Maitake mushroom extract in myelodysplastic syndromes (MDS): a phase II study

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• 作者：Kathleen M. Wesa ; Susanna Cunningham-Rundles…
• 关键词：Myelodysplastic syndrome ; Maitake ; Beta ; glucan ; Infections ; Neutrophil ; Monocyte
• 刊名：Cancer Immunology, Immunotherapy
• 出版年：2015
• 出版时间：February 2015
• 年：2015
• 卷：64
• 期：2
• 页码：237-247
• 全文大小：656 KB
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• 刊物类别：Biomedical and Life Sciences
• 刊物主题：Biomedicine
  Cancer Research
  Immunology
  Oncology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0851

文摘

Background Myelodysplastic syndromes (MDS) are characterized by ineffective erythropoiesis with dysplastic bone marrow leading to peripheral cytopenia, risk of infection, and progression to acute myelogenous leukemia. Maitake mushroom beta-glucan, a dietary supplement, stimulates hematopoietic progenitor cell differentiation, granulocyte colony-stimulating factor production, and recovery of peripheral blood leukocytes after bone marrow injury. This phase II trial examined the effects of Maitake on innate immune function in MDS. Methods Myelodysplastic syndromes patients with International Prognostic Scoring System Low- and Intermediate-1-risk disease received oral Maitake extract at 3?mg/kg twice daily for 12?weeks. Primary endpoints included neutrophil count and function tested as endogenous or stimulated neutrophil production of reactive oxygen species (ROS) by flow cytometry compared with age-matched healthy controls (HC). ROS activators were Escherichia coli, phorbol ester, and the bacterial peptide N-formylmethionyl-leucyl-phenylalanine (fMLP). Complete blood counts, chemistry panels, iron studies, and monocyte function were evaluated. Results Of 21 patients enrolled, 18 completed the study and were evaluable. Maitake increased endogenous (basal) neutrophil (p?=?0.005) and monocyte function (p?=?0.021). Pre-treatment monocyte response to E. coli was reduced in MDS patients compared with HC (p?=?0.002) and increased (p?=?0.0004) after treatment. fMLP-stimulated ROS production response also increased (p?=?0.03). Asymptomatic eosinophilia occurred in 4 patients (p?=?0.014). Other changes in albumin, hemoglobin, and total protein were not clinically relevant. Conclusions Maitake was well tolerated. Enhanced in vitro neutrophil and monocyte function following treatment demonstrate that Maitake has beneficial immunomodulatory potential in MDS. Further study is warranted.