publisher, 485-505.
27.
go back to reference Kienle GS, Kiene H: Wirkungen der Mistelextrakte auf Zytokine. Die Mistel in der Onkologie. 2003, Stuttgart, New York Schattauer, 288-296. Kienle GS, Kiene H: Wirkungen der Mistelextrakte auf Zytokine. Die Mistel in der Onkologie. 2003, Stuttgart, New York Schattauer, 288-296.
28.
go back to reference Preisfeld A: Influence of aqueous mistletoe preparations on humoral immune parameters with emphasis on the cytotoxicity of human complement in breast cancer patients. Forschende Komplementärmedizin. 1997, 4: 224-228.CrossRef Preisfeld A: Influence of aqueous mistletoe preparations on humoral immune parameters with emphasis on the cytotoxicity of human complement in breast cancer patients. Forschende Komplementärmedizin. 1997, 4: 224-228.CrossRef
29.
go back to reference van Wely M, Stoss M, Gorter RW: Toxicity of a standardized mistletoe extract in immunocompromised and healthy individuals. American Journal of Therapeutics. 1999, 6 (1): 37-43. 10.1097/00045391-199901000-00006.CrossRefPubMed van Wely M, Stoss M, Gorter RW: Toxicity of a standardized mistletoe extract in immunocompromised and healthy individuals. American Journal of Therapeutics. 1999, 6 (1): 37-43. 10.1097/00045391-199901000-00006.CrossRefPubMed
30.
go back to reference Mosman TR, Sad S: The expanding universe of Tcell subsets: Th1, Th2 and more. Immunology Today. 1996, 17: 138-146. 10.1016/0167-5699(96)80606-2.CrossRef Mosman TR, Sad S: The expanding universe of Tcell subsets: Th1, Th2 and more. Immunology Today. 1996, 17: 138-146. 10.1016/0167-5699(96)80606-2.CrossRef
31.
go back to reference Ellyard JI, Simson L, Parish CR: Th2-mediated anti-tumour immunity: friend or foe?. Tissue Antigens. 2007, 70 (1): 1-11. 10.1111/j.1399-0039.2007.00869.x.CrossRefPubMed Ellyard JI, Simson L, Parish CR: Th2-mediated anti-tumour immunity: friend or foe?. Tissue Antigens. 2007, 70 (1): 1-11. 10.1111/j.1399-0039.2007.00869.x.CrossRefPubMed
32.
go back to reference Simson L, Ellyard JI, Dent LA, Matthaei KI, Rothenberg ME, Foster PS, Smyth MJ, Parish CR: Regulation of carcinogenesis by IL-5 and CCL11: a potential role for eosinophils in tumor immune surveillance. Journal of Immunology. 2007, 178 (7): 4222-4229.CrossRef Simson L, Ellyard JI, Dent LA, Matthaei KI, Rothenberg ME, Foster PS, Smyth MJ, Parish CR: Regulation of carcinogenesis by IL-5 and CCL11: a potential role for eosinophils in tumor immune surveillance. Journal of Immunology. 2007, 178 (7): 4222-4229.CrossRef
33.
go back to reference Cuschieri A, Talbot IC, Weeden S, MRC Upper GI Cancer Working Party: Influence of pathological tumour variables on long-term survival in resectable gastric cancer. British Journal of Cancer. 2002, 86 (5): 674-679. 10.1038/sj.bjc.6600161.CrossRefPubMedPubMedCentral Cuschieri A, Talbot IC, Weeden S, MRC Upper GI Cancer Working Party: Influence of pathological tumour variables on long-term survival in resectable gastric cancer. British Journal of Cancer. 2002, 86 (5): 674-679. 10.1038/sj.bjc.6600161.CrossRefPubMedPubMedCentral
34.
go back to reference Nagtegaal ID, Marijnen CA, Kranenbarg EK, Mulder-Stapel A, Hermans J, van de Velde CJ, van Krieken JH: Local and distant recurrences in rectal cancer patients are predicted by the nonspecific immune response; specific immune response has only a systemic effect - a histopathological and immunohistochemical study. BMC Cancer. 2001, 1: 7-10.1186/1471-2407-1-7.CrossRefPubMedPubMedCentral Nagtegaal ID, Marijnen CA, Kranenbarg EK, Mulder-Stapel A, Hermans J, van de Velde CJ, van Krieken JH: Local and distant recurrences in rectal cancer patients are predicted by the nonspecific immune response; specific immune response has only a systemic effect - a histopathological and immunohistochemical study. BMC Cancer. 2001, 1: 7-10.1186/1471-2407-1-7.CrossRefPubMedPubMedCentral
35.
go back to reference Mabed M, El-Helw L, Shamaa S: Phase II study of viscum fraxini-2 in patients with advanced hepatocellular carcinoma. British Journal of Cancer. 2004, 90 (1): 65-69. 10.1038/sj.bjc.6601463.CrossRefPubMedPubMedCentral Mabed M, El-Helw L, Shamaa S: Phase II study of viscum fraxini-2 in patients with advanced hepatocellular carcinoma. British Journal of Cancer. 2004, 90 (1): 65-69. 10.1038/sj.bjc.6601463.CrossRefPubMedPubMedCentral
Metadata
Title
Safety and effects of two mistletoe preparations on production of Interleukin-6 and other immune parameters - a placebo controlled clinical trial in healthy subjects
Authors
Roman Huber
Holger Lüdtke
Johannes Wieber
Christiane Beckmann
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2011
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/1472-6882-11-116

Other articles of this Issue 1/2011

BMC Complementary Medicine and Therapies 1/2011 Go to the issue