Table 1 Pharmacodynamic interactions between medicinal mushrooms and cytotoxic drugs in clinical studies
Drugs | Interactions with Lingzhi | Interactions with Yunzhi |
|---|---|---|
5-FU | Increase in clinical efficacy [19, 52, 59, 76], survival time [19] and quality of life [52, 59] Better symptomatic relief [65, 139], less adverse effects (gastrointestinal, stomatitis) [19, 59] Less decrease in WBC [19, 52, 59], including T cells (CD4+, CD4+/CD8+ ratio) [76, 134], NK cells [52, 134], platelets [59], hemoglobin [52] Decrease level of miR-21, endoglin, TGF-β1 and VEGF in tumor tissue [76] | Increase in survival [22,23,24,25,26,27,28,29,30], reduce recurrence [25] and quality of life [60] Less decrease in WBC, hemoglobin, platelets [136,137,138] Increase in CD3+, CD4+, CD4+/CD8+, decrease in CD8+ T cells [60, 136, 138,139,140], increase in NK cell activity [23, 60, 136, 139, 140], LBT [138], IL-2 [136] Reduce adverse effects (fatigue, nausea/vomiting) [136] |
Capecitabine | Increase in disease control rate and quality of life [53] | Improve disease progression, survival and quality of life [48] Reduce adverse effects (BMS, mucositis, hand-foot syndrome, diarrhea) [48] |
Carboplatin | No studies available | Increase in efficacy, quality of life [49, 62], survival, and reduce metastasis [49] Better symptomatic relief [49] and relieve WBC decrease [49, 62] Increase in CD3+, CD4+ and decrease in CD8+ T cells [49, 62] Reduction in tumor cell markers and invasive cell factors, such as VEGF, MMP-9, CEA, sMICA [62] |
Cisplatin | Increase in clinical efficacy [20, 21, 52, 54,55,56, 76,77,78], survival [20] and quality of life [21, 52, 54,55,56,57,58] Reduce BMS [54, 56, 57, 77, 78] (increase in RBC [54], WBC [21, 52, 54, 56, 57], NK cells [52, 55], hemoglobin [52, 54], platelets [54, 56]), less decrease in CD3+, CD4+ T cells, CD4+/CD8+, less increase in CD8+ [20, 54, 55, 76, 77, 133] Better symptomatic relief [20, 21, 56] and less adverse effects (gastrointestinal, nausea/vomiting, anemia, renal damage, ALT increase) [56, 77, 78] Decrease level of miR-21, endoglin, TGF-β1 and VEGF in tumor tissue [76] | Increase in clinical efficacy [49, 79], increase in survival and lower metastasis [49] Increase in quality of life [49, 60] and better symptomatic relief [49, 141] Elevate CD3+, CD4+, CD4+/CD8+ [49, 60, 141, 142], NK cell activity [60, 141], immunoglobulin production [79], IL production [142] Reduce side effects (peripheral neuropathy, decrease in WBC) [143] Less weight loss [141] |
Cyclophosphamide | No studies available | Increase in clinical efficacy and survival, lower metastasis [49] Increase quality of life [49, 60], better symptomatic relief [49], increase appetite [144] Less decrease in WBC, platelets [137, 138, 144], increase CD3+, CD4+, CD4+/CD8+, decrease CD8+ T cells, increase NK cells, LBT [49, 60, 138, 142], IL-2 production [142] Reduce sister chromatid exchange frequency [172] |
Doxorubicin | Increase in efficacy and survival time [19] Better symptomatic relief [134], and less adverse effects (nausea, vomiting, diarrhea) [19] Less decrease in WBC [19], including T cells and NK cells [134] | Increase in survival [31, 49], efficacy [49, 80], quality of life [49, 60], reduce metastasis [49] Better symptomatic relief [49] and increase appetite [144] Relieve decrease in WBC (including T cells, NK cells) [60, 80, 144], platelet and hemoglobin [80, 140, 142, 144]. Increase in CD3+, CD4+, CD4+/CD8+ and decrease in CD8+ T cells [49, 60, 80, 140], reduce inhibition on IL-2 production [142] |
Etoposide | No studies available | Increase in efficacy [49, 79], survival, quality of life and lower metastasis [49] Better symptomatic relief [49] Less decrease in WBC (including CD3+ T cells) [49, 68] and increase in immunoglobulin production [79] |
Gemcitabine | Increase in efficacy and quality of life [21, 56] Better symptomatic relief [21, 56] and less adverse effects (anemia, gastrointestinal, nausea/vomiting, increase in ALT, renal damage) [56] | No studies available |
Leucovorin | Increase in efficacy [52, 59] and quality of life [52, 59] Less reduction in WBC [52, 59], NK cells [52], platelets [59], hemoglobin [52] Better symptomatic relief [59], reduce adverse events (gastrointestinal, nausea/vomiting, stomatitis) [59] | No benefits in survival [51] |
Mercaptopurine | No studies available | Prolongation of complete remission and survival [50] Increase cell-mediated immunity [50] |
Methotrexate | No studies available | Less decrease in WBC and platelet [137, 138] Less decrease in CD3+, CD4+, CD4+/CD8+ and LBT and greater decrease in CD8+ for PSK and selenium Yunzhi formulation, but not PSP [137, 138] |
Mitomycin | Increase in efficacy and survival [19, 20] Better symptomatic relief [20, 134] and less adverse effects (nausea/vomiting, diarrhea) [19] | Increase in survival [24, 28, 31, 33,34,35,36,37], quality of life [60] and better symptomatic relief [141] Less decrease in WBC [136, 143], hemoglobin and platelets [136] Increase in CD3+, CD4+ T cells, CD4+/CD8+ ratio, NK cell activity and IL production, decrease in CD8+ T cells [60, 136, 139,140,141] Reduce adverse effects (peripheral neuropathy [143], nausea/vomiting, fatigue [136]) and less weight loss [141] |
Oxaliplatin | Increase in clinical efficacy [53, 59], quality of life [53, 59] and better symptomatic relief [59] Relieve reduction in WBC [53, 59, 132] and platelets [59] Reduce side effects (gastrointestinal, nausea/vomiting, stomatitis) [53, 59] | Improve disease progression, survival and quality of life [48] Reduce adverse effects (BMS, mucositis, hand-foot syndrome, diarrhea) [48] |
Paclitaxel | Increase in clinical efficacy [55, 56, 59, 77, 78], quality of life [55, 56, 58, 59] Reduce BMS (less anemia, reduction in WBC—T cells, NK cells, platelets) [55, 56, 59, 77, 78], increase in CD3+, CD4+, CD4+/CD8+, decrease in CD8+ [55, 77, 78, 133] Better symptomatic relief [56, 59] and reduce side effects (gastrointestinal, nausea, vomiting, stomatitis, renal damage, increase in ALT) [56, 59, 77, 78] | Increase in efficacy [62] and quality of life [62] Relieve decrease in CD3+, CD4+ T cells and increase in CD8+ T cells [62] Reduction in tumor cell markers and invasive cell factors, such as VEGF, MMP-9, CEA, sMICA [62] |
UFT/Tegafur | No studies available | Increase in survival [23, 27, 29,30,31,32, 38,39,40,41,42,43,44,45,46,47] and reduce recurrence [38, 42, 44] Increase quality of life [61] and better symptomatic relief [32] Reduce adverse effects (appetite loss, nausea/vomiting, gastrointestinal) [61] Recover immunosuppression [47, 135], increase NK cells [23, 38] Decrease in suppressor T cells and increase cytotoxic T cells [38]. Reduction in CD57+ T cell [39]. Reduce T cell apoptosis and caspase 3 activity through downregulating Bax expression in T cells [170] |
Vincristine | Increase in efficacy and survival [20], better symptomatic relief [20] increase in T cells count (CD4, CD4/CD8) [20] | Better symptomatic relief [141] and increase appetite [144] Less reduction in WBC (CD3+, CD4+ T cells, NK cells) [141, 144], platelets [144] |
Vinorelbine | Increase quality of life [57] and reduce BMS (less decrease in WBC) [57] | No studies available |