## 4 Application of Phytoextract in DCs-Based Clinical Study of Cancer Therapy  
Dendritic cells play an important role in the initiation of immune responses for anticancer immunity. In cancer patients, dendritic cells are altered in the tumor microenvironment [1]. For this reason, modulation of DCs is suggested for cancer prevention and treatment. In the last couple of years, several studies have been performed to assess the role of plant extract in DC-based immunotherapy against cancer [66]. In Table 6, it has been reported that _Nicotiana benthamiana_ NbPVX-E7 pulsed-MDDCs/PBMCs can prime human blood-derived lymphocytes from healthy individuals to induce human papillomavirus (HPV16 E7) specific cytotoxic activity [23]. Dendritic cell activation was observed in breast cancer patients who were given the Chinese herbal medicine Shenqi Fuzheng [67]. Another study showed that Lingdankang composite and DC cytokine-induced killer cells were effective against leukemia patients [68]. NLGP overcomes the indoleamine 2,3 dioxygenase mediated tolerance in dendritic cells by attenuating hyperactive regulatory T-cells in cervical cancer (stage IIIB) patients [69]. Furthermore, DCs exposed to Amomi Semen extract exhibited activated phenotypes of DCs and also secreted IL-12p70 cytokines, which inhibited the growth of tumor cells [70]. A traditional herb named Juzen-tauho-to is used in East Asia for the treatment of cancer patients. The glycolipid mixture containing B-glucosylceramides stimulates primary DCs that express intercellular adhesion molecule-1 (ICAM 1), triggering an immune response [50]. Lipid-soluble extract of _Pinellia pedatiseta Schott_ stimulates intratumoral dendritic cell activation through suppressor of cytokine signaling 1 (SOCS1) in cervical cancer patients [71]. NLGP-pulsed DCs overcome the hyperactivity of regulatory cells in stage III cervical cancer patients [69].  
\begin{table}
\begin{tabular}{c c c} \hline \hline
**Plant Name/Extracts** & **DCs on In Vivo Study against Cancer** & **References** \\ \hline \multirow{2}{*}{Polysaccharide LBP (_Lycium barbarum_)} & Increase the number of DCs with anti-tumor immune function in mice & [60] \\ \hline \multirow{2}{*}{_Larix leptolepsi_} & Activates DCs to initiate type 1 immunity and inhibit tumor growth in mice & [61] \\ \hline \multirow{2}{*}{Grape seed proanthocyanindins} & Lowering the UV-induced immunosuppression by repairing DNA through activation of DCs in mice & [62] \\ \hline \multirow{2}{*}{Alcoholic extract of _Tinospora cardiifolia_} & Enhancing the differentiation of tumor-associated macrophages to DCs and increases cytotoxicity in tumor bearing mice & [28] \\ \hline \multirow{2}{*}{Plant DNA CpG} & Activates DCs and decreases tumor growth in mice & [63] \\ \hline \multirow{2}{*}{Plant-derived agonist CM-Glucan (carboxymethylal Beta- (1,3) (1,6) glucan); trade name Immunomax®} & Inhib tumor growth in mice through activation of DCs & [64] \\ \hline \multirow{2}{*}{Polysaccharide from root of _Ficus carica_} & Enhancing the activity of DC-based cancer immunotherapy immunotherapy in mice & [52] \\ \hline \multirow{2}{*}{Polysaccharide from _Carthamus tinctorius_} & Increase the efficiency of DC-based cancer vaccine through the cytotoxic activity of CD8 T-cells & [46] \\ \hline \multirow{2}{*}{Polysaccharide from _Dioscorea alata_ var. _Purpurea_} & Stimulates DCs and enhances anti-tumor activity in mice & [26] \\ \hline \hline \end{tabular}
\end{table}
Table 5: Plant extracts pulsed DCs on in vivo study against cancer.