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Published Studies and Trial Excerpts Glutacyan/Sport Recovery Max Reduced Glutathione Oral Supplement (formerly Recancostat) 1. Up-regulation of interferon-gamma production by reduced glutathione, anthocyane and L-cysteine treatment in children with allergic asthma and recurrent respiratory diseases. Negative correlation between serum IgE levels and production of IFN-gamma by lymphocytes and positive correlation between serum IgE levels and production of IL4 by lymphocytes was detected in 12 children with allergic asthma and recurrent respiratory diseases. Deficiency of reduced glutathione in whole blood and some disorders in phagocytic and oxidative burst activity of monocytes were observed in these children. Use of reduced glutathione, L-cysteine and anthocyane (Rec., Clear Vision, Switzerland) resulted in elevation of IFN-gamma production, lymphocyte response to mitogens, NK cell activity, increase in percentage of naive CD4(+) T lymphocytes (refreshment effect) and improvement of clinical status. Positive clinical results lasted 6 months. Source: Chernyshov VP, Omelchenko LI, Treusch G, et al. Russ J Immunol. 2002 Apr;7(1):48-56. 2. Effects of Rec. Comp. on immune system on Chernobyl children with RRD. Rec. Comp. (RC – tablets of reduced glutathione, l-cysteine, and anthyocane) were used in the treatment of children (8-14 years old) with recurrent respiratory diseases (RRD). Children lived on the territory with contamination of radionuclides after Chernobyl accident. Before treatment levels of absolute number of CD3/CD4 lymphocytes, PHA-lymphocyte response, and activity of phagocytosis were decreased. Levels of spontaneous NBT-test of blood neutrophils (without ex vivo stimulation) were high. After RC treatment significant elevation to normal ranges of numbers of CD3/CD4-lymphocytes, levels of PHA-stimulated lymphocyte response and activity of phagocytosis were detected. Immediately after treatment, levels of stimulated NBT-test were extremely low. But 5 months investigation confirmed positive effect of RC: normal levels of spontaneous and stimulated NBT-test and good levels of reserve were investigated. In temporary low levels of stimulated NBTtest immediately after treatment we suppose the mechanism of reduced glutathione metabolism to react with free radicals. Positive immunological dynamics correlated with good clinical effects. 1 Source: Chernyshov VP, Omelchenko LI, Treusch G, et al. Int J Immunorehabilitation. May 1997;5:72. 3. Preliminary study of GSH L-cysteine anthocyane (Rec. Comp) in metastatic colorectal carcinoma with relative denutrition. Reduced glutathione (GSH) is a sulphur-containing nucleophile natural metabolic molecule able to maintain cellular integrity and protect healthy cells against toxic and radicalic compounds at physiological doses. Administered orally at high doses GSH associated with both L-Cysteine Glutathione precursor and Anthocyane (Rec Comp). The drug had been reported concerning a chemoprotection against tissue toxicity of cytotoxic agents and multi-drug resistance. Also the drug may induce inhibition of tumor growth in vitro and tumor regression with recovered nutrition and weight in vivo (on rats). A clinical trial had conducted in eleven (first group of multi-step Fleming evaluation test) metastatic colorectal carcinomachemoresistant patients with various denutrition phase and loss of weight. We report first clinical data for this study. Treatment consisted in oral administration of 800 mg GSH twice a day for a minimum of 90 days or until progression or toxicity (total dose: 144g GSH, 28.8 g L-cysteine, 23 g. Anthocyane). No drug related toxicities observed. Eight patients were evaluated. All patients (8) are living (3-10 months) and the median duration of treatment was 21 weeks (11-33). Four patients recovered normal diet, high Karnowsky and increased weight (three were able to return home), four patients had no response. Conclusion: In addition of active therapeutic effect in cancer and chemoprotection, Rec. Comp. maintains Karnowsky, nutrition, and weight of multitreated patients. Because no toxicity with Rec. Comp. at high doses, we will select patients with cancer cachexia in second step of extended trial. Source: Garcia-Giralt E, Pedereau B, Brixy F, et al. Presented at the European Cancer Conference. September 14-18, 1997. Eur J Cancer. 1997:33(sup 8). 4. Immunological analysis of reduced glutathione, L-cysteine and anthocyane effects in Chernobyl children with recurrent respiratory infections and chronic inflammatory focal lesions. Deficiency in glutathione system: decreased levels of reduced glutathione (GSH) in plasma, whole blood; elevated intracellular levels of GSH in lymphocytes, and especially in monocytes, were detected in 12 Chernobyl children with recurrent respiratory infections (RRI) and chronic inflammatory focal lesions (CIFL group) in 2 comparison with 6 Chernobyl children with RRI only (placebo-controlled group) living in the same territory contaminated by radionuclides. Deficiency in cytokine release (TNF, IL-10, IL-12) by monocytes, in phagocytic function of neutrophils and monocytes and disorders in oxidative burst activity of neutrophils and monocytes; as some disorders in lymphocyte subsets were detected in CIFL children in comparison to placebo-control group. Use of reduced glutathione, Lcysteine and anthocyane (Rec. Comp., Clear Vision, Switzerland) resulted in normalization of immune status, glutathione balance (blood plasma and intracellular levels of GSH), and improvement in clinical status. Frequency of acute RRI per year decreased by 5.8 times in CIFL group of children and by 2 times in placebo control group. Source: Chernyshov VP, Omelchenko LI, Treusch G, et al. Cent Euro J Immunol. 2000;25(3):137-145. 5. Disorders in mononuclear phagocytes and reduced glutathione and their correction in Chernobyl children with recurrent respiratory infections and chronic inflammatory Deficiency in glutathione system revealed by decreased levels of reduced focal lesions. glutathione (GSH) in blood plasma and in whole blood and elevated intracellular levels of GSH in lymphocytes and especially in mononuclear phagocytes were detected in 12 Chernobyl children with recurrent respiratory infections (RRI) and chronic inflammatory focal lesions: chronic bronchitis, gastroduodenitis, maxilla sinusitis, and gastroesophageal reflux, (CIFL group of children) in comparison with six Chernobyl children with RRI only – placebo-control (PC) group, living in the same territory contaminated by radionuclides. Deficiency of TNF, IL-10, IL-12 release after LPS stimulation of mononuclear phagocytes were detected in CIFL group. Disorders in oxidative burst activity of mononuclear phagocytes neutrophils were observed. Therapy by GSH, L-cysteine and anthocyane resulted normalization (reconstitution_ of mononuclear phagocytes and neutrophils function, glutathione balance (blood plasma and intracellular levels of GSH) and improvement in clinical status. Elevated levels of lymphocyte subsets CD3+CD8+CD38+, CD3+CD8+CD57+, CD19+CD5+ in CIFL group decreased and reached levels of PC group. Proliferative response of T-lymphocytes to anti-CD3 mAb increased after therapy. Frequency of acute RRI per year decreased by 5.8 times after therapy in CIFL group and by 2 times in PC group of children. 3 Source: Chernyshov VP, Omelchenko LI, Treusch G, et al. Abstracts of the 14th European Immunology Meeting EFIS. September 23-27 2000. EFIS. 2000:73(2,3) :75302. 6. Refreshment effect of reduced glutathione, anthocyans and L-cysteine on lymphocyte subsets and prevention of respiratory infections in Chernobyl children. Objective: Analysis of immune mechanisms in prevention of recurrent respiratory infections in children by Rec. Comp. treatment (tablets of reduced glutathione, anthocyans and L-cysteine). Method and Populations: IMK-lymphocyte and CD28 monoclonal antibodies were used for two-color flow-cytometry. NK-cell activity, PHA and PWM proliferative response, anti-thyroid antibodies, thyroid hormones and IgE were studied before, after and 5 months after Rec. Comp. treatment in 11 Chernobyl children with recurrent respiratory infections living on contaminated by radionuclides territory (5-15 Ci/km^2). Results: Increase of CD28+/CD8+ lymphocyte levels, normalization of low NK-cell activity and PHA-proliferative response and decrease of high IgE levels, normalization of high levels of absolute counts and percentage of activate Tlymphocytes bearing HLA DR marker (CD3+/HLA DR+) especially in more heavy cases and complicated with anti-thyroid antibodies were detected after Rec. Comp. treatment. There was positive clinical effect during 5 months after treatment. Conclusion: Reduced glutathione, anthocyans, and L-cysteine in combined using have refreshment effect on lymphocyte subsets that prevent respiratory infections in immunocompromized Chernobyl children. Source:Chernyshov VP, Omelchenko LI, Treusch G, et al. Programs and Abstracts of the 5th International Conference on the Prevention of Infection. May 6-7, 1998. NICE. 1998. 7. Disorders in GSH, phagocytosis and monocyte production of TNF, IL-10, IL-12 in children with RRD complicated by allergy and chronic inflammatory focal lesions. 4 Deficiency of reduced glutathione (GSH) in whole blood of children with recurrent respiratory disorders (RRD) complicated by allergy (A) and chronic inflammatory focal lesions (CIFL) was detected. RRD patients without complications were as placebo-control group (PC). 42 Chernobyl children living on territory contaminated by radionuclides were included into study. Elevated percentage of phagocytosis but decreased phagocytosis intensity in neutrophils and monocytes were detected in A and CIFL patients. In CIFL but not in A patients percentage of neutrophils with oxidative burst activity after stimulation by fMLP and E.coli was elevated but intensity of oxidative burst was elevated in both groups. Deficiency of release of TNF, IL-10, IL-13 by monocytes was detected in A and CIFL patients. Therapy by Rec. Comp. (GSH, L-cysteine, anthocyane) resulted normalization in phagocytosis and intracellular ingesting of neutrophils and monocytes, GSH balance and improvement in clinical status. In CIFL children cytokine production was normalized. Positive clinical effect of therapy in A group during 0.5 year and in CIFL group during one year was registered. Source: Chernyshov VP, Omelchenko LI, Treusch G, et al. Abstracts of the 14th International Congress of Immunology. July 24, 2001. Scandinavian J Immunol. July/August 2001:54(Supp. 1). 8. An alternative for skin care during external radiation beam radiation. Objective: Skin reaction during radiation therapy for breast malignancy can result in significant discomfort and desquamation which may necessitate delays in therapy. Rreduced glutathione (GSH) and anthocyanins are natural antioxidants with transdermal absorption noted to dramatically decrease the observed skin reaction during radiotherapy (XRT) in a few patients treated in our department. This spurred us to undertake an objective evaluation of their effectiveness. Methods: Patients undergoing whole breast external beam irradiation were randomized to receive either placebo or GSH/anthyyanins one to three hours before daily therapy over their 6 weeks course of treatment. Standard skin care of Vitamin E oil and Aloe Vera was used in both groups. Patients and investigators/staff were blinded. Skin reaction was documented by photographs and a severity scale. 5 Results: Thirty two (32) patients were enrolled. Thirty (30) were evaluable. Fifteen (15) received placebo, 15 GSH/anthocyanins. Scores were calculated by percent of breast skin involved and grade of reaction. The group receiving GSH/anthocyanins had a lower average score, 93.67 vs the placebo groups 123.33. This translated to an average severity score in the GSH/anthocyanins group 24% less than that seen in the placebo group. Small group numbers for the pilot trial did not reach statistical significance (p > .05), but showed a trend in favor of GSH/anthocyanins. Conclusion: GSH/anthocyanins can provide skin protection during XRT which supercedes that observed with standard skin care and placebo. This formula may reduce discomfort associated with breast irradiation. Source: Enomoto TM, Johnson T, Petersen N, Homer L, Walts D, Johnson N. Presented at the Portland Surgical Society Annual Scientific Meeting (2003) and the North Pacific Surgical Association Annual Meeting (2004) . Unpublished studies 9. Peterson N. Benefit of GSH for prevention of radiation burn associated with external beam radiation therapy. Center for Traditional Medicine. Lake Oswego, Oregon. REFERENCES 1. The role of glutathione in combination with cisplatin in the treatment of ovarian cancer, Tedeschi, M; De Cesare, A.; Oriania, S.; Perego, P.; Silva, A.; Venturino, P.; Zunino, F.; Cancer Treatment Reviews (1991) 18, 253-259 2. Reduced Glutathione Protects against Cisplatin-induced Neurotoxicity in Rats, Hamers, F.P.T.; Brakkee, J.H.; Cavalletti, E.; Tedeschi, M.; Marmonti, L.; Pezzoni, G.; Neijt, J.P.; Gipsen, W.H.; Cancer Research 53, 544-549, February 1, (1993) 3. Protective effect of reduced glutathione against cisplatin induced renal and systemic toxicity and its influence on the therapeutic activity of antitumor drug, Zunino, F.; Pratesi, G.; Micheloni, A.; Cavalletti, E.; Sala, F.; Tofanetti, O.; Chem.-Biol. Interactions, 70 (1989) 89-101, Elsevier Scientific Publishers Ireland Ltd. 4. 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A preliminary clinical study of cyclophosphamide with reduced glutathione as uroprotector, Nobile, M.T.; Vidili, M.G.; Benasso, M.; Venturini, M.; Tedeschi, M.; Zunino, F.; Rosso, R.; Tumori, 75: 257-258, (1989) 12. Reduced glutathione and S-acethylglutathione as selective appoptosisinducing agents in cancer therapy, Donnerstag, B.; Ohlenschläger, G.; Cinatl, J.; Amrani, M.; Hofmann, D.; Flindt, S.; Treusch, G.; Träger, L.; Elsevier, Cancer Letters 110 (1996) 63-70 13. Glutathione augments the activation of cytotoxic T-lymphocytes in vivo, Dröge, W.; Pottmeyer-Gerber, Ch.; Schmidt, H.; Nick, S.; Immunobiol., Vol. 172, pp. 151-156 (1986) 14. Studie über die Wirkung von GSH, L-Cystein und Anthocyanen (Recancostat® 7 Comp.) bei metastatischem kolorektalem Karzinom mit relativer Mangelernährung, Garcia-Giralt, E.; Perdereau, B.; Brixy, F.; Rhilouch, H.; Treusch, G.; Ohlenschläger, G.; Pouillart, P.; Seventh International Congress on Anti-Cancer Treatment, 3.-6.02.1997 15. Attestation, Perdereau, B.; Institut Curie, Section médicale et hospitaliére, 5.7.1999 16. Refreshment effect of reduced glutathione, anthocyans and L-cystein on lymphocyte subsets and prevention of respiratory infections in chernobyl children, Chernyshov, V.; Omelchenko, L.; Treusch, G.; Vodyanik, M.; Vykhovanets, E.; Pochinok, T.; Institut of Pediatrics, Obstetrics and Gynecology, Academy of Medical Sciences, Kiev; 5th International Conference on the Prevention of Infection, May 6th7th 1998 Acropolis Nice (France) 17. Disorders in mononuclear phagocytes and reduced glutathione and their correction in Chernobyl children with recurrent respiratory infections and chronic inflammatory focal lesions, Chernyshov, V.P.; Omelchenko, L.I.; Treusch, G.; Vodyanik, M.A.; Pochinok, T.V.; Zelinsky, G.M.; Gumenyuk, M.V.; Institut of Pediatrics, Obstetrics and Gynecology, Academy of Medical Sciences, Kiev; Elsevier, Immunology Letters, Vol. 73, No. 2,3 73 75-302, Abstract No. 523, Abstracts of the 14th European Immunology Meeting EFIS 2000, 23.-27.09.2000 18. Immunological analysis of reduced glutathione, L-cystein and Anthocyane effects in Chernobyl children with recurrent respiratory infections and chronic inflammatory focal lesions, Chernyshov, V.P.; Omelchenko, L.I.; Treusch, G.; Vodyanik, M.A.; Pochinok, T.V.; Zelinsky, G.M.; Gumenyuk, M.V.; Institut of Pediatrics, Obstetrics and Gynecology, Academy of Medical Sciences, Kiev; Central European Journal of Immunology, Vol. 25, 3-2000 19. 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Lexikon der Biochemie und Molekularbiologie; Herder Verlag, Band 2, 1992 9