Reishi vs. Hepatitis B
The polysaccharide fractions and triterpenes isolated from Ganoderma lucidum have shown protection effects on the liver in animal studies. This double-blind, randomised, and multicentered study aimed to evaluate the safety and effect of a G. lucidum extraction, Ganopoly, in chronic hepatitis B. Ninety patients with chronic hepatitis B, hepatitis В viral (HBV) DNA positivity, and aminotransferase elevation were included in this multicenter prospective randomized Phase I/II study. Patients were randomized to be given Ganopoly (n = 60) or placebo (n = 30) for 12 weeks, then followed up for 13 weeks. Effect of therapy on levels of HBV DNA and aminotransferase activities in serum and hepatitis В е antigen (HBeAg) status were investigated. There were 78 assessable patients who entered the trial for efficacy and safety; 13 of 52 (25%) patients receiving Ganopoly responded by reducing HBeAg and HBV DNA, compared to 1 of 26 (4%) in the control group (P < 0.05). Among those with serum aspartate aminotransferase (AST) values < 100 U/L (n = 29), 41% (12/29) responded, and among those with AST values > 100 U/L (n = 23), 65% (15/23) responded. Within the 6-month study period, 33% (17/ 52) of treated patients had normal aminotransferase (ALT) values, and 13% (7/52) had cleared hepatitis B surface antigen (HBsAg) from serum, whereas none of the controls had normal ALT values or had lost HBsAg. Eight of 60 patients in Ganopoly group and 4 of 30 in the controls were unable to be followed up due to loss or withdrawal. Our study indicates that Ganopoly is well tolerated and appears to be active against HBV in patients with chronic hepatitis B.
Reishi vs. Hepatitis B (II)
Herbal medicines are always considered to be a safe and useful approach for the treatment of chronic hepatopathy. Ganoderma luciudm (Curt.:Fr.) P. Karst. [(Ling Zhi, Reishi mushroom) (Aphyllophoromycetideae)], a highly ranked medicinal mushroom in Oriental traditional medicine, has been widely used for the treatment of chronic hepatopathy of various etiologies. Data from in vitro and animal studies indicate that G. lucidum extracts (mainly polysaccharides or triterpenoids) exhibit protective activities against liver injury induced by toxic chemicals (e.g., CCl4) and Bacillus Calmette-Guerin (BCG) plus lipopolysaccharide (LPS). G. lucidum also showed anti–hepatitis B virus (HBV) activity in a duckling study. Recently, a randomized placebo-controlled clinical study showed that treatment with G. lucidum polysaccharides for 12 weeks reduced hepatitis B e antigen (HBeAg) and HBV DNA in 25% (13/52) patients with HBV infection. The mechanisms of the hepatoprotective effects of G. lucidum have been largely undefined. However, accumulating evidence suggests several possible mechanisms. These include antioxidant and radical-scavenging activity, modulation of hepatic Phase I and II enzymes, inhibition of b-glucuronidase, antifibrotic and antiviral activity, modulation of nitric oxide production, maintenance of hepatocellular calcium homeostasis, and immunomodulating effects. G. lucidum could represent a promising approach for the management of various chronic hepatopathies. Further studies are needed to explore the kinetics and mechanisms of action of G. lucidum constituents with hepatoprotective activities.
Reishi vs. tumors
Ganoderma lucidum has been established to be an antitumor natural product. Hot-water extracts of the mycelium of G. lucidum (GLP) exhibited antitumor effect against fibrosarcoma in male and female C3H mice and inhibited the metastasis of the tumor to the lung. Moreover, we have fractionated GLP into polysaccharide fraction [GLP(AI)] and nonpolysaccharide fraction. We found that GLP(AI) is the major component to show the in vivo antitumor effect on fibrosarcoma growth in C3H mice. The effect of PS-G purified from GLP(AI) by Sephadex and ion-exchange column chromatography on the induction of differentiation in leukemic U937 cells was examined. We found that it could stimulate blood mononuclear cells to secrete cytokines, TNF-a, IFN-g, IL-1b, and IL-6, etc., which were both antiproliferative and differentiation-inductive to the leukemic U937 and HL-60 cells. TNF-a and IFN-g, especially, induced apoptosis and differentiation in the treated leukemic cells. Furthermore, antitumor activity of G. lucidum on intraperitioneally implanted Lewis lung carcinoma in syngeneic C57BL/6 mice was investigated. The results showed that GLP significantly increased the lifespan of tumor-implanted mice, when administered intraperioneally alone or in combination with cytotoxic antitumor drugs (adriamycin, fluorouracil, thioguanine, methotrexate, or cisplatin) or a synthetic immunomodulator (imexon). The GLP was not cytotoxic to cultured cells, and the antitumor activity was abolished by pretreatment of mice with cyclosporine. These observations suggest that GLP exerts its antitumor effect mainly through immunopotentiation of the tumor-bearing animals.
Reishi vs. tumors and inflammation
A series of lanostane-type triterpene acids, including eleven lucidenic acids (3, 4, 9, 10, 13–19) and six ganoderic acids (20–22, 24, 26, 27), as well as six sterols (28–33), all isolated from the fruiting bodies of the fungus Ganoderma lucidum, were examined for their inhibitory effects on the induction of Epstein–Barr virus early antigen (EBV-EA) by 12-O-tetradecanoylphorbol-13-acetate (TPA) in Raji cells, a known primary screening test for anti-tumor promoters. All of the compounds tested, except for ganolactone (27) and three sterols (29–31), showed potent inhibitory effects on EBV-EA induction, with IC50 values of 235–370 mol ratio/32 pmol TPA. In addition, nine lucidenic acids (1, 2, 5–8, 11, 12, 18) and four ganoderic acids (20, 23–25) were found to inhibit TPA-induced inflammation (1 μg/ear) in mice, with ID50 values of 0.07–0.39 mg per ear. Further, 20-hydroxylucidenic acid N (18) exhibited inhibitory effects on skin-tumor promotion in an in vivo two-stage mouse-skin carcinogenesis test based on 7,12-dimethylbenz[a]anthracene (DMBA) as initiator, and with TPA as promoter.
Reishi vs. cancer
The meta-analysis results showed that patients who had been given G. lucidum alongside with chemo/radiotherapy were more likely to respond positively compared to chemo/radiotherapy alone (RR 1.50; 95% CI 0.90 to 2.51, P = 0.02). G. lucidum treatment alone did not demonstrate the same regression rate as that seen in combined therapy. The results for host immune function indicators suggested that G. lucidum simultaneously increases the percentage of CD3, CD4 and CD8 by 3.91% (95% CI 1.92% to 5.90%, P < 0.01), 3.05% (95% CI 1.00% to 5.11%, P < 0.01) and 2.02% (95% CI 0.21% to 3.84%, P = 0.03), respectively. In addition, leukocyte, NK-cell activity and CD4/CD8 ratio were marginally elevated. Four studies showed that patients in the G. lucidum group had relatively improved quality of life in comparison to controls. One study recorded minimal side effects, including nausea and insomnia. No significant haematological or hepatological toxicity was reported.
Our review did not find sufficient evidence to justify the use of G. lucidum as a first-line treatment for cancer. It remains uncertain whether G. lucidum helps prolong long-term cancer survival. However, G. lucidum could be administered as an alternative adjunct to conventional treatment in consideration of its potential of enhancing tumour response and stimulating host immunity. G. lucidum was generally well tolerated by most participants with only a scattered number of minor adverse events. No major toxicity was observed across the studies. Although there were few reports of harmful effect of G. lucidum, the use of its extract should be judicious, especially after thorough consideration of cost-benefit and patient preference. Future studies should put emphasis on the improvement in methodological quality and further clinical research on the effect of G. lucidum on cancer long-term survival are needed. An update to this review will be performed every two years.