Biological activity of mistletoe: in vitro and in vivo studies and mechanisms of action

Pre-treatment of Cucurbita maxima 'Hokkaido orange' by Viscum album aqueous extracts in search of allelopathic potential

Viscum album L. (VA) is a unique plant with regard to its biological content. It is rich in many different metabolites with high potential in various spheres of human activity. We conducted a pilot study with 5 VA aqueous extracts of different host-tree species for pre-sowing treatment of Cucurbita maxima 'Hokkaido orange' seeds. We set the following objectives consisting of hypotheses (1) H01 is based on different effects of tested VA extracts depending on host trees and time of pre-treatment; (2) H02 focuses on the allopathic properties of the tested extracts affecting the plant growth and development by dose-response relationship; (3) A01 considers highly biologically active compounds of VA extracts also containing allelochemicals that can be used to regulate plant growth processes and create eco-friendly and resilient cities. The analysis of the stimulatory allelopathy index for 7 parameters demonstrates the direct effect of VA extracts in 62.3% of cases. The variability of the broad spectrum of effects of VA extracts of different host trees on the ontogenesis of C. maxima plants shows the presence of potential allelochemicals, resulting from the vital products of the host-parasite relationship. These effects are not fully explained by total polyphenol content and antioxidant activity as in previous studies of other mistletoe species. The authors consider this work a pilot study that expands the areas of application of VA extracts and knowledge about potential sources of allelochemicals.

Unraveling potential neuroprotective mechanisms of herbal medicine for Alzheimer's diseases through comprehensive molecular docking analyses

Alzheimer's disease (AD) continues to be a worldwide health concern, demanding innovative therapeutic approaches. This study investigates the neuroprotective potential of herbal compounds by scrutinizing their interactions with Beta-Secretase-1 (BACE1). Through comprehensive molecular docking analyses, three compounds, Masticadienonic acid (ΔG: -9.6 kcal/mol), Hederagenin (ΔG: -9.3 kcal/mol), and Anthocyanins (ΔG: -8.1 kcal/mol), emerge as promising BACE1 ligands, displaying low binding energies and strong affinities. ADME parameter predictions, drug-likeness assessments, and toxicity analyses reveal favorable pharmacokinetic profiles for these compounds. Notably, Masticadienonic Acid exhibits optimal drug-likeness (-3.3736) and negligible toxicity concerns. Hederagenin (drug-likeness: -5.3272) and Anthocyanins (drug-likeness: -6.2041) also demonstrate promising safety profiles. Furthermore, pharmacophore modeling elucidates the compounds' unique interaction landscapes within BACE1's active site. Masticadienonic acid showcases seven hydrophobic interactions and a hydrogen bond acceptor interaction with Thr232. Hederagenin exhibits a specific hydrogen bond acceptor interaction with Trp76, emphasizing its selective binding. Anthocyanins reveal a multifaceted engagement, combining hydrophobic contacts and hydrogen bond interactions with key residues. In conclusion, Masticadienonic acid, Hederagenin, and Anthocyanins stand out as promising candidates for further experimental validation, presenting a synergistic balance of efficacy and safety in combating AD through BACE1 inhibition.

Chronobiology of Viscum album L.: a time series of daily metabolomic fingerprints spanning 27 years

Introduction: European mistletoe (Viscum album L.) has been gaining increasing interest in the field of oncology as a clinically relevant adjunctive treatment in many forms of cancer. In the field of phytopharmacology, harvesting time is pivotal. In the last century, a form of metabolomic fingerprinting based on pattern formation was proposed as a way to determine optimal harvesting times to ensure high quality of mistletoe as raw material for pharmaceutical use. In order to further evaluate the information obtained with this metabolomic fingerprinting method, we analysed a large time series of previously undigitised daily mistletoe chromatograms dating back to the 1950s. Methods: These chromatograms were scanned and evaluated using computerized image analysis, resulting in 12 descriptors for each individual chromatogram. We performed a statistical analysis of the data obtained, investigating statistical distributions, cross-correlations and time self-correlations. Results: The analysed dataset spanning about 27 years, contains 19,037 evaluable chromatograms in daily resolution. Based on the distribution and cross-correlation analyses, the 12 descriptors could be clustered into six independent groups describing different aspects of the chromatograms. One descriptor was found to mirror the annual rhythm being well correlated with temperature and a phase shift of 10 days. The time self-correlation analysis showed that most other descriptors had a characteristic self-correlation of ∼50 days, which points to further infradian rhythms (i.e., more than 24 h). Discussion: To our knowledge, this dataset is the largest of its type. The combination of this form of metabolomic fingerprinting with the proposed computer analysis seems to be a promising tool to characterise biological variations of mistletoe. Additional research is underway to further analyse the different rhythms present in this dataset.

Patients with Advanced or Metastasised Non-Small-Cell Lung Cancer with Viscum album L. Therapy in Addition to PD-1/PD-L1 Blockade: A Real-World Data Study

Immunotherapy with PD-1/PD-L1 inhibitors has significantly improved the survival rates of patients with metastatic non-small-cell lung cancer (NSCLC). Results of a real-world data study investigating add-on VA (Viscum album L.) to chemotherapy have shown an association with the improved overall survival of patients with NSCLC. We sought to investigate whether the addition of VA to PD-1/PD-L1 inhibitors in patients with advanced or metastasised NSCLC would have an additional survival benefit. In the present real-world data study, we enrolled patients from the accredited national registry, Network Oncology, with advanced or metastasised NSCLC. The reporting of data was performed in accordance with the ESMO-GROW criteria for the optimal reporting of oncological real-world evidence (RWE) studies. Overall survival was compared between patients receiving PD-1/PD-L1 inhibitor therapy (control, CTRL group) versus the combination of anti-PD-1/PD-L1 therapy and VA (combination, COMB group). An adjusted multivariate Cox proportional hazard analysis was performed to investigate variables associated with survival. From 31 July 2015 to 9 May 2023, 415 patients with a median age of 68 years and a male/female ratio of 1.2 were treated with anti-PD-1/PD-L1 therapy with or without add-on VA. Survival analyses included 222 (53.5%) patients within the CRTL group and 193 (46.5%) in the COMB group. Patients in the COMB group revealed a median survival of 13.8 months and patients in the CRTL group a median survival of 6.8 months (adjusted hazard ratio, aHR: 0.60, 95% CI: 0.43-0.85, p = 0.004) after adjustment for age, gender, tumour stage, BMI, ECOG status, oncological treatment, and PD-L1 tumour proportion score. A reduction in the adjusted hazard of death by 56% was seen with the addition of VA (aHR 0.44, 95% CI: 0.26-0.74, p = 0.002) in patients with PD-L1-positive tumours (tumour proportion score > 1%) treated with first-line anti-PD-1/PD-L1 therapy. Our findings suggest that add-on VA correlates with improved survival in patients with advanced or metastasised NSCLC who were treated with PD-1/PD-L1 inhibitors irrespective of age, gender, tumour stage, or oncological treatment. The underlying mechanisms may include the synergistic modulation of the immune response. A limitation of this study is the observational non-randomised study design, which only allows limited conclusions to be drawn and prospective randomised trials are warranted.

The cardioprotective potential of selected species of mistletoe

Mistletoe is an evergreen woody shrub with stems measuring 30-100 cm. It has leathery, yellowish-green strap-shaped leaves, yellowish-green flowers, and bears typical berries. The most common species is Viscum album L., mainly present in Europe and Asia. It is commonly known as European mistletoe or simply, mistletoe. Scientific interest in mistletoe was awakened in the XX century. Mistletoe, especially V. album L., has historically been used in the treatment and prophylaxis of CVD, with its properties being confirmed in recent studies. This mini-review describes new aspects of the cardioprotective properties of various species of mistletoe, especially V. album L. The effect of oral and subcutaneous application of fresh V. album L. extracts on blood pressure has been studied in various models; while the data suggests that mistletoe may be a promising herbal extract with cardioprotective properties, the species has only been tested in vitro and in vivo, on animals. In addition, it is unclear whether the cardioprotective activity of mistletoe may be due to particular chemical components, as the chemical composition of mistletoe extracts can vary depending on inter alia the time of harvest, extraction method and plant part. Hence, this activity may instead result from synergistic interactions between various secondary metabolites. Therefore, further studies are needed to identify the mechanisms of action of mistletoe compounds on CVDs, and determine their interactions with other cardioprotective drugs, their metabolic mechanisms, pharamacokinetics and adverse effects. More research is also needed to determine the therapeutic doses of active ingredients for use in clinical trials; this would require an accurate understanding of the chemical composition of extracts from different species of mistletoe (not only V. album L.) and from various host trees.

Etiology of lung carcinoma and treatment through medicinal plants, marine plants and green synthesized nanoparticles: A comprehensive review

Lung cancer, a leading global cause of mortality, poses a significant public health challenge primarily linked to tobacco use. While tobacco contributes to over 90% of cases, factors like dietary choices and radiation exposure also play a role. Despite potential benefits from early detection, cancer patients face hurdles, including drug resistance, chemotherapy side effects, high treatment costs, and limited healthcare access. Traditional medicinal plant knowledge has recently unveiled diverse cancer chemopreventive agents from terrestrial and marine sources. These phytochemicals regulate intricate molecular processes, influencing the immune system, apoptosis, cell cycle, proliferation, carcinogen elimination, and antioxidant levels. In pursuing cutting-edge strategies to combat the diverse forms of cancer, technological advancements have spurred innovative approaches. Researchers have focused on the green synthesis of metallic nanoparticles using plant metabolites. This method offers distinct advantages over conventional physical and chemical synthesis techniques, such as cost-effectiveness, biocompatibility, and energy efficiency. Metallic nanoparticles, through various pathways such as the generation of reactive oxygen species, modulation of enzyme activity, DNA fragmentation, disruption of signaling pathways, perturbation of cell membranes, and interference with mitochondrial function resulting in DNA damage, cell cycle arrest, and apoptosis, exhibit significant potential for preventive applications. Thus, the amalgamation of phytocompounds and metallic nanoparticles holds promise as a novel approach to lung cancer therapy. However, further refinements and advancements are necessary to enhance the environmentally friendly process of metallic nanoparticle synthesis.

Performance, HSP70 expression, antioxidant enzymes, oxidative DNA damage biomarkers, metabolic hormones, and intestinal microbiota of broiler chickens fed mistletoe leaf powder supplemented diets under tropical high ambient temperatures

The study investigated the impact of Mistletoe Leaf Powder (MLP) supplementation on some parameters in heat-stressed broiler chickens. The standard baseline diets, comprising four different formulations, were provided during the starter and finisher stages. Chickens were randomly assigned to the 4 dietary groups: a negative control (CON) with no supplementation, a positive control (VTC) with 200 mg/kg vitamin C, and 2 experimental treatment groups with 2500 mg/kg (MLP2) and 5000 mg/kg (MLP5) MLP supplementation. The Body Weight Gain (BWG) in MLP2 and MLP5 treatment groups was comparable (P > 0.05) to those in VTC, while the CON group exhibited significantly (P < 0.05) lower BWG. Feed consumption was significantly (P < 0.05) lower broiler chickens in the CON group compared to those VTC, MLP2, and MLP5. Heat shock protein 70 (HSP70) levels were lower in broiler chickens belonging to VTC, MLP2, and MLP5 groups compared to those in CON, and MLP2 showed no difference (P > 0.05) from MLP5 and VTC. Serum glutathione peroxidase and catalase concentrations were higher (P < 0.05) in birds belonging to MLP5, MLP2, and VTC groups compared to CON. The 8-hydroxy-2'-deoxyguanosine concentration was lower (P < 0.05) in birds of VTC, MLP2, and MLP5 compared to the CON, with VTC showing the least concentration. Serum insulin levels were higher (P < 0.05) in MLP5 compared to those in CON, while serum triiodothyronine and leptin concentrations were lower (P < 0.05) in CON compared to birds in VTC, MLP2, and MLP5. Microbiota analysis revealed that the Coliform bacteria population was higher (P < 0.05) in birds belonging to CON compared to those in VTC, MLP2, and MLP5 groups, whereas lactic acid-producing bacteria were significantly (P < 0.05) lower in birds of CON and highest in MLP2 and MLP5 groups. In conclusion, dietary supplementation of MLP at 5000 mg/kg enhanced performance, oxidative status, influenced metabolic hormones, and gut microbiota in broiler chickens raised under high ambient temperature.

Complementary and alternative medicine: A narrative review of nutritional approaches for cancer-related fatigue

Cancer-related fatigue (CRF) is a common symptom among patients with cancer, with a prevalence of >49%. CRF significantly affects the quality of life of patients and may also affect their overall survival. Pharmacological interventions serve as a last resort after carefully weighing the risks and benefits, with limited benefits for patients, many side effects, and adverse reactions. Compared to traditional medicine, nutritional approaches have fewer side effects, are highly accepted by patients, and do not affect the antitumor treatment of patients. Many studies have shown that nutritional approaches, as a form of complementary and alternative medicine, help improve the symptoms of CRF and the quality of life of patients. This study was designed to examine nutritional approaches to CRF and assess their effectiveness of nutritional approaches in improving CRF. We present an overview of clinical trials investigating nutritional approaches for CRF that have been published over the last 2 decades. A total of 33 records were obtained from 3 databases: Web of Science, MEDLINE, and PubMed. Some nutritional approaches, such as melatonin, PG2, and S-adenosyl-l-methionine, are potential options for CRF treatment. However, the trials included in the review varied widely in quality, most were weak in methodology, and there is currently insufficient evidence to conclude with certainty the effectiveness of nutritional approaches in reducing CRF. Therefore, the design and methods used in future complementary and alternative medicine trials should be more rigorous.

Viscum album (mistletoe) extract for dogs with cancer?

Compared with the options available to human patients with cancer, treatment choices for dogs are often more limited. Chemotherapy is frequently the first-line treatment for many cancers. However, its efficacy can be limited, and its side effects can affect the quality of the remaining life. This paper briefly summarizes the experience with Viscum album L. (mistletoe) extract in human patients as a stipulation to consider treatment with mistletoe extract for canines with cancer. The mistletoe extract contains -among others - lectins and viscotoxins that have documented anti-proliferative effect on cancer cells as well as immune-stimulatory function. Importantly, it also improves the well-being of patients with cancer due to its lectin ML-1 content, which can trigger the release of endorphins. Being cross-reactive with canine cells and having a relatively low side effect profile, it raises the question of whether mistletoe preparations might be considered as part of the treatment approach for dogs with cancer.

Traditional Uses, Phytochemical Constituents and Ethnopharmacological Properties of Mistletoe from Phoradendron and Viscum Species

Plants from the genus Phoradendron and Viscum, also known as American and European mistletoe, are a group of hemiparasitic plants traditionally used to treat many diseases. Mistletoes have a rich content of natural compounds like terpenes, alkaloids, proteins, and phenolic compounds associated with their potential medicinal properties. In this sense, mistletoes have shown antiproliferative, antioxidant, anti-inflammatory, and antimicrobial activity, which has been attributed to their phytochemical constituents. The mechanisms in which mistletoe plants act vary and depend on their phytochemical content and distribution, which in part will depend on the mistletoe species. In this sense, recent literature research is needed to visualize state of the art in the ethnopharmacological potential of mistletoe. Thus, this literature review aims to systematically report recent studies (2010-2023) on the phytochemical characterization and bioactive studies of mistletoe plants, mainly the Viscum and Phoradendron genera. We gather recent information of 140 references selected in our research. Here we report that although there are several bioactivity studies of mistletoe species, bioavailability studies are still scarce, and the precise mechanisms of action are not fully known. We encourage that further studies include a systematic strategy to cover these areas of opportunity.

Viscum album, as alternative and bridge to palliative chemotherapy in recurrent gallbladder cancer following laparoscopic radical cholecystectomy: a case report

A 78-year-old female patient was initially treated with laparoscopic radical cholecystectomy for gallbladder cancer (pT2aN1M0, stage IIIB). The patient then received adjuvant chemotherapy with gemcitabine. After completion of adjuvant chemotherapy, multiple lymph node metastases were observed in follow-up computed tomography (CT) scan, but the patient refused to go through further chemotherapy. One year after the recurrence, carbohydrate antigen 19-9 (CA19-9) level was 1,925 U/mL with follow-up high-resolution CT/abdomen-pelvic CT showing the increased size of multiple lymph node metastases, and the patient began to undergo Viscum album therapy (0.2 mg, subcutaneously, three times a week). After the V. album therapy was initiated, a decrease in the size of metastatic lymph nodes and CA19-9 level, which was decreased to 252 U/mL, was observed. Seventeen months after continuous V. album therapy, the patient agreed to have palliative chemotherapy. The patient underwent gemcitabine plus cisplatin chemotherapy and showed stable disease during follow-up. This case report suggests that V. album therapy showed anticancer effects and may act as a bridge to palliative chemotherapy for patients with inappropriate general conditions to undergo chemotherapy for recurrent gallbladder cancer.

Mistletoe Extracts during the Oncological Perioperative Period: A Systematic Review and Meta-Analysis of Human Randomized Controlled Trials

BACKGROUND

We aim to evaluate the safety and efficacy of mistletoe extract (ME) use during the oncological perioperative period.

METHODS

Details registered a priori on PROSPERO (CRD42018086168).

RESULTS

Seven RCTs (comprising 663 participants in nine reports) and three nonrandomized studies were included. In five RCTs, ME was evaluated as adjunctive care and the control group had no additional intervention, whereas in two RCTs, ME was compared head-to-head against common cancer treatments (i.e., etoposide or bacillus Calmette-Guérin) with the intervention groups not receiving standard care. Meta-analyses found no evidence for a difference between ME and no added therapy for mortality and recurrence (RR, 95% CI: 1.00, 0.79-1.27; and 1.03, 0.79-1.33, respectively). Two RCTs reported beneficial effects of ME on immune cells, specifically natural killer cells, in colorectal cancer, and one RCT reported quality of life improvement. Two RCTs reported ME discontinuations due to adverse events and grade 3/4 toxicities. Nevertheless, no safety signals were detected from these 10 studies. Quality appraisal revealed a substantial risk of bias.

CONCLUSIONS

Preliminary data are encouraging for mistletoe extracts, particularly in the context of colorectal cancer. However, the evidence is limited by the number of studies, an evaluation of different outcomes, and methodological limitations. Further high-quality research is warranted.

Viscum album Induces Apoptosis by Regulating STAT3 Signaling Pathway in Breast Cancer Cells

In this study, we investigated the potential anticancer effects of Viscum album, a parasitic plant that grows on Malus domestica (VaM) on breast cancer cells, and explored the underlying mechanisms. VaM significantly inhibited cell viability and proliferation and induced apoptosis in a dose-dependent manner. VaM also regulated cell cycle progression and effectively inhibited activation of the STAT3 signaling pathway through SHP-1. Combining VaM with low-dose doxorubicin produced a synergistic effect, highlighting its potential as a promising therapeutic. In vivo, VaM administration inhibited tumor growth and modulated key molecular markers associated with breast cancer progression. Overall, our findings provide strong evidence for the therapeutic potential of VaM in breast cancer treatment and support further studies exploring clinical applications.

The Anti-Inflammatory Activity of Viscum album

The therapeutic story of European mistletoe (Viscum album L.) presents a seesawing profile. In ancient times, this hemiparasitic plant was considered a panacea and even to be endowed with exceptional beneficial properties. In more recent times, despite its multiple uses in traditional medicines, some parts of the plant, in particular the berries, were considered poisonous and dangerous, including concerns of cytotoxicity, which spread serious suspicion on its medicinal utility. However, since the last century, medical interest in mistletoe has come back in force due to its utilization in clinical cancer treatments, based on its selective action on tumor cells. In Central Europe, the hydro-alcoholic extracts of European mistletoe register a relevant and continuous utilization in anthroposophic medicine, which is a holistic system that includes the utilization of phytomedicinal substances. In Switzerland and Germany, most physicians and patients use these products as complementary therapy in oncological treatments. However, despite its increasing use in this field, the results of mistletoe's use are not always convincing, and other aspects have appeared. Nowadays, products that contain mistletoe are utilized in several fields, including diet, phytotherapy, veterinary medicine and homeopathy, but in particular in cancer therapies as coadjuvant factors, in consideration of several positive effects including effects in the improvement of quality-of-life conditions and reinforcement of the immune system. In this review, based on the understanding of the association between cancer and inflammation, we propose a relationship between these recent uses of mistletoe, based on its antioxidant properties, which are supported by phytochemical and pharmacological data. The unicity of mistletoe metabolism, which is a direct consequence of its hemiparasitism, is utilized as a key interpretation element to explain its biological properties and steer its consequent therapeutic uses.

Antitumor Effect of Iscador on Breast Cancer Cell Lines with Different Metastatic Potential

Studies were performed for the first time on the effect of Iscador Qu and Iscador M on phototoxicity, cytotoxicity, antiproliferative activity, changes in ξ-potential of cells, membrane lipid order, actin cytoskeleton organization and migration on three breast cancer lines with different metastatic potential: MCF10A (control), MCF-7 (low metastatic) and MDA-MB231 (high metastatic) cells. The tested Iscador Qu and M did not show any phototoxicity. The antiproliferative effect of Iscador species appeared to be dose-dependent and was related to the metastatic potential of the tested cell lines. A higher selectivity index was obtained for Iscador Qu and M towards the low metastatic MCF-7 cell line compared to the high metastatic MDA-MB-231. Iscador Qu demonstrated higher selectivity for both cancer cell lines compared to Iscador M. The malignant cell lines exhibited a decrease in fibril number and thickness regardless of the type of Iscador used. The strongest effect on migration potential was observed for the low metastatic cancer cell line MCF-7 after Iscador treatment. Both Iscador species induced a slight increase in the percentage of cells in early apoptosis for the low and high metastatic cell lines, MCF-7 and MDA-MB-231, unlike control cells. Changes in the zeta potential and membrane lipid order were observed for the low metastatic MCF-7 cell line in contrast to the high metastatic MDA-MB-231 cells. The presented results reveal a higher potential of Iscador as an antitumor agent for the low metastatic cancer cell line MCF-7 compared to the high metastatic one. Iscador Qu appears to be more potent compared to Iscador M, but at this point, the exact mechanism of action is still unclear and needs further investigations.

Are Aspects of Integrative Concepts Helpful to Improve Pancreatic Cancer Therapy?

Numerous clinical studies have been conducted to improve the outcomes of patients suffering from pancreatic cancer. Different approaches using targeted therapeutic strategies and precision medicine methods have been investigated, and synergies and further therapeutic advances may be achieved through combinations with integrative methods. For pancreatic tumors, a particular challenge is the presence of a microenvironment and a dense stroma, which is both a physical barrier to drug penetration and a complex entity being controlled by the immune system. Therefore, the state of immunological tolerance in the tumor microenvironment must be overcome, which is a considerable challenge. Integrative approaches, such as hyperthermia, percutaneous irreversible electroporation, intra-tumoral injections, phytotherapeutics, or vitamins, in combination with standard-oncological therapies, may potentially contribute to the control of pancreatic cancer. The combined application of standard-oncological and integrative methods is currently being studied in ongoing clinical trials. An actual overview is given here.

Tapinanthus species: A review of botany and biology, secondary metabolites, ethnomedical uses, current pharmacology and toxicology

ETHNOPHARMACOLOGICAL RELEVANCE

Tapinanthus species are hemiparasites that grow on diverse hosts in African regions. Tapinanthus species are locally known as "all purpose herbs" as they are traditionally used to treat various diseases such as diabetes, hypertension, cancer, inflammation, malaria, anemia, anxiety, itching, and so on.

AIM OF THE STUDY

A comprehensive review on research outcomes and future perspectives of Tapinanthus species are presented to provide a reference for relevant researchers.

MATERIALS AND METHODS

The references regarding Tapinanthus species were retrieved from Google Scholar, Web of Science, Sci-finder, PubMed, Elsevier, Wiley, China National Knowledge Infrastructure, Open Access Library, and SpringerLink between 1963 and 2022. Scientific plant names were provided by "The Plant List" (www.theplantlist.org) and "The world Flora Online" (www.worldfloraonline.org).

RESULTS

Even though Tapinanthus species are regarded as notorious pests that can undermine various hosts, they are, as omnipotent herbs in folklore, meaningful for the development of potential phytomedicine sources. Phytochemistry screening has revealed the presence of glycosides, triterpenoids, flavonoids, alkaloids, tannins, steroids, anthraquinones. Among them, the chemical structures of 40 compounds have been elucidated by phytochemical methods without alkaloids and anthraquinones. These secondary metabolites might be responsible for ethnomedical uses and bioactivities of Tapinanthus species. Current research has provided scientific evidence for traditional uses of Tapinanthus species, especially unraveling hypoglycemic, hepatoprotective, antioxidant, antibacterial, anti-anxiety, anti-depression, anti-inflammatory, and other pharmacological properties. Given the fact that ethnomedical uses served as a valuable reference for pharmacology, however, some records to treat arthritis, fever, itching, dysentery, stomach pain, and anemia, have not been confirmed in current research. Furthermore, the toxic effects of Tapinanthus species were susceptible to the dosages, with relative safety across a wide range.

CONCLUSIONS

To reasonably yield Tapinanthus species, artificial culture might be a promising method to develop in the future. The discrepancies between phytochemistry screening and structure elucidation, as well as between ethnomedical uses and current pharmacology, need to be further clarified. The identification of bioactive compounds in crude extracts and fractions, the illustration of the underlying mechanisms of pharmacology, along with the addition of cytotoxicity, genotoxicity, and clinical trials of toxic tests, should be carried out in depth. This review highlights that Tapinanthus species can be considered promising phytomedicine sources as long as we adhere to digging more deeply into their potential role.

Utilization of the Viscum Species for Diet and Medicinal Purposes in Ruminants: A Review

A cost-effective, alternative protein and mineral source such as the Viscum species can be key to livestock production. Viscum spp. are used as feed in many semi-arid and arid regions globally, particularly during feed shortages. The species’ feeding value, and their pharmaceutical attributes, have been recognized worldwide, albeit with variation in nutritive value from one host to another. The antinutritional factors found in Viscum spp. may benefit livestock when consumed in moderation due to their immunomodulatory, proapoptotic, and antimicrobial properties. The Vachellia species are known to be the common hosts for Viscum spp. Further, even though Viscum spp. inhibit host tree development by reducing carbon absorption and the host tree’s carbohydrates, the efforts to regulate their infestation should not result in the plant’s total eradication due to the benefits to livestock (as well as in fodder and medicine). This review will help to improve understanding of Viscum species control measures, while also increasing the productivity of ruminants.

The Argentine mistletoes Ligaria cuneifolia (Ruiz & Pav.) Tiegh (Loranthaceae) and Phoradendron liga (Gillies ex Hook. & Arn.) Eichler (Santalaceae). Thirty years of research

Ligaria cuneifolia (Ruiz & Pav.) Tiegh (Loranthaceae) and Phoradendron liga (Gillies ex Hook. & Arn.) Eichler (Santalaceae) are regarded as Argentine mistletoes based on their similarities with the European counterpart, Viscum album L. (Santalaceae). These two species are the most used medicinal plants to treat high blood pressure in the Argentinian population. To provide scientific grounds to their traditional use and therapeutic potential, they were selected as herbal drug candidates. The main findings would support the anti-hypertensive action, the anticholesterolemic and antioxidant features of L. cuneifolia, and immunomodulatory properties for both species. Quercetin-O-glycosides, galloyl glycosides, and proanthocyanidins are present in L. cuneifolia while P. liga shows C-glycosyl flavones and 3-deoxyproanthocyanidins. This review summarizes the phytochemical characterization, medicinal properties and reveals promising results warranting future efforts for further investigation.

Mistletoe extracts for cancer treatment

This is a protocol for a Cochrane Review (intervention). The objectives are as follows:

To assess the effects of mistletoe extracts (Viscum album , European mistletoe) as antitumour treatment and for supportive/palliative care in adults with cancer. We will assess whether mistletoe extracts administered alone or in combination with tumour‐specific therapies prolong progression free‐intervals (PFI) and/or overall survival (OS); enhance tumour response; alleviate treatment‐related adverse effects from conventional cancer treatment e.g. chemo‐ or radiotherapy; improve patient‐reported outcomes including health‐related QOL; and whether mistletoe extracts produce adverse effects.

Romanian Viscum album L.—Untargeted Low-Molecular Metabolomic Approach to Engineered Viscum–AuNPs Carrier Assembly

Viscum is one of the most famous and appreciated medicinal plants in Europe and beyond. The symbiotic relationship with the host tree and various endogenous and ecological aspects are the main factors on which the viscum metabolites’ profiles depend. In addition, European traditional medicine mentions that only in two periods of the year (summer solstice and winter solstice) the therapeutic potential of the plant is at its maximum. Many studies have investigated the phytotherapeutic properties of viscum grown on different species of trees. However, studies on Romanian viscum are relatively few and refer mainly to the antioxidant and antiproliferative activity of mistletoe grown on Acer campestre, Fraxinus excelsior, Populus nigra, Malus domestica, or Robinia pseudoacacia. This study reports the first complete low-molecular-weight metabolite profile of Romanian wild-grown European viscum. A total of 140 metabolites were identified under mass spectra (MS) positive mode from 15 secondary metabolite categories: flavonoids, amino acids and peptides, terpenoids, phenolic acids, fatty acids, organic acids, nucleosides, alcohols and esters, amines, coumarins, alkaloids, lignans, steroids, aldehydes, and miscellaneous. In addition, the biological activity of each class of metabolite is discussed. The development of a simple and selective phyto-engineered AuNPs carrier assembly is reported and an evaluation of the nanocarrier system’s morpho-structure is performed, to capitalize on the beneficial properties of viscum and AuNPs.

Viscotoxin and lectin content in foliage and fruit of Viscum album L. on the main host trees of Hyrcanian forests

Mistletoe (Viscum album L.) is a hemiparasitic plant that absorbs water and nutrients from the host tree. Mistletoe contains two groups of cytotoxic, immunomodulatory and antitumor proteins, viscotoxins and lectins. This study evaluated the quantity and quality of viscotoxins and total lectins in the stems with leaves (foliage) and fruit of mistletoe on Parrotia persica and Carpinus betulus in September with immature green berries and in December with mature white berries. Viscum album L. plants were harvested from host species located in the Hyrcanian forests of Iran in 2019. The highest level of viscotoxins was detected in the December foliage of V. album settled on C. betulus (9.25 mg/g dry weight [DW]), and the highest content of lectins was found in the December foliage of V. album settled on P. persica (0.79 mg/g DW) and C. betulus (0.73 mg/g DW) respectively. The immature green berries of V. album from both host species contained much higher concentrations of viscotoxins and lectins than the mature white berries. Four isoforms of viscotoxins, viscotoxin A1, A2, A3 and B could be identified in all samples of both host species. Viscotoxin A3 was the predominant viscotoxin isoform followed by viscotoxin A1.

Bioactive Compounds and Their Derivatives: An Insight into Prospective Phytotherapeutic Approach against Alzheimer’s Disease

Alzheimer's disease (AD) is a common neurodegenerative brain disorder that causes cellular response alterations, such as impaired cholinergic mechanism, amyloid-beta (Aβ) AD aggregation, neuroinflammation, and several other pathways. AD is still the most prevalent form of dementia and affects many individuals across the globe. The exact cause of the disorder is obscure. There are yet no effective medications for halting, preventing, or curing AD's progress. Plenty of natural products are isolated from several sources and analyzed in preclinical and clinical settings for neuroprotective effects in preventing and treating AD. In addition, natural products and their derivatives have been promising in treating and preventing AD. Natural bioactive compounds play an active modulatory role in the pathological molecular mechanisms of AD development. This review focuses on natural products from plant sources and their derivatives that have demonstrated neuroprotective activities and maybe promising to treat and prevent AD. In addition, this article summarizes the literature pertaining to natural products as agents in the treatment of AD. Rapid metabolism, nonspecific targeting, low solubility, lack of BBB permeability, and limited bioavailability are shortcomings of most bioactive molecules in treating AD. We can use nanotechnology and nanocarriers based on different types of approaches.

Potential Therapeutic Applications of Plant-Derived Alkaloids against Inflammatory and Neurodegenerative Diseases

Alkaloids are a type of natural compound possessing different pharmacological activities. Natural products, including alkaloids, which originate from plants, have emerged as potential protective agents against neurodegenerative disorders (NDDs) and chronic inflammations. A wide array of prescription drugs are used against these conditions, however, not free of limitations of potency, side effects, and intolerability. In the context of personalized medicine, further research on alkaloids to unravel novel therapeutic approaches in reducing complications is critical. In this review, a systematic survey was executed to collect the literature on alkaloids and their health complications, from which we found that majority of alkaloids exhibit anti-inflammatory action via nuclear factor-κB and cyclooxygenase-2 (COX-2), and neuroprotective interaction through acetylcholinesterase (AChE), COX, and β-site amyloid precursor protein activity. In silico ADMET and ProTox-II-related descriptors were calculated to predict the pharmacological properties of 280 alkaloids isolated from traditional medicinal plants towards drug development. Out of which, eight alkaloids such as tetrahydropalmatine, berberine, tetrandrine, aloperine, sinomenine, oxymatrine, harmine, and galantamine are found to be optimal within the categorical range when compared to nicotine. These alkaloids could be exploited as starting materials for novel drug synthesis or, to a lesser extent, manage inflammation and neurodegenerative-related complications.

Evaluation of antitumoral effect of mistletoe fruit extract on Ehrlich ascites tumor cells with muse cell analyzer and argyrophilic nucleolar organizer region staining method

Introduction

Mistletoe has been used alone or as a complementary therapy in the treatment of different diseases for years. In this study, the antitumoral effect of mistletoe fruit extract on Ehrlich ascites tumor (EAT) cells was evaluated.

Materials and Methods

EAT cells from preformed stock mice were transferred to culture dishes containing 5-fluorouracil (5-FU) and mistletoe extracts at different doses (100, 200, 400, and 800 μg/ml). These cells were incubated at 37 °C in an environment with 95% humidity and 5% CO2. At the end of the incubations, the apoptosis status of the cells, cell cycle, mitochondrial membrane potential, and proliferation status with the argyrophilic (Ag) nucleolar organizer region staining (NORs) method were evaluated.

Results

As a result, it was observed that the mistletoe fruit extract and 5-FU induce apoptosis of EAT cells. It was concluded that the 5-FU substance arrests the cell cycle at the G0/G1 stage, while the mistletoe arrests the cell cycle at the S and G2/M stages. The depolarization rate of the mistletoe treated cells was higher. As a result of the evaluation made with the AgNORs method, it was seen that mistletoe and 5-FU could be effective in reducing the proliferation of EAT cells.

Conclusions

It was seen that mistletoe fruit extract could be effective in stimulating the apoptosis and depolarization of cancer cells. The results of other studies in the literature and our study support each other. It was concluded that the mistletoe plant may be useful in cancer treatment.

PCR-based rapid diagnostic tools for the authentication of medicinal mistletoe species

BACKGROUND

Taxilli Herba (TH) and Visci Herba (VH), defined as the leaves and branches of the mistletoe species Taxillus chinensis and Viscum coloratum, respectively, are popular herbal medicines in East Asia. However, commercial TH and VH products are frequently adulterated with related inauthentic mistletoe species, posing efficacy and safety concerns. Accurate species identification of herbal medicinal products is a prerequisite for quality control, but traditional morphological identification methods are hampered by difficulties in discriminating among closely related species and in identifying the source materials in processed products.

PURPOSE

This study aimed to develop sequence-characterized amplified region (SCAR) markers and a multiplex-SCAR assay for rapid and accurate identification of authentic TH and VH.

METHODS

The matK region was sequenced in a total of 20 samples from five mistletoe species, namely T. chinensis and V. coloratum, and three species often found in adulterated herbal medicines, T. sutchuenensis, V. articulatum, and Macrosolen tricolor. Species-specific nucleotide polymorphisms were identified and short regions (21-22 bp) containing at least two species-specific nucleotides close to the 3' end were incorporated into SCAR primers that produced uniquely sized PCR amplicons for each species. The five SCAR primer sets were also combined into a multiplex-SCAR assay.

RESULTS

The SCAR primers successfully generated amplicons of the expected size for each target species even with low-DNA templates or with templates containing DNA from multiple samples. No amplification was observed in non-target species. The SCAR markers and the multiplex-SCAR assay successfully identified commercial TH and VH products that were counterfeit or adulterated in both dried and processed products.

CONCLUSION

This is the first report to illustrate discrimination of genuine medicinal mistletoe species with DNA-based marker assays, enabling rapid and accurate species identification. The SCAR assays developed in this study will facilitate the standardization of commercial mistletoe products.

Comparative Study on Phytochemical Profile and Antioxidant Activity of an Epiphyte, Viscum album L. (White Berry Mistletoe), Derived from Different Host Trees

The study aimed at evaluating the antioxidant profile of a medicinal epiphyte Viscum album L. harvested from three tree species, namely, Populus ciliata L, Ulmus villosa L., and Juglans regia L. The crude extracts were obtained with ethanol, methanol, and water and were evaluated for the total phenol content (TPC), total flavonoid content (TFC), and antioxidant activities using total reducing power (TRP), ferric reducing antioxidant power (FRAP), 1, 1-diphenyl 1-2-picryl-hydrazyl (DPPH), superoxide radical scavenging (SOR), and hydroxyl radical scavenging (^•OH) assays. Our results showed that crude leaf extracts of plants harvested from the host Juglans regia L. exhibited higher yields of phytochemical constituents and noticeable antioxidative properties. The ethanolic leaf samples reported the highest phenols (13.46 ± 0.87 mg/g), flavonoids (2.38 ± 0.04 mg/g), FRAP (500.63 ± 12.58 μM Fe II/g DW), and DPPH (87.26% ± 0.30 mg/mL). Moreover, the highest values for TRP (4.24 ± 0.26 μg/mL), SOR (89.79% ± 0.73 mg/mL), and OH (67.16% ± 1.15 mg/mL) were obtained from aqueous leaf extracts. Further, Pearson correlation was used for quantifying the relationship between TPC, TFC, and antioxidant (FRAP, DPPH, SOR, OH) activities in Viscum album L. compared to their hosts. It was revealed that the epiphyte showed variation with the type of host plant and extracting solvent.

Neuroprotective Natural Products for Alzheimer's Disease

Alzheimer’s disease (AD) is the number one neurovegetative disease, but its treatment options are relatively few and ineffective. In efforts to discover new strategies for AD therapy, natural products have aroused interest in the research community and in the pharmaceutical industry for their neuroprotective activity, targeting different pathological mechanisms associated with AD. A wide variety of natural products from different origins have been evaluated preclinically and clinically for their neuroprotective mechanisms in preventing and attenuating the multifactorial pathologies of AD. This review mainly focuses on the possible neuroprotective mechanisms from natural products that may be beneficial in AD treatment and the natural product mixtures or extracts from different sources that have demonstrated neuroprotective activity in preclinical and/or clinical studies. It is believed that natural product mixtures or extracts containing multiple bioactive compounds that can work additively or synergistically to exhibit multiple neuroprotective mechanisms might be an effective approach in AD drug discovery.