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Markowitsch SD, Binali S, Rutz J, Chun FKH, Haferkamp A, Tsaur I, Juengel E, Fischer ND, Thomas A, Blaheta RA. Survey of Physicians and Healers Using Amygdalin to Treat Cancer Patients. Nutrients 2024; 16:2068. [PMID: 38999817 PMCID: PMC11243289 DOI: 10.3390/nu16132068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/14/2024] [Accepted: 06/18/2024] [Indexed: 07/14/2024] Open
Abstract
Amygdalin is purported to exhibit anti-cancer properties when hydrolyzed to hydrogen cyanide (HCN). However, knowledge about amygdalin efficacy is limited. A questionnaire evaluating the efficacy, treatment, and dosing protocols, reasons for use, HCN levels, and toxicity was distributed to physicians and healers in Germany, providing amygdalin as an anti-cancer drug. Physicians (20) and healers (18) provided amygdalin over 8 (average) years to nearly 80 annually treated patients/providers. Information about amygdalin was predominantly obtained from colleagues (55%). Amygdalin was administered both intravenously (100%) and orally (32%). Intravenous application was considered to maximally delay disease progression (90%) and relieve symptoms (55%). Dosing was based on recommendations from colleagues (71%) or personal experience (47%). If limited success became apparent after an initial 3g/infusion, infusions were increased to 27g/infusion. Treatment response was primarily monitored with established (26%) and non-established tumor markers (19%). 90% did not monitor HCN levels. Negative effects were restricted to a few dizzy spells and nausea. Only 58% were willing to participate in clinical trials or contribute data for analysis (34%). Amygdalin infusions are commonly administered by healers and physicians with few side effects. The absence of standardized treatment calls for guidelines. Since intravenous application bypasses metabolization, re-evaluation of its mode of action is required.
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Affiliation(s)
- Sascha D. Markowitsch
- Deparment of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany; (S.D.M.); (J.R.); (A.H.); (I.T.); (E.J.); (N.D.F.); (A.T.)
| | - Sali Binali
- Department of Urology, Goethe-University, 60590 Frankfurt am Main, Germany; (S.B.); (F.K.-H.C.)
| | - Jochen Rutz
- Deparment of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany; (S.D.M.); (J.R.); (A.H.); (I.T.); (E.J.); (N.D.F.); (A.T.)
| | - Felix K.-H. Chun
- Department of Urology, Goethe-University, 60590 Frankfurt am Main, Germany; (S.B.); (F.K.-H.C.)
| | - Axel Haferkamp
- Deparment of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany; (S.D.M.); (J.R.); (A.H.); (I.T.); (E.J.); (N.D.F.); (A.T.)
| | - Igor Tsaur
- Deparment of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany; (S.D.M.); (J.R.); (A.H.); (I.T.); (E.J.); (N.D.F.); (A.T.)
| | - Eva Juengel
- Deparment of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany; (S.D.M.); (J.R.); (A.H.); (I.T.); (E.J.); (N.D.F.); (A.T.)
| | - Nikita D. Fischer
- Deparment of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany; (S.D.M.); (J.R.); (A.H.); (I.T.); (E.J.); (N.D.F.); (A.T.)
| | - Anita Thomas
- Deparment of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany; (S.D.M.); (J.R.); (A.H.); (I.T.); (E.J.); (N.D.F.); (A.T.)
| | - Roman A. Blaheta
- Deparment of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany; (S.D.M.); (J.R.); (A.H.); (I.T.); (E.J.); (N.D.F.); (A.T.)
- Department of Urology, Goethe-University, 60590 Frankfurt am Main, Germany; (S.B.); (F.K.-H.C.)
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Xie H, Rutz J, Maxeiner S, Grein T, Thomas A, Juengel E, Chun FKH, Cinatl J, Haferkamp A, Tsaur I, Blaheta RA. Plant-Derived Sulforaphane Suppresses Growth and Proliferation of Drug-Sensitive and Drug-Resistant Bladder Cancer Cell Lines In Vitro. Cancers (Basel) 2022; 14:cancers14194682. [PMID: 36230603 PMCID: PMC9564120 DOI: 10.3390/cancers14194682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 11/24/2022] Open
Abstract
Simple Summary The natural compound sulforaphane is highly popular among tumor patients, since it is suggested to prevent oncogenesis and cancer progression. However, knowledge about its precise mode of action, particularly when drug resistance has been established, remains poor. The present study demonstrates the proliferation-blocking effects of SFN on a panel of drug-resistant bladder cancer cell lines. Abstract Combined cisplatin–gemcitabine (GC) application is standard for treating muscle-invasive bladder cancer. However, since rapid resistance to treatment often develops, many patients turn to supplements in the form of plant-based compounds. Sulforaphane (SFN), derived from cruciferous vegetables, is one such compound, and the present study was designed to investigate its influence on growth and proliferation in a panel of drug-sensitive bladder cancer cell lines, as well as their gemcitabine- and cisplatin-resistant counterparts. Chemo-sensitive and -resistant RT4, RT112, T24, and TCCSUP cell lines were exposed to SFN in different concentrations, and tumor growth, proliferation, and clone formation were evaluated, in addition to apoptosis and cell cycle progression. Means of action were investigated by assaying cell-cycle-regulating proteins and the mechanistic target of rapamycin (mTOR)/AKT signaling cascade. SFN significantly inhibited growth, proliferation, and clone formation in all four tumor cell lines. Cells were arrested in the G2/M and/or S phase, and alteration of the CDK–cyclin axis was closely associated with cell growth inhibition. The AKT/mTOR signaling pathway was deactivated in three of the cell lines. Acetylation of histone H3 was up-regulated. SFN, therefore, does exert tumor-suppressive properties in cisplatin- and gemcitabine-resistant bladder cancer cells and could be beneficial in optimizing bladder cancer therapy.
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Affiliation(s)
- Hui Xie
- Department of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany
- Department of Urology, Goethe-University, 60590 Frankfurt am Main, Germany
| | - Jochen Rutz
- Department of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Sebastian Maxeiner
- Department of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Timothy Grein
- Department of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Anita Thomas
- Department of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Eva Juengel
- Department of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Felix K.-H. Chun
- Department of Urology, Goethe-University, 60590 Frankfurt am Main, Germany
| | - Jindrich Cinatl
- Institute of Medical Virology, University Hospital, Goethe-University, 60596 Frankfurt am Main, Germany
| | - Axel Haferkamp
- Department of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Igor Tsaur
- Department of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Roman A. Blaheta
- Department of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany
- Correspondence:
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Harnett JE, Desselle S, Ung COL. Towards consensus: defining and supporting a professional role for pharmacists associated with traditional and complementary medicines - a protocol of implementing an international e-survey. BMJ Open 2022; 12:e061352. [PMID: 35902196 PMCID: PMC9341198 DOI: 10.1136/bmjopen-2022-061352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Traditional and complementary medicines (T&CM) are predominantly self-selected from retail outlets including pharmacies as part of self-care practices. Concerns about the appropriate and safe use of T&CM products raises questions about 'should' and 'how' pharmacists could adopt professional responsibilities. There lacks a consensus about the scope of these responsibilities, or the initiatives required to execute them. The aim of this study is to identify an international set of core responsibilities that support pharmacists' contribution to ensuring the quality and safe use of T&CMs to promote public health. METHODS AND ANALYSIS An international cross-sectional e-survey of pharmacists representing the six WHO regions will be conducted over a 12-month period. Pharmacists will be invited via representative organisations and professional networks within their respective country. Survey responses to statements about the relevance of T&CM to day-to-day practice; opinions about the bioethical and practice responsibilities; and support required to build their scope of practice associated with T&CM will be collected centrally via the online survey platform Survey Monkey and analysed using the Statistical Package for Social Sciences V.27 software for Windows. Bivariate statistical analysis will be conducted to examine the associations between agreement to statements within each section with key demographic variables, country of practice, pharmacy type, age, gender, qualification and years in practice. Cronbach's alpha will be used to test the internal consistency of items from certain sections of the survey and evince their clarity to respondents of the questionnaire. ETHICS AND DISSEMINATION Ethics approval has been obtained from the University of Macau (approval number SSHRE21-APP068-ICMS-01). The results of this survey will be used to inform key discussion points in a consensus process and a step towards developing an agreed and defined professional role for pharmacists in T&CMs.
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Affiliation(s)
- Joanna E Harnett
- Faculty of Medicine and Health Pharmacy School, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau
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HDI Highlighter, The First Intelligent Tool to Screen the Literature on Herb-Drug Interactions. Clin Pharmacokinet 2022; 61:761-788. [PMID: 35637377 DOI: 10.1007/s40262-022-01131-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 11/03/2022]
Abstract
Herbal food supplements are commonly used and can be an important part of patient self-care. Like all other bio-active and therapeutic products, they have a benefit/risk balance. These products are not without adverse effects and potentially interact with other therapies. Educating patients and providing information for health professionals about the risk of herb-drug interactions is key. One of the purposes of the biomedical literature is to inform prescribers. Scientific literature accessible on databases such as PubMed is dense and careful reading is time consuming. We propose a reading aid tool named "HDI highlighter" to help readers to find key information in clinical studies and case reports describing herb-drug interactions. It uses natural language processing algorithms (artificial intelligence) with a pharmaceutical focus. Semantic relation extraction for herb-drug interactions from the biomedical literature are overexpressed using keywords. We have tested it to review 120 published articles over the last 10 years. In these articles, we have shown that case reports often involved long-term or semi-long-term treatments such as cancer or human immunodeficiency virus therapies, antiepileptic drugs, or central nervous system drugs. Similarly, these classes of drugs are more extensively targeted by clinical studies. Herb-drug interactions described in case reports are identified in medicinal, recreational, and alimentary uses. They also usually lack a rigorous description of the herb(s) involved. Typically, clinical studies provide a complete description of protocols and dosages, with a few exceptions explained by patients' needs. Clinical studies on herbs are nevertheless conducted on a limited number of patients. All these limitations make the interpretation of herb-drug interactions complicated, but the HDI highlighter provides a quick overview of the herb-drug interaction literature.
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