Talk:Modified citrus pectin
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Heavy metal chelation in dispute
editIt seems that its effects on chelation are heavily disputed/debunked by this paper: http://www.altmedrev.com/publications/13/4/283.pdf — Preceding unsigned comment added by 67.184.200.25 (talk) 01:03, 12 February 2014 (UTC)
Major cleanup
editThis article was a disaster and I have cleaned it up to a small usable stub. In particular it was stuffed full of dubious medical claims sourced to non-WP:MEDRS (and which often ran against WP:FRINGE too). For good measure, the opening was largely word-for-word plagiarized from the American Cancer Society. How it got rated "B" is beyond me! Alexbrn talk|contribs|COI 09:18, 10 September 2014 (UTC)
Neutral point of view
editAlexbrn continually reverted edits about the study that has been done on MCP with regard to cancer prevention. This study represents evidence, though limited, that MCP is quite effective. In contrast, there is little or no evidence suggested it is not effective in preventing and treating cancer. In other words, it is 1 for 1 in study, but hasn't been studied enough. This should be reflected in detail in the article, because as it has been reading it seems to indicate it is ineffective in preventing cancer. The only evidence we have actually suggests the opposite. Omnibus (talk) 17:51, 21 October 2015 (UTC)
- There is no good evidence it is effective in treating cancer in people: no source says any such thing. However the two most prominent expert bodies in the field (ACS and CRUK) make a point of saying there is no good evidence MCP is an effective treatment. We must reflect the best sources. Alexbrn (talk) 17:54, 21 October 2015 (UTC)
- Omnibus has been adding text saying MCP may be effective in treating cancer,[1] when our sources say rather the opposite (although MCP is sold as a scam anti-cancer treatment). We should reflect what the best sources say. Alexbrn (talk) 17:52, 21 October 2015 (UTC)
- There is exactly one study, and is suggests it is effective. What are your sources for "scam" nature or purported ineffectiveness? Omnibus (talk) 17:54, 21 October 2015 (UTC)
- It says no such thing. The American Cancer Society source details the scam element. (I have raised a query at WT:MED). Alexbrn (talk) 17:56, 21 October 2015 (UTC)
- There is exactly one study, and is suggests it is effective. What are your sources for "scam" nature or purported ineffectiveness? Omnibus (talk) 17:54, 21 October 2015 (UTC)
- Yes, it does. Exact conclusion below for integrity. Omnibus (talk) 18:01, 21 October 2015 (UTC)
Due to its anti-adhesive, apoptosis-promoting, and apoptosis-inducing properties, it appears that MCP is capable of targeting multiple critical rate-limiting steps involved in cancer metastasis (Fig. 3). In addition, by inhibiting Gal-3 anti-apoptotic function and enhancing apoptosis induced by cytotoxic drugs, it holds the potential to increase dramatically the efficiency of a conventional chemotherapy. The progression of this promising anti-cancer agent into clinical practice, hampered by various factors, was rather slow. Nevertheless, limited clinical studies performed to date demonstrated that MCP significantly increased prostate specific antigen doubling time in patients with recurrent prostate cancer,38 thus confirming its potential usefulness in treating prostatic neoplasia. As the potential and the necessity of developing MCP-based pharmaceuticals and nutraceuticals is becoming more and more commonly recognized,27,36,37 the addition of MCP to armamentarium of anti-cancer drugs holds the promise of improving treatment of multiple human malignancies.
- You realise the first bloded stuff is about laboratory work right? (not cancer in people); the second bolded text couches the clinical evidence in terms of "promise" and "potential". Even so, this should not be used to "however" our sources from expert cancer organisations. Alexbrn (talk) 18:06, 21 October 2015 (UTC)
- "In patients with recurrent prostate cancer" is not a phrase referring to laboratory work. I realize that it needs to be studied more, but the only study we have in humans has shown positive results. There have been no studies showing no correlations or negative results. Omnibus (talk) 18:10, 21 October 2015 (UTC)
- It is far premature by reference to published research to suggest in the article that MCP has even a limited effect. Omnibus: please review WP:MEDASSESS, left pyramid, to see that development of human research takes years to complete. The potential efficacy of MCP has a long way to go in human studies before we can state anything about its clinical uses with confidence. Until then, the objective position is to say no effect has been conclusively proven, and the article's supporting literature gives adequate acknowledgement to work underway. --Zefr (talk) 00:22, 22 October 2015 (UTC)
- "In patients with recurrent prostate cancer" is not a phrase referring to laboratory work. I realize that it needs to be studied more, but the only study we have in humans has shown positive results. There have been no studies showing no correlations or negative results. Omnibus (talk) 18:10, 21 October 2015 (UTC)
- Thanks all. The current version of the article is much more neutral and comprehensive than the one I found this morning. I am removing the NPOV tag. Omnibus (talk) 02:34, 22 October 2015 (UTC)
Complementary vs alternative
editOmnibus has put this is a complementary therapy, yet our CRUK source is explicit: "Modified citrus pectin (MCP) is an alternative therapy that is claimed to stop prostate cancer". We need to have verifiable text, not editor opinion. Alexbrn (talk) 18:03, 21 October 2015 (UTC)
- Okay, I will mention the study above suggesting its use as complementary therapy. Thanks. Omnibus (talk) 18:05, 21 October 2015 (UTC)
- Except it (not a "study" BTW) makes no such recommendation. Alexbrn (talk) 18:08, 21 October 2015 (UTC)
- I have directly quoted it so there can be no room for subjective interpretation here. Omnibus (talk) 18:14, 21 October 2015 (UTC)
- Except it (not a "study" BTW) makes no such recommendation. Alexbrn (talk) 18:08, 21 October 2015 (UTC)
Research section; WP:PRIMARY
editAccountholder wishes to include the section below as a separate research discussion. I reverted it as WP:PRIMARY work on lab animals and in vitro, far from confirmed evidence and human relevance. --Zefr (talk) 00:54, 7 June 2016 (UTC)
Debated text and references below:
Research has demonstrated anticancer and chemopreventative effects in vivo on mice subjects[1] and in vitro[2][3][4], but there is no evidence MCP prevents or treats cancer in humans. Although all the modes of the observed effects in laboratory studies are not known, the molecule 4,5-dihydroxy-2-cyclopenten-1-one has been isolated as one contributor to MCP's cytotoxicity in experiments.[5]
It is also under research for its potential to increase the efficiency of a conventional chemotherapy.
References
- ^ Glinsky VV, Raz A (September 2009). "Modified citrus pectin anti-metastatic properties: one bullet, multiple targets". Carbohydr. Res. (Review). 344 (14): 1788–91. doi:10.1016/j.carres.2008.08.038. PMC 2782490. PMID 19061992.
- ^ Ramachandran, et al. (2011). "Activation of Human T-Helper/Inducer Cell, T-Cytotoxic Cell, B-Cell, and Natural Killer (NK)-Cells and induction of Natural Killer Cell Activity against K562 Chronic Myeloid Leukemia Cells with Modified Citrus Pectin". BMC Complement. Altern. Med. (Paper). 11 (59). doi:10.1186/1472-6882-11-59. PMC 3161912.
{{cite journal}}
: CS1 maint: unflagged free DOI (link) - ^ Leclere, et al. (2015). "Heat-Modified Citrus Pectin Induces Apoptosis-Like Cell Death and Autophagy in HepG2 and A549 Cancer Cells". PLoS One (Paper). 10 (3). doi:10.1371/journal.pone.0115831. PMC 4368604.
{{cite journal}}
: CS1 maint: unflagged free DOI (link) - ^ Wang, Li, Lu, Ling (2016). "Chemoprevention of Low-Molecular-Weight Citrus Pectin (LCP) in Gastrointestinal Cancer Cells". Int. J. Biol. Sci. (Paper). 12 (6): 746–756. doi:10.7150/ijbs.13988. PMC 4870717.
- ^ Leclere, Fransolet, Cambier, El Bkassiny, Tikad, Dieu, Vincent, Van Cutsem, Michiels (February 2016). "Identification of a cytotoxic molecule in heat-modified citrus pectin". Carbohydr Polym. (Paper). 10 (137): 39–51. doi:10.1016/j.carbpol.2015.10.055.
- Zefr misunderstands inclusion of research, which describes the direction of current studies, not implied human benefit. The standards cited only apply where human effect is implied. The scholarly relevance of research directions is relevant. Accountholder
- Agree with Zefr: in general we don't use primary sources for biomedical content. Also not sure what the point of using a 7 year-old mini-review in place of recent information from MSKCC. Alexbrn (talk) 01:53, 7 June 2016 (UTC)
Hi, so I was adding all of that research but Zefr wanted it here, please help me pick up what is useful. I spent a lot of time on this research and believe something could go up to help people.
editModified citrus pectin (also known as citrus pectin, Pecta-Sol and MCP) is a modified, more digestible form of pectin. It is obtained from the peels, seeds and pulp of citrus fruits using a chemical extraction process.[1]
In general, pectin is gel-forming polysaccharides from plant cell walls, especially apple and citrus fruits. Pectin is a type of viscous dietary fiber and varies in the length of its polysaccharide chains. Although pectin is not digestible by humans, it can be treated to create smaller fiber fragments to increase absorbability across the small intestine epithelium. Pectin in general, including modified citrus pectin, have been investigated for possible cardiovascular benefits, including lowering cholesterol and reducing atherosclerosis.[2]
- Wikipedia medical content is not intended to offer advice, WP:NOTADVICE, and relies on rigorous reviews or clinical position statements published in reputable sources, WP:MEDRS. Except for a small amount of content on adverse effects, you have not provided that, but rather have used primary sources in weak journals or have inserted quackery nonsense. Zefr (talk) 20:07, 18 November 2021 (UTC)
Modified citrus pectin
editModified citrus pectin (also known as depolymerized pectin, fractioned pectin, modified pectin, PectaSol, pH-modified pectin, low molecular weight pectin, and MCP) is a more digestible form of pectin. Still, the term is not rigidly defined, and all modified citrus pectin is not produced necessarily the same way or proven effective. Some experts caution that citrus pectin and all "modified" citrus pectin may not have the same effects as researched modified citrus pectin.[3] Citrus pectin does not have the same short polysaccharide chains as researched modified citrus pectin, and "modified" pectin could indicate that the pectin is altered somehow but not necessarily contain the shorter polysaccharide chains. The highly researched and clinically studied form, PectaSol, is obtained from the piths of citrus fruit rinds using heat and pH-controlled enzymatic process. At the same time, other low molecular mass pectin can be depolymerized through a treatment with sodium hydroxide and hydrochloric acid, and/or heat. The resultant smaller molecule is composed predominantly of D-polygalacturonates, which are more easily absorbed by the human digestive system.[4]
Modified citrus pectin is promoted and sold as a dietary supplement as an adjuvant oncological, cardiovascular disease, organ fibrosis, immune support, and toxin removal supplement.[5] It has been researched for its potential to increase the efficiency of conventional therapies such as chemotherapies and radiation.[6][7] As of 2020, clinical and preclinical studies have ranged from multiple cancer types, cardiovascular, kidney, and liver diseases, immune modulation, and detoxification.[5] Further larger randomized placebo-controlled clinical studies are warranted for all these areas. Modified citrus pectin is most often used as an adjuvant to cancer therapy to prevent metastasis. Modified citrus pectin is still considered an experimental compound for cancer and should be used as an adjuvant to standard cancer therapy under medical supervision.[8]
Modified citrus pectin acts as an antagonist for galectin-3, which plays a major role in tumor formation and progression, inflammation and fibrosis, and immune modulation.[5] In vivo, binding of modified citrus pectin to galectin-3 inhibited tumor growth, angiogenesis, and metastasis suggesting inhibitory effects with pectin in colon, breast, liver, and lung cancer cell lines.[9] In a pilot study in 10 men with relapsed prostate cancer taking six 800 mg capsules 3 times per day (total of 14.4 g/per day) for a 12-month period, modified citrus pectin increased prostate-specific antigen (PSA) doubling time in 70%, presumably by binding galectin-3.[10] A follow-up phase 2 study included 46 patients from multiple cancer centers with non-metastatic biochemical relapsed prostate cancer with a median age of 74 years given the same dose was performed. Patients who did not show disease worsening either clinically, biochemically (PSA), or radiologically at six months were treated for another 12 months. Seventy-six % (35 men) had no signs of disease progression at 6 months; 59% of them (27 men) had stable or lower PSA 70% of them had a lengthening of PSA doubling time demonstrating a slowing or attenuation of progression. All of them had no metastasis on imaging scans at 6 months.[11]
In an earlier study, 49 patients with advanced solid tumors of various types of cancers received modified citrus pectin (5 g modified citrus pectin powder dissolved in water) 3 times a day for at least 8 weeks. Following treatment, improvements were reported in some measures of quality of life, including physical functioning, global health status, fatigue, pain, and insomnia. In addition, 22.5% had stable disease after 8 weeks of modified citrus pectin treatment, and 12.3% of participants had disease stabilization lasting more than 24 weeks. One patient with metastasized prostate cancer showed a 50% decrease in serum PSA level after 16 weeks of treatment associated with a significant increase of clinical benefit, quality of life, and decrease in pain.[12]
Over 20 peer-reviewed published studies modified citrus pectin has shown its ability to target galectin-3 and to address fibrosis in multiple conditions.[5]
Modified citrus pectin has demonstrated its ability to greatly enhance immune function in a study that found it activated B-cells in a dose-dependent manner and induced a highly significant dose-dependent activation of T-cytotoxic cells and Natural Killer (NK) cells ex vivo in human blood. The NK-cell's cancer killing activity was demonstrated against live leukemia cancer cells.[13]
- Most of this is speculation or frank misinformation based on primary research in untrustworthy journals, resulting in this justified revert. The journals Molecules and Nutrients are untrustworthy as possible predatory publications in which the authors may have paid for publication or the editorial practices were weak or absent, as indicated on WP:CITEWATCH. If this content you are proposing had clinical significance or mainstream acceptance in medicine, it would be published in WP:MEDSCI sources. It is a long way from that quality. Zefr (talk) 20:16, 18 November 2021 (UTC)
References
- ^ "Pectins, Section 184.1588". US Food and Drug Administration, Code of Federal Regulations Title 21, Listing of Specific Substances Affirmed as GRAS. 7 November 1983. Retrieved 22 October 2015.
- ^ Zaitseva, Oksana; Khudyakov, Andrey; Sergushkina, Marta; Solomina, Olga; Polezhaeva, Tatyana (2020). "Pectins as a universal medicine". Fitoterapia. 146: 104676. doi:10.1016/j.fitote.2020.104676. ISSN 1873-6971. PMID 32561422.
- ^ Eliaz, Isaac (2019-05-01). "Letter to the Editor: Not all modified citrus pectins are the same: size does matter". American Journal of Physiology-Heart and Circulatory Physiology. 316 (5): H1232–H1233. doi:10.1152/ajpheart.00118.2019. ISSN 0363-6135. PMC 6580396. PMID 31070458.
- ^ Lara-Espinoza, Claudia; Carvajal-Millán, Elizabeth; Balandrán-Quintana, René; López-Franco, Yolanda; Rascón-Chu, Agustín (2018-04-18). "Pectin and Pectin-Based Composite Materials: Beyond Food Texture". Molecules : A Journal of Synthetic Chemistry and Natural Product Chemistry. 23 (4): 942. doi:10.3390/molecules23040942. ISSN 1420-3049. PMC 6017442. PMID 29670040.
{{cite journal}}
: CS1 maint: unflagged free DOI (link) - ^ a b c d Eliaz, Isaac; Raz, Avraham (2019-11-01). "Pleiotropic Effects of Modified Citrus Pectin". Nutrients. 11 (11): 2619. doi:10.3390/nu11112619. ISSN 2072-6643. PMC 6893732. PMID 31683865.
{{cite journal}}
: CS1 maint: unflagged free DOI (link) - ^ Hossein, Ghamartaj; Keshavarz, Maryam; Ahmadi, Samira; Naderi, Nima (2013). "Synergistic effects of PectaSol-C modified citrus pectin an inhibitor of Galectin-3 and paclitaxel on apoptosis of human SKOV-3 ovarian cancer cells". Asian Pacific journal of cancer prevention: APJCP. 14 (12): 7561–7568. doi:10.7314/apjcp.2013.14.12.7561. ISSN 2476-762X. PMID 24460334.
- ^ Conti, Sefora; Vexler, Akiva; Hagoel, Lior; Kalich-Philosoph, Lital; Corn, Benjamin W.; Honig, Nir; Shtraus, Natan; Meir, Yaron; Ron, Ilan; Eliaz, Isaac; Lev-Ari, Shahar (2018-07-25). "Modified Citrus Pectin as a Potential Sensitizer for Radiotherapy in Prostate Cancer". Integrative Cancer Therapies. 17 (4): 1225–1234. doi:10.1177/1534735418790382. ISSN 1534-7354. PMC 6247563. PMID 30043669.
- ^ "Natural Standard Herb & Supplement Guide - 1st Edition". www.elsevier.com. Retrieved 2021-11-04.
- ^ "Pectin | Memorial Sloan Kettering Cancer Center". www.mskcc.org. Retrieved 2021-11-04.
- ^ Guess, B. W.; Scholz, M. C.; Strum, S. B.; Lam, R. Y.; Johnson, H. J.; Jennrich, R. I. (2003). "Modified citrus pectin (MCP) increases the prostate-specific antigen doubling time in men with prostate cancer: a phase II pilot study". Prostate Cancer and Prostatic Diseases. 6 (4): 301–304. doi:10.1038/sj.pcan.4500679. ISSN 1365-7852. PMID 14663471.
- ^ Keizman, Daniel; Frenkel, Moshe A.; Peer, Avivit; Rosenbaum, Eli; Margel, David; Sarid, David; Neiman, Victoria; Leibovitch, Ilan; Sternberg, Itay Aharon; Boursi, Ben; Gottfried, Maya (2019-05-20). "Effect of pectasol-c modified citrus pectin (P-MCP) treatment (tx) on PSA dynamics in non- metastatic biochemically relapsed prostate cancer (BRPC) patients (pts): Primary outcome analysis of a prospective phase II study". Journal of Clinical Oncology. 37 (15_suppl): e16609–e16609. doi:10.1200/JCO.2019.37.15_suppl.e16609. ISSN 0732-183X.
- ^ Azémar, Marc; Hildenbrand, Bernd; Haering, Brigitte; Heim, Manfred E.; Unger, Clemens (2007-01-01). "Clinical Benefit in Patients with Advanced Solid Tumors Treated with Modified Citrus Pectin: A Prospective Pilot Study". Clinical medicine. Oncology. 1: CMO.S285. doi:10.4137/CMO.S285. ISSN 1177-9314.
- ^ Ramachandran, Cheppail; Wilk, Barry J.; Hotchkiss, Arland; Chau, Hoa; Eliaz, Isaac; Melnick, Steven J. (2011-08-04). "Activation of Human T-Helper/Inducer Cell, T-Cytotoxic Cell, B-Cell, and Natural Killer (NK)-Cells and induction of Natural Killer Cell Activity against K562 Chronic Myeloid Leukemia Cells with Modified Citrus Pectin". BMC Complementary and Alternative Medicine. 11 (1): 59. doi:10.1186/1472-6882-11-59. ISSN 1472-6882. PMC 3161912. PMID 21816083.
{{cite journal}}
: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
Safety, side effects, and warnings
editModified citrus pectin is "generally regarded as safe" (GRAS) by the U.S. Food and Drug Administration (FDA), with minimal adverse effects being reported in the available literature.[1]
Because it is a dietary fiber, modified citrus pectin may result in soft, loose stools, but it should not cause persistent gastrointestinal problems in healthy patients. Theoretically, modified citrus pectin may cause fluid or electrolyte loss, constipation, or fecal impaction in some patients, especially geriatric patients, because it is a fiber.[2]
It is recommended to use cautiously with chelating medications, as modified citrus pectin may significantly increase the urinary excretion of metals.[17,18,19] [3][4][5]
Modified citrus pectin is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.[2]
Although modified citrus pectin is more easily digested and systemically absorbed than untreated citrus pectin, individuals sensitive to increased amounts of soluble fiber in their diets or with citrus allergies may experience diarrhea or stomach discomfort when introducing them taking either.[6]
References
- ^ Cite error: The named reference
:3
was invoked but never defined (see the help page). - ^ a b Cite error: The named reference
:1
was invoked but never defined (see the help page). - ^ Eliaz, Isaac; Hotchkiss, Arland T.; Fishman, Marshall L.; Rode, Dorena (2006). "The effect of modified citrus pectin on urinary excretion of toxic elements". Phytotherapy research: PTR. 20 (10): 859–864. doi:10.1002/ptr.1953. ISSN 0951-418X. PMID 16835878.
- ^ Zhao, Zheng Yan; Liang, Li; Fan, Xiaoqing; Yu, Zhonghua; Hotchkiss, Arland T.; Wilk, Barry J.; Eliaz, Isaac (2008). "The role of modified citrus pectin as an effective chelator of lead in children hospitalized with toxic lead levels". Alternative Therapies in Health and Medicine. 14 (4): 34–38. ISSN 1078-6791. PMID 18616067.
- ^ Eliaz, Isaac; Weil, Elaine; Wilk, Barry (2007). "Integrative medicine and the role of modified citrus pectin/alginates in heavy metal chelation and detoxification--five case reports". Forschende Komplementarmedizin (2006). 14 (6): 358–364. doi:10.1159/000109829. ISSN 1661-4119. PMID 18219211.
- ^ Cite error: The named reference
:2
was invoked but never defined (see the help page).
The 'chelating' content is alt-med nonsense. There may be content useable here with better sources. Zefr (talk) 20:19, 18 November 2021 (UTC)