title: Characterisation of immunological reactivity of patients with adverse effects during therapy with an aqueous mistletoe extract.
abstract: Drugs, which are effective are also bond to exert adverse effects. This is also true for mistletoe extracts. Extracts from European mistletoe (Viscum album, VAL) belong to the complementary therapeutic regimens and are used for adjuvant cancer therapy. This study was performed to characterise immunological reactivity of patients with adverse effects during treatment with an aqueous VAL extract (Helixor). VAL-stimulated proliferation and cytokine release of peripheral blood mononuclear cells (PBMC) and anti-mistletoe lectin (ML)-1 antibody production were investigated. 34 patients with proven adverse effects due to VAL therapy (group 1) and 9 patients with unproven relation (group 2) were studied and compared to 14 tumour patients treated with VAL for more than 2 years without side effects (TTP). VAL-stimulated proliferation of PBMC of group 1 was significantly enhanced as compared to group 2 patients and TTP. PBMC from patients with local manifestations proliferated significantly stronger than those from patients with systemic symptoms. Anti-ML-1 antibodies of the IgE type were produced in patients with proven adverse effects but not in patients without adverse effects. Production of Th1 and Th2 specific cytokines varied considerably, indicating that different mechanisms were involved in the induction of adverse effects. In conclusion, our study provide evidence that adverse effects towards VAL (Helixor) are seldom and are dominated by an application site reaction suggesting the involvement of delayed type hypersensitivity (DTH) reactions.
authors.affiliation: Krebsforschung Herdecke, Dept. of Applied Immunology, Communal Hospital, University Witten/Herdecke, Gerhard-Kienle Weg 4, D-58313 Herdecke, Germany. stein.g@primus-online.de
authors.forename: G M
authors.initials: GM
authors.lastname: Stein
authors.forename: P A
authors.initials: PA
authors.lastname: Berg
mesh_terms: D000276:Adjuvants, Immunologic / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D000917:Antibody Formation; D016207:Cytokines / Q000378:metabolism; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D066298:In Vitro Techniques; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D014784:Mistletoe / Q000276:immunology*; D009369:Neoplasms / Q000276:immunology* / Q000628:therapy*; D009844:Oligosaccharides / Q000009:adverse effects* / Q000276:immunology*; D010936:Plant Extracts / Q000009:adverse effects* / Q000276:immunology*; D010946:Plants, Medicinal; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology
chemical_list: D000276:Adjuvants, Immunologic; D016207:Cytokines; D009844:Oligosaccharides; D010936:Plant Extracts; C027633:Helixor