Deutsche Zeitschrift für Onkologie 2019; 51(02): 81-88
DOI: 10.1055/a-0827-9646
Forschung
© Georg Thieme Verlag KG Stuttgart · New York

In-vitro-Untersuchungen zur Hemmung der Angiogenese und der Tumorzellmigration durch einen wässrigen Extrakt aus Viscum album ssp. album, Mali

In vitro studies on the inhibition of angiogenesis and tumor cell migration by an aqueous extract from Viscum album ssp. album, Mali
Jennifer E. Felenda
,
Kim Gruber
,
Claudia Turek
,
Florian C. Stintzing
Further Information

Publication History

Publication Date:
24 June 2019 (online)

Zusammenfassung

Hintergrund und Ziel Mistelpräparate, insbesondere aus der Apfelbaummistel (Viscum album ssp. album, Mali), werden häufig von Mammakarzinom-Patientinnen als komplementäre Therapiemaßnahme nach Resektion, Chemo- oder Radiotherapien angewendet. In klinischen Studien wurde bereits der Nutzen von Mistelpräparaten nachgewiesen. Da die dahinter liegenden Wirkmechanismen bisher nicht vollständig aufgeklärt sind, sollten die potenziell antitumoralen Effekte eingehender untersucht werden.

Material und Methoden Es wurden In-vitro-Untersuchungen zu den Effekten eines wässrigen Extrakts aus Viscum album ssp. album, Mali (Iscucin® Mali) auf die Zellviabilität, auf verschiedene Phasen der Angiogenese (Zellproliferation und Kapillarausbildung) sowie auf die Zellmigration humaner Tumorzellen durchgeführt.

Ergebnisse Zwei verschiedene Assays gaben Hinweise auf antiproliferative Effekte mit einer halbmaximalen Hemmung bei Konzentrationen<100 µg/ml. Es zeigten sich außerdem hemmende Effekte auf die Kapillarausbildung. Die Migrationsfähigkeit verschiedener Tumorzelllinien wurde durch Iscucin® Mali mit unterschiedlicher Effektivität gehemmt, vergleichbar mit der Referenzsubstanz Bosutinib bei den Zelllinien LN229, SK-N-SH, DLD-1, HeLa und etwas besser bei Caki-2.

Diskussion und Schlussfolgerung Ein Panel aus verschiedenen Untersuchungsmethoden zeigte in Abhängigkeit von der Zelllinie antitumorale Effekte von Iscucin® Mali, vor allem im Bereich der Kapillarausbildung und der Zellmigration. Dies lässt vermuten, dass sowohl das Tumorwachstum als auch die Metastasierung verzögert werden können. Weitere Studien sind erforderlich, um die Relevanz der gewonnenen Daten im klinischen Bereich zu untermauern.

Abstract

Purpose Mistletoe preparations are commonly used in the treatment of breast cancer as complementary therapy after resection, chemotherapy or radiotherapy. Most frequently, a preparation of the mistletoe from the apple tree is applied (Viscum album ssp. album, Mali). A benefit of mistletoe preparations has been shown in clinical studies though the underlying mechanism of action is not fully clarified so far. Therefore the aim of the study was to evaluate the potentially anti-tumoral effects in detail.

Material and Methods In vitro investigations evaluating the effects of an aqueous extract of Viscum album ssp. album, Mali (Iscucin® Mali) on cell viability, cell proliferation and tube formation in a two-dimensional and three-dimensional design, as well as tumor cell migration were performed.

Results Two different assays provided an indication for antiproliferative effects with an IC50 of less than 100 µg/ml. 309 µg/ml Iscucin® Mali and 500 µg/ml 5-fluorouracil (5-FU) reduced human endothelial cells proliferation by 90%. 500 µg/ml Iscucin® Mali inhibited cell growth almost completely (96.8%). Iscucin® Mali revealed also an inhibitory action on tube formation. 2.000 µg/ml Iscucin® Mali yielded more than 50% inhibition of cell migration of most cell lines tested in the present study. The intensity of effects was dependent on the respective cell lines. The inhibition of cell migration capacity by Iscucin® Mali was comparable with the reference substance Bosutinib for cell line LN229, SK-N-SH, DLD-1, Caki-2 and HeLa. The mamma carcinoma cell line MCF-7 and MDA-MB-231 as well as A437 (squamous cell carcinoma) and U87-MG (glioblastoma) did not respond. The strongest effects were shown for Caki-2 (renal cell carcinoma) and SK-N-SH (neuroblastoma).

Discussion and Conclusion A panel of different assays showed an anti-tumoral effect of Iscucin® Mali depending on cell line, especially on tube formation and cell migration. It is therefore assumed that this mistletoe preparation has an impact on tumor growth and retards the progression of disease or metastasis. Further studies are necessary to investigate these effects on a clinical scale.

 
  • Literatur

  • 1 Beztsinna N, de Matos MB, Walther J. et al. Quantitative analysis of receptor-mediated uptake and pro-apoptotic activity of mistletoe lectin-1 by high content imaging. Sci Rep 2018; 8: 2768-2778
  • 2 Büssing A, Schietzel M. Apoptosis-inducing properties of Viscum album L. extracts from different host trees, correlate with their content of toxic mistletoe lectins. Anticancer Res 1999; 19: 23-28
  • 3 Carayon P, Bord A. Identification of DNA-replicating lymphocyte subsets using a new method to label the bromo-deoxyuridine incorporated into the DNA. J Immunol Methods 1992; 147: 225-230
  • 4 Crouch SPM, Kozlowski R, Slater KJ, Fletcher J. The use of ATP bioluminescence as a measure of cell proliferation and cytotoxicity. J Immunol Methods 1993; 160: 81-88
  • 5 DeSantis CE, Fedewa SA, Goding Sauer A. et al. Breast cancer statistics, 2015: Convergence of incidence rates between black and white women. CA Cancer J Clin 2016; 66: 31-42
  • 6 Duong Van Huyen JP, Bayry J, Delignat S. et al. Induction of apoptosis of endothelial cells by Viscum album: A role for anti-tumoral properties of mistletoe lectins. Mol Med 2002; 10: 600-606
  • 7 Eggenschwiler J, von Balthazar L, Stritt B. et al. Mistletoe lectin is not the only cytotoxic component in fermented preparations of Viscum album from white fir (Abies pectinata). BMC Complement Altern Med 2007; 7: 14
  • 8 Eisenbraun J, Scheer R, Kröz M. et al. Quality of life in breast cancer patients during chemotherapy and concurrent therapy with a mistletoe extract. Phytomedicine 2011; 18: 151-157
  • 9 Frame MC. Src in cancer: deregulation and consequences for cell behaviour. Biochim Biophys Acta 2002; 1602: 114-130
  • 10 Gough W, Hulkower KI, Lynch R. et al. A quantitative, facile, and high throughput image-based cell migration method is a robust alternative to the scratch assay. J Biomol Screen 2011; 16: 155-163
  • 11 Heidecke H, Meyer U. Iscucin®-Wirkung auf die Angiogenese in vitro. Zeitschrift für anthroposophische Medizin 2005; 58: 302-304
  • 12 Horneber M, Bueschel G, Dennert G. et al. How many cancer patients use complementary and alternative medicine: a systemic review and metaanalysis. Integr Cancer Ther 2012; 11: 187-203
  • 13 Hugo F, Schwitalla S, Niggemann B. et al. Viscum album extracts Iscador P and Iscador M counteract the growth factor induced effects in human follicular B-NHL cells and breast cancer cells. Medicina 2007; 67: 90-96
  • 14 Janssen O, Scheffler A, Kabelitz D. In vitro effects of mistletoe extracts and mistletoe lectins. Drug Res 1993; 43: 1221-1227
  • 15 Kienle GS, Glockmann A, Schink M, Kiene H. Viscum album L. extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research. J Exp Clin Cancer Res 2009; 28: 79
  • 16 Korff T, Augustin HG. Tensional forces in fibrillar extracellular matrices control directional capillary sprouting. J Cell Sci 1999; 112: 3249-3258
  • 17 Kurschat P, Mauch C. Mechanismen der Metastasierung. In: Szeimies RM, Hauschild A, Garbe C, Kaufmann R, Landthaler M. Hrsg Tumoren der Haut. Stuttgart: Georg Thieme; 2010: 11-15
  • 18 Marvibaigi M, Supriyanto E, Amini N. et al. Preclinical and clinical effects of mistletoe against breast cancer. BioMed Res Int 2014; 785479
  • 19 Matthes H. Die Misteltherapie in der Onkologie – ein Update. Praxismagazin 2017; 9: 6-14
  • 20 Micke O, Bruns F, Glatzel M. et al. Predictive factors for the use of complementary and alternative medicine (CAM) in radiation oncology. Eur J Integr Med 2009; 1: 22-30
  • 21 Molassiotis A, Fernández-Ortega P, Pud D. et al. Use of complementary and alternative medicine in cancer patients: a European survey. Ann. Oncology 2005; 16: 655-663
  • 22 Molassiotis A, Scott JA, Kearney N. et al. Complementary and alternative medicine use in breast cancer patients in Europe. Support Care Cancer 2006; 14: 260-267
  • 23 Moon JM, Chung YJ, Chae B. et al. Effect of mistletoe on endometrial stromal cell survival and vascular endothelial growth factor expression in patients with endometriosis. Int J Med Sci 2018; 15: 1530-1536
  • 24 Paepke D. Die Misteltherapie in der Onkologie. Studienlage und Einsatzgebiete. Im Focus Onkologie 2018; 3: 64-68
  • 25 Papaetis GS, Syrigos KN. Sunitinib, a multitargeted receptor tyrosine kinase inhibitor in the era of molecular cancer therapies. BioDrugs 2009; 23: 377-389
  • 26 Ponce L. Section IV: In vitro techniques. Chapter 10: Tube Formation: An in vitro Matrigel Angiogenesis Assay. In: Martin S, Murray C. eds Methods in Molecular Biology, Angiogenesis Protocols. 2nd ed. New York City: Humana Press; 2009: 183-188
  • 27 Potente M, Gerhardt H, Carmeliet P. Basic and therapeutic aspects of angiogenesis. Cell 2011; 146: 873-887
  • 28 Pryme IF, Bardocz S, Pusztai A, Ewen SW. Suppression of growth of tumour cell lines in vitro and tumours in vivo by mistletoe lectins. Histol Histopathol 2006; 21: 285-299
  • 29 Sommer M, Soldner G. Die Mistel und ihre Wirtsbäume. Zeitschrift für anthroposophische Medizin 2000; 53: 29-43
  • 30 Tautz E, Momm F, Hasenburg A, Guethlin C. Use of complementary and alternative medicine in breast cancer patients and their experiences: a cross-sectional study. Eur J Cancer 2012; 48: 3133-3139
  • 31 Torre LA, Siegel RL, Ward EM, Jemal A. Global cancer incidence and mortality rates and trends – An update. Cancer Epidemiol Biomarkers Prev 2016; 25: 16-27
  • 32 Tröger W. Zusammenhang von Lebensqualität und Neutropenie bei Brustkrebspatientinnen, die alleine mit Chemotherapie oder zusätzlich mit Misteltherapie behandelt wurden. Dtsch Z Onkol 2011; 43: 58-67
  • 33 Tröger W, Zdrale Z, Tisma N, Matijasevic M. Additional therapy with a mistletoe product during adjuvant chemotherapy of breast cancer patients improves quality of life: an open randomized clinical pilot trial. Evid Based Complement Alternat Med 2014; 2014: 430518. doi:10.1155/2014/430518
  • 34 Vultur A, Buettner R, Kowolik C. et al. SKI-606 (bosutinib), a novel Src kinase inhibitor, suppresses migration and invasion of human breast cancer cells. Mol Cancer Ther 2008; 7: 1185-1194
  • 35 Wilkens J. Misteltherapie. Stuttgart: Sonntag Verlag; 2006: 90-96
  • 36 Wilkens J, Böhm G. Misteln. Aarau und München: AT Verlag; 2016: 75-83
  • 37 Zuzak T, Rist L, Viviani A. et al. Das Mistelpräparat Iscucin®–Herstellung, Analytik, Wirkung in vitro. Zeitschrift für anthroposophische Medizin 2004; 57: 467-473