Phase 1 Clinical Trial of Trametes versicolor in Women with Breast Cancer

Introduction. Orally administered preparations from the Trametes versicolor (Tv) mushroom have been hypothesized to improve immune response in women with breast cancer after standard chemotherapy and radiotherapy. Methods. A phase I, two-center, dose escalation study was done to determine the maximum tolerated dose of a Tv preparation when taken daily in divided doses for 6 weeks after recent completion of radiotherapy. Eleven participants were recruited and nine women completed the study. Each cohort was comprised of three participants given one of three doses of Tv (3, 6, or 9 grams). Immune data was collected pre- and postradiation, at 3 on-treatment time points and after a 3-week washout. Results. Nine adverse events were reported (7 mild, 1 moderate, and 1 severe), suggesting that Tv was well tolerated. Immunological results indicated trends in (1) increased lymphocyte counts at 6 and 9 grams/day; (2) increased natural killer cell functional activity at 6 grams/day; (3) dose-related increases in CD8+ T cells and CD19+ B cells , but not CD4+ T cells or CD16+56+ NK cells. Conclusion. These findings show that up to 9 grams/day of a Tv preparation is safe and tolerable in women with breast cancer in the postprimary treatment setting. This Tv preparation may improve immune status in immunocompromised breast cancer patients following standard primary oncologic treatment

Concept analysis of dispositional humility in professionals and expanding the understanding of the concept in a multidisciplinary primary care environment: A mixed methods study

Thesis (Ph.D.)--University of Washington, 2018Dispositional humility of healthcare professionals balances self-centered occupational drive and the needs of other professionals, and may contribute to effective collaboration. After the concept of dispositional humility was analyzed by a literature review, a study surveying dispositional profiles and attitudes toward integrative medicine was conducted among primary care professionals working in interdisciplinary community-based healthcare clinics. In this exploratory sequential mixed method design study, the initial phase of quantitative survey was followed up by the qualitative study of individual interviews which was analyzed by directed content analysis. It was observed that the: 1) honesty-humility trait (p<0.01), conscientiousness (p<0.01), and openness (p<0.05) of primary care clinicians were statistically significantly higher than the reference norms of collage students; 2) attitudes toward integrative medicine were not different among the three different clinician types with different professional healthcare training backgrounds and credentials (MD/DO, NP, ND); and 3) the summative coding counted themes such as 'patient-centeredness' (other-oriented rather than self-oriented), 'humility', and 'trust', that were considered as attributes of dispositional humility. The directed content analysis identified the dynamic elements of the concept map of dispositional humility, which theoretically connected to functional collaboration among professionals. Dispositional humility allows clinicians to have an accurate self-assessment, be open to new ideas, appreciate the contribution of others, and develop generosity. Dispositional humility in leaders can facilitate character development of team members and create an environment characterized by fairness and equality, transparency, non-punitive consequences for reporting errors and near-misses, and a safe and encouraging environment for performing work. However, dispositional humility must be nurtured and developed through professional training because high educational attainment, career and financial success, and busy schedules may lead to a sense of self-importance and entitlement that can promote separation of team members into hierarchies based on professional disciplines and specialties. To maintain high quality patient care while working as a team, limiting self-interest while focusing on the needs of others may be necessary and in the best interest of patients. People who display high levels of honesty-humility as well as conscientiousness tend to place trust in other people and act themselves as trustworthy individuals

Echinacea alkylamides inhibit interleukin-2 production by Jurkat T cells

Abstract: Alkylamides present in Echinacea species have reported immunomodulatory actions, yet their direct effects on T lymphocytes, key mediators of antiviral immunity, are poorly understood. We hypothesized that constituents present in ethanolic extracts of Echinacea species exert direct immunomodulatory effects on human Jurkat T cells. Modulation of IL-2 production by submaximally stimulated Jurkat cells was determined in response to treatment with extracts prepared from dried aerial parts of Echinacea purpurea. Cells were treated with the extracts, with alkylamides or caffeic acid derivatives isolated from Echinaceaspecies, or with corresponding ethanol vehicle, in the absence or presence of phytohemagglutinin and phorbal ester. E. purpurea extracted in a solvent mixture of 95:5 ethanol/water dose-dependently inhibited IL-2 production. This IL-2 inhibitory activity correlated with the presence of alkylamides but not caffeic acid derivatives, as determined by high performance liquid chromatography/electrospray ionization-mass spectrometry analysis. Simultaneous measurement of secreted IL-2 by ELISA and cell viability by the XTT assay showed that the 95:5 ethanol/water extract of E. purpurea was both IL-2 suppressive and cytotoxic at 50 and 100 μg/mL. Lower concentrations from 6.25 to 25 μg/mL significantly decreased IL-2 production but not cell viability. Alkylamides at concentrations found in a 50 μg/mL extract decreased IL-2 production by approximately 50%. Two Echinacea-derived alkylamides significantly depressed IL-2 production but not cell viability in a dose-dependent manner. Thus, alkylamides present in E. purpurea suppress the ability of activated Jurkat T cells to produce IL-2 independently of direct, cytotoxic effects