Oral β-Glucan for Mucositis and Leukopenia in Colorectal Cancer Patients Receiving Adjuvant FOLFOX-4

A significant proportion of cancer patients receive complementary medical/herbal therapy while undergoing conventional anti-cancer treatment (McEachrane-Gross et al., 2006; Inglin et al., 2008; Mueller et al., 2008; Yang et al., 2008; Supoken et al., 2009; Nazik et al., 2011). β-glucans (1,3-1,6 β-D-glucan) were recently reported to be one of the active ingredients responsible for the immunomodulation of many of the herbs used in such therapy (Ooi VE, 2000; Vannucci et al., 2013). β-glucans are complex polysaccharides in the cell walls of yeasts, fungi, and pathogenic bacteria. β-glucans have been shown to act on several immune receptors, including Dectin-1, complement receptor 3 (CR3), and toll-like receptor (TLR)-2/6, and stimulated the production of macrophages, neutrophils, monocytes, natural killer cells, and dendritic cells in in-vitro studies (Chan et al., 2009). Thus, β-glucans may have antibacterial, immunomodulator, and anticancer effects. In addition, the effects of β-glucans as chemo-immunotherapeutic agents in a number of solid cancers have also been shown (Hazama, 2009; Akazawa et al., 2010; Harada et al., 2010; Nakagawa et al., 2010; Watanabe et al., 2013). There is a growing interest in