INSTITUTE OF LONGEVITY MEDICINE, U.S. SCIENTIFIC STUDIES

Institute of Longevity Medicine U.S. Scientific Studies

Preliminary Report pt.1

JEUNESSE Inc.
Institute of Longevity Medicine


11/5/99
PRELIMINARY REPORT (additional test results to follow)
Transfer factor testing

Background and rationale:

1) Cancer is the second leading cause of death in the US. The rate of nearly every type of cancer is on the rise. Despite billions of dollars in research, the mortality rate has remained nearly unchanged since the 1960’s using convention treatments such as radiation, surgery and chemotherapy. Thus, there is considerable interest in using immune modulation as an adjuvant for cancer therapy. Natural killer cells are particularly important in destroying cancer cells.

Purpose of study:

1) To determine the in vitro anti-cancer effects of Transfer Factor and Transfer Factor Plus using PBMC isolated from human volunteers and assaying the increased ability of the NK cell population to kill K562 erythroleukemic cells.

Methods:

1) PBMC killing of K562 (erythroleukemic) cells

Results: 

1) Transfer Factor increased NK-cell killing by 100% and Transfer Factor Plus by 250%.

Conclusions:

Transfer Factor and Transfer Factor Plus induced immune-based lysis of K562 cells at a level unprecedented in the director’s experience or in the known medical literature. Since NK cell function is so crucial in killing cancer cells, these products are ideal candidates for cancer adjuvant therapy. In addition, NK cells form a first line of defense against infections from viruses and certain other microorganisms. Killing assays against K562 cells have also been correlated with increased activity against chronic and acute infections as well.

Darryl See, MD
Director, Bioassay Laboratory
Institute of Longevity Medicine

Preliminary Report pt.2

Transfer Factor Plus® Study (4Life®)
Sample Name# of Live K562 Cells# of Dead K562 CellsMean of Dead Cells% Increase in Killing
Baseline - a 99.0 1.3    
Baseline - b 98.1 1.9 1.6  
Positive (PBMC) - a 95.8 4.2    
Positive (PBMC) - b 97.1 2.9 3.6  
Negative (Flour) - a 97.3 2.7    
Negative (Flour) - b 96.6 3.4 3.1  
Transfer Factor Plus® (200µl) - a 89.7 10.3    
Transfer Factor Plus® (200µl) - b 89.1 10.9 10.6 248%
Transfer Factor Plus® (20µl) - a 91.8 8.2    
Transfer Factor Plus® (20µl) - b 92.3 7.7 8.0 161%


Transfer Factor Study (4Life®)
Sample Name# of Live K562 Cells# of Dead K562 CellsMean of Dead Cells% Increase in Killing
Baseline - a 95.8 4.2    
Baseline - b 96.9 3.1 3.7  
Positive (PBMC) - a 95.2 4.8    
Positive (PBMC) - b 94.8 5.2 5.0  
Negative (Flour) - a 94.2 5.8    
Negative (Flour) - b 94.7 5.3 5.6  
Transfer Factor - a 87.8 12.2    
Transfer Factor - b 89.7 10.3 11.3 103%


Transfer Factor and Transfer Factor Plus® Study (4Life®)
SampleResult
Transfer Factor No toxicity observed
Transfer Factor No toxicity observed
Transfer Factor Plus® No toxicity observed
Transfer Factor Plus® No toxicity observed


Transfer Factor and Transfer Factor Plus® Study (4Life®)
HHV-6 assay 11/18/99
(ug/ml)Day 1Day 3Day 7 Mean (Day 3)log reduction in killing
Flour (negative)
100 1.6 2.8 4.9   4.75  
10 1.7 2.2 4.6    
 
Transfer Factor
100 1 1.4 3.2   3.3 1.45
10 1 1.6 3.4    
 
Transfer Factor Plus®
100 1 1 2.5   2.65 2.1
10 1 1.3 2.8    

Unprecedented Boost

Study by Darryl See, M.D.

This latest study reports that 4Life Transfer Factor® and Transfer Factor Plus® “induced immune-based killing of K562 cancer cells at a level unprecedented in our experience or known in medical research,” according to the director of the laboratory.

4Life Transfer Factor® and Transfer Factor Plus® were tested for their ability to increase Natural Killer Cell (NK) activity by killing live cancer cells. The test results showed that 4Life Transfer Factor® boosted NK cell activity 103% above normal immune response without supplementation, or about two times higher than the next highest product. In addition, it was revealed that Transfer Factor Plus® increased the NK cell activity 248% above normal immune response without supplementation, or about five times higher than any of the other previously tested products. The best of more than 200 other products tested showed an increase of only 48.6%. (See chart page 2)

Natural Killer Cells are a critical part in the first line of defense against germs. They seek and destroy infected or malignant cells through direct contact. NK cells are very important in fighting cancer cells and cells infected by viruses (colds/flues). The independent laboratory which conducted the study, The Institute of Longevity Medicine in California, is recognized for its research and expertise in measuring the ability of ingredients to significantly boost the immune system.

The results come as no surprise to 4Life® Research’s Dr. William Hennen, Vice President of Research and Development. “Natural Killer Cells are a critical part of our immune system defenses. The results of the NK cell activity tests clearly demonstrate one of the mechanisms whereby 4Life Transfer Factor® and Transfer Factor Plus® strengthens and supports the immune system. We believe that enhancement of Natural Killer Cell activity is only one of the many ways 4Life Transfer Factor® benefits the immune system,” said Dr. Hennen.

“I have followed the benefits of transfer factor in the medical literature for many years now. The strong results of commercial (4Life®) Transfer Factor® under standard pharmaceutical testing protocols demonstrated that the commercial (4Life®) Transfer Factor® has great potential for widespread benefits. Further, 4Life Transfer Factor® and Transfer Factor Plus® showed no toxicity even at the highest levels tested, thus maintaining the safety profile of research-grade transfer factor,” according to the laboratory director.

David Lisonbee, President of 4Life® Research, in response to this research said, “These recent findings support and substantiate the reports from thousands of distributors who use Transfer Factor® and Transfer Factor Plus® and the many other clinical experiences and other studies we are familiar with.”

Purpose of Study:

To determine the in vitro Natural Killer Cell (NK) activation effects of 4Life Transfer Factor® and Transfer Factor Plus® using peripheral blood mononuclear cells (PBMC) isolated from human volunteers and assaying the increased ability of the NK cell population to kill K562 erthroleukemic (leukemia) cells.

Conclusions:

4Life Transfer Factor® and Transfer Factor Plus® induced immune-based lysis (breakdown) of K562 cells at a level unprecedented in the director’s experience or in known medical literature. Since NK cell function is so crucial in killing dangerous cells, these products are ideal candidates for human and animal immune support.

Nutraceutical TestedPercent (%) Rise in NK Cell Activity Over Baseline
4Life Transfer Factor Plus® 248%
4Life Transfer Factor® 103%
IP6 (highest of group previously tested) 49%
Plant Polysaccharide Formula 48%
Echinacea 43%
Shiitake Mushroom 42%
Cordyceps Formula 28%
Bovine Colostrum 23%
Phytonutrient Formula with Garlic 21%
Endocrine System Formula 16%
Aloe Vera Concentrate (acemannan) 92.3
Noni (Morinda citrafolia) 15%


A. Noni (Morinda citrifolia)
B. Aloe Vera Concentrate (acemannan)
C. Endocrine System Formula
D. Phytonutrient Formula with Garlic
E. Bovine Colostrum
F. Cordyceps Formula
G. Shiitake Mushroom
H. Echinacea
I. Plant Polysaccharide Formula
J. IP6 highest of group previously tested
K. 4Life Transfer Factor®
L. 4Life Transfer Factor Plus®

Some of these products reflect an average of different brands.

Baseline activity is the measure of the ability of human white blood cells to kill K562 leukemia (cancer) cells without supplementation.

Natural Killer Cells are the body’s first line of defense against cancers and viruses.

The increase in the ability of white blood cells to kill K562 cancer cells is directly related to the increase in Natural Killer Cell activity.

Tumour Necrosis Factor Alpha (TNF-α) and Natural Killer (NK) Cell

INCREASED TUMOR NECROSIS FACTOR ALPHA (TNF-a) AND NATURAL KILLER CELL (NK) FUNCTION USING AN INTEGRATIVE APPROACH IN LATE STAGE CANCERS

           Publication:   Immunological Investigations
           Authors:         Darryl See, Stephanie Mason, Ramesh Roshan
           Publisher:       Taylor & Francis
           Issue:              Volume 31, Number 2/2002
           Excerpt:          As below

Center for Advanced Medicine, Encinitias, California 92024, USA.

Natural products may increase cytotoxic activity of Natural Killer Cells (NK) and Tumor Necrosis Factor alpha (TNF-a) while decreasing DNA damage in patients with late-stage cancer. Pilot studies have suggested that a combination of Nutraceuticals can raise NK cell function and TNF-a activity and result in improved clinical outcomes in patients with late stage cancer.

The objective of the study is to determine if Nutraceuticals can significantly raise NK function and TNF levels in patients with late stage cancer. 

After informed consent was obtained, 20 patients with stage IV, end-stage cancer were evaluated (one bladder, five breast, two prostate, one neuroblastoma, two non-small cell lung, three colon, 1 mesothelioma, two lymphoma, one ovarian, one gastric, one osteosarcoma). 

Transfer Factor Plus (TFP+, 3 tablets 3 times per day),
IMUPlus (non denatured milk whey protein, 40 gm/day);
Intravenous (50 to 100 gm/day) and
oral (1-2 gm/day) ascorbic acid;
Agaricus Blazeii Murill teas (10 gm/day);
Immune Modulator Mix (a combination of vitamin, minerals, antioxidants and immune-enhancing natural products);
nitrogenated soy extract (high levels of genistein and dadzein) and
Andrographis Paniculata (500 mg twice, daily) were used.

Baseline NK function by standard 4 h 51Cr release assay and TNF alpha and receptor levels were measured by ELISA from resting and phytohemagglutinin (PHA) stimulated adherent and non-adherent Peripheral Blood Mononuclear Cell (PBMC). Total mercaptans and glutathione in plasma were taken and compared to levels measured 6 months later. Complete blood counts and chemistry panels were routinely monitored.

As of a mean of 6 months, 16/20 patients were still alive. The 16 survivors had significantly higher NK function than baseline (p < .01 for each) and TNF-alpha levels in all four cell populations studied (p < .01 for each). Total mercaptans (p < .01) and TNF-alpha receptor levels were significantly reduced (p < .01). It was also observed that hemoglobin, hematocrit and glutathione levels were significantly elevated. The only toxicity noted was occasional diarrhea and nausea. The quality of life improved for all survivors by SF-36 form evaluation. An aggressive combination of immunoactive Nutraceuticals was effective in significantly increasing NK function, other immune parameters and hemoglobin from PBMC or plasma in patients with late stage cancers. Nutraceutical combinations may be effective in late stage cancers. Clinical outcomes evaluations are ongoing.




INCREASED TUMOR NECROSIS FACTOR ALPHA AND NK CELL FUNCTION
USING AN INTEGRATIVE APPROACH IN LATE STAGE CANCERS
PATIENT DEMOGRAPHICSPATIENT REGIME INCLUDEDRESULTS AFTER SIX MONTHS
Twenty patients Average age: 49.3 All stage 4 cancers 12 males, 8 females Prognosis from physician: 3.7 months to live Transfer Factor Plus, Beta Glucans, soy extract, digestive enzymes, vegetarian, low-sugar diet, hyperthermia and more. Average Tumor Necrosis Factor alpha (TNF-a) increased from 12.4 to 1287.5. Average increase in Natural Killer (NK) cell function: 6.4 to 27.6

Transfer Factor Study with 20 Cancer Patients

Darryl See, M.D.

Twenty patients, 12 men and 8 women, were selected for this in vivo study. The average age was 49.3. The twenty individuals were each level 3 or level 4 cancer patients. Each patient was basically sent home by his or her oncologist to die. The average life expectancy was 3.7 months. The protocol was to place each patient on 9 capsules per day of Transfer Factor Plus®. The patients were given a number of other general nutrients*. After eight months, 16 of these individuals were still living and were either in remission, improving or stabilized.

The baseline for natural killer cell function was 6.4. Within 4 weeks the average NK Cell function was increased to 25.7 and in 6 months it increased to 27.6. This represented a 400% increase in NK Cell function. This is an ongoing study. This study has been submitted to a peer reviewedpublication.

*Antioxidants, Digestive Enzymes, Probiotics and multi-vitamins.

The following study was conducted at the Institute of Longevity Medicine. The purpose of the study was to examine the synergistic effects of the components of Transfer Factor Plus®. Each component was tested separately and then tested as a whole unit. Together the proprietary blend increased NK Cell functions more than the sum total of all of the ingredients tested separately. This study indicates that the intelligence contained in Transfer Factor® has an enhancing effect on other nutrients.


In vitro study:

Ingredient 10 GM /ml NK Function
  • PBMC (Control) 25.6%
  • Zinc 26.8% NS
  • Proprietary Blend 59.9% less than 0.02 (Mushrooms etc)
  • Zinc +Prop. Blend 95.4 less than 0.01
  • Transfer Factor® alone 128.5% less than 0.01
  • Complete Prod. (Transfer Factor Plus®) 273.6% less than 0.01
The sum of the individual product is less than the Complete Product (Transfer Factor Plus®). There is synergy in having a combination of Transfer Factor Plus®.

Transfer Factor Study with 20 Cancer Patients Peer Review

Darryl See, M.D.

Introduction

Despite enormous expenditures, little real progress has been made in the treatment of most cancers. Cancer incidence in the United States has risen 60 percent since 1950 and 27 fold since 1900 according to Surveillance, Epidemiology, and End Results (SEER).[1] Each year one in two men and one in three women in the U.S. develop some form of cancer according to the American Cancer Society.[1] Mortality has climbed dramatically. In 1999, 560,000 people died of cancer in the U.S. alone. The mortality rate for cancer in 1994 was 6 percent higher than in 1970.[1] Major gains have been made using chemotherapy in childhood leukemias, testicular cancer and some rare cancers, but the ability of chemotherapy and radiation to alter mortality of most cancers is negligible at best. Because of these facts, many Americans are utilizing some sort of alternative medicine in their battle against cancer. Estimates range from 9% of patients by the National Cancer Institute (NCI) to 60% of patients by other estimates. It appears that only about 5% of patients completely abandon traditional treatments for alternatives.[2] There is a significant need for research to determine, which if any alternative therapies show promise in the treatment of cancers. The role of the immune system in fighting cancer was first proposed by Paul Ehrlich around 1900, and the concept renewed by Lewis Thomas in 1959 and MacFarlane Burnet in 1969. Various research centers have been looking at immunotherapy for some time, and in fact in certain cancers recombitant interleukin-2 (IL-2) and interferons are used, but these therapies are plagued with serious side-effects.[3] Various natural products have been shown to have immune modulating properties.

The importance of the immune system in cancer prevention and adjuvant therapy has been well-established. Penn reports the following evidences for the role of the immune system in the development of cancers.[4]

Children with immunodeficiency diseases have increased rates of lymphoma, leukemia and Hodgkin's disease.

High rates of Kaposi's sarcoma and lymphoma in HIV infected individuals.

In organ transplant patients on immunosuppressive medications, there is a 3 fold increase in malignancies including skin, lips, vulva, anus, liver, lymphoma and Kaposi's sarcoma.

Cancer risk increases with duration of immunosuppressive treatment. In a study of heart transplant patients, cancer incidence increased 3 fold after one year of immunosuppressive therapy and 26 fold after 5 y.

Patients with autoimmune diseases treated with immunosuppressive therapy showed increased incidence of acute leukemia, lymphoma, liver cancer, bladder cancer and skin cancer.

Secondary tumors are common in cancer patients who receive immunosuppressive chemotherapy treatment. These may include acute leukemias, lymphoma, and bladder cancers. However this increase may be due to the DNA damage caused by the chemotherapeutic agent.

The importance of Natural Killer (NK) cells in effective immunotherapy has been broadly accepted. Our laboratory has consistently found that stage 4 cancer patients typically have severely depressed NK function, and sometimes decreased numbers (unpublished data). This is consistent with a plethora of other research on the subject.[5] Decreases in NK function are believed to be, at least in part, attributable to neoplasm's ability to “steer” the immune system towards T-helper 2 (Th2) vs. cell mediated or T-helper 1 (Th1) immunity. Many cancers secrete interleukin-10 (IL-10) as part of this mechanism.

Human Tumor Necrosis Factor-alpha (TNF-a) is a 233 amino acid residue, nonglycosylated polypeptide that exists as either a transmembrane or soluble protein. When expressed as a 26 kDa membrane bound protein, TNF-a consists of a 29 amino acid residue cytoplasmic domain, a 28 amino acide residue transmembrane segment, and a 176 amino acid residue extracellular region. The soluble protein is a 17 kDa, 157 amino acid residue molecule that normally circulates as a homotrimer. The variety of cell types known to express TNF-alpha includes macrophages, CD4+ and CD8+ T cells adipocytes, keratinocytes, mammary and colon epithelium, osteoblasts mast cells, dendritic cells, pancreatic beta-cells, astrocytes, neurons, monocytes, and steroid-producing cells of the adrenal zona reticularis.[6] Results of adenoviral mediated gene transfer of human TNF-alpha indicate a reduced systemic toxicity with an enhanced local antitumor effect in mice.[7] Gillio-Tos and colleagues demonstrated that TNF-alpha antitumoral effect was due to apoptosis mediated by the down-regulation of the antiapoptotic gene bcl-2.[8] Also, retroviral mediated gene transfer of the human TNF-alpha (hTNF) gene into U373MG human glioblastoma cells was shown to result in a reduction of the cells growth rate as compared to the parental cells.[9]

Tumor necrosis factor has direct in vitro antitumor activity on 30 to 50% of cell lines. Because of its pleiotropy, it is not fully understood which mechanism is responsible for its necrotic and apoptotic activities. When membrane bound, TNF-alpha exhibits antineoplastic potential, but when free floating, is a negative prognosticator of survival, being associated with wasting both in cancer and AIDS patients.

Transfer factors are small peptides that act as immune system regulatory cytokines.[10] Transfer Factor Plus (TFP®) contains several immunoactive components that have been shown to act synergistically in raising NK function and also effective as adjuvant therapy in cancer therapy.[11] In fact, one study (submitted) has suggested that TFP® alone may raise NK function by nearly 250%. One component, inositol hexaphosphate (IP-6), has been shown to have at least three anti-cancer properties (NK enhancer, induces p53 and diminishes mutagenesis). The other components, namely, three medicinal mushrooms, mannans, thymic lipoproteins, and beta glucan, have all been proven to enhance NK function as well as transfer factor itself.

Non-denatured milk whey protein isolates have been found to have a number of bioactive properties. Bovine milk contains around 3% protein by weight, with only 6.3% of that protein being whey protein. Normal processes to separate the whey component from the other constituents leads to significant denaturing of the bioactive whey proteins. Non-denatured whey protein isolates utilize proprietary processes to attain a protein containing over 90% non-denatured whey protein. Bioactive components include lactoferrin, lysozyme, lactoperoxidase, glycomacropeptide, alpha-lactalbumin, and bovine serum albumin. Lactoferrin exhibits anticancer, antiviral, antibacterial, and antifungal activity. It plays an active role in iron transport, an active role in the cytotoxic defenses of neutrophils, and scavenges free iron which acts as a free radical.[12 13]

Of particular interest with non-denatured milk whey proteins, is their up-regulation of intracellular glutathione via supplying cystine. The roles of glutathione (GSH) has been summarized by Gutman[14] and include enhancement of immune function, elimination of toxins, elimination of carcinogens, antioxidant cell protection, protection from ionizing radiation, DNA synthesis and repair, protein synthesis, prostaglandin synthesis, leukotriene syntheses, amino acid transport, and enzyme activity and regulation. Bounous et al have demonstrated that non-denatured whey protein isolate formula increased lymphocyte intracellular glutathione by greater than 120% in mice vs. mice fed standard, commercially available whey protein concentrates, or casein proteins.[15 16]

Table I. Ingredients in Immune Enhancing Formula

Ingredient Amount

Co-enzyme Q10 80 mg
Grape seed extract (95%) 40 mg
Alpha Carotene 5 mg
Lipoic acid 15 mg
Lycopene 1 mg
Vitamin E (Mixed tocopherols) 66 IU
Vitamin C (Beet-source) 1320 mg
Folic acids 90 mcg
Vitamin A (Acetate) 3300 IU
Vitamin B-1 5 mg
Vitamin B-2 6 mg
Vitamin B-3 (Niacinamide and Niacin) 74 mg
Pantothenic acid 40 mg
L-Glycine 500 mg
Vitamin B-6 6 mg
Vitamin B-12 (Cyanocobalamine) 400 mcg
Biotin 55 mcg
IP-6 (Inositol hexaphosphate) 200 mg
Choline 60 mg
Germanium sesquioxide 25 mg
N-Acetyl -L-Cysteine 100 mg
Glutathione 150 mg
L-Carnitine 100 mg
Calcium (Ascorbate) 40 mg
Magnesium 80 mg
Vitamin D-3 65 IU
Zinc 10 mg
Potassium 75 mg
Chromium 50 mcg
Molybdenum 25 mcg
Manganese 0.5 mg
Selenium 35 mcg
Iodine 25 mcg
MSM (Methylsulfonylmethane) 100 mg
Borage Oil (20% GLA) 150 mg
Tocotrienols 25 mg
Bioflavenoid complex 40 mg
TMG (Trimethyl Glycine) 200 mg
Sulforaphane (Broccoli) 45 mg
Beta Glucan 50 mg
Olive leaf extract 80 mg
Milk thistle extract (80% Silymarin) 25 mg
Green tea extract (40% Catechines) 45 mg
Mushroom extract cordyceps sinensis, Tremella fuciformis, Ganoderma lucidum, Lentinula edodes, Grifola frondosa, Coriolus versicolor 2200 mg
Agaricus blazei 200 mg
Andrographis paniculata 50 mg
Bromelain 175 mg
Turmuric extract (Curcumin 95%) 90 mg
Panax ginseng 15 mg
Cats claw 150 mg
L-Taurine 100 mg
Lactoferrin 60 mg

Kennedy demonstrated that non-denatured whey protein isolate formula increased glutathione in normal cells, but decreased glutathione in cancer cells.[17] It has been proposed that cancer cells produce more intracellular glutathione than normal cells in order to protect themselves from various reactive oxygen species. Thus, it would appear possible that the ingestion of non-denatured whey protein isolates may oxidatively stress cancer cells, while protecting normal cells. Bounous et al. have also demonstrated that mice fed non-denature whey protein isolates exhibit a significantly smaller tumor load than controls, when both groups are fed known carcinogens.[18]

Additionally, wasting (cachexia) can be a significant problem for the cancer patient. Though the mechanisms of cachexia are not fully understood, it is clear that there are major metabolic alterations in the cancer patient.[19] Tumor cells usually resort to the anaerobic rather than the aerobic metabolism for the production of energy. This type of metabolism is grossly inefficient and generates large amounts of lactic acid that must in turn be regenerated back into glucose in the liver, via the cori cycle, which also requires additional amounts of energy. Eventually the body begins to consume skeletal muscle for energy. Cachexia is also characterized by decreased appetite. Non-denatured whey protein isolate supplies a concentrated form of easily digestible high efficiency protein, without the need to consume large volumes of food. Finally, a number of clinics, including our own, have observed that patients rendered anemic due to chemotherapy and radiation appear to have robust recovery of their hemoglobin and hematocrit when fed adequate levels of non-denatured whey protein isolate (personal communication).

Our institute employs the use of a specialized powder containing a number of immune enhancing ingredients, including high potency antioxidants (Vitamins A, C, E, Selenium), products that enhance phase 2 detoxi fication in the liver, and products known to have effects on restoring cell cycle dynamics in cancer cells via a number of mechanisms including upregulation of tumor suppressor genes, downregulation of oncogenes, and other modulating effects on cyclin dependent kinases and other modulators of cell cycle dynamics (green tea extract, andrographis paniculata, Vitamin A, Vitamin D, to name a few).[20] The full regime each patient used is shown in Table 2.

Table II. Regime

1 Nutraceuticals:
TFP®, ImuPlus® milk whey protein, Agaricus Blazeii Murill teas, Transfer Factor Plus®, Beta Glucan, immune augmenting powder, and Soy Extract (and others cancer specific e.g., PC-Spes for Prostate)
2 Hyperthermia-local and systemic (far infrared sauna)
3 Light generator
4 Filtered, magnetic resonant water
5 Enemas
6 Lymphatic massage
7 Immunoimagery
8 Vegetarian, low sugar diet
9 Digestive enzymes
10 DMSA
11 Intravenous semi-benzyl Ted ascorbic acid (50–10 gm/day)

The purpose of this pilot study is to show if a regimen of natural immunomodulators could increase NK function and augment TNF-a production from PBMC; decrease tumor load; and increase quality of life in end-stage patients with cancer.

MATERIALS AND METHODS

Patient Selection

Twenty sequential patients with previously known stage IV malignancies were selected to participate in this study at the Immune Institute. After informed consent was obtained, 20 patients with stage IV, end-stage cancer were enrolled (one bladder, five breast, two prostate, one neuroblastoma, two non-small cell lung, three colon, 1 mesothelioma, two lymphoma, one ovarian, one gastric, one osteosarcoma). Therapy and surgery within 1 month of the procedure were exclusion criteria. The protocol was explained to them and consent forms were signed as required by the local Institutional Review Board. Inclusion criteria included age 18 to 75; 1 month to 6 month survival diagnosed by a Board Certified Oncologist; palliative therapy only planned in the future and no evidence of acute organ failure. Exclusion criteria included patients with severe leukopenia; poor respiratory or renal function; heart failure above New York heart association grade II; ventricular arrhythmias; autoimmune disorders; and coagulation abnormalities (Table 3).

Table III. Patient Demographics

Average age 49.3+/-15.6
Gender 12 males, 8 females[20]
Previous surgery 13
Previous chemotherapy 15
Previous radiation 14
Stage All stage IV
Liver involvement 9
Avg. length of diagnosis 6.9+/-6.1 months
Oncologist prognosis median survival 3.7+/-3.0 months
Further standard therapy planned 3/20 (all palliative)

Peripheral blood monocytic cells (PBMC) were isolated from the 400 mL of heparinized whole blood by density gradient centrifugation using Lymphocyte Separation Media (LSM), Cellgro® (Mediatech, Herndon, VA). The PBMC were washed three times with phosphate-buffered saline (PBS; Mediatech, Herndon, VA) to remove platelets and any traces of LSM. The washed cells were then used fresh for laboratory studies.

Laboratory Studies

NK Cell Activity

MOLT-4 cells (5×106, ATCC, Manassas VA) were incubated with 30 µCi of 51-Chromium (51Cr) for 1 h at 37°C with 5% CO2. The cells were washed once with PBS to remove excess chromium and transferred to a 96 well microplate. Each assay was done in triplicate and the results of the three wells averaged. Wells to assess total release contained 50 µL of the labeled cells, 50 µL of 3% triton-X and 100 µL of RPMI. Wells to determine spontaneous release consisted of 50 µL of labeled cells and 150 µL of RPMI. Test wells contained 100 µL of the PBMC (5×105/plate), 50 µL (5000 cells) of the labeled MOLT-4 cells and 50 µL of RPMI. The micro plate was then incubated for 4 h at 37°C with 5% CO2. Following the incubation, the plate was centrifuged at 4000 rpm for 15 min. A 100 µL sample of the supernatant from each well was transferred into a test tube and radioactivity was counted for one minute with a gamma counter. A standard formula was used to calculate the NK activity.

Tumor Necrosis Factor-a

A dilution series for TNF-a standard was prepared as specified by the manufacturer's package insert (Sigma, St. Louis MO). 200 µL of each standard and samples were pipetted into the designated wells of a microplate. 50 µL of assay diluent 1 F (PBS with 2% Fetal Bovine Serum [FBS]) was added to each well. The plate was then incubated for 2 h at room temperature. Following the incubation, each well was washed three times with 400 µL of washed buffer. Excess wash buffer was removed and 200 µL of TNF-a conjugate was pipetted into the wells. The plate was then incubated for 1 h at room temperature.

After the second incubation the wells are washed again. A 200 µL of the substrate solution containing equal volumes of colored reagent A and B (kit component) was pipetted into the washed wells. The plate was then incubated for 20 min at room temperature. The reaction was stopped by adding 50 µL of stop solution. The absorbance of each well was read using an ELISA micro plate reader set at 450 nm.

Soluble TNF Receptor Type I (sTNF R1)

A dilution series for human sTNF RI standard was prepared as specified by the manufacturer's package insert (R&D Systems, Minneapolis MN). 200 µL of each standard and samples were pipetted into the designated wells of a 96-well microplate. 50 µL of assay diluent RD1M was added to each well. The plate was then incubated for 2 h at room temperature. Following the incubation each well was washed three times with 400 µL of washed buffer. Excess wash buffer was removed and 200 µL of sTNF RI conjugate was pipetted into the wells. The plate was then incubated for 2 h at room temperature. After the second incubation the wells are washed again. A 200 µL aliquot of the substrate solution containing equal volumes of colored reagent A and B was pipetted into the washed wells. The plate was then incubated for 20 min at room temperature. The reaction was stopped by adding 50 µL of stop solution. The absorbance of each well was read using an ELISA microplate reader set at 450 nm.

Total Mercaptans

A dilution series for Total Mercaptan assay standards was prepared as specified by the manufacturer's kit (Calbiochem-Novabiochem, San Diego CA) package insert. 100 µL of patient sample and standards was pipetted into spectrophotometer cuvettes. The total volume of the cuvettes containing the samples and standards was adjusted to 900 µL with buffer solution . 50 µL of solution R1 (1% trimethylbenzine [TMB]) was added to each cuvette mixed and the absorbance read at 356 nm using a spectrophotometer.

Glutathione

A dilution series for Glutathione assay standards was prepared as speci fied by the manufacturer's kit (Calbiochem-Novabiochem, San Diego CA) package insert. 100 µL of patient sample and standards was pipetted into spectrophotometer cuvettes. The total volume of the cuvettes containing the samples and standards was adjusted to 900 µL with buffer solution. 50 µL of solution R1 was added to each cuvette mixed and the absorbance read at 356 nm using a spectrophotometer.

Hemaglobin, Hematocrit, Chemistry Panels

Standard complete blood count and chemistry panels were performed in the clinical laboratory by established methods.

STATISTICS

Differences in laboratory parameters between baseline and 4 weeks or 6 months were determined by ANOVA. Differences in projected vs. average survival were evaluated by chi square testing.

RESULTS

Twenty sequential late-stage cancer patients were that met inclusion criteria and were willing to participate were enrolled in order to avoid bias. By definition, the study inclusion criteria included an Oncologist projected survival of less than 6 months. Therefore, all patients technically should have been dead at 6 months. If one looks at the projected survival estimate (3.7+/-3.0), approximately 15 of the patients should be have been dead compared to only 4.

Immune parameters consistently and statistically improved over the 6 month trial. NK function increased by over 400% (Table 4).


Table IV. Baseline and 6 Month Natural Killer Cell Function Results (LU)

Patient Baseline 4 Weeks 6 Months

1 3.7 18.6 20.4
2 1.2 14.8 26.8
3 5.5 34.6 21.3
4 6.6 32.7 29.3
5 11.7 36.6 36.1
6 10.4 29.2 32.6
7 7.4 33.6 30.1
8 8.8 28.2 19.6
9 4.8 21.5 24.3
10 10.1 31.2 33.2
11 6.5 32.4 31.1
12 2.4 21.3 22.8
13 5.3 28.9 25.6
14 7.8 21.6 33.7
15 1.8 11.6 20.8
16 6.6 15.6 34.6
Mean >400% p<0.01 6.4 25.7 27.6 Four patients with very advanced cancer (mean estimated survival 1.5 months) died during the study. The patient with gastric cancer died after three weeks. The other three patients showed a partial response, dying between 4 and 6 months (bladder, non-small cell lung and colon). There was no correlation between type of tumor and response. Many studies have verified the ability of NK cells to lyse cancer cells in vivo.[15] Submitted data indicated that the synergistic, combination product TFP® alone could increase NK function by almost 250%. Combination nutraceuticals can be used to significantly boost NK function in the face of cancers that release toxins which inhibit NK function. The mean baseline NK function was 6.4 LU, which is significantly suppressed compared to normals, who have been determined to have over 20 LU activity.[5] TNF is a cytokine that is a potent anticancer agent. Serum recordings of TNF can be deceiving because end-stage patients often have high circulating levels as their immune system attempts, but ultimately fails, to control metastatic cancers. High serum TNF levels have been associated with cachexia in end stage cancer patients due to its significant proinflammatory properties.[19] However, evaluating the ability of a cancer patient's PBMC to release TNF alpha correlates with cancer killing and an ability to mount a response to the cancer.[6] In the current study, PBMC-derived TNF alpha was increased by over 10,000% after 6 months on the regimen the subjects received (Table 5). Baseline levels were all less than 40 pg/mL, compared to an average person with approximately 300 to 600 pg/mL response under similar laboratory conditions.[6] Table V. Baseline and 6 Months Tumor Necrosis Factor Alpha Results
(Adherent, Non stimulated PBMC Subpopulation, pg/mL)


Patient Baseline 4 Weeks 6 Months

1 2.2 794.2 1238.1
2 2.6 914.4 1341.5
3 11.6 1014.8 827.1
4 4.3 981.6 993.5
5 10.1 1286.3 1003.1
6 18.8 1342.1 1254.2
7 3.7 871.6 737.2
8 12.7 900.6 1042.7
9 2.7 639.7 737.2
10 35.7 1264.6 1563.7
11 1.7 783.4 804.1
12 23.2 741.9 1768.3
13 3.6 339.5 1673.0
14 18.9 238.4 1163.9
15 19.9 1672.7 3124.7
16 31.5 538.2 1327.4
Mean >10,000% P<0.01 12.4 895.0 1287.5 TNF-alpha type I receptors are found in high numbers on tumor cells. The significant decrease (p<.01; Table 6) found in this study could be considered a crude estimate of lowered tumor burden. Table VI. Baseline and 6 Months Tumor Necrosis Factor Alpha Type I Receptor Results (Optical Density)

Patient Baseline 4 Weeks 6 Months

1 2.2 1.9 1.4
2 2.0 2.1 1.6
3 3.4 3.1 1.7
4 2.9 2.7 0.8
5 3.7 3.5 2.7
6 1.8 1.6 1.2
7 3.7 3.2 2.9
8 3.8 3.6 2.7
9 1.9 1.9 1.6
10 3.8 3.4 2.1
11 1.6 0.6 <0.5 12 1.8 1.9 1.9 13 3.2 2.1 1.7 14 2.5 1.3 0.8 15 3.0 2.7 1.8 16 2.6 2.4 1.6 Mean P<0.01 2.74 2.38 1.69 Likewise, circulating mercaptans are associated with damaged DNA, including carcinogenic genes. A significant decrease (p<.01; Table 7) in the current study could be viewed as a similar marker for lessened DNA damage, and perhaps lower concentrations of oncogenes. Table VII. Baseline and 6 Month Serum Mercaptans Results (Optical Density)

Patient Baseline 4 Weeks 6 Months

1 2.6 2.4 2.0
2 3.4 1.8 0.8
3 4.1 3.7 1.4
4 4.9 3.4 3.6
5 3.2 3.4 3.0
6 2.4 2.7 2.8
7 2.7 3.5 1.8
8 2.8 2.2 1.1
9 3.7 3.4 1.9
10 3.2 3.0 2.4
11 2.4 1.1 1.1
12 2.9 1.7 1.4
13 3.8 2.6 1.9
14 2.9 1.8 1.1
15 3.9 2.3 1.0
16 4.1 2.8 1.7
Mean P<0.01 3.3 2.6 1.8 Glutathione is a potent intracellular antioxidant that improves immune function and was shown to be significantly improved in the study. Of the supplements used, ImuPlus has been shown to be the greatest inducer of glutathione, and may have been primarily responsible for the systemic increase in the face of cancer, which typically lowers this protein.[13]Table VIII. Plasma Glutathione and Hematocrit Levels (OD)

Glutathione Hematacrit

Patient Baseline 6 Months Baseline 6 Months

1 0.63 1.25 32.1 34.6
2 0.48 1.83 28.7 36.4
3 0.96 1.64 24.7 33.7
4 1.23 1.21 25.4 34.2
5 0.31 0.97 30.8 35.7
6 0.47 1.53 32.6 29.6
7 0.65 1.43 22.7 28.3
8 0.77 1.24 21.6 34.5
9 0.43 1.51 29.4 35.6
10 0.64 1.34 36.8 37.5
11 1.03 1.94 34.8 35.9
12 0.14 0.78 25.7 31.1
13 0.66 1.53 31.2 35.6
14 0.74 1.48 29.4 34.5
15 0.63 1.42 34.7 37.2
16 0.43 1.04 30.5 33.6
Mean 64 1.38 28.3 32.7
p<.01 p<.05 The 16 survivors all had significantly improved quality of life by SF-36 evaluation at 6 months (p< 0.6). Therefore, not only was life extended, but the patients in general felt better on the current regimen. Mean hemaglobin and hematocrit levels were significantly increased (Table 6), improving oxygen carrying capacity to tissues, a crucial defense to normal tissues in resisting an anaerobic environment conducive to cancergrowth.[18] DISCUSSION

Adequate levels of vitamins, minerals, orthomolecular compounds such as vitamin C, and nutrition from food are essential for health, and is especially important during times of physical and emotional stress. Cancer is stressful to the body in many ways. Numerous biological pathways and enzymes require vitamins for proper functioning. The immune system is no exception. Critical nutrients on which the immune system depends include vitamin C, folic acid, beta-carotene, and the minerals manganese, selenium, and zinc, among many others.

The February 25th, 1994 issue of Science magazine reported that scientists had been able to extend the lifespan of fruit flies by 30% with supplementation with antioxidant vitamins such as C, E, A, beta-carotene and selenium. It is postulated that vitamins protect cells from cancer in a number of ways including strengthening the immune system (vitamins C, E, A, and beta-carotene and the minerals selenium, zinc and manganese), neutralizing carcinogens (C and E) and preventing DNA and cellular damage (vitamins A and E, beta carotene and the minerals selenium, zinc and manganese).

Ascorbic acid, when given at sufficiently high dosages, has demonstrated preferential cytotoxicity to tumor cells in vitro and in vivo. Levels required to be cytotoxic in vivo to tumor cells are not attainable via oral administration. Cytotoxic effect requires intravenous administration of 50 Gms or more.[21]

It is hypothesized that ascorbic acid exhibits cytotoxic activity via a prooxidant effect. There is a 10 to 100 fold greater content of catalase in normal cells than in tumor cells. Due to this, cancer cells reach high levels of intracellular hydrogen peroxide leading to their destruction, while normal cells are protected.[22 23]

Andrographis Paniculata is an herb commonly used in Ayurvedic medicine which possesses a number of pharmacological properties. Of particular interest to us is the observation that the herb is involved in restoration of cell cycle dynamics in cancer cells, a phenomenon often referred to as dedifferentiation.[24]

The medicinal mushroom Agaricus Blazei Murill, like other medicinal mushrooms, has been observed to possess significant ability to stimulate macrophages, increase natural killer cells, and have other immunomodulatory effects. It is believed that the various fractions of beta glucans in medicinal mushrooms are responsible for this effect, but it appears that different fractions possess different immunomodulatory properties.[25 26] More recently Takaku identified a substance (ergosterol) in Agaricus possessing anti-angiogenic activity.[26]

Glutathione is a potent intracellular tripeptide which vigorously binds damaging free radical molecules that would other wise harm the cell by several mechanisms. Non-denatured milk whey protein (ImuPlus) has been shown to be a potent inducer of glutathione, thereby reducing cellular damage and improving intracellular function. Interestingly, a study by Kennedy[17] showed that non-denatured milk whey protein increased glutathione in cancer cells.

Most patients with cancer usually have decreased hemaglobin and hematocrit levels. However, in unpublished, preliminary data, ImuPlus has been shown to increase these levels, improving oxygen carrying capacity to tissues, improving their resistance to cancer.

It is beyond the scope of the current publication to discuss the actions and ramifications of all the constituents of the regimen used by the 20 study subjects, but the combination accomplished the following: immune function was significantly increased; markers of tumor load such as total circulating mercaptans were decreased; life span was increased; quality of life was improved; and glutathione and hemoglobin were increased. Combination approaches such as that used in the study may be necessary to improve the dismal statistics in stage III and IV cancers by acting at several sites in cancer growth, gene expression, biochemistry and mechanisms of metastases.

ACKNOWLEDGMENTS

We are grateful for the technical assistance of Dr. Romin Roshan. We are appreciative of the free product and partial funding of the study provided by Swiss Bioceuticals, and a portion of TFP® provided free of charge by 4-life International.

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