Food as medicine, turkey tail mushroom, trametes versicolor, bioactive compounds, PSK, PSP, bioavailability, pharmacological actions, immuno-modulation, anti-cancer, toxicity

1. FOOD AS MEDICINE:
TURKEY TAIL MUSHROOM,
TRAMETES VERSICOLOR
By
Kevin KF Ng, MD, PhD
Former Professor of Medicine
Division of Clinical Pharmacology
University of Miami, Miami, FL, USA
Email: kevinng68@gmail.com
A slide presentation for HealthCare Provider Seminar Feb 2019

2. Lecture outline
▪ Name, history, scientific classification
▪ Bioactive compounds: PSK, PSP
▪ Pharmacology: bioavailability, actions, toxicity
▪ Health benefits
▪ Clinical studies, meta-analysis
▪ Commercial products: supplements and dosage
▪ Summary

3. What is a Turkey Tail Mushroom ?
(Trametes versicolor formerly Coriolus versicolor)
▪ It is a colorful mushroom that resembles the color of the turkey tail.
▪ In Latin, Trametes means thin and Versicolor means many colors.
▪ In Chinese medicine, it is referred to as yun zhi.
▪ In Japan, it is called kawaratake.
▪ It is a medicinal mushroom.

4. Milestons in the scientific studies of Turkey Tail Muschroom
(Trametes versicolor)
Adapted from http://mushroomstudies.co/history/

5. Number of publications on Turkey Tail mushroom
(Trametes versicolor) in PubMed from 1970 to 2018
https://www.ncbi.nlm.nih.gov/pubmed/?term=Trametes+versicolor

6. Scientific classification of turkey tail mushroom
(Trametes versicolor)

7. Life cycle of a mushroom
http://www.permaville.com/book/soil/

8. Anatomy of a turkey tail mushroom (Trametes versicolor)

9. Major bioactive compounds in turkey tail extracts

10. Bioactive compounds in Turkey tail mushroom
(Trametes versicolor)
▪ Compound 1, Ergostero
▪ Compound 2, Ergosterol Peroxide
▪ Compound 3, Trilinolein
▪ Compound 4, Ergosta-7,22-dien-3β-ol
▪ Compound 5, 4-Isobutoxyphenyl Palmitate
▪ Compound 6, N-D-2′-Hydroxyheptanoic-1-O-β-D-
Glucopyranosyl-9-Methyl-4,8-Sphinga-Dienine
▪ Compound 7, 3β-Linoleyloxyergosta-7,22-Diene
▪ Compound 8, 3β-Linoleyloxyergosta-7-ene
▪ Compound 9, Betulinic Acid
▪ Compound 10, Betulin
Adapted from International Journal of Medicinal Mushrooms, 17(3): 255–265 (2015

11. What is a beta-glucan?
▪ A polysaccharide is a compound made of many glucose molecules linked together.
▪ The molecular structure (linkage) of beta glucan consists of a main and side chains.
▪ The compound β 1-3 (main chain) and β 1-6 (side chain) is the most effective immune
booster.

12. What have been shown by the scientific studies on
turkey tail mushroom (Trametes versicolor) ?
▪ Turkey tail mushroom is an edible and medicinal mushroom.
▪ It has been used as medicine for more than 5000 years.
▪ Its medicinal properties were investigated scientifically since 1960s.
▪ Two water soluble polysaccharides PSK and PSP had been studied
extensively as immune modulator and anti-cancer agents.
▪ Problems in assays of polysaccharides in general and β-glucans in particular
made it difficult to study the bioavailability and fate of the bioactive compounds.
▪ However, clinical observations over the last 50 years have shown the beneficial
effects of turkey tail mushroom for the immune system and cancer.

13. Bioactive compounds and their functions in turkey tail mushroom
(Trametes versicolor)

14. Structures of polysaccharides (PSK. PSP)in turkey tail mushrooms
▪ 1960 : PSK was discovered in Japan ▪ 1983 : PSP was discovered in China
PSP with β1-3 main chain
and side 1-6 linkage
PSK 1-4 backbone
With 1-3/1-6 branching β-glucan
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5592279/https://cdn.intechopen.com/pdfs/62477.pdf

15. Some properties of PSK, PSP, TVC
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5592279/

16. Immuno-modulatory actions of
PSK and PSP of turkey tail mushroom
PSK ad PCP stimulate the immune system by enhancing the
• actions of white blood cells: ▪ Neutrophils
▪ Macrophages
▪ NK cells
• activation of lymphocytes: ▪T cells
▪ B cells
• suppressing the release of cytokines e.g:
▪ TNF-α
▪ iL-1Ᏸ
Inflammation
Phagocytosis Lysis

17. The human beta-glucan receptor is widely expressed in
immune cells
▪ Monocyte
▪ Macrophage
▪ Dendritic cells
▪ Neutrophils
▪ Eosinophils
▪ B cells
▪ Subpopulation T cells
https://www.ncbi.nlm.nih.gov/pubmed/15816015
β-glucan

18. Mechanism of action of polysaccharide-peptide (PSP).
(2016)
https://www.researchgate.net/publication/310674952

19. Conceptual model for the interaction between β-glucans and receptors of the
innate immune system (macrophages)
Interaction between Dectin-1 and toll-like receptors (TLRs) results in synergistic effects. ROS, reactive oxygen species.
https://www.sciencedirect.com/topics/food-science/glucans

20. Cellular and hormonal effects of β-Glucans on the
immune system
Adapted from Medicina (Kaunas) 2007; 43(8) and
https://jhoonline.biomedcentral.com/articles/10.1186/1756-8722-2-25

21. Effects of Ᏸ-glucans on the Immune System
▪ Removal of dead cells by phagocytosis.
▪ Destruction of cancer cells by lysis.
▪ Generation and release of cytokines.
▪ Communication with immune cells.
▪ Protection from fungi, bacteria and virus.

22. Bioavailability of radiolabeled
polysaccharide-K (PSK)
Oral
intake
Small fraction is
absorbed through
intestine
Radioactivity detected
in bone marrow,
salivary glands, brain,
liver, spleen, pancreas
and tumor in mice &
rabbits within 24 hrs

23. Uptake of Beta 1,3/1,6 Glucan in the intestinal tract
https://www.action-inter.net/beta-1316-glucan-and-the-immune-system.html
23
prebiotics

24. The uptake and fate of
insoluble β-glucan in immune cells
https://openi.nlm.nih.gov/detailedresult.php?img=PMC2704234_1756-8722-2-25-2&req=4
in small intestine

25. Actions of PSK and PSP on immune cells
Cellular immunity response

26. Difference between polysaccharide-K PSK and
polysaccharide-peptide PSP
▪ Both the compounds PSK and PSP come from the mushroom Trametes versicolor,
which is more commonly known as the turkey tails fungus.
▪ The PS in PSK represents polysaccharide and K represents the initial letter of the
name of the company that first manufactured it (Kureha Chemical Industry Co. Ltd,
Japan). The commercial name of the product is Krestin.
▪ PSP is an abbreviation of the name polysaccharide-peptide.
▪ The two compounds are chemically similar, in that they are polysaccharides;
however, the PSP polysaccharides contains arabinose and rhamnose, whereas the
PSK polysaccharides contain only fucose.
http://www.davidmoore.org.uk/Sec04_13.htm

27. Health benefits of turkey tail mushroom (Trametes versicolor)
▪ May prevent oxidative stress
▪ May act as biological response modifier
▪ May act as anti-cancer agent
▪ May act as adjuvant in chemotherapy and radiotherapy
▪ May act as anti-hyperglycemic
▪ May act as prebiotic

28. Side effects and interactions of turkey tail
(Trametes versicolor)
▪ Tiger tail mushroom is possibly safe when taken by mouth.
▪ There is no reported side effects so far.
▪ No serious interaction has been documented.

29. Minimal toxic effects of polysaccharide-peptide (PSP)
▪ LD50 for PSP is 20 g/kg by oral administration in mice.
▪ LD50 for PSP is 300.36 mg/kg by IV injection in mice
▪ 200 times clinical dose in mice did not show toxic effects.
▪ 100 times clinical dose in monkeys did not show toxic effects
http://www.discoverymedicine.com/Yajing-Chang-2/2017/04/coriolus-versicolor-
polysaccharopeptide-as-an-immunotherapeutic-in-china/

30. A safety assessment of Coriolus versicolor biomass
as a food supplement (2016)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4788765/

31. Presence of lead, arsenic and mercury in
some commercial T. versicolor products
https://www.ahc.umn.edu/img/assets/20825/StandishPresentation1-25-08.pdf

32. Comparison of cancer death rates in the general population of
Nagano Prefecture, Japan, with rates among mushroom farm workers
(1972-1986)
http://www.davidmoore.org.uk/Assets/Printed_documents/2002_Smith_etal_Medicinal_Mushrooms_complete.pdf

33. PSP has been used alone or in combination with other drugs in
treating different types of diseases in China in the past 40 years
http://www.discoverymedicine.com/Yajing-Chang-2/2017/04/coriolus-versicolor-polysaccharopeptide-as-an-immunotherapeutic-in-china/

34. Summary of cancer Clinical Trials with turkey tail mushroom
(Trametes versicolor) in Asia
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845472/

35. Clinically significant extension of survival by PSK, in
stomach cancer (2000)
http://europepmc.org/abstract/MED/10696116

36. Polysaccharide K (PSK) and Coriolus versicolor Extracts for Lung Cancer:
A Systematic Review (2015)
▪ Thirty-one reports of 28 studies were included for full review and analysis.
▪ 6 studies were randomized controlled trials,
▪ 5 were nonrandomized controlled trials,
▪ 7 were preclinical studies
▪ 9 of the reports were Japanese language publications.
▪ 15 of 17 preclinical studies supported anticancer effects for PSK through immunomodulation and potentiation of
immune surveillance, as well as through direct tumor inhibiting actions in vivo that resulted in reduced tumor growth and
antimetastatic effects.
▪ Nonrandomized controlled trials showed improvement of various survival measures including median survival and 1-, 2-,
and 5-year survival.
▪ Randomized controlled trials showed benefits on a range of endpoints, including immune parameters and hematological
function, performance status and body weight, tumor-related symptoms such as fatigue and anorexia, as well as
survival.
▪ Although there were conflicting results for impact on some of the tumor-related symptoms and median survival, overall
most randomized controlled trials supported a positive impact for PSK on these endpoints. PSK was safely administered
following and in conjunction with standard radiation and chemotherapy.
https://journals.sagepub.com/doi/full/10.1177/1534735415572883

37. Positive Effects of Oral β-Glucan on Mucositis and Leukopenia
in Colorectal Cancer Patients Receiving Adjuvant FOLFOX-4
Combination Chemotherapy
Leukocytes Neutrophils Platelets
http://journal.waocp.org/article_29133_3c7bc0eb51eef36fba4611caa843e5d3.pdf
FOLFOX-4 =(oxaliplatin, 5-fluorouracil, and folinic acid)

38. Phase 1 Clinical Trial of Turkey tail mushroom (Trametes versicolor)
in Women with Breast Cancer (2012): to be continued
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3369477/

39. Phase 1 Clinical Trial of Turkey tail mushroom (Trametes versicolor)
in Women with Breast Cancer (2012): to be continued
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3369477/

40. Phase 1 Clinical Trial of Trametes versicolor in
Women with Breast Cancer 2012
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3369477/

41. Novel medicinal mushroom blend suppresses growth and
invasiveness of human breast cancer cells (2010)
▪ mushroom mycelia from the species:
1. Agaricus blazei
2. Cordyceps sinensis,
3. Coriolus versicolor
4. Ganoderma lucidum,
5. Grifola frondosa
6. Polyporus umbellatus
7. β-1,3-glucan isolated from the yeast,
Saccharomyces cerevisiae.
Cell proliferation Cell viability
https://www.spandidos-publications.com/ijo/37/6/1529

42. Effects of Turkey Tail Mushroom (Coriolus versicolor) on Survival in
Cancer Patients:
Systematic Review and Meta-Analysis (2012)
Recent Patents on Inflammation & Allergy Drug Discovery 2012, 6, 78-87

43. Evaluation of the efficacy of coriolus versicolor in the
treatment of HPV lesions (LSIL)
http://docs.wixstatic.com/ugd/68c8ed_c42b38e231e946f89d4f459a5faff68e.pdf

44. Turkey tail mushroom (Coriolus versicolor)-based
drugs approved by SFDA in China
http://www.discoverymedicine.com/Yajing-Chang-2/2017/04/coriolus-versicolor-polysaccharopeptide-as-an-immunotherapeutic-in-china/

45. Commercially available turkey tail mushroom
(Trametes versicolor) products
▪ Powder
▪ Tablets
▪ Capsule
▪ Liquid extract
▪ Oral spray

46. Supplement Facts
single mushroom multiple mushrooms

47. Summary
▪ The medicinal properties of turkey tail mushroom (Trametes versicolor) were
tested orally by ShenNong, the father of Chinese Medicine, 5000 years ago.
▪ The isolation of polysaccharide-K (PSK) in the 1960s and polysaccharide-peptide
(PSP) in the 1980s led to an extensive studies on their immuno-modulatory and
anti-cancer properties in Japan, China, and Korea.
▪ Studies on the beneficial effects of turkey tail mushroom had recently begun and
supported by NIH in the United States.
▪ Systematic reports and meta-analysis on the effects of turkey tail mushroom on
cancer confirm the studies in Asia.
▪ However, the chemical analysis, the pharmacokinetics and pharmacodynamics of
the active polysaccharides have yet to be developed and standardized.

48. ANY QUESTION?
Please contact
Kevin KF Ng, MD, PhD
Email: kevinng68@gmail.com