Conclusions

Experimental research, however, was initiated within the last century and suggested that the VA-E may have beneficial effects as a cancer treatment. Also, treatment of arthrosis with intracutaneously applied VA-E extracts seems to be effective in several cases. Due to the lack of convincing studies, the benefit of VA-E treatment for hypertension and arteriosclerosis remains unclear.

The claims of pharmacologists to define the main biologically relevant component present in VA-E is difficult because several biologically active components are present in the drug used as a cancer treatment (Figure 6). It is obvious that VA-E contains potent cytotoxic proteins such as the ML and viscotoxins which induce apoptosis and accidental cell death, respectively. The mechanisms of cytotoxicity are known in several details, but several aspects remain to be clarified. Apart from an immunomodulation, these cytotoxic effects might be of relevance in the treatment of cancer patients. The clinical benefit must be examined carefully because the effects depend on the mode of application. However, introduction of VA-E normed or standardised on single components suggested to exert the main biological effects of the drug, obviously did not improve the quality of clinical results as compared to whole plant extracts standardised on other criteria. Encouraging results of cytotoxicity to cultured and implanted tumour cells are only reproducible in humans by the direct application of VA-E into the tumour or intracavitally. Preliminary results indicate that the intra- or peritumoural application of VA-E might be more effective in tumour reduction as compared to a subcutaneous one. Subcutaneous and intravenous application are recommended to modulate the immune system. The possible impact of the DNA stabilising properties of VA-E requires further research. An improvement of life quality and well-being is one of the most consistent effects of subcutaneous treatment with VA-E. However, the last and final chapters of the mistletoe story remain to be written, and thus, more rigorous scientific investigations are encouraged.

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