Download PDF
Zeitschrift für Phytotherapie 2025; 46(02): 85-98
DOI: 10.1055/a-2537-2980
Forschung

Die Rolle von Heilpilzen in der Integrativen Onkologie

Ein narratives Review
Michael Jeitler
1   Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, korporatives Mitglied der Freien Universität Berlin und der Humboldt-Universität zu Berlin, Berlin, Deutschland
2   Immanuel Krankenhaus Berlin, Abteilung für Innere und Integrative Medizin, Berlin, Deutschland
3   Institut für Allgemeinmedizin & Interprofessionelle Versorgung, Universitätsklinikum Tübingen, Tübingen, Deutschland
4   Robert Bosch Centrum für Integrative Medizin und Gesundheit, Bosch Health Campus, Stuttgart, Deutschland
,
Christian S. Kessler
1   Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, korporatives Mitglied der Freien Universität Berlin und der Humboldt-Universität zu Berlin, Berlin, Deutschland
5   Charité Competence Center for Traditional and Integrative Medicine (CCCTIM), Charité - Universitätsmedizin Berlin, korporatives Mitglied der Freien Universität Berlin und der Humboldt-Universität zu Berlin, Berlin, Deutschland
› Author Affiliations
› Further Information
    Permissions and Reprints

Zusammenfassung

Hintergrund/Ziel Heilpilze haben eine lange Tradition in der (ost-) asiatischen Medizin und gewinnen zunehmend auch in der westlichen Medizin an Bedeutung. Eine wachsende Anzahl präklinischer Studien weist auf mögliche onkotherapeutische Eigenschaften hin. Dennoch ist die klinische Relevanz von Mykotherapeutika (jenseits von Antibiotika) bislang völlig unzureichend erforscht, sodass ihr potenzieller Nutzen für die medizinische Praxis weiterhin unklar ist. Dieser narrative Review soll einen Überblick über die klinische Evidenz, die Bedeutung und die potenzielle Rolle von Heilpilzen in der Komplementäronkologie geben.

Methoden Es wurden wissenschaftliche Datenbanken nach (randomisierten) kontrollierten klinischen Studien durchsucht, in denen Vollspektrumpräparate aus Heilpilzen bei Krebspatienten während und/oder nach einer konventionellen onkologischen Behandlung untersucht wurden. 9 Studien erfüllten die Einschlusskriterien (8 randomisierte kontrollierte Studien, 1 kontrollierte klinische Studie). Bei den untersuchten Heilpilzen handelte es sich um Agaricus sylvaticus (2 Studien), Agaricus blazei (2 Studien), Antrodia cinnamomea (1 Studie), Trametes versicolor (1 Studie) und Ganoderma lucidum (3 Studien); in allen Studien wurde mit Placebo verglichen. Die Präparate wurden oral verabreicht.

Ergebnisse Die Studienergebnisse deuten auf günstige Effekte von Heilpilzen hin, insbesondere bzgl. Lebensqualität und der Reduktion unerwünschter Wirkungen konventioneller Therapien. Zudem wurde über positive Auswirkungen auf die Antitumoraktivität und die Immunmodulation berichtet, z. B. eine erhöhte Aktivität natürlicher Killerzellen. Darüber hinaus lassen die Daten vermuten, dass Krebspatienten, die Mykotherapeutika erhalten, möglicherweise eine verlängerte Überlebenszeit aufweisen. Unerwünschte Ereignisse wurden nur in 3 Studien berichtet; hier traten v. a. gastrointestinale Reaktionen und ein Rückgang der Thrombozytenzahl auf. Die methodische Qualität der meisten inkludierten Studien war generell unzureichend.

Schlussfolgerung Heilpilze haben möglicherweise ein therapeutisches Potenzial für Krebspatienten während und nach konventionellen onkologischen Behandlungen, insbesondere hinsichtlich Lebensqualität, der Verringerung unerwünschter Wirkungen konventioneller Behandlungen und möglicherweise auch bezüglich anderer Surrogatparameter wie Immunfunktionen. Es besteht ein dringender Bedarf, die Sicherheit und mögliche Wechselwirkungen von Heilpilzen mit anderen arzneilichen Substanzen zu untersuchen. Qualitativ hochwertige klinische (und präklinische) Forschung ist erforderlich, um das Potenzial von Heilpilzen in der Krebstherapie zu klären.

Schlüsselwörter

Heilpilze - Mykotherapie - Integrative Onkologie - Komplementärmedizin - Naturheilkunde


Publication History

Article published online:
17 April 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Global Burden of Disease Cancer Collaboration. Fitzmaurice C, Allen C. et al. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol 2017; 3: 524-548
    CrossrefPubMedSearch in Google Scholar
  • 2 Urruticoechea A, Alemany R, Balart J. et al. Recent advances in cancer therapy: An overview. Current Pharmaceutical Design 2010; 16: 3-10
    CrossrefPubMedSearch in Google Scholar
  • 3 Miller KD, Nogueira L, Mariotto AB. et al. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin 2019; 69: 363-385
    CrossrefPubMedSearch in Google Scholar
  • 4 Haun MW, Estel S, Rucker G. et al. Early palliative care for adults with advanced cancer. Cochrane Database Syst Rev 2017; 6: CD011129
    CrossrefPubMedSearch in Google Scholar
  • 5 Astin JA. Why patients use alternative medicine: results of a national study. JAMA 1998; 279: 1548-1553
    CrossrefPubMedSearch in Google Scholar
  • 6 Ernst E, Cassileth BR. The prevalence of complementary/alternative medicine in cancer: a systematic review. Cancer 1998; 83: 777-782
    CrossrefPubMedSearch in Google Scholar
  • 7 Jeitler M, Ortiz M, Brinkhaus B. et al. Use and acceptance of traditional, complementary and integrative medicine in Germany – an online representative cross-sectional study. Front Med 2024; 11: 1372924
    CrossrefPubMedSearch in Google Scholar
  • 8 Grant SJ, Hunter J, Seely D. et al. Integrative oncology: International perspectives. Integr Cancer Ther 2019; 18: 1534735418823266
    CrossrefPubMedSearch in Google Scholar
  • 9 Wasser SP. Medicinal mushroom science: History, current status, future trends, and unsolved problems. Int J Med Mushrooms 2010; 12: 1-16
    CrossrefPubMedSearch in Google Scholar
  • 10 Wasser SP. Medicinal mushroom science: Current perspectives, advances, evidences, and challenges. Biomed J 2014; 37: 345-356
    CrossrefPubMedSearch in Google Scholar
  • 11 Geng X, Tian G, Zhang W. et al. A Tricholoma matsutake peptide with angiotensin converting enzyme inhibitory and antioxidative activities and antihypertensive effects in spontaneously hypertensive rats. Sci Rep 2016; 6: 24130
    CrossrefPubMedSearch in Google Scholar
  • 12 Shigesue K, Kodama N, Nanba H. Effects of maitake (Grifola frondosa) polysaccharide on collagen-induced arthritis in mice. Jpn J Pharmacol 2000; 84: 293-300
    CrossrefPubMedSearch in Google Scholar
  • 13 Gao W, Sun Y, Chen S. et al. Mushroom lectin enhanced immunogenicity of HBV DNA vaccine in C57BL/6 and HBsAg-transgenic mice. Vaccine 2013; 31: 2273-2280
    CrossrefPubMedSearch in Google Scholar
  • 14 Reis FS, Lima RT, Morales P. et al. Methanolic extract of Ganoderma lucidum induces autophagy of AGS human gastric tumor cells. Molecules 2015; 20: 17872-17882
    CrossrefPubMedSearch in Google Scholar
  • 15 Fan M-J, Lin Y-C, Shih H-D. et al. Crude extracts of Agaricus brasiliensis induce apoptosis in human oral cancer CAL 27 cells through a mitochondria-dependent pathway. In Vivo 2011; 25: 355-366
    PubMedSearch in Google Scholar
  • 16 Zhang G-L, Wang Y-H, Ni W. et al. Hepatoprotective role of Ganoderma lucidum polysaccharide against BCG-induced immune liver injury in mice. World J Gastroenterol 2002; 8: 728-733
    CrossrefPubMedSearch in Google Scholar
  • 17 Kim HM, Kang JS, Kim JY. et al. Evaluation of antidiabetic activity of polysaccharide isolated from Phellinus linteus in non-obese diabetic mouse. Int Immunopharmacol 2010; 10: 72-78
    CrossrefPubMedSearch in Google Scholar
  • 18 Singdevsachan SK, Auroshree P, Mishra J. et al. Mushroom polysaccharides as potential prebiotics with their antitumor and immunomodulating properties: A review. Bioactive Carbohydrates and Dietary Fibre 2016; 7: 1-14
    CrossrefPubMedSearch in Google Scholar
  • 19 Wasser SP, Weis AL. Therapeutic effects of substances occurring in higher Basidiomycetes mushrooms: a modern perspective. Crit Rev Immunol 1999; 19: 65-96
    PubMedSearch in Google Scholar
  • 20 Wasser SP. Medicinal Mushrooms in Human Clinical Studies. Part I. Anticancer, Oncoimmunological, and Immunomodulatory Activities: A Review. Int J Med Mushrooms 2017; 19: 279-317
    CrossrefPubMedSearch in Google Scholar
  • 21 Blagodatski A, Yatsunskaya M, Mikhailova V. et al. Medicinal mushrooms as an attractive new source of natural compounds for future cancer therapy. Oncotarget 2018; 9: 29259-29274
    CrossrefPubMedSearch in Google Scholar
  • 22 Joseph TP, Chanda W, Padhiar AA. et al. A Preclinical Evaluation of the Antitumor Activities of Edible and Medicinal Mushrooms: A Molecular Insight. Integr Cancer Ther 2018; 17: 200-209
    CrossrefPubMedSearch in Google Scholar
  • 23 Sakamoto J, Morita S, Oba K. et al. Efficacy of adjuvant immunochemotherapy with polysaccharide K for patients with curatively resected colorectal cancer: a meta-analysis of centrally randomized controlled clinical trials. Cancer Immunol Immunother 2006; 55: 404-411
    CrossrefPubMedSearch in Google Scholar
  • 24 Zhang Y, Zhang M, Jiang Y. et al. Lentinan as an immunotherapeutic for treating lung cancer: a review of 12 years clinical studies in China. J Cancer Res Clin Oncol 2018; 144: 2177-2186
    CrossrefPubMedSearch in Google Scholar
  • 25 Wasser SP. Medicinal mushrooms as a source of antitumor and immunomodulating polysaccharides. Appl Microbiol Biotechnol 2002; 60: 258-274
    CrossrefPubMedSearch in Google Scholar
  • 26 Rossi P, Difrancia R, Quagliariello V. et al. B-glucans from Grifola frondosa and Ganoderma lucidum in breast cancer: an example of complementary and integrative medicine. Oncotarget 2018; 9: 24837-24856
    CrossrefPubMedSearch in Google Scholar
  • 27 Torkelson CJ, Sweet E, Martzen MR. et al. Phase 1 clinical trial of Trametes versicolor in women with breast cancer. ISRN Oncol 2012; 2012: 251632
    CrossrefPubMedSearch in Google Scholar
  • 28 Ohno S, Sumiyoshi Y, Hashine K. et al. Quality of life improvements among cancer patients in remission following the consumption of Agaricus blazei Murill mushroom extract. Complement Ther Med 2013; 21: 460-467
    CrossrefPubMedSearch in Google Scholar
  • 29 Palomares MR, Rodriguez J, Phung S. et al. A dose-finding clinical trial of mushroom powder in postmenopausal breast cancer survivors for secondary breast cancer prevention. JCO 2011; 29: 1582-1582
    CrossrefPubMedSearch in Google Scholar
  • 30 Twardowski P, Kanaya N, Frankel P. et al. A phase I trial of mushroom powder in patients with biochemically recurrent prostate cancer: Roles of cytokines and myeloid-derived suppressor cells for Agaricus bisporus-induced prostate-specific antigen responses. Cancer 2015; 121: 2942-2950
    CrossrefPubMedSearch in Google Scholar
  • 31 Kodama N, Komuta K, Nanba H. Can maitake MD-fraction aid cancer patients?. Altern Med Rev 2002; 7: 236-239
    PubMedSearch in Google Scholar
  • 32 Gao Y, Zhou S, Jiang W. et al. Effects of ganopoly (a Ganoderma lucidum polysaccharide extract) on the immune functions in advanced-stage cancer patients. Immunol Invest 2003; 32: 201-215
    PubMedSearch in Google Scholar
  • 33 Suzuki N, Takimoto Y, Suzuki R. et al. Efficacy of oral administration of Lentinula eododes mycelia extract for breast cancer patients undergoing postoperative hormone therapy. Asian Pac J Cancer Prev 2013; 14: 3469-3472
    CrossrefPubMedSearch in Google Scholar
  • 34 Yoshimura K, Kamoto T, Ogawa O. et al. Medical mushrooms used for biochemical failure after radical treatment for prostate cancer: an open-label study. Int J Urol 2010; 17: 548-554
    CrossrefPubMedSearch in Google Scholar
  • 35 Valadares F, Garbi Novaes MRC, Canete R. Effect of Agaricus sylvaticus supplementation on nutritional status and adverse events of chemotherapy of breast cancer: a randomized, placebo-controlled, double-blind clinical trial. Indian J Pharmacol 2013; 45: 217-222
    CrossrefPubMedSearch in Google Scholar
  • 36 Costa Fortes R, Carvalho Garbi Novaes MR. The effects of Agaricus sylvaticus fungi dietary supplementation on the metabolism and blood pressure of patients with colorectal cancer during post surgical phase. Nutr Hosp 2011; 26: 176-186
    PubMedSearch in Google Scholar
  • 37 Fortes RC, Recova VL, Melo AL. et al. Effects of dietary supplementation with medicinal fungus in fasting glycemia levels of patients with colorectal cancer: a randomized, double-blind, placebo-controlled clinical study. Nutr Hosp 2008; 23: 591-598
    PubMedSearch in Google Scholar
  • 38 Costa Fortes R, Lacorte Recova V, Lima Melo A. et al. Life quality of postsurgical patients with colorectal cancer after supplemented diet with Agaricus sylvaticus fungus. Nutr Hosp 2010; 25: 586-596
    PubMedSearch in Google Scholar
  • 39 Ahn W-S, Kim D-J, Chae G-T. et al. Natural killer cell activity and quality of life were improved by consumption of a mushroom extract, Agaricus blazei Murill Kyowa, in gynecological cancer patients undergoing chemotherapy. Int J Gynecol Cancer 2004; 14: 589-594
    CrossrefPubMedSearch in Google Scholar
  • 40 Tangen J-M, Tierens A, Caers J. et al. Immunomodulatory effects of the Agaricus blazei Murrill-based mushroom extract AndoSan in patients with multiple myeloma undergoing high dose chemotherapy and autologous stem cell transplantation: a randomized, double blinded clinical study. Biomed Res Int 2015; 2015: 718539
    CrossrefPubMedSearch in Google Scholar
  • 41 Tsai M-Y, Hung Y-C, Chen Y-H. et al. A preliminary randomised controlled study of short-term Antrodia cinnamomea treatment combined with chemotherapy for patients with advanced cancer. BMC Complement Altern Med 2016; 16: 322
    CrossrefPubMedSearch in Google Scholar
  • 42 Chay WY, Tham CK, Toh HC. et al. Coriolus versicolor (Yunzhi) use as therapy in advanced hepatocellular carcinoma patients with poor liver function or who are unfit for standard therapy. J Altern Complement Med 2017; 23: 648-652
    CrossrefPubMedSearch in Google Scholar
  • 43 Oka S, Tanaka S, Yoshida S. et al. A water-soluble extract from culture medium of Ganoderma lucidum mycelia suppresses the development of colorectal adenomas. Hiroshima J Med Sci 2010; 59: 1-6
    PubMedSearch in Google Scholar
  • 44 Zhao H, Zhang Q, Zhao L. et al. Spore Powder of Ganoderma lucidum Improves Cancer-Related Fatigue in Breast Cancer Patients Undergoing Endocrine Therapy: A Pilot Clinical Trial. Evid Based Complement Alternat Med 2012; 2012: 809614
    CrossrefPubMedSearch in Google Scholar
  • 45 Gao Y, Dai X, Chen G. et al. A Randomized, Placebo-Controlled, Multicenter Study of Ganoderma lucidum (W.Curt.:Fr.) Lloyd (Aphyllophoromycetideae) Polysaccharides (Ganopoly) in Patients with Advanced Lung Cancer. Int J Med Mushrooms 2003; 5: 14
    PubMedSearch in Google Scholar
  • 46 Fortes RC, Novaes MRCG, Recova VL. et al. Immunological, hematological, and glycemia effects of dietary supplementation with Agaricus sylvaticus on patients’ colorectal cancer. Exp Biol Med (Maywood) 2009; 234: 53-62
    CrossrefPubMedSearch in Google Scholar
  • 47 Visser MR, Smets EM. Fatigue, depression and quality of life in cancer patients: how are they related?. Support Care Cancer 1998; 6: 101-108
    CrossrefPubMedSearch in Google Scholar
  • 48 Bottomley A. The cancer patient and quality of life. Oncologist 2002; 7: 120-125
    CrossrefPubMedSearch in Google Scholar
  • 49 Jin X, Ruiz Beguerie J, Sze D. et al. Ganoderma lucidum (Reishi mushroom) for cancer treatment. Cochrane Database Syst Rev 2016; 4: CD007731
    CrossrefPubMedSearch in Google Scholar
  • 50 Hofer M, Pospisil M. Modulation of animal and human hematopoiesis by beta-glucans: a review. Molecules 2011; 16: 7969-7979
    CrossrefPubMedSearch in Google Scholar
  • 51 Sorimachi K, Akimoto K, Ikehara Y. et al. Secretion of TNF-alpha, IL-8 and nitric oxide by macrophages activated with Agaricus blazei Murill fractions in vitro. Cell Struct Funct 2001; 26: 103-108
    CrossrefPubMedSearch in Google Scholar
  • 52 Su Y-K, Shih P-H, Lee W-H. et al. Antrodia cinnamomea sensitizes radio-/chemo-therapy of cancer stem-like cells by modulating microRNA expression. J Ethnopharmacol 2017; 207: 47-56
    CrossrefPubMedSearch in Google Scholar
  • 53 Lin Y-S, Lin Y-Y, Yang Y-H. et al. Antrodia cinnamomea extract inhibits the proliferation of tamoxifen-resistant breast cancer cells through apoptosis and skp2/microRNAs pathway. BMC Complement Altern Med 2018; 18: 152
    CrossrefPubMedSearch in Google Scholar
  • 54 Martel J, Ojcius DM, Ko Y-F. et al. Phytochemicals as prebiotics and biological stress inducers. Trends Biochem Sci 2020; 45: 462-471
    CrossrefPubMedSearch in Google Scholar
  • 55 Kalaras MD, Richie JP, Calcagnotto A. et al. Mushrooms: A rich source of the antioxidants ergothioneine and glutathione. Food Chem 2017; 233: 429-433
    CrossrefPubMedSearch in Google Scholar
  • 56 De Silva DD, Rapior S, Fons F. et al. Medicinal mushrooms in supportive cancer therapies: an approach to anti-cancer effects and putative mechanisms of action. Fungal Diversity 2012; 55: 1-35
    CrossrefPubMedSearch in Google Scholar
  • 57 Aras A, Khalid S, Jabeen S. et al. Regulation of cancer cell signaling pathways by mushrooms and their bioactive molecules: Overview of the journey from benchtop to clinical trials. Food Chem Toxicol 2018; 119: 206-214
    CrossrefPubMedSearch in Google Scholar
  • 58 Ayeka PA. Potential of mushroom compounds as immunomodulators in cancer immunotherapy: A review. Evid Based Complement Alternat Med 2018; 2018: 7271509
    CrossrefPubMedSearch in Google Scholar
  • 59 Wasser SP. Current findings, future trends, and unsolved problems in studies of medicinal mushrooms. Appl Microbiol Biotechnol 2011; 89: 1323-1332
    CrossrefPubMedSearch in Google Scholar
  • 60 Calabrese EJ. Cancer biology and hormesis: human tumor cell lines commonly display hormetic (biphasic) dose responses. Crit Rev Toxicol 2005; 35: 463-582
    CrossrefPubMedSearch in Google Scholar
  • 61 Friedman M. Mushroom Polysaccharides: Chemistry and Antiobesity, Antidiabetes, Anticancer, and Antibiotic Properties in Cells, Rodents, and Humans. Foods 2016; 5: 80
    CrossrefPubMedSearch in Google Scholar
  • 62 Jayachandran M, Xiao J, Xu B. A Critical Review on Health Promoting Benefits of Edible Mushrooms through Gut Microbiota. Int J Mol Sci 2017; 18: 1934
    CrossrefPubMedSearch in Google Scholar
  • 63 Vivarelli S, Salemi R, Candido S. et al. Gut Microbiota and Cancer: From Pathogenesis to Therapy. Cancers (Basel) 2019; 11: 38
    CrossrefPubMedSearch in Google Scholar
  • 64 Boulangé CL, Neves AL, Chilloux J. et al. Impact of the gut microbiota on inflammation, obesity, and metabolic disease. Genome Med 2016; 8: 42
    CrossrefPubMedSearch in Google Scholar
  • 65 Harris ESJ, Cao S, Littlefield BA. et al. Heavy metal and pesticide content in commonly prescribed individual raw Chinese Herbal Medicines. Sci Total Environ 2011; 409: 4297-4305
    CrossrefPubMedSearch in Google Scholar
  • 66 Pilkington K, Wieland LS, Teng L. et al. Coriolus (Trametes) versicolor mushroom to reduce adverse effects from chemotherapy or radiotherapy in people with colorectal cancer. Cochrane Database Syst Rev 2022; 11: CD012053
    CrossrefPubMedSearch in Google Scholar
  • 67 Chen Q, Shu C, Laurence AD. et al. Effect of Huaier granule on recurrence after curative resection of HCC: a multicentre, randomised clinical trial. Gut 2018; 67: 2006-2016
    CrossrefPubMedSearch in Google Scholar
  • 68 Li J, Zou L, Chen W. et al. Dietary mushroom intake may reduce the risk of breast cancer: evidence from a meta-analysis of observational studies. PLoS One 2014; 9: e93437
    CrossrefPubMedSearch in Google Scholar