Turkey Tail

Scientific Name(s): Coriolus versicolor L. ex Fr. Quel. Family: Polyporaceae

Common Name(s): Cloud mushroom , PSK , PSP , yun zhi , polysaccharide krestin , turkey tail 1

Uses

Turkey tail has antioxidant activity, boosts immune response, and is considered an adjunctive treatment in cancer chemotherapy. Several clinical trials have supported these uses.

Dosing

There is no recent clinical evidence to support specific dosage of turkey tail.

Contraindications

Contraindications have not yet been determined.

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

None well documented.

Adverse Reactions

Patients have reported diarrhea, darkened stools, and darkened nail pigmentation.

Toxicology

Research reveals little or no information regarding toxicology with the use of this product.

Botany

The turkey tail fungus is commonly found throughout North America, Asia, and Europe. Its fruiting bodies overlap one another, forming a dense mass that grows on tree trunks, stumps, and fallen trees. The colors of the distinctive layers created by these bodies may be light to dark brown or gray. The polysaccharides of the fruiting bodies are commercially marketed as a tea that is commonly used in Asian and European traditional medicine. 1

History

Folklore remedies of turkey tail include the treatment of lung and liver infections. In China, turkey tail has been used as a preventive and curative agent for liver infections and liver cancer. In Japan, it is considered a panacea for a variety of cancers. Overall, the mycelium and fruiting body of the mushroom is considered an immune stimulant and is believed to have anticarcinogenic activity. 1 , 2 , 3

Chemistry

The water-extracted protein-bound polysaccharide krestin (PSK) and polysaccharide peptide (PSP) polysaccharides of C. versicolor have immunomodulating and antitumor activity. They are chemically similar but distinguished by fucose in PSK and rhamnose and arabinose in PSP. PSP has a molecular weight of 100 kDa. The polypeptide component contains mostly glutamic and aspartic acids and the polysaccharides contain primarily alpha-1,4 and beta-1,3 glucosidic linkages. 2 , 3 , 4

Uses and Pharmacology

Clinical research with PSK began around 1970 and has focused on its immunotherapeutic efficacy in stomach, colorectal, esophageal, nasopharyngeal, lung, and breast cancers. Overall, the polysaccharides in PSK reportedly increase gamma-interferon production, interleukin-2 production, and T-cell proliferation, therefore improving immune system functioning. Other studies have focused on the antimicrobial, antiviral, and antioxidant properties of PSK. 1

Immune system stimulant
Animal data

Research reveals little or not information regarding immune system stimulants with the use of this product.

Clinical data

A multicentered, randomized clinical trial of 262 gastric cancer patients in Japan resulted in PSK improving the 5-year disease-free rate (p = 0.047) and 5-year survival rate ( P = 0.044) when combined as an adjuvant treatment with standard chemotherapy in patients after curative gastrectomy. 5 , 6 Another clinical study of 579 patients followed for 5 years also supports the use of PSK as an adjuvant immunochemotherapeutic agent for patients who have had curative gastric resection. 7 , 8 Meta-analysis of clinical trials provide evidence of a survival benefit for stage I gastric cancer with PSK. 9 , 10

A retrospective study of 185 patients with non-small cell lung cancer at stages I through III supports the use of PSK as adjuvant treatment after radiotherapy. The 5-year survival rates of patients were statistically significant. 11

Two randomized clinical trials found PSK useful as a maintenance therapy for patients following curative surgical operations for colorectal cancer. In both trials, the survival rate of patients was significantly increased ( P < 0.05) probably because of increased immune system response induced by PSK. 12 , 13

An in vitro study with PSP demonstrated antiviral activity against human immunodeficiency virus type 1 infection (HIV-1). The mechanism of action is postulated to include PSK interfering with the binding of HIV-1 to its cellular target. 14 Other in vitro studies in mice suggest a protective effect of PSK against Candida infection mainly through TNF-alpha activity. 15

There are several review articles on PSK as a cancer chemo-preventative agent. The effect is postulated to include induction of immunomodulatory cytokines and cytokine receptors as well as antioxidant activity. 16 , 17 , 18 , 19

Dosage

There is no recent clinical evidence to support specific dosage of turkey tail.

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

None well documented.

Adverse Reactions

Adverse effects observed in patients include diarrhea, darkened stools, and darkened nail pigmentation. PSK is considered to be very well tolerated by patients. 1 Additional scientific studies are needed to determine a profile of potential serious side effects.

Toxicology

Research reveals little or no information regarding toxicology with the use of this product.

Bibliography

1. Kidd PM. The use of mushroom glucans and proteoglycans in cancer treatment. Altern Med Rev . 2000;5:4-27.
2. Tsukagoshi S, Hashimoto Y, Fujii G, Kobayashi H, Nomoto K, Orita K. Krestin (PSK). Cancer Treat Rev . 1984;11:131-155.
3. Ng TB. A review of research on the protein-bound polysaccharide (polysaccharopeptide, PSP) from the mushroom Coriolus versicolor (Basidiomycetes: Polyporaceae). Gen Pharmacol . 1998;30:1-4.
4. Kobayashi H, Matsunaga K, Oguchi Y. Antimetastatic effects of PSK (Krestin), a protein-bound polysaccharide obtained from basidiomycetes: an overview. Cancer Epidemiol Biomarkers Prev . 1995;4:275-281.
5. Nakazato H, Koike A, Saji S, Ogawa N, Sakamoto J. Efficacy of immunochemotherapy as adjuvant treatment after curative resection of gastric cancer. Study Group of Immunochemotherapy with PSK for Gastric Cancer. Lancet . 1994;343:1122-1126.
6. Fukushima M. Adjuvant therapy of gastric cancer: the Japanese experience. Semin Oncol . 1996;23:369-378.
7. Niimoto M, Hattori T, Tamada R, Sugimachi K, Inokuchi K, Ogawa N. 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;18:681-686.
8. Iguchi C, Nio Y, Takeda H, et al. Plant polysaccharide PSK: cytostatic effects on growth and invasion; modulating effect on the expression of HLA and adhesion molecules on human gastric and colonic tumor cell surface. Anticancer Res . 2001;21:1007-1013.
9. Kim R, Yoshida K, Toge T. Current status and future perspectives on chemotherapy in patients with gastric cancer: can the clinical data from Japan lead to a standard international therapy? [in Japanese]. Nippon Geka Gakkai Zasshi . 2001;102:770-777.
10. Ogoshi K, Kondoh Y, Tajima T, Mitomi T. Effect of PSK on cell-mediated immune status in the patients of stomach cancer [in Japanese]. Gan To Kagaku Ryoho . 1983;10:811-817.
11. Hayakawa K, Mitsuhashi N, Saito Y, et al. Effect of krestin (PSK) as adjuvant treatment on the prognosis after radical radiotherapy in patients with non-small cell lung cancer. Anticancer Res . 1993;13:1815-1820.
12. Mitomi T, Tsuchiya S, Iijima N, 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;35:123-130.
13. Torisu M, Hayashi Y, Ishimitsu T, 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;31:261-268.
14. Collins RA, Ng TB. Polysaccharopeptide from Coriolus versicolor has potential for use against human immunodeficiency virus type 1 infection. Life Sci . 1997;60:PL383-PL387.
15. Ohmura Y, Matsunaga K, Motokawa I, Sakurai K, Ando T. Protective effects of a protein-bound polysaccharide, PSK, on Candida albicans infection in mice via tumor necrosis factor-alpha induction. Int Immunopharmacol . 2001;1:1797-1811.
16. Kobayashi H, Matsunaga K, Fujii M. PSK as a chemopreventive agent. Cancer Epidemiol Biomarkers Prev . 1993;2:271-276.
17. Garcia-Lora A, Pedrinaci S, Garrido F. Protein-bound polysaccharide K and interleukin-2 regulate different nuclear transcription factors in the NKL human natural killer cell line. Cancer Immunol Immunother . 2001;50:191-198.
18. Ooi VE, Liu F. Immunomodulation and anti-cancer activity of polysaccharide-protein complexes. Curr Med Chem . 2000;7:715-729.
19. Yang MM, Chen Z, Kwok JS. The anti-tumor effect of a small polypeptide from Coriolus versicolor (SPCV). Am J Chin Med . 1992;20:221-232.

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