Publications

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    ABSTRACT: Objectives Extracts of the tubers of Harpagophytum procumbens (devil's claw, DC) inhibit different proinflammatory mediators important in the pathophysiology of osteoarthritis. Many plant-derived preparations interfere with cytochrome P450 liver enzymes, which influence their different biological activities. Therefore, the present study was designed to investigate the influence of an external metabolic activation of a DC extract on the cytotoxicity and the release of proinflammatory cytokines. MethodsA screening experiment with a panel of 12 inflammatory cytokines identified three as suitable for the study: tumour necrosis factor- (TNF-), interleukin (IL) IL-6 and IL-8. They were determined using enzyme-linked immunosorbent assays in lipopolysaccharide (LPS)-stimulated monocytic THP-1 cells, which were treated with rat liver S9 mix metabolically activated DC extract (DCm). For the cytotoxity experiments, a WST-1 assay was used. Key findingsDC dose-dependently suppressed the release of TNF-, IL-6 and IL-8 in LPS-stimulated monocytic THP-1 cells at non-cytotoxic concentrations (50-250g/ml). The metabolic activation of the DC extract by S9 mix did not alternate its cytotoxicity and did not diminish its inhibitory effect. This effect was improved in the case of TNF- inhibition as reflected by their EC50 values of 1168.2g/ml and 49 +/- 3.5g/ml for DC and DCm (P<0.01). Conclusions Cytokines inhibitory activity of DC was not affected after its external metabolic activation. However, the amount of harpagoside and caffeic acid derivates was decreased. Other components of the extract might have contributed to its anti-inflammatory effect.
    09/2014; 66(11). DOI:10.1111/jphp.12242
  • Forschende Komplementärmedizin / Research in Complementary Medicine 01/2014; 21 Suppl 1:2-18. DOI:10.1159/000362393 · 1.65 Impact Factor
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    ABSTRACT: Oral mucositis is one of the common side effects of chemotherapy treatment with potentially severe implications. Despite several treatment approaches by conventional and complementary western medicine, the therapeutic outcome is often not satisfactory. Traditional Chinese Medicine (TCM) offers empirical herbal formulas for the treatment of oral ulceration which are used in adaptation to chemotherapy-induced mucositis. While standard concepts for TCM treatment do not exist and acceptance by conventional oncologists is still low, we conducted a review to examine the evidence of Chinese herbal treatment in oral mucositis. Eighteen relevant studies on 4 single herbs, 2 combinations of 2 herbs, and 11 multiherbal prescriptions involving 3 or more compounds were included. Corresponding molecular mechanisms were investigated. The knowledge about detailed herbal mechanisms, especially in multi-herbal prescriptions is still limited. The quality of clinical trials needs further improvement. Meta-analysis on the existent database is not possible but molecular findings on Chinese medicinal herbs indicate that further research is still promising for the treatment of chemotherapy-induced oral mucositis.
    Evidence-based Complementary and Alternative Medicine 10/2013; 2013:284959. DOI:10.1155/2013/284959 · 2.18 Impact Factor
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    ABSTRACT: Chemotherapy-induced neuropathy (CIPN) has a relevant impact on the quality of life of cancer patients. There are no curative conventional treatments, so further options have to be investigated. We conducted a systematic review in English and Chinese language databases to illuminate the role of medical herbs. 26 relevant studies on 5 single herbs, one extract, one receptor-agonist, and 8 combinations of herbs were identified focusing on the single herbs Acorus calamus rhizoma, Cannabis sativa fructus, Chamomilla matricaria, Ginkgo biloba, Salvia officinalis, Sweet bee venom, Fritillaria cirrhosae bulbus, and the herbal combinations Bu Yang Huan Wu, modified Bu Yang Huan Wu plus Liuwei Di Huang, modified Chai Hu Long Gu Mu Li Wan, Geranii herba plus Aconiti lateralis praeparata radix , Niu Che Sen Qi Wan (Goshajinkigan), Gui Zhi Jia Shu Fu Tang (Keishikajutsubuto), Huang Qi Wu Wu Tang (Ogikeishigomotsuto), and Shao Yao Gan Cao Tang (Shakuyakukanzoto). The knowledge of mechanism of action is still limited, the quality of clinical trials needs further improvement, and studies have not yielded enough evidence to establish a standard practice, but a lot of promising substances have been identified. While CIPN has multiple mechanisms of neuronal degeneration, a combination of herbs or substances might deal with multiple targets for the aim of neuroprotection or neuroregeneration in CIPN.
    Evidence-based Complementary and Alternative Medicine 07/2013; 2013:423713. DOI:10.1155/2013/423713 · 2.18 Impact Factor
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    Markus Horneber, Matthias Rostock
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    ABSTRACT: Die Fortschritte der modernen Onkologie mit ihren vielfältigen und komplexen Möglichkeiten der Diagnose und Therapie von Krebserkrankungen haben dazu geführt, dass mehr Patientinnen und Patienten geheilt werden. Dafür müssen viele Betroffene allerdings eine beeinträchtigende Therapiephase bewältigen und erleben für die Dauer ihres geretteten Lebens bleibende Krankheitsauswirkungen und Rezidivängste. Auch die Fortschritte der palliativen Onkologie, die mehr Krebskranken ein längeres Leben mit der Erkrankung ermöglichen, fordern eine längere Adaptationsleistung an das Leben mit einer lebensbedrohlichen chronischen Krankheit und oft nebenwirkungsträchtigen Langzeittherapien. In dieser prozesshaften und mehrdimensionalen Auseinandersetzung mit Krankheit und Kranksein spielt für viele Patientinnen und Patienten und ihr soziales Umfeld der Umgang mit der sog. Komplementärmedizin eine wichtige Rolle. Dieser Beitrag gibt einen Überblick über die wichtigsten Verfahren.
    best practice onkologie 04/2013; 5(4):44-54. DOI:10.1007/s11654-010-0250-0
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    ABSTRACT: Purpose. Chemotherapy-induced peripheral neuropathy (CIPN) is a common and dose-limiting side effect of cytostatic drugs. Since there are no proven therapeutic procedures against CIPN, we were interested to define the role of electroacupuncture (EA) from which preliminary data showed promising results. Methods. In a randomized trial with a group sequential adaptive design in patients with CIPN, we compared EA (LV3, SP9, GB41, GB34, LI4, LI11, SI3, and HT3; n = 14) with hydroelectric baths (HB, n = 14), vitamin B1/B6 capsules (300/300 mg daily; VitB, n = 15), and placebo capsules (n = 17). The statistical power in this trial was primarily calculated for proving EA only, so results of HB and VitB are pilot data. Results. CIPN complaints improved by 0.8 ± 1.2 (EA), 1.7 ± 1.7 (HB), 1.6 ± 2.0 (VitB), and 1.3 ± 1.3 points (placebo) on a 10-point numeric rating scale without significant difference between treatment groups or placebo. In addition no significant differences in sensory nerve conduction studies or quality of life (EORTC QLQ-C30) were found. Conclusions. The used EA concept, HB, and VitB were not superior to placebo. Since, contrary to our results, studies with different acupuncture concepts showed a positive effect on CIPN, the effect of acupuncture on CIPN remains unclear. Further randomized, placebo controlled studies seem necessary. This trial is registered with DRKS00004448.
    Evidence-based Complementary and Alternative Medicine 01/2013; 2013:349653. DOI:10.1155/2013/349653 · 2.18 Impact Factor
  • R Saller, M Rostock
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    ABSTRACT: The active components of herbal drugs and substances are pleiotropic multi-ingredient compounds with multitarget properties including antiinflammatory effects. A pleiotropic inhibition of inflammation could play an important role in mutlimorbide patients as an attempt of prevention or retardation of metastasis. A large number of experimental data for European and non-European herbal drugs as well as various herbal drug combinations suggest such a possibility. Despite the so far small number of clinical studies, such an experimental herbal treatment could appear to be reasonable and acceptable, provided that there are data available on quality and safety of these herbal drugs by treatments of patients with various diseases. Besides, herbal drugs and substances play a growing role the treatment of patients with multimorbidity. Many of these herbal drugs have antiinflammatory effects beside their proved symptomatic efficacy in a lot of other diseases. The specific selection of herbal drugs that are efficacious in specific indications and additionally showed antiinflammatory effects offers the possibility of simultaneous antiinflammatory and specific efficacy. St. John's Wort and milk thistle belong to the oldest and to the best experimentally and clinically examined herbal remedies. The spectrum of internal and external uses of Hypercum perforatum as a multicompound herbal drug includes functional gastro-intestinal complaint and illness, skin disease, mucosal lesion, superficial injury, depressive upset and depression, somatoform disorders, restlessness, nervosity, convalescence, exhaustion and sleep disturbances respectively. The plurivalent character of the multicompound even enables a broad spectrum of activity. This might justify to prefer St. John's Wort to other drugs in a wide range of treatments: In multimorbide patients with depression or in depressive patients with coronary heart disease the anti-inflammatory effects could mean an additional advantage. However, at present there is still a great need and demand for therapy-oriented clinical research.
    Praxis 12/2012; 101(25):1637-42. DOI:10.1024/1661-8157/a001149
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    ABSTRACT: BACKGROUND: Drugs of plant origin such as Arnica montana, Calendula officinalis or Hypericum perforatum have been frequently used to promote wound healing. While their effect on wound healing using preparations at pharmacological concentrations was supported by several in vitro and clinical studies, investigations of herbal homeopathic remedies on wound healing process are rare. The objective of this study was to investigate the effect of a commercial low potency homeopathic remedy Similasan(R) Arnica plus Spray on wound closure in a controlled, blind trial in vitro. METHODS: We investigated the effect of an ethanolic preparation composed of equal parts of Arnica montana 4x, Calendula officinalis 4x, Hypericum perforatum 4x and Symphytum officinale 6x (0712-2), its succussed hydroalcoholic solvent (0712-1) and unsuccussed solvent (0712-3) on NIH 3T3 fibroblasts. Cell viability was determined by WST-1 assay, cell growth using BrdU uptake, cell migration by chemotaxis assay and wound closure by CytoSelect TM Wound Healing Assay Kit which generated a defined "wound field". All assays were performed in three independent controlled experiments. RESULTS: None of the three substances affected cell viability and none showed a stimulating effect on cell proliferation. Preparation (0712-2) exerted a stimulating effect on fibroblast migration (31.9%) vs 14.7% with succussed solvent (0712-1) at 1:100 dilutions (p<0.001). Unsuccussed solvent (0712-3) had no influence on cell migration (6.3%; p>0.05). Preparation (0712-2) at a dilution of 1:100 promoted in vitro wound closure by 59.5% and differed significantly (p<0.001) from succussed solvent (0712-1), which caused 22.1% wound closure. CONCLUSION: Results of this study showed that the low potency homeopathic remedy (0712-2) exerted in vitro wound closure potential in NIH 3T3 fibroblasts. This effect resulted from stimulation of fibroblasts motility rather than of their mitosis.
    BMC Complementary and Alternative Medicine 07/2012; 12(1):100. DOI:10.1186/1472-6882-12-100 · 1.88 Impact Factor
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  • Schweizerische Zeitschrift fur GanzheitsMedizin 01/2012; 24:95-100. DOI:10.1159/000337474
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    Onkologie 01/2012; 35 Suppl 3:2-5. · 0.84 Impact Factor
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    ABSTRACT: Background: In outpatient settings diagnostic classification of depressive symptoms is mostly descriptive based on ICD-10. Depending on clinical experience and consultation time, diagnosis can be verified by validated scales. However, physicians working in primary care are familiar with ICD-10 criteria. Therefore, the aim of the present study was to examine the feasibility of the validation of an ICD-10-derived symptom scale for depression. Methods: For this preliminary trial we generated a symptom scale derived 1:1 from the diagnostic criteria for depression given in the ICD-10 with 10 items. The Hamilton Rating Scale for Depression (HAMD-17) was used as reference in a population of 226 outpatients suffering from depressive symptoms. Correlation between scales as well as sensitivity and specificity of the ICD-10 scale were calculated. Results: The generated ICD-10 symptom scale for depression could be analyzed in 219 patients and showed a significant and strong correlation with the HAMD-17 (p < 0.0001; ρ = 0.75). The best tradeoffs between specificity and sensitivity of the ICD-10 score were found at 10 points for the lower and 14 points for the upper cut-off. Overall sensitivity and specificity was 76.7 and 88.6%. Almost two thirds (i.e. 65.3%) of the patients were correctly classified by the ICD-10 scale. Conclusion: The ICD-10 symptom scale examined in the current population was found to have fair correlation with the HAMD-17 as well as, in face of the limited variance of the patients' condition, acceptable sensitivity and specificity. Therefore, this preliminary study showed that the ICD-10-derived symptom scale seems appropriate to be investigated in a thorough validation trial.
    Forschende Komplementärmedizin / Research in Complementary Medicine 01/2012; 19(4):191-6. DOI:10.1159/000342018 · 1.65 Impact Factor
  • Markus Horneber, Friedrich Overkamp, Matthias Rostock
    Onkologie 01/2012; 35 Suppl 5:3-11. DOI:10.1159/000340025 · 0.84 Impact Factor
  • Onkologie 01/2012; 35:2-5. DOI:10.1159/000338974 · 0.84 Impact Factor
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    Phytomedicine 10/2011; 18. DOI:10.1016/j.phymed.2011.09.037 · 2.88 Impact Factor
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    ABSTRACT: The antihormonal therapy of breast cancer patients with the antiestrogen tamoxifen often induces or aggravates menopausal complaints. As estrogen substitution is contraindicated, herbal alternatives, e.g. extracts of black cohosh are often used. A prospective observational study was carried out in 50 breast cancer patients with tamoxifen treatment. All patients had had surgery, most of them had undergone radiation therapy (87%) and approximately 50% had received chemotherapy. Every patient was treated with an isopropanolic extract of black cohosh (1-4 tablets, 2.5 mg) for 6 months. Patients recorded their complaints before therapy and after 1, 3, and 6 months of therapy using the menopause rating scale (MRS II). The reduction of the total MRS II score under black cohosh treatment from 17.6 to 13.6 was statistically significant. Hot flashes, sweating, sleep problems, and anxiety improved, whereas urogenital and musculoskeletal complaints did not change. In all, 22 patients reported adverse events, none of which were linked with the study medication; 90% reported the tolerability of the black cohosh extract as very good or good. Black cohosh extract seems to be a reasonable treatment approach in tamoxifen treated breast cancer patients with predominantly psychovegetative symptoms.
    Gynecological Endocrinology 10/2011; 27(10):844-8. DOI:10.3109/09513590.2010.538097 · 1.14 Impact Factor
  • M. Rostock, R. Saller
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    ABSTRACT: Zusammenfassung Viele Brustkrebspatientinnen leiden unter den Nebenwirkungen ihrer antihormonellen Therapie. Klimakterische Beschwerden in Form von Hitzewallungen, Nachtschweiß, Libidoverlust, Ängsten, Depressionen oder auch Muskel- und Gelenkschmerzen führen in vielen Fällen zu einer Verschlechterung der Therapieadhärenz. Die Effektivität einer Begleittherapie mit selektiven Serotonin-Wiederaufnahmehemmern (SSRI), Gabapentin oder Clonidin konnte in verschiedenen randomisierten klinischen Studien (RCT) belegt werden. Allerdings lehnen viele Patientinnen eine Behandlung mit diesen Medikamenten ab, u. a. weil sie zusätzliche Nebenwirkungen fürchten. Demgegenüber besteht eine große Nachfrage nach komplementären Therapiemöglichkeiten, aber erst in den letzten Jahren gibt es zunehmend mehr und auch qualitativ bessere klinische Studien zu ihrer wissenschaftlichen Erforschung. Drei RCT mit isolierten Soja-Isoflavonen zeigten keine Überlegenheit gegenüber Placebo. Drei von fünf klinischen Studien mit Extrakt aus der Traubensilberkerze ergaben eine Reduktion der Hitzewallungen, die vierte Studie wies keinen Effekt auf Hitzewallungen nach, jedoch auf die Intensität des Schwitzens; in der fünften war das Verum dem Placebo nicht überlegen. In einer Phase-II-Studie reduzierten sich unter Einnahme von Leinsamenschrot die Hitzewallungen, eine placebokontrollierte Folgestudie ergab jedoch keinen signifikanten Unterschied zur Kontrolle. Ebenso wurden in einer unkontrollierten Kohortenstudie unter homöopathischer Behandlung positive Effekte auf die klimakterischen Beschwerden der behandelten Patientinnen erreicht, während zwei nachfolgende RCT zu einem Nullergebnis führten. Demgegenüber ergab eine Metaanalyse für die Verum-Akupunktur eine signifikante Überlegenheit gegenüber Sham-Akupunktur. Auch mit einem komplexen Entspannungstraining mit Yoga, Meditation und Atemübungen ließen sich Hitzewallungen im Vergleich zur Kontrolle statistisch signifikant reduzieren. Zwei kleine unkontrollierte Pilotstudien zeigten nach Stellatumblockade einen deutlichen Rückgang von Anzahl und Schwere der Hitzewallungen.
    09/2011; 26(5). DOI:10.1007/s12312-011-0678-3
  • K Hostanska, M Rostock, R Saller
    Planta Medica 08/2011; 77(12). DOI:10.1055/s-0031-1282787 · 2.34 Impact Factor
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    ABSTRACT: Although several clinical studies have shown that mistletoe therapy (MT, Viscum album) may improve cancer patients' quality-of-life (QoL), qualitative information on the improvement's nature is still lacking. This exploratory, prospective, cohort-study comprised 25 patients with different types of cancer. The patients filled in the EORTC QLQ-C30 Version 3.0 questionnaire at the beginning of MT (n = 25) and three months later (n = 21). If patients agreed, they were interviewed on both occasions (n = 17); the interviews were transcribed verbatim and submitted to a qualitative content analysis (n = 12). Analysis of the questionnaires showed significant improvements in several subscales during MT. The interviews analysis revealed that most patients adopted the MT with a supportive goal, with all patients undergoing conventional therapies. After three months of MT, most interviewed patients revealed higher vitality and autonomy. MT was often seen as a chance to make an own personal contribution to the therapy, which was particularly appreciated in cases in which no conventional therapy was (anymore) advised. Concrete personal achievements such as changes in the private and/or in the professional environment were spontaneously mentioned by the patients, illustrating and corroborating their improvements in QoL. Our results show that the patients experienced an improvement of QoL during MT. This therapy seemed to offer a platform for an integrative coping with the disease, which might be important in reconciling the perceived shock of an existential illness with a good QoL.
    Integrative Cancer Therapies 07/2011; 11(2):90-100. DOI:10.1177/1534735411413267 · 2.01 Impact Factor
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    ABSTRACT: Many cancer patients seek homeopathy as a complementary therapy. It has rarely been studied systematically, whether homeopathic care is of benefit for cancer patients. We conducted a prospective observational study with cancer patients in two differently treated cohorts: one cohort with patients under complementary homeopathic treatment (HG; n = 259), and one cohort with conventionally treated cancer patients (CG; n = 380). For a direct comparison, matched pairs with patients of the same tumour entity and comparable prognosis were to be formed. Main outcome parameter: change of quality of life (FACT-G, FACIT-Sp) after 3 months. Secondary outcome parameters: change of quality of life (FACT-G, FACIT-Sp) after a year, as well as impairment by fatigue (MFI) and by anxiety and depression (HADS). HG: FACT-G, or FACIT-Sp, respectively improved statistically significantly in the first three months, from 75.6 (SD 14.6) to 81.1 (SD 16.9), or from 32.1 (SD 8.2) to 34.9 (SD 8.32), respectively. After 12 months, a further increase to 84.1 (SD 15.5) or 35.2 (SD 8.6) was found. Fatigue (MFI) decreased; anxiety and depression (HADS) did not change. CG: FACT-G remained constant in the first three months: 75.3 (SD 17.3) at t0, and 76.6 (SD 16.6) at t1. After 12 months, there was a slight increase to 78.9 (SD 18.1). FACIT-Sp scores improved significantly from t0 (31.0 - SD 8.9) to t1 (32.1 - SD 8.9) and declined again after a year (31.6 - SD 9.4). For fatigue, anxiety, and depression, no relevant changes were found. 120 patients of HG and 206 patients of CG met our criteria for matched-pairs selection. Due to large differences between the two patient populations, however, only 11 matched pairs could be formed. This is not sufficient for a comparative study. In our prospective study, we observed an improvement of quality of life as well as a tendency of fatigue symptoms to decrease in cancer patients under complementary homeopathic treatment. It would take considerably larger samples to find matched pairs suitable for comparison in order to establish a definite causal relation between these effects and homeopathic treatment.
    BMC Cancer 01/2011; 11:19. DOI:10.1186/1471-2407-11-19 · 3.32 Impact Factor
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