Agaricus sylvaticus mantarının kemoterapi gören meme kanseri hastalarında besin takviyesi olarak hematolojik ve bağışıklık sistemine etkisi

Öz

Amaç: Kanser hastaları hastalığın seyri sırasında immünolojik ve hematolojik değişimler gelişmesine eğilimlidir. Tıbbi mantarlar, prognozda iyileşme ve fizyolojik yanıtı artırıcı etkiyle bağışıklık ve hematopoetik sistemleri uyarabilirler. Bu çalışmada Agaricus sylvaticus ile besin takviyesi sonrası kemoterapi gören meme kanserli hastalardaki hematolojik ve immünolojik parametrelerin değerlendirilmesi amaçlanmıştır. Yöntem: Randomize seçilmiş, çift-kör, plasebo kontrollü bir çalışma uygulanmıştır. 46 hastaya grup II ve III rastgele olarak ya plasebo ya da besin kaynağı olarak A. sylvaticus 2,1 g/gün verilmiştir. Hastalara 3 doz n=26 ve 6 doz kemoterapi uygulanmış, klinik ve laboratuvar değerlendirmeleri yapılmıştır. Çalışma sonuçları Microsoft Excel 2003 ve R-version 2.11.1 kullanılarak analiz edilmiş ve p

Anahtar Kelimeler

• Hematolojik sistem, immun sistem, kemoterapi, A. sylvaticus

Effect of dietary supplementation with Agaricus sylvaticus fungus on the hematology and immunology systems of breast cancer patients undergoing chemotherapy.

Abstract

Objective: Patients with cancer tend to develop hematological and immunological alterations during the disease process. Medicinal fungi can stimulate the immune and hematopoietic systems, promoting improvements in the prognosis and physiological response. In this trial it is aimed to evaluate changes in hematological and immunological parameters in patients with breast cancer undergoing chemotherapy after dietary supplementation with Agaricus sylvaticus. Method: A randomized, double-blind, placebocontrolled study was carried out. 46 patients stadiums II and III , were randomly assigned to receive either: nutritional supplement with A. sylvaticus 2.1 g/day or placebo. Patients received three cycles n=26 and six cycles n=20 of chemotherapy. Clinical and laboratory evaluations were performed. The results were analyzed using Microsoft Excel 2003 and R-version 2.11.1, significant results at p≤ 0.05. Results: The A. sylvaticus group showed an increase of hematocrits p=0.04 , red blood count p=0.03 , mean corpuscular hemoglobin concentration p=0.001 , leukocytes p=0.03 , monocytes p=0.001 , and total lymphocyte count p=0.009 after three months. Those changes were not observed in the placebo group. After six months, patients receiving A. sylvaticus showed increased levels of red blood count p=0.02 , hemoglobin p=0.02 , hematocrits p=0.02 , corpuscular hemoglobin concentration p=0.02 , leukocytes p=0.02 ; lymphocytes p=0.02 , neutrophils p=0.02 and TLC p=0.02 . The placebo group showed a reduction in leukocytes p=0.004 , basophiles p=0.005 and TLC p=0.01 . Conclusion: The results suggest the usefulness of dietary supplementation with A. sylvaticus in patients with breast cancer undergoing chemotherapy.

Keywords

• Hematological system, immune system, Chemotherapy, A. sylvaticus

Kaynakça

1. 1. Brazil. Ministério da Saúde. Secretaria Nacional de Assistência à Saúde. Instituto Nacional do Câncer [INCA]. Estimate 2010: Cancer Incidence in Brazil. Rio de Janeiro: INCA 2009. Brazil.
2. 2. Tiezzi DG. Epidemiology of breast cancer. Rev Bras Obstetr Ginecol. 2009; 3(5): 213-5.
3. 3. Guerra MR, Gallo CVM, Mendonça GAS. Risk of cancer in Brazil: trends and recent epidemiological studies. Rev Cancer Brazil, 2005; 51(3):227- 34.
4. 4. Brazil. Ministério da Saúde. Instituto Nacional do Câncer [INCA]. Control of Breast Cancer: Consensus Document. Rio de Janeiro: INCA 2004.
5. 5. Brito C, Portela MC, Vasconcellos MTL. SUS oncological care to women with breast cancer in Rio de Janeiro. Rev Public Health, 2005; 39(6): 874- 81.
6. 6. Brito C, Portela MC, Vasconcellos MTL. Survival of women treated for breast cancer in Rio de Janeiro. Rev S Pub, 2009; 43(3): 481-9.
7. 7. Shang EC, Weiss PS, Kaehler G. The Influence of early supplementation of parenteral on nutrition quality of life and body composition in patients with advanced cancer. J Par Ent Nutr, 2006; 30(3): 222-30.
8. 8. Giglio A. A quimioterapia adjuvante para cancer de mama engorda? Rev Assoc Med Bras, 2004; 50(3): 238-45.

9. 9. Giglio A. A quimioterapia adjuvante para câncer de mama engorda? Rev Assoc Med Bras, 2004; 50(3): 32-9.
10. 10. Neugut AI, Matthew M, Xiaoyan W, Russell M, Jacobson JS, Wei-Yann T, Grann VR, Dawn LH. Duration of adjuvant chemotherapy for colon cancer and survival among the elderly. J Clin Oncol, 2006; 24(15): 2368-75.
11. 11. Perez E, Muss HB. Optimizing adjuvant chemotherapy in early-stage of breast cancer. Oncology, 2005; 19(4): 1759-67.
12. 12. Novaes MRCG, Fortes RC. Antitumor effects of edible Agaricaceae mushrooms. Nutrition Brazil, 2005; 4(4): 15-9.
13. 13. Novaes MRCG, Novaes LCG. Drug-nutrient in edible mushrooms and other basidiomycetous Agaricales. Rev Bras Nutr Clin, 2005; 20(3): 181-7.
14. 14. Fortes RC, Novaes MRCG. Effects of dietary supplementation with Agaricales mushrooms and other fungi in medicinal therapy against cancer. RBC, 2006; 52(4): 363-71.
15. 15. Novaes MRCG, Fortes R, Melo A, Recova V. Alterations on the metabolism of lipids in postsurgery patients suffering from colorectal cancer supplemented with Agaricus sylvaticus fungus. Proceedings of the 27th International Congress of ESPEN and Clinical Nutrition. August, 27-30, Brussels, Belgium. 2005.
16. 16. Novaes MRCG, Novaes LCG, Recova V, Melo A. Evalution of acute toxicity of edible mushroom Agaricus sylvaticus. Proceedings of the 27th International Congress of ESPEN and Clinical Nutrition. August, 27-30, Brussels, Belgium. 2005.
17. 17. Novaes MRG, Novaes Garcez LCG, Melo A, Recova V. Effects of administration of Agaricus sylvaticus fungi on hematological and immunological systems of rats with Walker carcinoma-256. Fundamental & Clinical Pharmacology, 2004; 18 (S1): 125-9.
18. 18. Takimoto HD, Wakita KK, Kumazawa Y. Potentiation of cytotoxic activity in naive and tumor-bearing mice by oral administration of hot-water extracts from Agaricus braze f ruiting bodies. Biol Pharm Bull, 2004; 27: 404-6.
19. 19. Chu KKW, Ho SSS, Chow AHL. Coriolus versicolor: a medicinal mushroom with promising immunotherapeutic values. J Clin Pharmacol, 2002; 42: 976-84.
20. 20. Soh CSR, Phung HS, Ye JJ, Kwok SL, Shroder GE, Belury M, Adams LS. Williams D. Anti-aromatase activity of phytochemicals in white button mushrooms (Agaricus bisporus). Cancer Res, 2006; 66: 12026-34.
21. 21. Grube JB, Eng ET, Kao YC, Kwon A, Chen S. White button mushroom phytochemicals inhibit aromatase activity and breast cancer cell proliferation. J Nutr, 2001; 131: 3288-93.
22. 22. Shang EC, Weiss PS, Kaehler G. The influence of early supplementation of parenteral on nutrition quality of life and body composition in patients with advanced cancer. J Par Ent Nut, 2006; 30(3): 222-30.
23. 23. Fang N, Li Q, Yu S, Zhang J, He L, Ronis MJ, Badger TM. Inhibition of growth and induction of apoptosis in human cancer cell lines by an ethyl acetate fraction from shiitake mushrooms. J Altern Complement Med, 2006; 12(2): 125-32.
24. 24. Takaku T, Kimura Y, Okuda H. Isolation of an antitumor compound from Agaricus blazei Murill and Its mechanism of action. Journal of Nutrition, 2001; 131: 1409-13.
25. 25. Jedinak A, Sliva D. Pleorotus ostreatus inhibits proliferation of human breast cancer and colon cancer cells through p53-dependent as well as p53- independent pathway. Inter J Oncol, 2008; 33(6): 1307-13.
26. 26. Hetland G, Johnson E, Lyberg T, Bernardshaw S, Tryggestad AM, Grinde B. Effects of the medicinal mushroom Agaricus blazei Murill on immunity, infection and cancer. Scand J Immunol, 2008; 68(4): 363-70.
27. 27. Ajith TA, Janardhanan KK. Indian Medicinal Mushrooms as a source of antioxidant and antitumor agents. J Clin Biochem Nutr, 2007; 40(3): 157-62.
28. 28. Bernadshaw S, Lyberg T, Hetland G, Johnson E. Effect of an extract of the mushroom Agaricus blazei Murill on expression of adhesion molecule and production of reactive oxygen species in monocytes and granulocytes in human whole blood ex vivo. APMIS. 2007; 115(6): 719-25.
29. 29. Talorete TP, Isoda H, Maekawa T. Agaricus blazei (class Basidiomycotina) aqueous extract enhances the expression of c-Jun protein in MCF-7 cells. J Agric Food Chem. 2002; 50(18): 5162-6.
30. 30. Hong SA, Kim K, Nam SJ, Kong G, Kim MKA casecontrol study on the dietary intake of mushrooms and breast cancer risk among Korean women. Int J Cancer. 2008; 122(4th): 919-23.
31. 31. Fortes RC, Novaes MRCG. The impact of dietary supplementation with Agaricus sylvaticus on immune function of post-surgical patients suffering from colorectal cancer: a randomized, double blind, placebo-controlled clinical trial. Proceedings of the I. World Congress of Public Health Nutrition / VII National Congress of the Spanish Society of Community Nutrition. Public Health Nutrition, 28- 30 September 2006, Barcelona, Spain: NS 2006.
32. 32. Dolby V. In maitake mushroom extract froom is important in anti-cancer. Better Nutrition. 1997; 59(8): 38.
33. 33. See D. Mason St. Roshan R. Increased tumor necrosis factor alpha (TNF-alpha) and natural killer cell (NK) function using an integrative approach in late stage cancers. Immunol Invest. 2002; 31: 137-53.
34. 34. Gennari J, Gennari M, Felippe J. The Agaricus sylvaticus increases the number of natural killer cells in cancer patients. J Com Med. 2001; 7: 42-5.
35. 35. Gennari JL,Veronesi R, Gennari M. Use of Agaricus sylvaticus as a supplement therapy in patients with breast cancer and lung metastasis. Revista Brasileira de Medicina. 2002; 59(7): 237-8.
36. 36. Aguiar MRS. Impact of Food Supplementation on Hematologic Toxicity And Quality of Life and Women with Breast Cancer under Adjuvant Chemotherapy Regimen. Thesis [Master's Degree - Science and Environmental Health] Catholic University of Goiás, 2008.
37. 37. Padilha MM, Avila AA, Sousa PJ, Cardoso LG, Perazzo FF, Carvalho JC. Anti-inflammatory activity of aqueous and alkaline extracts from mushrooms (Agaricus blazei Murill). J Med Food. 2009; 12(2): 59-64.