Chemotherapy is generally considered indispensable in the treatment of cancer, but it often lowers the quantity of white blood cells drastically. Two reports study the effect of moxibustion in preventing or treating this type of leukopenia.

In one study, 114 patients had lung cancer, cancer of the esophagus, lymphoma, or other malignant tumors. They all received 1-3 courses of chemotherapy, and as a result, their white blood cells fell below 4000/mm3.

Moxa cones the size of a half a Chinese date were burned on slices of ginger (0.2-0.3 cm thick) on dazhui Du14, geshu UB17, pishu UB20, weishu UB21, and shenshu UB23. Three cones were used on each point to make redness and a tolerable burning pain. Blisters were avoided. Treatment was given daily for 9 days. Other drugs to raise the white cell count were not taken during this time. Blood work was analyzed every three days. Moxibustion was stopped if the white cell count rose over 4000/mm3.

Results: 44.7% reached 4000/mm3 in three days. 29.8% reached it in 6 days. 16.7% made the goal in 9 days. 8.8% failed to rise to 4000/mm3. (JTCM 1993;13(4):266-7)

The 111 subjects in another study had suffered cancer of the lungs, stomach, breast, or colon. They were prescribed chemotherapy which was expected to result in bone marrow suppression. These subjects were randomly divided into two groups. After beginning chemotherapy, members of the moxibustion group received moxibustion on zusanli ST36 on one side (the side alternated each treatment). Medium-sized cones were stuck on with petroleum jelly. The cones were burned until the patient felt a small burning pain at the site. The number of cones varied for each patient. They were treated once a day.

The comparison group received three days of injections of granulocyte colony stimulation factor (G-CSF) in order to stimulate the bone marrow to produce more white blood cells.

Both groups had their blood drawn daily to measure WBC, starting on day 5. To summarize the results, the injections were more effective in preventing bone marrow suppression during days 5 through 9. In days 11 through 13, there were no significant statistical differences between the two groups.
It seems that moxibustion is a little slower but is able to perform the same job as G-CSF. Since G-CSF can have many side-effects and is certainly more expensive than moxibustion, some may want to choose moxibustion as an alternative or may want to use it along with G-CSF. (Jilin Zhongyi Yao 2005;2:33-34)

BACKGROUND:
Many widely used botanical medicines are claimed to be immune enhancers. Clear evidence of augmentation of immune responses in vivo is lacking in most cases. To select botanicals for further study based on immune enhancing activity, we study them here mixed with antigen and injected subcutaneously (s.c.). Globo H and GD3 are cell surface carbohydrates expressed on glycolipids or glycoproteins on the cell surface of many cancers. When conjugated to keyhole limpet hemocyanin (KLH), mixed with an immunological adjuvant and administered s.c. the magnitude of the antibody responses against globo H, GD3 and KLH depend largely on the potency of the adjuvant. We describe here the results obtained using this s.c. immunization model with seven botanicals purported to have immune stimulant effects.

METHODS:
Groups of 5-10 mice were immunized with globo H-KLH or GD3-KLH mixed with botanical, saline or positive control immunological adjuvant, s.c. three times at 1 week intervals. Antibody responses were measured 1 and 2 weeks after the 3rd immunization. The following seven botanicals and fractions were tested:
(1) H-48 (Honso USA Co.), (2) Coriolus versicolor raw water extract, purified polysaccharide-K (PSK) or purified polysaccharide-peptide (PSP) (Institute of Chinese Medicine (ICM)), (3) Maitake extract (Yukiguni Maitake Co. Ltd. and Tradeworks Group), (4) Echinacea lipophilic, neutral and acidic extracts (Gaia Herbs), (5) Astragalus water, 50% or 95% ethanol extracts (ICM), (6) Turmeric supercritical (SC) or hydro-ethanolic (HE) extracts (New Chapter) or 60% ethanol extract (ICM) and (7) yeast beta-glucan (Biotec Pharmacon). Purified saponin extract QS-21 (Antigenics) and semisynthetic saponin GPI-0100 (Advanced BioTherapies) were used as positive control adjuvants. Sera were analyzed by ELISA against synthetic globo H ceramide or GD3 and KLH.

RESULTS:
Consistent significant adjuvant activity was observed after s.c. vaccination with the Coriolus extracts (especially PSK), a 95% ethanol extract of Astragalus and yeast beta-glucan, and (to a lesser extent) Maitake. Antibodies against KLH in all cases and against globo H in most cases were induced by these botanicals. Little or no adjuvant activity was demonstrated with H-48 or Echinacea extracts or the Astragalus water extract. Experiments with GD3-KLH as immunogen confirmed the adjuvant activity of the Coriolus, yeast beta-glucan and Astragalus extracts. While extraction with ethanol concentrated the active ingredients in Astragalus, it had no impact on Coriolus where the 90% ethanol precipitate and solute were equally active.

CONCLUSIONS:
Some, but not all, botanicals purported to be immune stimulants had adjuvant activity in our model. PSK and Astragalus were surprisingly active and are being further fractionated to identify the most active adjuvant components.

Author information

Author/s: Ragupathi, Govind (G); Yeung, K Simon (KS); Leung, Ping-Chung (PC); Lee, Mavis (M); Lau, Clara Bik San (CB); Vickers, Andrew (A); Hood, Chandra (C); Deng, Gary (G); Cheung, Nai-Kong (NK); Cassileth, Barrie (B); Livingston, Philip (P);

Affiliation: Laboratory of Tumor Vaccinology, Melanoma and Sarcoma Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States. ragupatg(-atsign-)mskcc.org

Grants: 1 P50 AT002779-01 (Agency:NCCAM NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov’t

Journal: Vaccine (Vaccine), published in Netherlands. (Language: eng)

Reference: 2008-Sep; vol 26 (issue 37) : pp 4860-5

Dates: Created 2008/08/25; Completed 2008/10/15;

PMID: 18640165, status: MEDLINE (last retrieval date: 2/18/2009)