Memorial Sloan-Kettering & Coriolus Versicolor

Here is what the New york Institution Memorial Sloan-Kettering has to say about Coriolus.

Scientific Name
Coriolus versicolor, Trametes versicolor, Polyporus versicolor, Polystictus versicolor

Common Name
PSK, PSP, VPS, Trametes versicolor, Turkey Tai, Yun Zhi, Kawaratake, Krestin

Brand Name

Clinical Summary
Coriolus versicolor is a mushroom of the Basidiomycetes class. It was used initially in Traditional Chinese medicine as a tonic, but 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. When used as an adjuvant, PSK appears to improve survival rates in patients with gastric () 1 () 2 and colorectal () 3 () 4 () 5 cancers. Other Coriolus extracts, such as polysaccharide-peptide (PSP) and VPS, are available as dietary supplements. When used in conjunction with chemotherapy, PSP may benefit patients with advanced non-small cell lung cancer () 7. Other clinical studies using Coriolus extract alone or in combination with other botanicals also suggest positive immunomodulatory effects () 8 () 9. However, studies on breast cancer () 10, hepatocellular carcinoma () 11, and leukemia () 12 produced mixed results. A hot water extract of Coriolus, VPS, was found to enhance development of large intestinal tumors in mice () 21. 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 prevention
˜  Cancer treatment
˜  Chemotherapy side effects
˜  Hepatitis
˜  Herpes
˜  Immunostimulation
˜  Infections
˜  Radiation therapy side effects
˜  Strength and stamina

Proteoglycans: Polysaccharide-K (PSK), a beta-1,4-glucan (isolated from the CM-101 strain), polysaccharide-P (PSP), isolated from the COV-1 strain

Mechanism of Action
Coriolus versicolor is thought to be a biological response modifier. The proteoglycan constituents are thought to be responsible for its immunostimulant and anticancer activities. Many different mechanisms of action have been proposed. PSK induces cytokine expression in human peripheral blood mononuclear cells in vitro. TNF-alpha and IL-8 gene expression are significantly induced after PSK administration in healthy volunteers and gastric cancer patients, although individual response varies () 13.   Several animal studies report of synergism between PSK and biologic therapies, including a concanavalin A-bound L1210 vaccine and the IgG2a monoclonal antibody against human colon cancer cells () 14. PSP induces cytokine production and T-cell proliferation and prevents immune suppression due to cyclophosphamide in animal models. Peritoneal macrophages isolated from mice that were fed PSP show increased production of reactive nitrogen intermediates, superoxide anions, and tumor necrosis factor () 15. PSP selectively induced apoptosis of human promyelocytic leukemia HL-60 cells () 16. In vitro, PSP inhibits the interaction between HIV-1 gp120 and CD4 receptor, HIV-1 transcriptase activity, and glycohydrolase enzyme activity associated with viral glycosylation () 17.   PSP also shows analgesic activity in mouse models () 18. Non-small cell lung cancer patients have increased leukocyte and neutrophil counts, and increased serum IgG and IgM after consumption of PSP () 7. Healthy volunteers as well as breast cancer
patients who used a formula containing Coriolus and Salvia were found to have elevated counts of T-helper lymphocytes (CD4+), high ratio of CD4+/CD8+), and elevated absolute counts of B-lymphocytes () 8 () 9.

Absorption Animal studies with radiolabeled PSK show that it is partially decomposed to small molecular products in the digestive tract. The full molecular spectrum of labeled PSK is absorbed within 24 hours following oral administration in mice. Peak plasma levels of low molecular weight substances occur at 0.5-1 h in rats and 1-2 h in rabbits, while molecules the size of PSK appear in serum after 4, 10, and 24 h. Distribution Radiolabeled PSK or its metabolites are detected in the digestive tract, bone marrow, salivary glands, thymus, adrenal gland, brain, liver, spleen, pancreas, and tumor tissue in sarcoma-bearing mice. Activity remains high longest in the liver and bone marrow. Excretion Approximately 70% of radiolabeled PSK is excreted in expired air, 20% in feces, 10% in urine, and 0.8% in bile. Approximately 86% is excreted within 24 h. () 4

Adverse Reactions
Adverse reactions from Coriolus are rare. However, passage of dark colored stools (not originating from occult blood) () 19, darkening of fingernails () 20, and low-grade hematological and gastrointestinal toxicities have been reported when used in conjunction with chemotherapy agents () 3. However, such effects may be caused by the chemo agents themselves.

Herb-Drug Interactions
None known

Lab Interactions
None known
Literature Summary and Critique
Wong CK, et al. Immunomodulatory effects of Yun Zhi and Danshen capsules in health subjects—a randomized, double-blind, placebo-controlled, crossover study. Int Immunopharmacology 2004;4:201-211. One hundred healthy subjects were given a combination of Yun Zhi (Coriolus versicolor, 50 mg/kg body weight) and Danshen (Salvia miltiorrhiza, 20mg/kg body weight) capsules or placebo for four months. After a 2-month washout period, subjects who received Coriolus and Salvia capsules were given placebo while those on placebo received Coriolus and Salvia capsules for another four months. Researchers used flow cytometry and cDNA expression arrays to assess immune functions and gene expression. Results indicated that oral consumption of Coriolus-Salvia capsules significantly increased the peripheral blood mononuclear cell (PBMC) gene expression of interleukin (IL-2) receptor, increased the percentage and absolute counts of T helper cell and ratio of Thelper/Tsuppressor cells, and also the production of interferon-gamma from PBMC. Since T helper cells participate in both cell mediated and humoral immunities, Coriolus-Salvia combination may be used to enhance immune function. Studies are being conducted in cancer patients to determine the immunomodulating potential of these agents.
Nakazato H, et al. Efficacy of immunochemotherapy as adjuvant treatment after curative resection of gastric cancer. Lancet 1994;343:1122-6.
A randomized, controlled, multicenter evaluation of chemotherapy with or without PSK in 262 patients after curative gastrectomy. Chemotherapy consisted of intravenous mitomycin C on postoperative days 1 and 7 plus 150 mg/d oral fluorouracil. The PSK group received 3 g/d oral PSK for 4 weeks alternating with 4 weeks fluorouracil, while control patients received only fluorouracil alternated with 4 weeks without treatment. Ten courses were given to both groups. PSK patients experienced a greater 5-year disease-free rate (70.7% vs. 59.4%) and 5-year survival rate (73% vs 60%) than the control group. Because eligibility criteria included a positive PPD, this trial only represents the benefits of PSK in patients with a preserved immune response.

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. Tsang KW, et al. Coriolus versicolor polysaccharide peptide slows progression of advanced non-small cell lung cancer. Respir Med 2003; 97(6): 618-24.
8. 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.
9. 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.
10. Iino Y, et al. Immunochemotherapies versus chemotherapy as adjuvant treatment after curative resection of operable breast cancer. Anticancer Res 1995; 15(6B): 2907-11.
11. Suto T, et al. Clinical study of biological response modifiers as maintenance therapy for hepatocellular carcinoma. Cancer Chemother Pharmacol 1994; 33: S145-8.
12. 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.
13. 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.
14. Tsukagoshi S, et al. Krestin (PSK). Cancer Treat Rev 1984; 11(2): 131-55.
15. Liu WK, et al. Activation of peritoneal macrophages by polysaccharopeptide from the mushroom, Coriolus versicolor. Immunopharmacology 1993; 26(2): 139-46.
16. 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.
17. 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.
18. 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.
19. Shiu WCT, et al. A Clinical Study of PSP on Peripheral Blood Counts during Chemotherapy. Phytotherapy Research 1992; (6): 217-218.
20. Kidd, PM. The use of mushroom glucans and proteoglycans in cancer treatment. Altern Med Rev 2000 5(1): 4-27.
21. 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