HCV May Respond to Herbal Concoction, Including Mistletoe, When
Interferon Fails

By Karla Gale

NEW ORLEANS (Reuters Health) May 19 - Treatment with a mix of herbs that
includes extracts of mistletoe and green tomato may lead to a sustained
response in patients with hepatitis C (HCV) for whom treatment with
pegylated interferon-alpha has failed or is contraindicated, according
to findings presented here at Digestive Disease Week.

Dr. Harald Matthes and colleagues included 85 patients in their sample,
7 of whom withdrew from the study. Treatment included subcutaneous
injections of mistletoe extract (Viscum album), and oral extracts of
green tomato (Solanum lycopersicum) and Hepatodoron (Fragaria vesca and
Tritis vinifer).

After 12 months, 18% were complete responders, 49% were partial
responders and 33% were nonresponders. After 1 more year of treatment
and an additional 6 months' follow-up, the corresponding rates were 44%,
28% and 28%.

About 60% of patients exhibited local responses to the injection, but
otherwise adverse events were mild and uncommon. The group estimates the
cost to treat each patient who achieves a sustained response is $5,600
with the herbal extracts, compared with $28,000 for treatment with
interferon.

In an interview with Reuters Health, Dr. Matthes, based at Charite
University of Berlin in Germany, explained that the mistletoe extract
activates CD4 T helper-1 cells to induce an HCV-specific immune
response, and the Hepatodoron stimulates liver regeneration.

The green tomato contains alkaloids that induce apoptosis through the
caspase 8 pathway. "This is important because HCV blocks heaptocyte
apoptosis, which is required to clear infected cells from the liver," he
said.

[...] Dr. Paul Pockros, from Scripps Clinic in La Jolla, California,
told Reuters Health he was concerned that herbal treatment could induce
heaptocyte apoptosis, "which could be quite dangerous for patients with
an impaired hepatic reserve." He also thinks it should not be
recommended until its mechanism of action is better understood.

However, he agrees with Dr. Matthes that such treatment could be
appropriate for patients who have no other choice of treatment for HCV.
[...]

Full text at http://www.medscape.com/viewarticle/478275
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