http://orcid.org/0000-0001-7431-4588
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Abstract
Introduction: Radioprotectors can enhance the efficacy of cancer radiotherapy, but their clinical use remains uncommon. The present study aimed to assess the radioprotective potential of mistletoe extract (commercial name: Abnoba Viscum), a well-known complementary cancer medicine, in zebrafish larvae.
Materials and methods: Wild-type AB zebrafish embryos at 4 h-post-fertilization were exposed to 5 Gy 9-MeV electron beam irradiation after being treated for 1 h with 4 mMl/L amifostine or 0.2 mg/ml Abnoba Viscum A, F, M, or Q. Primary endpoints were abnormality-free survival and abnormality-free rates among survivors at 5 days-post-fertilization.
Results: The crude abnormality-free survival rates were 33.7%, 49.0%, 38.8%, 43.9%, 38.1%, and 52.6%, whereas abnormality-free rates among survivors were 36.4%, 49.6%, 37.8%, 45.6%, 52.0%, and 62.8% for the control (with no pharmacologic treatment), amifostine, Abnoba Viscum A, F, M, and Q groups, respectively. Abnormality-free survival rates in the amifostine and Abnoba Viscum Q groups were significantly different from those in the control (p = .040 and .012, respectively), with an odds ratio (OR) of 1.90 [95% confidence interval (CI): 1.03–3.51] and 2.20 (95% CI: 1.19–4.08), respectively. Abnormality-free rates among survivors in the amifostine and Abnoba Viscum M and Q groups were significantly different from those in the control group (p = .048, .042, and <.001, respectively), with an OR of 1.79 (95% CI: 1.00–3.20), 1.82 (95% CI: 1.02–3.26), and 2.98 (1.67–5.33), respectively.
Conclusion: Abnoba Viscum Q has at least a similar radioprotective effect to that of amifostine. Mistletoe extracts have been clinically applied for a long time and their effectiveness and feasibility have been verified. Abnoba Viscum Q might be a new candidate radioprotectant to enhance cancer radiotherapy efficacy.
Graphical Abstract
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No potential conflict of interest was reported by the authors.
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Notes on contributors
Chai Hong Rim
Chai Hong Rim performed most of drafting and statistical analyses. He has his expertise not only in the clinical radiotherapy, but also published more than 20 articles with subjects of meta-analyses, cancer prevention, and in vivo studies using a zebrafish model, in recent 2 years.
Soonil Koun
Soonil Koun performed all experiments and management of zebrafishes.
Hae-Chul Park
Hae-Chul Park is a head of the zebrafish research lab of Korea University Ansan Hospital. He supervised the research and present study, and shared his expertise.
Suk Lee
Suk Lee is an experienced medical physicist. He supervised and advised as a radiation physics expert.
Chul Yong Kim
Chul Yong Kim is a head of radiation oncology department at Korea University Anam Hospital. He has more than 30 years of experience in the field of radiation oncology, and shared expertise and supervised the current study.