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Viscum album (European mistletoe) is a semi-parasitic plant whose extracts are used in complementary and alternative medicine. The berry, leaf, and stem are utilized for medicinal purposes. Its preparations contain a variety of bioactive compounds including viscotoxins (thionin-type proteins), lectins (notably viscumin), alkaloids, flavonoids (quercetin and others), glycosides (including cardiac glycosides), phenolic compounds, saponins, steroids and more[4][6]. The main mechanisms of action proposed for Viscum album extracts include: - Direct cytotoxicity against cancer cells via inhibition of protein synthesis by mistletoe lectins such as viscumin[6]. - Immune system stimulation through increased white blood cell activity[3][6]. - Vasorelaxant effects mediated by noncompetitive inhibition of calcium influx through calcium-gated channels and promotion of nitric oxide signaling; possible muscarinic receptor blockade; positive ionotropic effect via β-adrenergic innervation[5]. - Enhancement of insulin secretion from pancreatic beta cells without cytotoxicity; antioxidant effects that may protect vasculature[5]. Viscum album extracts have been most widely studied as adjunctive therapy in cancer care—especially in German-speaking countries—and have also been traditionally used for cardiovascular conditions such as hypertension and heart failure symptoms. They are not approved as drugs in the United States but are listed in the Homeopathic Pharmacopoeia. Administration is usually subcutaneous injection but other routes have been described[8].
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