Comprehensive Guide to Modified Citrus Pectin

Modified Citrus PectinDr. James Meschino DC, MS, ND
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General Features
Modified Citrus Pectin is a dietary supplement that has demonstrated an ability to prevent the spread of cancer (metastasis), with strong evidence to support its use in the prevention and/or management of prostate cancer metastasis. Modified Citrus Pectin is a special form of pectin that has been altered in the laboratory by a proprietary process that shortens the length of pectin’s polysaccharide chain. This results in a lower molecular weight, enabling the molecule to be absorbed through the intestinal wall into the bloodstream. By contrast, pectin itself cannot be absorbed from the intestinal tract into the bloodstream and thus, is primarily categorized as a type of water-soluble fiber with a proven ability to lower cholesterol and provide other health benefits via its actions in the intestinal tract. Pectin is found in the peel and pulp of citrus fruits such as lemons, grapefruits, oranges and tangerines. Its long chain of monosaccharides has numerous branches with important binding capabilities, which play a key role in pectin’s unique anti-metastatic attributes. Therefore, researchers were interested in manipulating pectin’s structure is such a way as to allow it to be absorbed into the bloodstream, while maintaining its ability to bind to carbohydrate-binding proteins (glycoproteins) on the surface of metastatic cancer cells, blocking their ability to invade adjacent tissue, and inhibiting their proliferation and colonization into new tumor masses. As explained below, Modified Citrus Pectin does not prevent the development of cancer (cancer initiation), but rather appears to play an important role in preventing the spread of cancer to other tissues (metastasis), which usually is the manner in which cancer death occurs.
Principle Active Constituents
The laboratory modification of citrus pectin to Modified Citrus Pectin yields a galactose-rich pectin product with a lower molecular weight than citrus pectin in its native (original) form. This structural modification allows Modified Citrus Pectin to be absorbed from the intestinal tract into the bloodstream, and exert an anti-metastatic effect on cancer cells, which contain certain carbohydrate-binding proteins (galectins) on their cell surface.
Clinical Application and Mechanism of Action
1. Preventing the Spread of Cancer (Anti-metastatic)
One of the dominant carbohydrates contained within Modified Citrus Pectin is galactose. Galactose has a strong affinity for binding to the surface of metastatic cancer cells, which express a particular cell surface receptor known as galectin-3 (a galactoside-binding lectin). In turn, the binding of Modified Citrus Pectin to the galectin-3 receptor on metastatic cancer cells creates a type of galectin-3 blockade. With the galectin-3 receptor blocked in this fashion, cancer cells are less able to adhere to other healthy tissues and cells, essentially inhibiting cancer cells from invading and spreading to new areas and tissues in the body (anti-metastatic effect). As well, the blockade of the galectin-3 receptor prevents cancer cells from adhering to each other, discouraging their ability to form colonies (tumor mass). If cancer cells are deprived of their own adhesive ability, they fail to thrive and can be more easily destroyed by the body’s immune system. Thus, Modified Citrus Pectin has been shown to attach to galectin-3 receptors on metastatic cancer cells, preventing their clustering and colonization into a larger tumor mass and blocking their ability to spread to other tissues. Interestingly, non-metastatic cancer cells do not have high levels of galectins on their cell surface. Thus, it appears that these galectins are essential for the spread of cancer (metastasis) to a very significant degree.
Research into this area, in fact, confirms that galectin-3 receptors play a very pivotal role in the metastasis of cancer in the body. Galectins on the surface of cancer cells are known for their carbohydrate-binding abilities,playing an important role in cellular interactions during the metastatic process. In short, galectin-3 receptors bind to the galactose molecules on neighboring cancer cells, as well as to the other sugars and monosaccharides on the surface of healthy cells. Upon binding to other cancer cells they encourage the development of a larger tumor mass (colonization) and upon binding to healthy cells they are able to invade these tissues and propagate further spread of the cancer. In essence, Modified Citrus Pectin denies metastatic cancer cells of the opportunity of attaching to other cancer cells and healthy cells, by binding to and fully saturating all of their galectin-3 cell surface receptors. The importance of this mechanism of action is highlighted by the fact that many human cancer cells express galectins on their cell surface, including carcinoma of the prostate, breast, colon, and larynx, as well as lymphoma, melanoma and glioblastoma. Human studies of the colon, stomach and thyroid cancers have also shown that the amount of galectin produced increases proportionally as the cancer progresses from its early to advanced stages. Higher galectin levels encourage greater adhesion of cancer cells to each other, and also facilitates the process of binding to non-cancerous cells at distant sites within the body.1,2,3,4,5,6
There is also evidence to show that Modified Citrus Pectin may augment the immune response in cancer by enhancing cytotoxicity of CD3+ T-cells and natural killer cells, while also mediating increased monocyte cytotoxicity. These effects have been shown to be due to the presence of rhamnogalacturonan, another constituent of Modified Citrus Pectin.1
A significant number of animal trials have revealed that Modified Citrus Pectin inhibits metastasis of melanoma cancer in mice, prostate cancer in rats 1,2,3 with other in vitro studies showing similar effects for cancer of the breast and larynx
Human Cancer Studies - A pilot study involving prostate cancer patients who failed first-line androgen-deprivation therapy, were in relapse after radical prostatectomy, external beam radiation therapy or cryosurgery, and were either untreated or off intermittent hormone blockade, demonstrated that supplementation with 15 gms per day of Modified Citrus Pectin (5 gms, three times per day) increased the length of the PSA doubling time by 30% in 4 of 7 patients, one patient had a partial response, one patient had stable disease and one patient did not respond. The researchers conclude that Modified Citrus Pectin appears to slow the PSA doubling time in prostate cancer patients with low levels of PSA, and that all patients were still alive three years after the official end of the study. This research abstract of this study was presented at the International Conference on Diet and Prevention of Cancer; May 28-June 2, 1999, Tampere, Finland.1 As reported by PM Kidd, Ph.D., Modified Citrus Pectin’s apparent safety and proven anti-metastatic action, and the lack of proven therapies against metastasis would justify its inclusion into comprehensive orthomolecular anticancer regimes.

2. Reversal of Atherosclerosis and Heavy Metal Chelation
In its native form citrus pectin is a water-soluble fiber that is known to bind to cholesterol and bile acids in the intestinal tract and block their absorption into the bloodstream. Bile acids are a building block of cholesterol in the body, thus pectin fiber is known to help reduce high blood cholesterol by inhibiting the absorption of both dietary cholesterol and bile acids. Pectin fiber also binds to certain heavy metals (lead, aluminum, cadmium) in the intestinal tract and helps to block their absorption into the bloodstream. As Modified Citrus Pectin still retains much of the properties of pectin fiber (with the exception that it can be absorbed into the bloodstream and pectin fiber cannot), Modified Citrus Pectin appears to be able to pull cholesterol out of the artery wall in places where it was previously deposited. This effect helps to open up the artery, allowing improved blood flow and reducing risk of heart disease and stroke. Modified Citrus Pectin has also been shown to act as chelating agent in the bloodstream by pulling out heavy metals that were previously deposited due to environmental exposures and heavy metals entering the body from contaminated food and water. Modified Citrus Pectin is currently under investigation to see how effectively it can perform these functions
Dosage and Standardized Grade
1. To Help Prevent Cancer Metastasis - Typically 5 gms, three times per day. Dilute Modified Citrus Pectin powder in favorite beverage. Up to 30 gms per day may be taken safely. It is also available in capsules and tablets.1,8
2. Cholesterol Lowering - 5 gms, three times per day
Adverse Side Effects and Toxicity
Modified Citrus Pectin is well tolerated, with no reported side effects except for occasional mild gastrointestinal complaints. No toxic effects have been seen in animal or human intervention studies.1Drug-Nutrient Interactions
Drug-Nutrient Interactions
There are no well-known drug-nutrient interactions for Modified Citrus Pectin.
Pregnancy and Lactation
During pregnancy and lactation, the only supplements that are considered safe include standard prenatal vitamin and mineral supplements. All other supplements or dose alterations may pose a threat to the developing fetus and there is generally insufficient evidence at this time to determine an absolute level of safety for most dietary supplements other than a prenatal supplement. Any supplementation practices beyond a prenatal supplement should involve the cooperation of the attending physician (e.g., magnesium and the treatment of preeclampsia.)

References: Pregnancy and Lactation
1. Encyclopedia of Nutritional Supplements. Murray M. Prima Publishing 1998.
2. Reavley NM. The New Encyclopedia of Vitamins, Minerals, Supplements, and Herbs. Evans and Company Inc. 1998.
3. The Healing Power of Herbs (2nd edition). Murray M. Prima Publishing 1995.
4. Boon H and Smith M. Health Care Professional Training Program in Complementary Medicine. Institute of Applied Complementary Medicine Inc. 1997.
1. Eliaz I. The role of modified citrus pectin in the prevention of cancer metastasis. Townsend Letter for Doctors & Patients, Jul99(192):p64
2. Kidd PM. A new approach to metastatic cancer prevention: modified citrus pectin (MCP), a unique pectin that blocks cell surface lectins. Alternative medicine Review Jan 1, 1997;1(1):4-10
3. Inohara H, Raz, A. Effects of natural complex carbohydrate 9citrus pectin) on murine melanoma cell properties related to galextin-3 functions. Glycoconj J 1994 Dec;11(6):527-32
4. Modified Citris Pectin-Monograph. Altern med Rev Dec2000;5(6):573-5
5. Pienta KJ, Naik H, Akhtar A, Yamazaki K, Replogle TS, Lehr J, et al. Inhibition of spontaneious metastasis in a rat prostate cancer model by oral administration of modified citrus pectin. J Natl Cancer Inst 1995 Mar 1;87(5):348-53
6. Klotter J. Scientific Journal for Natural Therapies: Alternative Medicine Review. Townsend Letter for Doctors & Patients, Jul97(168):p145
7. Vargo D, Doyle R, Floch MH. Colonic bacterial flora and serum cholesterol: Alterations induced by dietary citrus pectin. Am J Gastroenterol, May1985;80(5):361-4
8. Strum S, Scholz M, McDermed J. Modified citrus pectin slows PSA doubling time: A pilot clinical trial. Presentation: International Conference On Diet and Prevention of Cancer. Tampere, Finland. May 1999