Coriolus Versicolor

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Common Names

PSK
PSP
VPS
Turkey Tail
Yun Zhi
Kawaratake
Krestin

For Patients & Caregivers

How It Works

Coriolus versicolor extracts have been studied in cancer patients with some positive results. However, more studies are needed to verify their effects.

Coriolus versicolor is a mushroom that is used in traditional Chinese medicine as a tonic. Polysaccharide compounds from Coriolus called PSK and PSP were shown to improve immune function in patients with certain cancers when used along with chemotherapy.

Purported Uses

To prevent and treat cancer
When used in combination with certain chemotherapy regimens, PSK has been shown to benefit patients following surgical removal of stomach and colorectal cancers. Clinical trials in patients with breast cancer, leukemias, and liver cancer do not show beneficial results.
To reduce cancer treatment side effects
Animal studies suggest that PSK can prevent immune suppression caused by chemotherapy or radiation, but clinical trials have not been performed to confirm this effect in humans.
To stimulate the immune system
Studies in animals and humans suggest that PSK might stimulate the immune system.
To treat infections
The effects of Coriolus on infections have not been studied in clinical trials.

Side Effects

Dark-colored stools
Darkening of fingernails
Low-grade toxicities were reported when used with chemotherapy. However, such effects may be caused by the chemotherapy agents themselves.

Special Point

PSK is approved for clinical use in Japan. Purified PSK, PSP extracts, or raw Coriolus extract alone or in combination with other herbs were used in clinical studies. However, the clinical effects of these products have not been compared.

For Healthcare Professionals

Brand Name

Krestin

Scientific Name

Coriolus versicolor, Trametes versicolor, Polyporus versicolor, Polystictus versicolor

Clinical Summary

Coriolus versicolor is a mushroom of the Basidiomycetes class. It is used in traditional Chinese medicine as a tonic, and recent studies suggest that it has immunostimulant and anti-tumor properties. Polysaccharide-K (PSK), a proprietary product derived from Coriolus, was developed for cancer treatment in Japan. Other Coriolus extracts such as polysaccharide-peptide (PSP) and VPS are available as dietary supplements.

When used as an adjuvant, PSK appears to improve survival rates in patients with gastric ⁽¹⁾ ⁽²⁾ and colorectal ⁽³⁾ ⁽⁴⁾ ⁽⁵⁾ cancers. It may also benefit patients with esophageal cancer ⁽²⁷⁾. One clinical study demonstrated that PSP used in conjunction with chemotherapy may benefit patients with advanced non-small cell lung cancer ⁽⁶⁾. Studies using Coriolus extract alone or in combination with other botanicals also suggest positive immunomodulatory effects ⁽⁷⁾ ⁽⁸⁾. However, studies on breast cancer ⁽⁹⁾, hepatocellular carcinoma ⁽¹⁰⁾ ⁽²⁸⁾, and leukemia ⁽¹¹⁾ produced mixed results. Although a meta-analysis suggests adjuvant Coriolus may lower mortality risk with some types of cancers ⁽²⁹⁾, additional confirmatory studies are needed.

Coriolus extracts are generally well tolerated but minor adverse effects have been reported. Many over-the-counter Coriolus products are not standardized, making it difficult to compare potency between brands. It is also unclear if PSK, PSP, and other Coriolus extracts have comparable effects.

Purported Uses

Cancer
Treatment side effects
Immunostimulant
Infections

Mechanism of Action

Coriolus versicolor is thought to be a biological response modifier. In vitro, PSP, PSK, and Coriolus extract induces apoptosis in leukemia cells ⁽¹³⁾ ⁽²³⁾ ⁽²⁴⁾. PSP also increased apoptosis in cells treated with camptothecin, reduced proliferation, progression, and 3H-thymidine uptake, and prolonged DNA synthesis time ⁽¹⁴⁾. A Coriolus medicinal mushroom blend inhibited cell proliferation and induced G2/M cell cycle arrest in an invasive breast cancer cell line ⁽¹⁵⁾. The mushroom extract inhibits expression of cell-cycle regulatory genes and suppresses metastatic behavior via inhibition of cell adhesion, migration, and invasion. Antiproliferative effects were linked to suppression of urokinase plasminogen activator ⁽¹⁵⁾. PSP also inhibits interaction between HIV-1 gp120 and CD4 receptor, HIV-1 transcriptase activity, and glycohydrolase enzyme activity associated with viral glycosylation ⁽¹⁶⁾.

Several animal studies report synergy between PSK and biologic therapies, including a concanavalin A-bound L1210 vaccine and the IgG2a monoclonal antibody against human colon cancer cells ⁽¹⁷⁾. PSP induces cytokine production and T-cell proliferation, and prevents cyclophosphamide-induced immune suppression. Peritoneal macrophages isolated from PSP-fed mice show increased production of reactive nitrogen intermediates, superoxide anions, and TNF ⁽¹⁸⁾. PSP also shows analgesic activity in mouse models ⁽¹⁹⁾.

In human studies, non-small cell lung cancer patients have increased leukocyte and neutrophil counts after PSP consumption, as well as increased serum IgG and IgM ⁽⁶⁾. Healthy volunteers and breast cancer patients who used a formula containing Coriolus and Salvia had elevated CD4+ counts, a high CD4+/CD8+ ratio, and elevated absolute counts of B-lymphocytes ⁽⁷⁾ ⁽⁸⁾. TNF-alpha and IL-8 gene expression were significantly induced after PSK administration in healthy volunteers and gastric cancer patients, although individual response varied ⁽²⁰⁾.

High doses of a hot water extract of Coriolus enhanced development of large intestinal tumors in mice ⁽¹²⁾. However, this is not clinically relevant as the dosage was 10-13x higher than what is used in human studies and the mice were injected with known potent carcinogens.

Adverse Reactions

Rare: Dark colored stools not originating from occult blood ⁽²¹⁾, darkening of fingernails ⁽²²⁾, and low-grade hematological and gastrointestinal toxicities when used in conjunction with chemotherapy ⁽³⁾. However, such effects may be caused by the chemotherapy agents themselves.

Dosage (OneMSK Only)

References

Nakazato H, et al. Efficacy of immunochemotherapy as adjuvant treatment after curative resection of gastric cancer. Study Group of Immunochemotherapy with PSK for Gastric Cancer. Lancet 1994; 343(8906): 1122-6.
Niimoto M, et al. Postoperative adjuvant immunochemotherapy with mitomycin C, futraful and PSK for gastric cancer. An analysis of data on 579 patients followed for five years. Jpn J Surg 1988; 18(6): 681-6.
Ohwada S, et al. Adjuvant immunochemotherapy with oral Tegafur/Uracil plus PSK in patients with stage II or III colorectal cancer: a randomised controlled study. Br J Cancer 2004; 90(5): 1003-10.
Mitomi T, et al. Randomized, controlled study on adjuvant immunochemotherapy with PSK in curatively resected colorectal cancer. The Cooperative Study Group of Surgical Adjuvant Immunochemotherapy for Cancer of Colon and Rectum (Kanagawa). Dis Colon Rectum 1992; 35(2): 123-30.
Torisu M, et al. Significant prolongation of disease-free period gained by oral polysaccharide K (PSK) administration after curative surgical operation of colorectal cancer. Cancer Immunol Immunother 1990; 31(5): 261-8.
Tsang KW, et al. Coriolus versicolor polysaccharide peptide slows progression of advanced non-small cell lung cancer. Respir Med 2003; 97(6): 618-24.
Wong CK, et al. Immunomodulatory effects of yun zhi and danshen capsules in health subjects—a randomized, double-blind, placebo-controlled, crossover study. Int Immunopharmacol 2004; 4(2): 201-11.
Wong CK, et al. Immunomodulatory activities of Yunzhi and Danshen in post-treatment breast cancer patients. Am J Chin Med 2005; 33(3): 381-95.
Iino Y, et al. Immunochemotherapies versus chemotherapy as adjuvant treatment after curative resection of operable breast cancer. Anticancer Res 1995; 15(6B): 2907-11.
Suto T, et al. Clinical study of biological response modifiers as maintenance therapy for hepatocellular carcinoma. Cancer Chemother Pharmacol 1994; 33: S145-8.
Ohno R, et al. A randomized trial of chemoimmunotherapy of acute nonlymphocytic leukemia in adults using a protein-bound polysaccharide preparation. Cancer Immunol Immunother 1984; 18(3): 149-54.
Toth B, Coles M, Lynch J. Effects of VPS extract of Coriolus versicolor on cancer of the large interstine using a serial sacrifice technique. In Vivo 2006;20(3):341-6.
Yang X, et al. The cell death process of the anticancer agent polysaccharide-peptide (PSP) in human promyelocytic leukemic HL-60 cells. Oncol Rep 2005; 13(6): 1201-10.
Wan JMF, Sit WH, Yang X, Jiang P, Wong LY. Polysaccharopeptides derived from Coriolus versicolor potentiate the S-phase specific cytotoxicity of Camptothecin (CPT) on human leukemia HL-60 cells. Chinese Medicine. 2010;5:16.
Jiang J, Sliva D. Novel medicinal mushroom blend suppresses growth and invasiveness of human breast cancer cells. Int J Oncol. 2010 Dec;37(6):1529-36.
Collins RA, Ng TB. Polysaccharopeptide from Coriolus versicolor has Potential for Use Against Human Immunodeficiency Virus type I Infection. Pharmcology Letters 1997; 60(25): 387-387.
Tsukagoshi S, et al. Krestin (PSK). Cancer Treat Rev 1984; 11(2): 131-55.
Liu WK, et al. Activation of peritoneal macrophages by polysaccharopeptide from the mushroom, Coriolus versicolor. Immunopharmacology 1993; 26(2): 139-46.
Ng TB, Chan WY. Polysaccharopeptide from the mushroom Coriolus versicolor possesses analgesic activity but does not produce adverse effects on female reproductive or embryonic development in mice. Gen Pharmacol 1997; 29(2): 269-73.
Kato M, et al. Induction of gene expression for immunomodulating cytokines in peripheral blood mononuclear cells in response to orally administered PSK, an immunomodulating protein-bound polysaccharide. Cancer Immunol Immunother 1995; 40(3): 152-6.
Shiu WCT, et al. A Clinical Study of PSP on Peripheral Blood Counts during Chemotherapy. Phytotherapy Research 1992; (6): 217-218.
Kidd, PM. The use of mushroom glucans and proteoglycans in cancer treatment. Altern Med Rev 2000 5(1): 4-27.
Lau CB, et al. Cytotoxic activities of Coriolus versicolor (Yunzhi) extract on human leukemia and lymphoma cells by induction of apoptosis. Life Sci 2004; 75(7): 797-808.
Hirahara N, Edamatsu T, Fujieda A, et al. Protein-bound polysaccharide-K (PSK) induces apoptosis via p38 mitogen-activated protein kinase pathway in promyelomonocytic leukemia HL-60 cells. Anticancer Res. 2012 Jul;32(7):2631-7.
Fisher M, Yang LX. Anticancer effects and mechanisms of polysaccharide-K (PSK): implications of cancer immunotherapy. Anticancer Res. 2002 May-Jun;22(3):1737-54.
Cui J, Chisti Y. Polysaccharopeptides of Coriolus versicolor: physiological activity, uses, and production. Biotechnol Adv. 2003 Apr;21(2):109-22.
Ogoshi K, Satou H, Isono K, Mitomi T, Endoh M, Sugita M. Immunotherapy for esophageal cancer. A randomized trial in combination with radiotherapy and radiochemotherapy. Cooperative Study Group for Esophageal Cancer in Japan. Am J Clin Oncol. 1995 Jun;18(3):216-22.
Chay WY, Tham CK, Toh HC, et al. Coriolus versicolor (Yunzhi) Use as Therapy in Advanced Hepatocellular Carcinoma Patients with Poor Liver Function or Who Are Unfit for Standard Therapy. J Altern Complement Med. Aug 2017;23(8):648-652.
Zhong L, Yan P, Lam WC, et al. Coriolus versicolor and Ganoderma lucidum Related Natural Products as an Adjunct Therapy for Cancers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Pharmacol. 2019;10:703.

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Last Updated

Friday, April 12, 2019