Glutatyon
Synopsis
Glutatyon, antioksidan özellikleriyle hücreleri oksidatif zarardan koruyan ve glutamat-sistein ligaz ile glutatyon sentetaz enzimleri aracılığıyla üretilen bir moleküldür. Klinik çalışmalar, vücuttaki glutatyon düzeylerinin azalmasının çeşitli kronik hastalıklarla bağlantılı olduğunu ortaya koymaktadır. Oral glutatyon takviyesinin faydası ise tartışmalı bir konudur; bazı araştırmalar bu takviyenin vücuttaki glutatyon depolarını artırabileceğini belirtirken, diğer çalışmalar anlamlı bir etki gösterememiştir. Klinik araştırmalar, glutatyonun kemoterapötik ilaçların nörolojik yan etkilerini hafifletme potansiyeline işaret etmektedir. Bu bağlamda, glutatyonun kanser tedavisindeki etkinlik ve yan etkileri azaltma potansiyeli üzerine daha kapsamlı araştırmaların ve klinik deneylerin yapılması gerekmektedir.
Glutathione, with its antioxidant properties, protects cells from oxidative damage and is synthesized through the action of glutamate-cysteine ligase and glutathione synthetase enzymes. Scientific studies have demonstrated that a decrease in glutathione levels in the body is linked to various chronic diseases. The benefit of oral glutathione supplementation remains a contentious issue; while some research indicates that this supplementation can increase glutathione stores in the body, other studies have not found significant effects. Clinical research suggests that glutathione may alleviate the neurological side effects of chemotherapeutic drugs. In summary, further research and clinical trials are needed to fully understand the efficacy of glutathione in cancer treatment and its potential to reduce side effects.
References
H. Lv, C. Zhen, J. Liu, P. Yang, L. Hu, and P. Shang, “Unraveling the potential role of glutathione in multiple forms of cell death in cancer therapy,” Oxidative Medicine and Cellular Longevity, vol. 2019. Hindawi Limited, 2019. doi: 10.1155/2019/3150145.
R. Franco, O. J. Schoneveld, A. Pappa, and M. I. Panayiotidis, “The central role of glutathione in the pathophysiology of human diseases,” Archives of Physiology and Biochemistry, vol. 113, no. 4–5. pp. 234–258, Oct. 2007. doi: 10.1080/13813450701661198.
G. Wu, Y.-Z. Fang, S. Yang, J. R. Lupton, and N. D. Turner, “Recent Advances in Nutritional Sciences Glutathione Metabolism and Its Implications for Health 1,” 2004.
E. Hatem, N. El Banna, and M. E. Huang, “Multifaceted Roles of Glutathione and Glutathione-Based Systems in Carcinogenesis and Anticancer Drug Resistance,” Antioxid Redox Signal, vol. 27, no. 15, pp. 1217–1234, Nov. 2017, doi: 10.1089/ARS.2017.7134.
M. E. Anderson, “Glutathione: an overview of biosynthesis and modulation,” Chem Biol Interact, vol. 111–112, pp. 1–14, Apr. 1998, doi: 10.1016/S0009-2797(97)00146-4.
S. C. Lu, “Glutathione synthesis,” Biochim Biophys Acta, vol. 1830, no. 5, pp. 3143–3153, May 2013, doi: 10.1016/J.BBAGEN.2012.09.008.
D. H. Lee and D. R. Jacobs, “Hormesis and public health: can glutathione depletion and mitochondrial dysfunction due to very low-dose chronic exposure to persistent organic pollutants be mitigated?,” J Epidemiol Community Health (1978), vol. 69, no. 3, pp. 294–300, 2015, doi: 10.1136/JECH-2014-203861.
B. Halliwell, “The antioxidant paradox: less paradoxical now?,” Br J Clin Pharmacol, vol. 75, no. 3, pp. 637–644, Mar. 2013, doi: 10.1111/J.1365-2125.2012.04272.X.
D. W. Nebert and V. Vasiliou, “Analysis of the glutathione S-transferase (GST) gene family.,” Hum Genomics, vol. 1, no. 6, pp. 460–464, Nov. 2004, doi: 10.1186/1479-7364-1-6-460/FIGURES/2.
A. L. Hollman, P. B. Tchounwou, and H. C. Huang, “The Association between Gene-Environment Interactions and Diseases Involving the Human GST Superfamily with SNP Variants,” Int J Environ Res Public Health, vol. 13, no. 4, Mar. 2016, doi: 10.3390/IJERPH13040379.
A. Meister and M. E. Anderson, “Glutathione,” Annu Rev Biochem, vol. 52, pp. 711–760, 1983, doi: 10.1146/ANNUREV.BI.52.070183.003431.
A. L. López-López, H. J. Bonilla, M. del C. Escobar Villanueva, M. P. Brianza, G. P. Vázquez, and F. J. A. Alarcón, “Chronic unpredictable mild stress generates oxidative stress and systemic inflammation in rats,” Physiol Behav, vol. 161, pp. 15–23, Jul. 2016, doi: 10.1016/J.PHYSBEH.2016.03.017.
A. M. Feoli et al., “Brain glutathione content and glutamate uptake are reduced in rats exposed to pre- and postnatal protein malnutrition,” J Nutr, vol. 136, no. 9, pp. 2357–2361, 2006, doi: 10.1093/JN/136.9.2357.
N. Ballatori, S. M. Krance, S. Notenboom, S. Shi, K. Tieu, and C. L. Hammond, “Glutathione dysregulation and the etiology and progression of human diseases,” Biol Chem, vol. 390, no. 3, pp. 191–214, Mar. 2009, doi: 10.1515/BC.2009.033.
K. J. Habermann, L. Grünewald, S. van Wijk, and S. Fulda, “Targeting redox homeostasis in rhabdomyosarcoma cells: GSH-depleting agents enhance auranofin-induced cell death,” Cell Death & Disease 2017 8:10, vol. 8, no. 10, pp. e3067–e3067, Oct. 2017, doi: 10.1038/cddis.2017.412.
J. L. Roh, E. H. Kim, H. J. Jang, J. Y. Park, and D. Shin, “Induction of ferroptotic cell death for overcoming cisplatin resistance of head and neck cancer,” Cancer Lett, vol. 381, no. 1, pp. 96–103, Oct. 2016, doi: 10.1016/J.CANLET.2016.07.035.
J. Midander, P. J. Deschavanne, E. P. Malaise, and L. Revesz, “Survival curves of irradiated glutathione-deficient human fibroblasts: indication of a reduced enhancement of radiosensitivity by oxygen and misonidazole,” Int J Radiat Oncol Biol Phys, vol. 8, no. 3–4, pp. 443–446, 1982, doi: 10.1016/0360-3016(82)90657-5.
“Expression of heavy subunit of gamma-glutamylcysteine synthetase (gamma-GCSh) in human colorectal carcinoma - PubMed.” Accessed: Nov. 14, 2023. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/11774239/
S. Tatebe et al., “Expression of heavy subunit of gamma-glutamylcysteine synthetase (gamma-GCSh) in human colorectal carcinoma,” Int J Cancer, vol. 97, no. 1, pp. 21–27, Jan. 2002, doi: 10.1002/IJC.1574.
“Cellular glutathione and thiol measurements from surgically resected human lung tumor and normal lung tissue - PubMed.” Accessed: Nov. 14, 2023. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/1868449/
“Sensitive enzymatic cycling assay for glutathione: measurements of glutathione content and its modulation by buthionine sulfoximine in vivo and in vitro in human colon cancer - PubMed.” Accessed: Nov. 14, 2023. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/8033140/
“Assessment of P-glycoprotein, glutathione-based detoxifying enzymes and O6-alkylguanine-DNA alkyltransferase as potential indicators of constitutive drug resistance in human colorectal tumors - PubMed.” Accessed: Nov. 14, 2023. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/1672623/
“Glutathione levels and variability in breast tumors and normal tissue - PubMed.” Accessed: Nov. 14, 2023. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/8392905/
F. Joncourt et al., “Patterns of drug resistance parameters in adult leukemia,” Leuk Lymphoma, vol. 17, no. 1–2, pp. 101–109, 1995, doi: 10.3109/10428199509051709.
A. Meister, “Glutathione deficiency produced by inhibition of its synthesis, and its reversal; applications in research and therapy,” Pharmacol Ther, vol. 51, no. 2, pp. 155–194, 1991, doi: 10.1016/0163-7258(91)90076-X.
A. Meister and M. E. Anderson, “Glutathione,” Annu Rev Biochem, vol. 52, pp. 711–760, 1983, doi: 10.1146/ANNUREV.BI.52.070183.003431.
J. Allen and R. D. Bradley, “Effects of oral glutathione supplementation on systemic oxidative stress biomarkers in human volunteers,” J Altern Complement Med, vol. 17, no. 9, pp. 827–833, Sep. 2011, doi: 10.1089/ACM.2010.0716.
A. Witschi, S. Reddy, B. Stofer, and B. H. Lauterburg, “The systemic availability of oral glutathione,” Eur J Clin Pharmacol, vol. 43, no. 6, pp. 667–669, Dec. 1992, doi: 10.1007/BF02284971.
E. Y. Park et al., “Increase in the protein-bound form of glutathione in human blood after the oral administration of glutathione,” J Agric Food Chem, vol. 62, no. 26, pp. 6183–6189, Jul. 2014, doi: 10.1021/JF501338Z.
J. P. Richie et al., “Randomized controlled trial of oral glutathione supplementation on body stores of glutathione,” Eur J Nutr, vol. 54, no. 2, pp. 251–263, Mar. 2015, doi: 10.1007/S00394-014-0706-Z.
R. Sinha et al., “Oral supplementation with liposomal glutathione elevates body stores of glutathione and markers of immune function,” Eur J Clin Nutr, vol. 72, no. 1, pp. 105–111, Jan. 2018, doi: 10.1038/EJCN.2017.132.
G. Sechi et al., “Reduced intravenous glutathione in the treatment of early Parkinson’s disease,” Prog Neuropsychopharmacol Biol Psychiatry, vol. 20, no. 7, pp. 1159–1170, Oct. 1996, doi: 10.1016/S0278-5846(96)00103-0.
G. A. P. Hospers, E. A. Eisenhauer, and E. G. E. De Vries, “The sulfhydryl containing compounds WR-2721 and glutathione as radio- and chemoprotective agents. A review, indications for use and prospects,” Br J Cancer, vol. 80, no. 5–6, pp. 629–638, 1999, doi: 10.1038/SJ.BJC.6690404.
D. S. Alberts and J. K. Noel, “Cisplatin-associated neurotoxicity: Can it be prevented?,” Anticancer Drugs, vol. 6, no. 3, pp. 369–383, 1995, doi: 10.1097/00001813-199506000-00003.
M. Treskes, U. Holwerda, I. Klein, H. M. Pinedo, and W. J. F. Van Der Vijgh, “The chemical reactivity of the modulating agent WR2721 (ethiofos) and its main metabolites with the antitumor agents cisplatin and carboplatin,” Biochem Pharmacol, vol. 42, no. 11, pp. 2125–2130, Nov. 1991, doi: 10.1016/0006-2952(91)90347-8.
J. F. Smyth et al., “Glutathione reduces the toxicity and improves quality of life of women diagnosed with ovarian cancer treated with cisplatin: results of a double-blind, randomised trial,” Ann Oncol, vol. 8, no. 6, pp. 569–573, 1997, doi: 10.1023/A:1008211226339.
S. Cascinu et al., “Neuroprotective effect of reduced glutathione on oxaliplatin-based chemotherapy in advanced colorectal cancer: a randomized, double-blind, placebo-controlled trial,” J Clin Oncol, vol. 20, no. 16, pp. 3478–3483, Aug. 2002, doi: 10.1200/JCO.2002.07.061.
H. Greenlee, D. L. Hershman, and J. S. Jacobson, “Use of antioxidant supplements during breast cancer treatment: a comprehensive review,” Breast Cancer Res Treat, vol. 115, no. 3, pp. 437–452, Jun. 2009, doi: 10.1007/S10549-008-0193-0.
“Glutathione in the prevention of cisplatin induced toxicities. A prospectively randomized pilot trial in patients with head and neck cancer and non small cell lung cancer - PubMed.” Accessed: Nov. 15, 2023. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/11008323/
S. Cascinu, L. Cordella, E. Del Ferro, M. Fronzoni, and G. Catalano, “Neuroprotective effect of reduced glutathione on cisplatin-based chemotherapy in advanced gastric cancer: a randomized double-blind placebo-controlled trial,” J Clin Oncol, vol. 13, no. 1, pp. 26–32, 1995, doi: 10.1200/JCO.1995.13.1.26.
F. Di Re, S. Bohm, S. Oriana, G. Battista Spatti, and F. Zunino, “Efficacy and safety of high-dose cisplatin and cyclophosphamide with glutathione protection in the treatment of bulky advanced epithelial ovarian cancer,” Cancer Chemother Pharmacol, vol. 25, no. 5, pp. 355–360, Sep. 1990, doi: 10.1007/BF00686237.
R. Franco, O. J. Schoneveld, A. Pappa, and M. I. Panayiotidis, “The central role of glutathione in the pathophysiology of human diseases,” Archives of Physiology and Biochemistry, vol. 113, no. 4–5. pp. 234–258, Oct. 2007. doi: 10.1080/13813450701661198.
G. Wu, Y.-Z. Fang, S. Yang, J. R. Lupton, and N. D. Turner, “Recent Advances in Nutritional Sciences Glutathione Metabolism and Its Implications for Health 1,” 2004.
E. Hatem, N. El Banna, and M. E. Huang, “Multifaceted Roles of Glutathione and Glutathione-Based Systems in Carcinogenesis and Anticancer Drug Resistance,” Antioxid Redox Signal, vol. 27, no. 15, pp. 1217–1234, Nov. 2017, doi: 10.1089/ARS.2017.7134.
M. E. Anderson, “Glutathione: an overview of biosynthesis and modulation,” Chem Biol Interact, vol. 111–112, pp. 1–14, Apr. 1998, doi: 10.1016/S0009-2797(97)00146-4.
S. C. Lu, “Glutathione synthesis,” Biochim Biophys Acta, vol. 1830, no. 5, pp. 3143–3153, May 2013, doi: 10.1016/J.BBAGEN.2012.09.008.
D. H. Lee and D. R. Jacobs, “Hormesis and public health: can glutathione depletion and mitochondrial dysfunction due to very low-dose chronic exposure to persistent organic pollutants be mitigated?,” J Epidemiol Community Health (1978), vol. 69, no. 3, pp. 294–300, 2015, doi: 10.1136/JECH-2014-203861.
B. Halliwell, “The antioxidant paradox: less paradoxical now?,” Br J Clin Pharmacol, vol. 75, no. 3, pp. 637–644, Mar. 2013, doi: 10.1111/J.1365-2125.2012.04272.X.
D. W. Nebert and V. Vasiliou, “Analysis of the glutathione S-transferase (GST) gene family.,” Hum Genomics, vol. 1, no. 6, pp. 460–464, Nov. 2004, doi: 10.1186/1479-7364-1-6-460/FIGURES/2.
A. L. Hollman, P. B. Tchounwou, and H. C. Huang, “The Association between Gene-Environment Interactions and Diseases Involving the Human GST Superfamily with SNP Variants,” Int J Environ Res Public Health, vol. 13, no. 4, Mar. 2016, doi: 10.3390/IJERPH13040379.
A. Meister and M. E. Anderson, “Glutathione,” Annu Rev Biochem, vol. 52, pp. 711–760, 1983, doi: 10.1146/ANNUREV.BI.52.070183.003431.
A. L. López-López, H. J. Bonilla, M. del C. Escobar Villanueva, M. P. Brianza, G. P. Vázquez, and F. J. A. Alarcón, “Chronic unpredictable mild stress generates oxidative stress and systemic inflammation in rats,” Physiol Behav, vol. 161, pp. 15–23, Jul. 2016, doi: 10.1016/J.PHYSBEH.2016.03.017.
A. M. Feoli et al., “Brain glutathione content and glutamate uptake are reduced in rats exposed to pre- and postnatal protein malnutrition,” J Nutr, vol. 136, no. 9, pp. 2357–2361, 2006, doi: 10.1093/JN/136.9.2357.
N. Ballatori, S. M. Krance, S. Notenboom, S. Shi, K. Tieu, and C. L. Hammond, “Glutathione dysregulation and the etiology and progression of human diseases,” Biol Chem, vol. 390, no. 3, pp. 191–214, Mar. 2009, doi: 10.1515/BC.2009.033.
K. J. Habermann, L. Grünewald, S. van Wijk, and S. Fulda, “Targeting redox homeostasis in rhabdomyosarcoma cells: GSH-depleting agents enhance auranofin-induced cell death,” Cell Death & Disease 2017 8:10, vol. 8, no. 10, pp. e3067–e3067, Oct. 2017, doi: 10.1038/cddis.2017.412.
J. L. Roh, E. H. Kim, H. J. Jang, J. Y. Park, and D. Shin, “Induction of ferroptotic cell death for overcoming cisplatin resistance of head and neck cancer,” Cancer Lett, vol. 381, no. 1, pp. 96–103, Oct. 2016, doi: 10.1016/J.CANLET.2016.07.035.
J. Midander, P. J. Deschavanne, E. P. Malaise, and L. Revesz, “Survival curves of irradiated glutathione-deficient human fibroblasts: indication of a reduced enhancement of radiosensitivity by oxygen and misonidazole,” Int J Radiat Oncol Biol Phys, vol. 8, no. 3–4, pp. 443–446, 1982, doi: 10.1016/0360-3016(82)90657-5.
“Expression of heavy subunit of gamma-glutamylcysteine synthetase (gamma-GCSh) in human colorectal carcinoma - PubMed.” Accessed: Nov. 14, 2023. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/11774239/
S. Tatebe et al., “Expression of heavy subunit of gamma-glutamylcysteine synthetase (gamma-GCSh) in human colorectal carcinoma,” Int J Cancer, vol. 97, no. 1, pp. 21–27, Jan. 2002, doi: 10.1002/IJC.1574.
“Cellular glutathione and thiol measurements from surgically resected human lung tumor and normal lung tissue - PubMed.” Accessed: Nov. 14, 2023. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/1868449/
“Sensitive enzymatic cycling assay for glutathione: measurements of glutathione content and its modulation by buthionine sulfoximine in vivo and in vitro in human colon cancer - PubMed.” Accessed: Nov. 14, 2023. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/8033140/
“Assessment of P-glycoprotein, glutathione-based detoxifying enzymes and O6-alkylguanine-DNA alkyltransferase as potential indicators of constitutive drug resistance in human colorectal tumors - PubMed.” Accessed: Nov. 14, 2023. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/1672623/
“Glutathione levels and variability in breast tumors and normal tissue - PubMed.” Accessed: Nov. 14, 2023. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/8392905/
F. Joncourt et al., “Patterns of drug resistance parameters in adult leukemia,” Leuk Lymphoma, vol. 17, no. 1–2, pp. 101–109, 1995, doi: 10.3109/10428199509051709.
A. Meister, “Glutathione deficiency produced by inhibition of its synthesis, and its reversal; applications in research and therapy,” Pharmacol Ther, vol. 51, no. 2, pp. 155–194, 1991, doi: 10.1016/0163-7258(91)90076-X.
A. Meister and M. E. Anderson, “Glutathione,” Annu Rev Biochem, vol. 52, pp. 711–760, 1983, doi: 10.1146/ANNUREV.BI.52.070183.003431.
J. Allen and R. D. Bradley, “Effects of oral glutathione supplementation on systemic oxidative stress biomarkers in human volunteers,” J Altern Complement Med, vol. 17, no. 9, pp. 827–833, Sep. 2011, doi: 10.1089/ACM.2010.0716.
A. Witschi, S. Reddy, B. Stofer, and B. H. Lauterburg, “The systemic availability of oral glutathione,” Eur J Clin Pharmacol, vol. 43, no. 6, pp. 667–669, Dec. 1992, doi: 10.1007/BF02284971.
E. Y. Park et al., “Increase in the protein-bound form of glutathione in human blood after the oral administration of glutathione,” J Agric Food Chem, vol. 62, no. 26, pp. 6183–6189, Jul. 2014, doi: 10.1021/JF501338Z.
J. P. Richie et al., “Randomized controlled trial of oral glutathione supplementation on body stores of glutathione,” Eur J Nutr, vol. 54, no. 2, pp. 251–263, Mar. 2015, doi: 10.1007/S00394-014-0706-Z.
R. Sinha et al., “Oral supplementation with liposomal glutathione elevates body stores of glutathione and markers of immune function,” Eur J Clin Nutr, vol. 72, no. 1, pp. 105–111, Jan. 2018, doi: 10.1038/EJCN.2017.132.
G. Sechi et al., “Reduced intravenous glutathione in the treatment of early Parkinson’s disease,” Prog Neuropsychopharmacol Biol Psychiatry, vol. 20, no. 7, pp. 1159–1170, Oct. 1996, doi: 10.1016/S0278-5846(96)00103-0.
G. A. P. Hospers, E. A. Eisenhauer, and E. G. E. De Vries, “The sulfhydryl containing compounds WR-2721 and glutathione as radio- and chemoprotective agents. A review, indications for use and prospects,” Br J Cancer, vol. 80, no. 5–6, pp. 629–638, 1999, doi: 10.1038/SJ.BJC.6690404.
D. S. Alberts and J. K. Noel, “Cisplatin-associated neurotoxicity: Can it be prevented?,” Anticancer Drugs, vol. 6, no. 3, pp. 369–383, 1995, doi: 10.1097/00001813-199506000-00003.
M. Treskes, U. Holwerda, I. Klein, H. M. Pinedo, and W. J. F. Van Der Vijgh, “The chemical reactivity of the modulating agent WR2721 (ethiofos) and its main metabolites with the antitumor agents cisplatin and carboplatin,” Biochem Pharmacol, vol. 42, no. 11, pp. 2125–2130, Nov. 1991, doi: 10.1016/0006-2952(91)90347-8.
J. F. Smyth et al., “Glutathione reduces the toxicity and improves quality of life of women diagnosed with ovarian cancer treated with cisplatin: results of a double-blind, randomised trial,” Ann Oncol, vol. 8, no. 6, pp. 569–573, 1997, doi: 10.1023/A:1008211226339.
S. Cascinu et al., “Neuroprotective effect of reduced glutathione on oxaliplatin-based chemotherapy in advanced colorectal cancer: a randomized, double-blind, placebo-controlled trial,” J Clin Oncol, vol. 20, no. 16, pp. 3478–3483, Aug. 2002, doi: 10.1200/JCO.2002.07.061.
H. Greenlee, D. L. Hershman, and J. S. Jacobson, “Use of antioxidant supplements during breast cancer treatment: a comprehensive review,” Breast Cancer Res Treat, vol. 115, no. 3, pp. 437–452, Jun. 2009, doi: 10.1007/S10549-008-0193-0.
“Glutathione in the prevention of cisplatin induced toxicities. A prospectively randomized pilot trial in patients with head and neck cancer and non small cell lung cancer - PubMed.” Accessed: Nov. 15, 2023. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/11008323/
S. Cascinu, L. Cordella, E. Del Ferro, M. Fronzoni, and G. Catalano, “Neuroprotective effect of reduced glutathione on cisplatin-based chemotherapy in advanced gastric cancer: a randomized double-blind placebo-controlled trial,” J Clin Oncol, vol. 13, no. 1, pp. 26–32, 1995, doi: 10.1200/JCO.1995.13.1.26.
F. Di Re, S. Bohm, S. Oriana, G. Battista Spatti, and F. Zunino, “Efficacy and safety of high-dose cisplatin and cyclophosphamide with glutathione protection in the treatment of bulky advanced epithelial ovarian cancer,” Cancer Chemother Pharmacol, vol. 25, no. 5, pp. 355–360, Sep. 1990, doi: 10.1007/BF00686237.
Pages
369-376
Published
March 11, 2024
Copyright (c) 2024 Academician Publishing Book Portal
License
LicenseHow to Cite
1.
Açar FP. Glutatyon. In: Sakin A, editor. Kanser Hastalarının Başvurduğu Geleneksel ve Tamamlayıcı Tedaviler - Tıbbi Onkolog Gözü ile Bakış ve Onkolojik İlaçlarla Etkileşim [Internet]. Türkiye: Academician Publishing Book DOI Portal; 2024 [cited 2026 Jul. 13]. pp. 369-76. Available from: https://www.omp35.books.akademisyen.net/index.php/akya/catalog/book/2380/chapter/13957
