Foods for Rosai-dorfman Disease!

Introduction

Foods for Rosai-dorfman Disease should be personalized for each individual and also must adapt when cancer treatment or tumor genetic change. The personalization and adaptation must consider all the active ingredients or bioactives contained in different foods with respect to cancer tissue biology, genetics, treatments, lifestyle conditions and diet preferences. Hence while nutrition is one of the very important decisions for a cancer patient and individual at risk of cancer to make – how to choose foods to eat is not an easy task.

Rosai Dorfman disease, also known as sinus histiocytosis with massive lymphadenopathy, is a rare non-neoplastic disorder characterized by an overgrowth of histiocytes (immune cells) in various tissues. Pathology outlines can help provide insights into the characteristic features of Rosai Dorfman disease. Radiology plays a crucial role in the diagnosis and evaluation of the disease. Treatment options for Rosai Dorfman disease may involve observation or surgical excision of symptomatic lesions. Cytology can assist in confirming the diagnosis. Although skin involvement can occur, Rosai Dorfman disease commonly affects lymph nodes and sometimes the brain. Prognosis for Rosai Dorfman disease is generally good, with most cases showing a self-limiting course. Raising awareness and creating more comprehensive guidelines for the diagnosis and management of Rosai Dorfman disease are still areas of ongoing research. By seeking appropriate medical care and accessing the latest treatment options, individuals diagnosed with Rosai Dorfman disease can achieve better outcomes and enhance their quality of life.

For Rosai-dorfman Disease does it matter what vegetables, fruits, nuts, seeds one eats?

A very common nutrition question asked by cancer patients and individuals at-genetic risk of cancer is – for cancers like Rosai-dorfman Disease does it matter what foods I eat and which I do not? Or if I follow a plant-based diet is that enough for cancer like Rosai-dorfman Disease?

For example does it matter if vegetable Cabbage is consumed more compared to Chinese Broccoli? Does it make any difference if fruit Pummelo is preferred over Red Raspberry? Also if similar choices are made for nuts/seeds like Common Walnut over Flaxseed and for pulses like Black-eyed Pea over Catjang Pea. And if what I eat matters – then how does one identify foods which are recommended for Rosai-dorfman Disease and is it the same answer for everyone with the same diagnosis or genetic risk?

Yes! Foods you eat matters for Rosai-dorfman Disease!

Food recommendations may not be the same for everyone and can be different even for the same diagnosis and genetic risk.

All foods (vegetables, fruits, nuts, seeds, pulses, oils etc.) and nutritional supplements are made up of more than one active molecular ingredient or bio-actives in different proportions and quantities. Each active ingredient has a unique mechanism of action – which can be activation or inhibition of different biochemical pathways. Simply stated foods and supplements which are recommended are those which do not cause an increase of molecular drivers of cancer but reduce them. Else those foods should not be recommended. Foods contain multiple active ingredients – hence when evaluating foods and supplements you need to consider the impact of all active ingredients cumulatively rather than individually.

For example Pummelo contains active ingredients Lycopene, Protocatechuic Acid, Apigenin, Curcumin, Cinnamaldehyde. And Red Raspberry contains active ingredients Ellagic Acid, Protocatechuic Acid, Curcumin, Gallic Acid, Cinnamaldehyde and possibly others.

A common mistake made when deciding and choosing foods to eat for Rosai-dorfman Disease – is to evaluate only selected active ingredients contained in foods and ignore the rest. Because different active ingredients contained in foods may have opposing effects on cancer drivers – you cannot cherry pick active ingredients in foods and supplements for making a nutrition decision for Rosai-dorfman Disease.

YES – FOOD CHOICES MATTER FOR CANCER. NUTRITION DECISIONS MUST CONSIDER ALL ACTIVE INGREDIENTS OF FOODS.

Skills Needed for Nutrition Personalization for Rosai-dorfman Disease?

Personalized nutrition for cancers like Rosai-dorfman Disease consists of recommended foods / supplements; not recommended foods / supplements with example recipes which prioritize use of recommended foods. An example of personalized nutrition can be seen at this link.

Deciding which foods are recommended or not is extremely complicated, requiring expertise in Rosai-dorfman Disease biology, food science, genetics, biochemistry along with good understanding of how cancer treatments work and associated vulnerabilities by which the treatments could stop being effective.

MINIMUM KNOWLEDGE EXPERTISE NEEDED FOR NUTRITION PERSONALIZATION FOR CANCER ARE: CANCER BIOLOGY, FOOD SCIENCE, CANCER TREATMENTS AND GENETICS.

Characteristics of cancers like Rosai-dorfman Disease

All cancers like Rosai-dorfman Disease can be characterized by a unique set of biochemical pathways – the signature pathways of Rosai-dorfman Disease. Biochemical pathways like PI3K-AKT-MTOR Signaling, RAS-RAF Signaling, MAPK Signaling, Oncogenic Histone Methylation are part of the signature definition of Rosai-dorfman Disease. Each individual’s cancer genetics can be different and hence their specific cancer signature could be unique.

The treatments which are effective for Rosai-dorfman Disease need to be cognizant of the associated signature biochemical pathways for each cancer patient and individual at genetic risk. Therefore different treatments with different mechanisms of actions are effective for different patients. Similarly and for the same reasons foods and supplements need to be personalized for each individual. Hence some foods and supplements are recommended for Rosai-dorfman Disease when taking cancer treatment Cladribine, and some foods and supplements are not recommended.

Sources like cBioPortal and many others provide population representative patient anonymized data from clinical trials for all cancer indications. This data consists of clinical trial study details like sample size / number of patients, age groups, gender, ethnicity, treatments, tumor site and any genetic mutations.

KRAS, MAP2K1, KMT2C, SMC3 and NOTCH3 are the top ranked reported genes for Rosai-dorfman Disease. KRAS is reported in 20.8 % of the representative patients across all clinical trials. And MAP2K1 is reported in 12.5 %. The combined population patient data cover ages from to . % of the patient data are identified as men. The Rosai-dorfman Disease biology along with reported genetics together define the population represented signature biochemical pathways for this cancer. If the individual cancer tumor genetics or genes contributing to the risk are also known then that should also be used for nutrition personalization.

NUTRITION CHOICES SHOULD MATCH WITH EACH INDIVIDUAL’S CANCER SIGNATURE.

Food and Supplements for Rosai-dorfman Disease

For Cancer Patients

Cancer patients on treatment or on palliative care need to make decisions on food and supplements – for the needed dietary calories, for managing any treatment side effects and also for improved cancer management. All plant-based foods are not equal and choosing and prioritizing foods which are personalized and customized to ongoing cancer treatment is important and complicated. Here are some examples providing guidelines for making nutrition decisions.

Choose Vegetable CABBAGE or CHINESE BROCCOLI?

Vegetable Cabbage contains many active ingredients or bioactives such as Myricetin, Lycopene, Protocatechuic Acid, Glucaric Acid, Curcumin. These active ingredients manipulate various biochemical pathways like MAPK Signaling, RAS-RAF Signaling and PI3K-AKT-MTOR Signaling and others. Cabbage is recommended for Rosai-dorfman Disease when ongoing cancer treatment is Cladribine. This is because Cabbage modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Cladribine.

Some of the active ingredients or bioactives in vegetable Chinese Broccoli are Myricetin, Protocatechuic Acid, Apigenin, Curcumin, Cinnamaldehyde. These active ingredients manipulate various biochemical pathways like PI3K-AKT-MTOR Signaling and MYC Signaling and others. Chinese Broccoli is not recommended for Rosai-dorfman Disease when ongoing cancer treatment is Cladribine because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE CABBAGE IS RECOMMENDED OVER CHINESE BROCCOLI FOR Rosai-dorfman Disease AND TREATMENT Cladribine.

Choose Fruit RED RASPBERRY or PUMMELO?

Fruit Red Raspberry contains many active ingredients or bioactives such as Ellagic Acid, Protocatechuic Acid, Curcumin, Gallic Acid, Cinnamaldehyde. These active ingredients manipulate various biochemical pathways like RAS-RAF Signaling, PI3K-AKT-MTOR Signaling and MYC Signaling and others. Red Raspberry is recommended for Rosai-dorfman Disease when ongoing cancer treatment is Cladribine. This is because Red Raspberry modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Cladribine.

Some of the active ingredients or bioactives in fruit Pummelo are Lycopene, Protocatechuic Acid, Apigenin, Curcumin, Cinnamaldehyde. These active ingredients manipulate various biochemical pathways like PI3K-AKT-MTOR Signaling and MYC Signaling and others. Pummelo is not recommended for Rosai-dorfman Disease when ongoing cancer treatment is Cladribine because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

FRUIT RED RASPBERRY IS RECOMMENDED OVER PUMMELO FOR Rosai-dorfman Disease AND TREATMENT Cladribine.

Choose Nut COMMON WALNUT or FLAXSEED?

Common Walnut contains many active ingredients or bioactives such as Ellagic Acid, Myricetin, Protocatechuic Acid, Curcumin, Gallic Acid. These active ingredients manipulate various biochemical pathways like RAS-RAF Signaling, PI3K-AKT-MTOR Signaling and MYC Signaling and others. Common Walnut is recommended for Rosai-dorfman Disease when ongoing cancer treatment is Cladribine. This is because Common Walnut modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Cladribine.

Some of the active ingredients or bioactives in Flaxseed are Myricetin, Protocatechuic Acid, Curcumin, Apigenin, Cinnamaldehyde. These active ingredients manipulate various biochemical pathways like RAS-RAF Signaling and PI3K-AKT-MTOR Signaling and others. Flaxseed is not recommended for Rosai-dorfman Disease when ongoing cancer treatment is Cladribine because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

COMMON WALNUT IS RECOMMENDED OVER FLAXSEED FOR Rosai-dorfman Disease AND TREATMENT Cladribine.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Rosai-dorfman Disease or familial history is “What Should I Eat Differently from Before?” and how they should choose foods and supplements to manage risks of the disease. Since for cancer risk there is nothing actionable in terms of treatment – decisions of foods and supplements become important and one of the very few actionable things which can be done. All plant-based foods are not equal and based on identified genetics and pathway signature – the choices of food and supplements should be personalized.

Choose Vegetable GIANT BUTTERBUR or MUSTARD SPINACH?

Vegetable Giant Butterbur contains many active ingredients or bioactives such as Myricetin, Delphinidin, Curcumin, Apigenin, Lycopene. These active ingredients manipulate various biochemical pathways like Angiogenesis, Growth Factor Signaling, MAPK Signaling and RAS-RAF Signaling and others. Giant Butterbur is recommended for risk of Rosai-dorfman Disease when associated genetic risk is KMT2C. This is because Giant Butterbur increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in vegetable Mustard Spinach are Myricetin, Delphinidin, Curcumin, Apigenin, Lycopene. These active ingredients manipulate various biochemical pathways like Oxidative Stress and others. Mustard Spinach is not recommended when risk of Rosai-dorfman Disease when associated genetic risk is KMT2C because it increases the signature pathways of it.

VEGETABLE GIANT BUTTERBUR IS RECOMMENDED OVER MUSTARD SPINACH FOR KMT2C GENETIC RISK OF CANCER.

Choose Fruit NANCE or JUJUBE?

Fruit Nance contains many active ingredients or bioactives such as Myricetin, Delphinidin, Curcumin, Apigenin, Lupeol. These active ingredients manipulate various biochemical pathways like Angiogenesis, Growth Factor Signaling, MAPK Signaling and RAS-RAF Signaling and others. Nance is recommended for risk of Rosai-dorfman Disease when associated genetic risk is KMT2C. This is because Nance increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in fruit Jujube are Quercetin, Myricetin, Delphinidin, Curcumin, Apigenin. These active ingredients manipulate various biochemical pathways like Angiogenesis, Growth Factor Signaling and Oxidative Stress and others. Jujube is not recommended when risk of Rosai-dorfman Disease when associated genetic risk is KMT2C because it increases the signature pathways of it.

FRUIT NANCE IS RECOMMENDED OVER JUJUBE FOR KMT2C GENETIC RISK OF CANCER.

Choose Nut COMMON HAZELNUT or EUROPEAN CHESTNUT?

Common Hazelnut contains many active ingredients or bioactives such as Quercetin, Myricetin, Delphinidin, Curcumin, Lycopene. These active ingredients manipulate various biochemical pathways like Angiogenesis, MAPK Signaling, Cell Cycle Checkpoints and RAS-RAF Signaling and others. Common Hazelnut is recommended for risk of Rosai-dorfman Disease when associated genetic risk is KMT2C. This is because Common Hazelnut increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in European Chestnut are Ellagic Acid, Quercetin, Myricetin, Delphinidin, Curcumin. These active ingredients manipulate various biochemical pathways like Oxidative Stress and others. European Chestnut is not recommended when risk of Rosai-dorfman Disease when associated genetic risk is KMT2C because it increases the signature pathways of it.

COMMON HAZELNUT IS RECOMMENDED OVER EUROPEAN CHESTNUT FOR KMT2C GENETIC RISK OF CANCER.

In Conclusion

Foods and Supplements chosen are important decisions for cancers like Rosai-dorfman Disease. Rosai-dorfman Disease patients and individuals with genetic-risk always have this question: “What foods and nutritional supplements are recommended for me and which are not?” There is a common belief which is a misconception that all plant-based foods could be beneficial or not but would not be harmful. Certain foods and supplements can interfere with cancer treatments or promote molecular pathway drivers of cancer.

There are different types of cancer indications like Rosai-dorfman Disease, each with different tumor genetics with further genomic variations across each individual. Further every cancer treatment and chemotherapy has a unique mechanism of action. Each food like Cabbage contains various bioactives in different quantities, which have an impact on different and distinct sets of biochemical pathways. The definition of personalized nutrition is individualized food recommendations for the cancer indication, treatments, genetics, lifestyle and other factors. Nutrition personalization decisions for cancer require knowledge of cancer biology, food science and an understanding of different chemotherapy treatments. Finally when there are treatment changes or new genomics is identified – the nutrition personalization needs re-evaluation.

The addon nutrition personalization solution makes the decision making easy and removes all the guesswork in answering the question, “What foods should I choose or not choose for Rosai-dorfman Disease?”. The addon multi-disciplinary team includes cancer physicians, clinical scientists, software engineers and data scientists.

References

• Daidzein exerts anti-tumor activity against bladder cancer cells via inhibition of FGFR3 pathway.
• Preventive effects of butyric acid, nicotinamide, calcium glucarate alone or in combination during the 7, 12-dimethylbenz (a) anthracene induced mouse skin tumorigenesis via modulation of K-Ras-PI3K-AKTpathway and associated micro RNAs.
• https://histio.org/histiocytic-disorders/rosai-dorfman-disease
• https://rarediseases.org/rare-diseases/rosai-dorfman-disease/#:~:text=In%20most%20cases%2C%20affected%20individuals,of%20the%20disorder%20(asymptomatic
• https://rarediseases.info.nih.gov/diseases/7588/rosai-dorfman-disease