Viscum album L. extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research

<p>Abstract</p> <p>Background</p> <p><it>Viscum album </it>L. extracts (VAE, European mistletoe) are a widely used medicinal plant extract in gynaecological and breast-cancer treatment.</p> <p>Methods</p> <p>Systematic review to evaluate clinical studies and preclinical research on the therapeutic effectiveness and biological effects of VAE on gynaecological and breast cancer. Search of databases, reference lists and expert consultations. Criteria-based assessment of methodological study quality.</p> <p>Results</p> <p>19 randomized (RCT), 16 non-randomized (non-RCT) controlled studies, and 11 single-arm cohort studies were identified that investigated VAE treatment of breast or gynaecological cancer. They included 2420, 6399 and 1130 patients respectively. 8 RCTs and 8 non-RCTs were embedded in the same large epidemiological cohort study. 9 RCTs and 13 non-RCTs assessed survival; 12 reported a statistically significant benefit, the others either a trend or no difference. 3 RCTs and 6 non-RCTs assessed tumour behaviour (remission or time to relapse); 3 reported statistically significant benefit, the others either a trend, no difference or mixed results. Quality of life (QoL) and tolerability of chemotherapy, radiotherapy or surgery was assessed in 15 RCTs and 9 non-RCTs. 21 reported a statistically significant positive result, the others either a trend, no difference, or mixed results. Methodological quality of the studies differed substantially; some had major limitations, especially RCTs on survival and tumour behaviour had very small sample sizes. Some recent studies, however, especially on QoL were reasonably well conducted. Single-arm cohort studies investigated tumour behaviour, QoL, pharmacokinetics and safety of VAE. Tumour remission was observed after high dosage and local application. VAE application was well tolerated. 34 animal experiments investigated VAE and isolated or recombinant compounds in various breast and gynaecological cancer models in mice and rats. VAE showed increase of survival and tumour remission especially in mice, while application in rats as well as application of VAE compounds had mixed results. <it>In vitro </it>VAE and its compounds have strong cytotoxic effects on cancer cells.</p> <p>Conclusion</p> <p>VAE shows some positive effects in breast and gynaecological cancer. More research into clinical efficacy is warranted.</p

Plants and their ectomycorrhizosphere: Cost and benefit of symbiotic soil organisms.

The ectomycorrhizosphere is a heterogeneous and variable micro-environment, predominantly established by variously formed extramatrical mycelia (EMM) that emanate from the hyphal mantle of ectomycorrhizae that envelopes the short roots. The mycelia differ fungal species-dependent regarding range, density and differentiation. Contingent upon the amount of sugars available for the ectomycorrhizal fungi &mdash; controlled, e.g. by elevated above-ground concentrations of ozone or carbon dioxide exposure to host trees &mdash; an ectomycorrhizal community can change its total amount of EMM, leading to changes in space occupation, and consequently, to alterations in its capacity to explore and exploit soil resources. We quantify the exploration type specific space occupation under the influence of twice-ambient ozone concentrations and estimate the carbon cost the tree has to pay for. Further, we address enzymatic capacities of ectomycorrhizal communities and focus on bacteria being associated with the mycelium. Finally we discuss the impact of soil micro-niches on ectomycorrhizal communities and mention briefly the ectomycorrhizal competition with each other and with saprotrophic fungi