A brief review on Opuntia megacantha (Opuntia ficus-indica (L.) Mill ), a major component of the Millennium® Powdered Beverage (E. Excel International)

[source of picture : http://www.thelovelyplants.com/striking-landscape-plant-opuntia-ficus-indica-prickly-pear/]

The first gift I received from my family upon my diagnosis was the Millennium® Powdered Beverage. The exclusive gold coloured packaging clearly reflected its price! I nearly choked up and was in tears when I found out that it cost a few hundred bucks for the price of 30 sachets!

My sister proudly said “This will help boost up your immune system and strength, drink 1 or 2 sachets a day to keep yourself strong to fight!” Well, I was smart not to get myself in trouble by asking too many questions (ehem…proven evidences etc). I have read about Nutritional Immunology and thus, I totally agree with the concept of nutrition and immune system. Ehem...since this product is so expensive and a best-selling item, I should be expecting some results there…..

The main ingredient in the Millenium series of products eg. Millennium® and Millennium® Red is the Millennium® Cactus Blend comprising prickly pear cactus pad extract and other ingredients. On the other hand, the Millennium® Powdered Beverage is a proprietary blend consisting of cactus powder, cactus, orange powder, lemon powder, fructose, maltodextrin and stevia. Unfortunately, I could not find any information to confirm that the “cactus components” mentioned are derived from the prickly pear cactus pad extract or any specific part of the cactus plant.  

Anyway the cactus species used in these products is Opuntia megacantha Salm-Dyck. It is also known as Opuntia ficus-indica (L.) Mill (http://www.theplantlist.org/tpl1.1/record/kew-2391644) and belongs to the dicotyledonous angiosperm Cactaceae family, a family with at least 1500 species of cactus.  Common names include prickly pear or nopal cactus.

O. ficus-indica is grown for the large, sweet fruits (often called “tunas”) in regions such as Mexico, Sicily, Algeria, Chile, Brazil, and northern Africa (Griffith 2004). The young cladodes (stem segments) of O. ficus-indica are usually harvested as a vegetable crop. Apparently, the medicinal properties of this cactus species have been documented as early as 1552! (Griffith 2004).  

Prickly pear cactus is used in the forms of tea, jam, juice and oil extracted from prickly pear seeds, for health, nutrition or cosmetic purposes. Opuntia species have been used for thousands of years as a folk medicine and as a herbal remedy for a diverse of health problems in various countries (El-Mostafa et al. 2014). Traditionally, it is used to treat ulcers, diarrhoea, burns, wounds, edema, hyperlipidemia, obesity, aging, gastritis and inflammation.

A search in Pubmed with the keyword “Opuntia ficus-indica” yielded more than 250 studies, clearly indicating that this plant is well-researched. A number of in vitro and in vivo (animal) studies were carried out to provide substantial evidences supporting its diverse pharmacological activities. Only a few clinical trials were conducted in areas such as obesity and weight loss. Interestingly, a clinical trial among healthy subjects concluded that consumption of cactus pear fruit positively affects the body's redox balance, decreases oxidative damage to lipids, and improves antioxidant status in healthy humans (Tesoriere et al. 2004).  Unfortunately, there weren’t any clinical evidences supporting the claim that cactus extracts improve the human immune status or function!

Cactus fruit contains substantial amounts of ascorbic acid, vitamin E, carotenoids, fibers, amino acids and antioxidant compounds (phenols, flavonoids, betaxanthin and betacyanin). Several reports have also mentioned the abundance of vitamins and minerals such as calcium and potassium (Ammar et al. 2015, Mata et al. 2016, Stintzing et al. 2001, Stintzing et al. 2003).

In addition, some of the main constituents identified and present in the extract are flavonoids, namely isorhamnetins and derivatives such as isorhamnetin 3-O-rhamnose-rutinoside and isorhamnetin 3-O-rutinoside) and phenolic acids (such as ferulic, piscidic and eucomic acids). These compounds and flavanoid-rich extracts are known to function effectively as antioxidants and anti-inflammatory components (Antunes-Ricardo et al. 2015, Chaouch et al. 2015, Kim et al. 2015, Matias et al. 2014, Nakahara et al. 2015, Yeddes et al. 2014). Other flavonoids such as quercetin, (+)-dihydroquercetin, and quercetin 3-methyl ether are also found in the fruits and stems of O. ficus-indica and are reported to have neuroprotective actions against the oxidative injuries in brain cells (Dok-Go et al. 2003).

Large quantities of GABA (γ-Aminobutyric acid) have been detected in the cactus extract. Proline (Pro) and Glutamine (Gln) are the most abundant amino acids in prickly pear fruits.  Ornithine, Citrulline and 2-aminoethanolamine have also been detected in low amounts in the juices (Ali et al. 2014, Kugler et al. 2006). Interestingly, and from a nutritional aspect, the relatively large quantities of Gln, and Pro are of interest as these amino acids are considered as functional amino acids, or key metabolic amino acids (Wu 2010). We all know that foods containing GABA is beneficial for mental health, as GABA is a key neurotransmitter in the brain for stress relief and relaxation. Well, one needs GABA to feel calm, relaxed and happy!

Cactus pear extracts effectively inhibited cell growth in several different immortalized and cancer cell cultures, suppressed tumor growth in nude mice, and modulated expression of tumor-related genes, thus emphasizing the chemoprevention and anti-tumor properties of this plant (Keller et al. 2015, Zou et al. 2005).  Unfortunately there was no laboratory or animal data on how the cactus extracts improves or strengthens the immune cells or system!

My personal experience with this product

The powdered extract when mixed with a glass of water gives a mild lemony flavoured drink. Not sweet but pleasant and soothing to the queasy stomach (especially after chemotherapy). I took it at least once daily after my surgery and throughout the FEC chemotherapy sessions. Luckily, I neither needed any immune booster jab (filgrastim) nor was I down with illness such as sore throat, flu, cough or mouth ulcers. I am not sure if this product helped, as I also took a lot of coconut water, beetroot juice, napier grass and barley drink! I would say that I am eating well and adequately nourished! Could all these be contributing factors? I am not sure…..but cactus extracts are pretty darn expensive!

I increase the dose to twice daily after my 5^th cycle Taxotere injection. I developed a bad allergy towards filgrastim (immune booster jab) during my 4^th cycle, and thus I have to skip this drug for good. Fortunately, so far, my blood work was ok without filgrastim! 

In conclusion, I think cactus pear extract is an excellent source of antioxidants, anti-inflammatory components, vitamins, minerals and functional acid amino. It fits the description of an impressive functional food and should be beneficial for patients in different stages of recovery. Generally, patients who are eating well and adequately nourished with balance nutrition are usually the ones able to cope and manage the harsh side effects of chemotherapy.

References:

Ali HSM, Al-Khalifa AS and Brückner H (2014). Taurine is absent from amino components in fruits of Opuntia ficus-indica. SpringerPlus, 3, 663.

Ammar I, Ennouri M, Bouaziz M, Ben Amira A and Attia H (2015). Phenolic Profiles, Phytchemicals and Mineral Content of Decoction and Infusion of Opuntia ficus-indica Flowers. Plant Foods Hum Nutr, 70(4), 388-394.

Antunes-Ricardo M, Gutierrez-Uribe JA, Martinez-Vitela C and Serna-Saldivar SO (2015). Topical anti-inflammatory effects of isorhamnetin glycosides isolated from Opuntia ficus-indica. BioMed research international, 2015, 847320.

Chaouch MA, Hafsa J, Rihouey C, Le Cerf D and Majdoub H (2015). Depolymerization of polysaccharides from Opuntia ficus indica: Antioxidant and antiglycated activities. International journal of biological macromolecules, 79, 779-786.

Dok-Go H, Lee KH, Kim HJ, Lee EH, Lee J, Song YS, et al. (2003). Neuroprotective effects of antioxidative flavonoids, quercetin, (+)-dihydroquercetin and quercetin 3-methyl ether, isolated from Opuntia ficus-indica var. saboten. Brain Research, 965(1–2), 130-136.

El-Mostafa K, El Kharrassi Y, Badreddine A, Andreoletti P, Vamecq J, El Kebbaj M, et al. (2014). Nopal Cactus (Opuntia ficus-indica) as a Source of Bioactive Compounds for Nutrition, Health and Disease. Molecules, 19(9), 14879.

Griffith MP (2004). The origins of an important cactus crop, Opuntia ficus-indica (Cactaceae): new molecular evidence. American Journal of Botany, 91(11), 1915-1921.

Keller J, Camare C, Bernis C, Astello-Garcia M, de la Rosa AP, Rossignol M, et al. (2015). Antiatherogenic and antitumoral properties of Opuntia cladodes: inhibition of low density lipoprotein oxidation by vascular cells, and protection against the cytotoxicity of lipid oxidation product 4-hydroxynonenal in a colorectal cancer cellular model. Journal of physiology and biochemistry, 71(3), 577-587.

Kim J, Soh SY, Shin J, Cho CW, Choi YH and Nam SY (2015). Bioactives in cactus (Opuntia ficus-indica) stems possess potent antioxidant and pro-apoptotic activities through COX-2 involvement. Journal of the science of food and agriculture, 95(13), 2601-2606.

Kugler F, Graneis S, Schreiter PP, Stintzing FC and Carle R (2006). Determination of free amino compounds in betalainic fruits and vegetables by gas chromatography with flame ionization and mass spectrometric detection. Journal of agricultural and food chemistry, 54(12), 4311-4318.

Mata A, Ferreira JP, Semedo C, Serra T, Duarte CM and Bronze MR (2016). Contribution to the characterization of Opuntia spp. juices by LC-DAD-ESI-MS/MS. Food chemistry, 210, 558-565.

Matias A, Nunes Sl Fau - Poejo J, Poejo J Fau - Mecha E, Mecha E Fau - Serra AT, Serra At Fau - Madeira PJA, Madeira Pj Fau - Bronze MR, et al. (2014). Antioxidant and anti-inflammatory activity of a flavonoid-rich concentrate recovered from Opuntia ficus-indica juice. (2042-650X (Electronic)).

Nakahara T, Mitoma C, Hashimoto-Hachiya A, Takahara M, Tsuji G, Uchi H, et al. (2015). Antioxidant Opuntia ficus-indica Extract Activates AHR-NRF2 Signaling and Upregulates Filaggrin and Loricrin Expression in Human Keratinocytes. Journal of medicinal food, 18(10), 1143-1149.

Stintzing FC, Schieber A and Carle R (2001). Phytochemical and nutritional significance of cactus pear. European Food Research and Technology, 212(4), 396-407.

Stintzing FC, Schieber A and Carle R (2003). Evaluation of colour properties and chemical quality parameters of cactus juices. European Food Research and Technology, 216(4), 303-311.

Tesoriere L, Butera D, Pintaudi M, Allegra M and Livrea MA (2004). Supplementation with cactus pear (Opuntia ficus-indica) fruit decreases oxidative stress in healthy humans: a comparative study with Vit C. Am J Clin Nutr, 80.

Wu G (2010). Functional amino acids in growth, reproduction, and health. Advances in nutrition (Bethesda, Md.), 1(1), 31-37.

Yeddes N, Cherif JK and Trabelsi Ayadi M (2014). Comparative study of antioxidant power, polyphenols, flavonoids and betacyanins of peel and pulp of three Tunisian Opuntia forms. Pakistan journal of biological sciences : PJBS, 17(5), 650-658.

Zou D-m, Brewer M, Garcia F, Feugang JM, Wang J, Zang R, et al. (2005). Cactus pear: a natural product in cancer chemoprevention. Nutrition Journal, 4(1), 25.