Introduction

As the holiday season approaches, bundles of mistletoe will no doubt appear in many homes across the world. This popular holiday decoration, with its green leaves and white berries dangling from doorways, may induce the act of kissing between passersby. Mistletoe (Viscum album L.) is a semi-parasitic shrub that often grows upon oak, pine, and elm trees and is a member of the Viscaceae family commonly found in northern Europe.¹ The name mistletoe is derived from the Anglo Saxon words "mistel," meaning dung (excrement), and "tan," meaning branch, since the seeds are spread through bird droppings.² This shrub with a not-so-pleasant name-origin has a fascinating history, from a symbol of fertility to a spectrum of healing properties. One may never look at mistletoe the same after learning about its therapeutic offerings, especially as those therapeutic properties relate to wound care.

Holiday History

The celebratory facet of mistletoe’s complex history is likely traced back to the 1st century AD, with the Celtic Druids who lived in modern-day Ireland and Scotland.² The ability of mistletoe to thrive, even through harsh winters, inspired the Druids to see it as a religious symbol of fertility and vitality. It played a key role in the Ritual of Oak and Mistletoe, where the shrub was mixed with the blood of a sacrificed bull.² Mistletoe is also featured in Norse mythology as a sacred plant that granted love and peace to people who kissed underneath it.² It was in 18th century England that mistletoe became synonymous with the celebration of Christmas.³

Therapeutic History

Mistletoe’s recognition as a healing plant predates its festive reputation by several centuries. Hippocrates used it to treat diseases of the spleen and menstruation issues, and during the Middle Ages it was prescribed as a remedy for epilepsy and ulcers.¹ Native American cultures have used a tincture of mistletoe to treat migraines for hundreds of years.³ In China, it is still used to treat congestive heart failure and venous insufficiency.³

Therapeutic Capacity

In recent literature, the Viscum species have exhibited anti-glycemic and insulin tropic activity, which can lower blood glucose in diabetic patients.¹ It also contains antifungal activity against the Candida species and antiviral qualities useful to combat human parainfluenza virus type 2 (HPIV-2).¹ Mistletoe’s cytotoxic and anti-tumor characteristics make it a promising treatment for breast cancer, with more research on the horizon.⁴ The medicinal effects of mistletoe on the treatment of Alzheimer's disease are currently being studied and may offer hope for the future.¹

Mistletoe and Wound Care

Surprisingly enough, using extracts of mistletoe, researchers have tested through in vivo and in vitro models the application of this parasitic holiday plant. In animal models, mistletoe has been found to increase the re-epithelization rate regarding cutaneous wound healing.¹ In particular, an in vitro study from 2013 found a treatment that used mistletoe extract facilitated the migration of fibroblasts across the wound bed.¹

Mistletoe demonstrates antibacterial properties as well, targeting Staphylococcus epidermis, Escherichia coli, Salmonella typhi, Proteus mirabilis, and Pseudomonas aeruginosa.¹ Although, it may be important to note that the testing and results of mistletoe's antibacterial properties varied to a degree, as researchers used differing extracts. One study also found these extracts displayed effectiveness against gram-negative bacteria as opposed to gram-positive bacteria.¹

Conclusion

It is safe to say that mistletoe is far more than a mere decoration because of its healing capability; it has been used to treat many different diseases over the course of human history. This once sacred plant is now best known as a piece of festivity but is indeed the gift that keeps on giving! Happy Holidays!

References

1. Szurpnicka A, Kowalczuk A, Szterk A. Biological activity of mistletoe: In vitro and in vivo studies and mechanisms of action. Arch Pharm Res. 2020;43(6):593–629. https://doi.org/10.1007/s12272-020-01247-w
2. Sterkenberg Z. The curious KISStory of mistletoe. Ambius.com. Available at: https://www.ambius.com/blog/the-curious-kisstory-of-mistletoe/. Published December 18, 2018. Accessed November 22, 2022.
3. Rice AO. 'Tis the season: Mistletoe offers a rich history as medicine. Today's RDH. Available at: https://www.todaysrdh.com/tis-the-season-mistletoe-offers-a-rich-history... Published December 19, 2021. Accessed November 28, 2022.
4. Marvibaigi M, Supriyanto E, Amini N, Abdul Majid FA, Jaganathan SK. Preclinical and clinical effects of mistletoe against breast cancer. BioMed Res Int. 2014;2014:785479. https://doi.org/10.1155/2014/785479

About the Author

Christine Miller, DPM, PhD is a certified wound specialist by the American Board of Wound Management and a Fellow of the American College of Clinical Wound Specialists. She currently serves as the Co-Director of the Limb Salvage Program at the University of Florida, College of Medicine-Jacksonville.