Ganoderma lucidum spore induced CA72-4 elevation in gastrointestinal cancer: a five-case report

Potentialities of Ganoderma lucidum extracts as functional ingredients in food formulation

Owing to the recognized therapeutic characteristics of G. lucidum, it is one of the most extensively researched mushrooms as a chemopreventive agent and as a functional food. It is a known wood-degrading basidiomycete possessing numerous pharmacological functions and is termed a natural pharmacy store due to its rich number of active compounds which have proved to portray numerous therapeutic properties. This current review highlights studies on the potentialities of G. lucidum extracts as functional ingredients on organoleptic and nutritional properties of food products (e.g., dairy, wine, beverage, bakery, meat, and other products). In addition, the study delved into various aspects of encapsulated G. lucidum extracts, their morphological and rheological characteristics, prebiotic and immunomodulatory importance, the effects on apoptosis, autophagy, cancer therapy, inflammatory responses, oxidative stress, antioxidant activities, and safety concerns. These findings have significant implications for the development of new products in the food and pharmaceutical industries. On the other hand, the various active compounds extracted from G. lucidum exhibited no toxic or adverse effects, and the appeal for it as a dietary food, natural remedy, and health-fortifying food is drastically increasing as well as attracting the interest of both the industrial and scientific communities. Furthermore, the formation of functional foods based on G. lucidum appears to have actual promise and exciting prospects in nutrition, food, and pharmaceutical sciences.

Pharmacological Activities and Safety of Ganoderma lucidum Spores: A Systematic Review

Ganoderma lucidum is traditionally used to prevent and treat some diseases such as liver disorders, hypertension, insomnia, diabetes, and cancer. G. lucidum spore extracts are also reported to share similar bioactivities as extracts from its other parts. However, there is no systematic review that elucidates its pharmacological effect. Our aim is to comprehensively summarise current evidence of G. lucidum spore extracts to clarify its benefits to be applied in further studies. We searched five primary databases: PubMed, Virtual Health Library (VHL), Global Health Library (GHL), System for Information on Grey Literature in Europe (SIGLE), and Google Scholar on September 13, 2021. Articles were selected according to inclusion and exclusion criteria. A manual search was applied to find more relevant articles. Ninety studies that reported the pharmacological effects and/or safety of G. lucidum spores were included in this review. The review found that G. lucidum spore extracts showed quite similar effects as other parts of this medicinal plant including anti-tumor, anti-inflammatory, antioxidant effects, and immunomodulation. G. lucidum sporoderm-broken extract demonstrated higher efficiency than unbroken spore extract. G. lucidum extracts also showed their effects on some genes responsible for the body's metabolism, which implied the benefits in metabolic diseases. The safety of G. lucidum should be investigated in depth as high doses of the extract could increase levels of cancer antigen (CA)72-4, despite no harmful effect shown on body organs. Generally, there is a lot of potential in the studies of compounds with pharmacological effects and new treatments. Sporoderm breaking technique could contribute to the production of extracts with more effective prevention and treatment of diseases. High doses of G. lucidum spore extract should be used with caution as there was a concern about the increase in CA.

Elevated serum CA72-4 predicts gout flares during urate lowering therapy initiation: a prospective cohort study

OBJECTIVE

Gout flares during urate-lowering therapy (ULT) initiation are common, but predictors of these flares are poorly understood. The aim of this study was to determine whether serum CA72-4 is an independent predictor for gout flares during ULT initiation.

METHODS

A prospective cohort study was conducted between March 2021 and January 2022. Men with gout, at least one gout flare in the past year, and at least three serum CA72-4 measurements in the previous six months were enrolled. Participants were grouped according to their highest recorded serum CA72-4 levels (above or within the normal range). All participants took oral febuxostat 20 mg daily without flare prophylaxis therapy, and attended face-to-face visits every four weeks until 24 weeks. The incidence of gout flare was compared between the two groups. Backward stepwise logistic regression analyses were used to identify risk factors associated with flares. Receiver operating characteristic curve analysis was used to evaluate prediction efficacy.

RESULTS

A total of 193 completed the study (79 with high CA72-4; 114 with normal CA72-4). The cumulative incidence of at least one gout flare was 48.1% (62.1% in the high CA72-4 group, 38.4% in the normal CA72-4 group, P = 0.001), and recurrent (≥2) flares was 33.0% (47.1% in the high CA72-4 group, 23.2% in the normal CA72-4, P < 0.001). High CA72-4, disease duration, intra-articular tophus size, glucose, high-density lipoprotein-cholesterol and ESR were independent risk factors for gout flares. Serum CA72-4 alone predicted recurrent flares with an area under the curve of 0.63 (95% CI = 0.54, 0.71), and 0.78 (95% CI = 0.71, 0.85) when combined with other independent variables.

CONCLUSION

High serum CA72-4 predicts the risk of gout flares during ULT initiation.

TRIAL REGISTRATION

ChiCTR; https://www.chictr.org.cn/; ChiCTR2100043573.

Therapeutic potential and nutritional significance of Ganoderma lucidum - a comprehensive review from 2010 to 2022

With a long history in traditional Asian medicine, Ganoderma lucidum (G. lucidum) is a mushroom species suggested to improve health and extend life. Its medicinal reputation has merited it with numerous attributes and titles, and it is evidenced to be effective in the prevention and treatment of various metabolic disorders owing to its unique source of bioactive metabolites, primarily polysaccharides, triterpenoids, and polyphenols, attributed with antioxidant, anti-inflammatory, anticancer, hepatoprotective, antidiabetic activities, etc. These unique potential pharmaceutical properties have led to its demand as an important resource of nutrient supplements in the food industry. It is reported that the variety of therapeutic/pharmacological properties was mainly due to its extensive prebiotic and immunomodulatory functions. All literature summarized in this study was collated based on a systematic review of electronic libraries (PubMed, Scopus databases, Web of Science Core Collection, and Google Scholar) from 2010-2022. This review presents an updated and comprehensive summary of the studies on the immunomodulatory therapies and nutritional significance of G. lucidum, with the focus on recent advances in defining its immunobiological mechanisms and the possible applications in the food and pharmaceutical industries for the prevention and management of chronic diseases. In addition, toxicological evidence and the adoption of standard pharmaceutical methods for the safety assessment, quality assurance, and efficacy testing of G. lucidum-derived compounds will be the gateway to bringing them into health establishments.

Ganoderma lucidum (Reishi) an edible mushroom; a comprehensive and critical review of its nutritional, cosmeceutical, mycochemical, pharmacological, clinical, and toxicological properties

Reishi owes an exceptional value in nutritional, cosmeceutical, and medical treatments; however, none of the studies has provided its future-driven critical assessment. This study documents an up-to-date review (2015-2020, wherever applicable) and provide valuable insights (preclinical and clinical evidence-based) with comprehensive and critical assessments. Various databases 'Google scholar', 'Web of Science', 'ScienceDirect', 'PubMed', 'Springer Link', books, theses, and library resources were used. The taxonomic chaos of G. lucidum and its related species was discussed in detail with solution-oriented emphasis. Reishi contains polysaccharides (α/β-D-glucans), alkaloids, triterpenoids (ganoderic acids, ganoderenic acids, ganoderol, ganoderiol, lucidenic acids), sterols/ergosterol, proteins (LZ-8, LZ-9), nucleosides (adenosine, inosine, uridine), and nucleotides (guanine, adenine). Some active drugs are explored at an optimum level to make them potential drug candidates. The pharmacological potential was observed in diabetes, inflammation, epilepsy, neurodegeneration, cancer, anxiety, sedation, cardiac diseases, depression, hepatic diseases, and immune disorders; however, most of the studies are preclinical with a number of drawbacks. In particular, quality clinical data are intensely needed to support pharmacological activities for human use. The presence of numerous micro-, macro, and trace elements imparts an essential nutritional and cosmeceutical value to Reishi, and various marketed products are available already, but the clinical studies regarding safety and efficacy, interactions with foods/drinks, chronic use, teratogenicity, mutagenicity, and genotoxicity are missing for Reishi. Reishi possesses many valuable pharmacological activities, and the number of patents and clinical trials is increasing for Reishi. Yet, a gap in research exists for Reishi, which is discussed in detail in the forthcoming sections.

Practical Application of "About Herbs" Website: Herbs and Dietary Supplement Use in Oncology Settings

The Integrative Medicine Service at Memorial Sloan Kettering Cancer Center developed and maintains About Herbs (www.aboutherbs.com), which provides summaries of research data including purported uses, adverse effects, and herb-drug interactions for about 284 dietary supplements. Using Google Analytics, we found the website registered more than 26,317,000 hits since November 2002. The 10 most searched-for herbs/supplements of 2018 are chaga mushroom, turmeric, ashwagandha, reishi mushroom, graviola, Active Hexose-Correlated Compound, boswellia, dandelion, green tea, and Coriolus versicolor. Here we discuss their safety, herb-drug interactions, and appropriate uses in the oncology setting, based on literature searches in PubMed. Over the past 16 years, the evidence for use of these supplements is based mostly on preclinical findings, with few well-designed studies and limited trials conducted in cancer patients. It is important to familiarize health care professionals about popular supplements, so patients can be informed to make decisions that maximize benefits and minimize risks.

An abnormal elevation of serum CA72-4 rather than other tumor markers can be caused by use of colchicine

OBJECTIVE

The aim of this study is to investigate the effect of colchicine and other medications for gout treatment on serum CA72-4 and other tumor markers including alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), CA19-9, CYFRA21-1, neuron specific enolase (NSE), prostate-specific antigen (PSA).

METHODS

A total of 143 gout patients and 40 healthy individuals were randomly recruited. Of these patients, 38 did not receive any treatment; 42 received colchicines; 62 received other medications for gout treatment (Etoricoxib, glucocorticoid, Benzbromarone, allopurinol, Febuxostat, nonsteroidal antiinflammatory drugs or their combinations). Of 42 gout patients receiving colchicines, 23 were followed up. All tumor markers were detected by electrochemiluminescence immunoassays. Statistical analysis was performed by SPSS 17.0 software.

RESULTS

The serum CA72-4 level was significantly higher in gout patients receiving colchicine than that in healthy control and gout patients without any treatment or who were receiving other treatments (P<0.001). There was no significant difference regarding other tumor markers among the various groups. All patients receiving colchicine, but no healthy individuals, patients with no treatment, or those receiving other medications had increased serum CA72-4 levels. Additionally, none or only a few of the subjects had increased AFP, CA19-9, CYFRA21-1, NSE, CEA, or PSA, while the proportion was not significantly different among various groups.

CONCLUSIONS

Colchicine can cause abnormal elevation of serum CA72-4, but other medications have no effect on serum CA72-4. Furthermore, serum CA72-4 gradually increased and decreased after the initiation and cessation of colchicine therapy, respectively. Other tumor markers are not influenced by colchicine and other medications.

Ganoderma lucidum for cancer treatment: we are close but still not there

The medicinal fungus Ganoderma lucidum has been used in traditional Chinese medicine for millennia to improve health and promote longevity. The idea of using G. lucidum for cancer treatment is based on numerous laboratory and preclinical studies with cancer and immune cells as well as animal models demonstrating various biological activities in vitro and in vivo. For example, G. lucidum possesses cytotoxic, cytostatic, antimetastatic, anti-inflammatory, and immunomodulating activities. Limited clinical studies, including case reports and randomized controlled trials, suggest G. lucidum as an alternative adjunct therapy for stimulating the immune system in cancer patients. To confirm the efficacy of G. lucidum in cancer treatment, systematic translational research programs should be started worldwide. In addition, only standardized preclinically evaluated, biologically active G. lucidum extracts should be used in alternative treatments. This approach will lead to the development of standardized G. lucidum preparations with specific chemical fingerprint-associated anticancer activities.