- Hua gu; Snake butter; Forest mushroom
- Pasania fungus
For Patients & Caregivers
How It Works
Lentinan may help extend the survival of patients with some cancers when used with chemotherapy, but additional studies are needed.
Lentinan is a type of sugar molecule called 1,3 beta glucan that comes from the shiitake mushroom. In laboratory tests, lentinan does not kill cancer cells directly. Instead, it enhances the immune system, which may aid in slowing the growth of tumors. Lentinan also kills viruses and microbes directly in laboratory studies.
- To prevent and treat cancer Several clinical trials show that lentinan combined with chemotherapy extends survival in patients with stomach, prostate, colorectal, and liver cancers.
- To lower cholesterol Laboratory studies support this use, but human data are lacking.
- To stimulate the immune system Laboratory and a few human studies show that lentinan increases the activity of certain immune cells.
- To treat infections Laboratory and a few human studies show that lentinan increases the activity of certain immune cells.
- Side effects with lentinan infusions are mainly mild, with more severe reactions (hypersentivity reaction, back pain, leg pain, depression, fever, chills, decreased white blood cell count, and elevated liver enzymes) related to short infusion times.
For Healthcare Professionals
Lentinan, a polysaccharide, is derived from the mycelium of the shiitake mushroom body, and its active component is 1,3 beta glucan. In some countries, parenteral lentinan is classified as an antineoplastic polysaccharide and is available for clinical use. Only oral formulations and extracts, which are considered dietary supplements, are available for use in the United States.
Although lentinan is a biological response modifier, it does not have a direct cytotoxic effect on tumor cells (17). In various cancer models, lentinan has also been shown to enhance activity of gemcitabine (18), paclitaxel (19), docetaxel and cisplatin (20), and monoclonal antibodies (21). Addition of lentinan to standard cancer therapies, considered chemoimmunotherapy (22), resulted in improved survival in hepatocellular (1) and gastric (11) cancers, and improved quality of life in patients with esophageal carcinoma (15). Meta-analyses also suggest adjuvant lentinan may be beneficial in advanced or gastric cancers (28) (29).
Improvements in quality of life were seen with an oral formulation of lentinan in some cancer patients (10) (12) (13) (14). However, larger well-designed studies are needed to establish the role of lentinan as a useful adjunct to cancer treatment.
Mechanism of Action
Lentinan’s active polysaccharide, 1,3 beta glucan, is not cytotoxic but seems to enhance T-helper cell function and increase stimulation of interleukin, interferon, and normal killer cells (3) (4). In addition to their primary structures, immunopotentiation activity of beta-D-glucans is linked to their molecular weight and triple helical conformation, which varied greatly between batches and manufacturers (23).
In vivo studies suggest that 1,3 beta glucan increases IL-4-producing cells, suggesting a stimulation of Th2-mediated immunity (5). In addition to antitumor activity, lentinan also possesses immune-regulatory effects, antiviral activity, antimicrobial properties, and cholesterol-lowering effects (6).
In murine bone marrow cells, lentinan enhanced repair of paclitaxel-induced DNA damage and protected against paclitaxel-induced apoptosis partly via modulation of cellular antioxidant levels (24). Lentinan also was shown to induce apoptosis in gastric cancer cells, and this effect was enhanced when combined with docetaxel and cisplatin (16). In urothelial bladder cancer cell lines, increased concentrations of lentinan alone or combined with gemcitabine correlated with enhanced T24 cell apoptosis (18). Lentinan cotreatment with paclitaxel enhanced effects in a lung cancer cell line through ROS production and activation of NLRP3 inflammasome and ASK1/p38 MAPK signal pathway (19).
Side effects with lentinan infusions are mainly mild, with more severe reactions (anaphylactoid reaction, back pain, leg pain, depression, rigor, fever, chills, granulocytopenia and elevated liver enzymes) related to short infusion times (9).
Chest tightness: Following parenteral injection of lentinan (7).
Shiitake dermatitis (rash): Patterns of whiplike, linear, erythematous wheals within 1 to 2 days after consumption of raw or even cooked shiitake mushrooms caused by toxic reactions to lentinan, which typically resolve within days to weeks of their appearance (25) (26) (27) (30).