Sanem BULAM, Nebahat ÜSTÜN, AYSUN PEKŞEN

Health Benefits of Ganoderma lucidum as a Medicinal Mushroom

Ganoderma lucidum (Curtis) P. Karst., known as “Lingzhi” in China or “Reishi” in Japan, is a wellknown medicinal mushroom and traditional Chinese medicine, which has been used for the prevention and treatment of bronchitis, allergies, hepatitis, immunological disorders and cancer. G. lucidum is rarely collected from nature and mostly cultivated on wood logs and sawdust in plastic bags or bottles to meet the demands of international markets. Diverse groups of chemical compounds with pharmacological activities, isolated from the mycelia and fruiting bodies of G. lucidum are triterpenoids, polysaccharides (β-D-glucans), proteins, amino acids, nucleosides, alkaloids, steroids, lactones, lectins, fatty acids, and enzymes. The biologically active compounds as primarily triterpenoids and polysaccharides of G. lucidum have been reported to possess hepatoprotective, antihypertensive, hypocholesterolemic, antihistaminic effects and antioxidant, antitumor, immunomodulatory, and antiangiogenic activities. Several formulations have been developed, patented and used as nutraceuticals, nutriceuticals and pharmaceuticals from G. lucidum’s water or ethanol extracts and rarely purified active compounds. As the result of clinical trials, various products have commercially become available as syrup, injection, tablet, tincture or bolus of powdered medicine and an ingredient or additive in dark chocolate bars and organic fermented medicinal mushroom drink mixes such as green teas, coffees, and hot cacaos. This review has intended to give and discuss recent knowledge on phytochemical and pharmacological compositions, therapeutic and side effects, clinical trials, and commercial products of G. lucidum.

Tıbbi Mantar Olarak Ganoderma lucidum’un Sağlık Üzerine Faydaları

Çin’de “Lingzhi” veya Japonya'da “Reishi” olarak bilinen Ganoderma lucidum (Curtis) P. Karst., bronşit, alerji, hepatit, immünolojik bozukluklar ve kanser gibi çeşitli hastalıkların önlenmesi ve tedavisinde kullanılan, tanınmış bir tıbbi mantar ve geleneksel Çin ilacıdır. G. lucidum nadiren doğadan toplanmakta ve uluslararası pazarların taleplerini karşılamak için çoğunlukla kütüklerde ve plastik torbalar veya şişeler içinde talaşlarda yetiştirilmektedir. G. lucidum’dan izole edilmiş farmakolojik aktiviteye sahip kimyasal bileşik grupları, triterpenoidler, polisakkaritler (β-Dglukanlar), proteinler, aminoasitler, nükleozitler, alkaloitler, steroidler, laktonlar, lektinler, yağ asitleri ve enzimlerdir. G. lucidum’un triterpenoidleri ve polisakkaritleri gibi biyolojik aktif bileşiklerinin hepatoprotektif, antihipertensif, hipokolesterolemik, antihistaminik etkileri ve antioksidan, antitümör, immünomodülatör ve antianjiyogenik aktiviteleri olduğu rapor edilmiştir. Başta G. lucidum’un meyve veren organları ve sporları, su veya etanol ekstraktları ve nadiren saflaştırılmış aktif bileşikleri ile çeşitli formülasyonlar geliştirilmiş, patenti alınmış ve nutrasötikler, nutrisötikler ve farmasötikler olarak kullanılmıştır. Klinik denemeler sonucunda, ticari olarak şurup, enjeksiyon, tablet, tentür veya kapsül ve bitter çikolatalarda ve yeşil çaylar, kahveler ve sıcak kakaolar gibi organik fermente edilmiş tıbbi mantar içecek karışımlarında bir bileşen veya katkı maddesi olarak kullanılabilmektedir. Bu derleme G. lucidum’un fitokimyasal ve farmakolojik kompozisyonları, terapötik ve yan etkileri, klinik denemeleri ve ticari ürünleri hakkında son bilgileri vermeyi ve tartışmayı amaçlamıştır.

PDF

___

Bal C. 2019. Antioxidant and antimicrobial capacities of Ganoderma lucidum. J Bacteriol Mycol Open Access, 7(1): 5-7.

Bishop KS, Kao CHJ, Xu Y, Glucina MP, Paterson RRM, Ferguson LR. 2015. From 2000 years of Ganoderma lucidum to recent developments in nutraceuticals. Phytochemistry, 114: 56-65.

Boh B. 2013. Ganoderma lucidum: A potential for biotechnological production of anti-cancer and immunomodulatory drugs. Recent Pat Anticancer Drug Discov, 8: 255-287.

Cao Y, Xu X, Liu S, Huang L, Gu J. 2018. Ganoderma: A cancer immunotherapy review. Front Pharmacol, 9: 1217.

Chang ST, Buswell JA. 2008. Safety, quality control and regulational aspects relating to mushroom nutriceuticals. Proc. 6th Intl. Conf. Mushroom Biology and Mushroom Products. GAMU Gmbh, Krefeld, Germany. pp. 188-95.

Chang YS, Lee SS. 2004. Utilisation of macrofungi species in Malaysia. Fungal Divers, 15: 15-22.

Chen RY, Kang J, Du GH. 2016. Construction of the quality control system of Ganoderma products. Edi and Med Mushr, 24(6): 339-344.

Cheng S, Sliva D. 2015. Ganoderma lucidum for cancer treatment: We are close but still not there. Integr Cancer Ther, 14(3): 249-257.

Chung H, Lee J, Kwon O. 2004. Bread properties utilizing extracts of Ganoderma lucidum (GL). J. Korean Soc. Food Sci., Nutr. 33: 1201-1205.

Cör D, Knez Z, Hrnčič MK. 2018. Antitumour, antimicrobial, antioxidant and antiacetylcholinesterase effect of Ganoderma lucidum terpenoids and polysaccharides: A review. Molecules, 23: 649.

De Silva DD, Rapior S, Fons F, Bahkali AH, Hyde KD. 2012. Medicinal mushrooms in supportive cancer therapies: an approach to anti–cancer effects and putative mechanisms of action. Fungal Divers, 55: 1-35.

De Silva DD, Rapior S, Sudarman E, Stadler M, Xu J, Alias SA, Hyde KD. 2013. Bioactive metabolites from macrofungi: ethnopharmacology, biological activities and chemistry. Fung Divers, 62: 1-40.

Deepalakshmi K, Mirunalini S. 2011. Therapeutic properties and current medical usage of medicinal mushroom: Ganoderma lucidum. IJPSR, 2(8): 1922-1929.

Dinesh Babu P, Subhasree RS. 2008. The sacred mushroom “Reishi”-A review. American-Eurasian J Bot, 1(3):107-110.

Duru ME, Tel Çayan G. 2015. Biologically active terpenoids from mushroom origin: A review. Rec. Nat. Prod., 9(4): 456-483.

Ferreira ICFR, Heleno SA, Reis FS, Stojković D, Queiroz MJ, Vasconcelos MH, Soković M, 2015. Chemical features of Ganoderma polysaccharides with antioxidant, antitumor and antimicrobial activities. Phytochemistry, 114: 38-55.

Gao H, Chan E, Zhou F. 2004. Immunomodulating activities of Ganoderma, a mushroom with medicinal properties. Food Rev Int, 20: 123-161.

Gao Y, Gao H, Chan E, Tang W, Xu A, Yang H, Huang M, Lan J, Li X, Duan W, Xu C, Zhou S. 2005. Antitumor activity and underlying mechanisms of Ganopoly, the refined polysaccharides extracted from Ganoderma lucidum, in mice. Immunol Invest, 34: 171-198.

Ghobadi R, Mohammadi R, Chabavizade J, Sami M. 2018. Effect of Ganoderma lucidum powder on oxidative stability, microbial and sensory properties of emulsion type sausage. AdvBiomed Res,7: 24.

Giavasis I. 2014. Polysaccharides from medicinal mushrooms for potential use as nutraceuticals. In: Benkeblia N (Ed.), Polysaccharides: Natural Fibers in Food and Nutrition, 1st Edition, CRC Press. pp.171-206.

Gill SK, Rieder MJ. 2008. Toxicity of a traditional Chinese medicine, Ganoderma lucidum, in children with cancer. Can J Clin Pharmacol, 15(2): 275-85.

Hapuarachchi KK, Cheng CR, Wen TC, Jeewon R, Kakumyan P. 2017. Mycosphere Essays 20: Therapeutic potential of Ganoderma species: Insights into its use as traditional medicine. Mycosphere, 8(10): 1653-1694.

Hapuarachchi KK, Elkhateeb WA, Karunarathna SC, Cheng CR, Bandara AR, Kakumyan P, Hyde KD, Daba GM, Wen TC. 2018. Current status of global Ganoderma cultivation, products, industry and market. Mycosphere, 9(5): 1025-1052.

Hapuarachchi KK, Wen TC, Jeewon R, Wu XL, Kang JC, Hyde KD. 2016a. Mycosphere Essays 7. Ganoderma lucidum-are the beneficial anti-cancer properties substantiated? Mycosphere, 7(3): 305-332.

Hapuarachchi KK, Wen TC, Jeewon R, Wu XL, Kang JC. 2016b. Mycosphere Essays 15. Ganoderma lucidum–are the beneficial medical properties substantiated? Mycosphere, 7(6): 687-715.

Heleno SA, Barros L, Martins A, Ferreira ICFR. 2012. Fruiting body spores and in vitro produced mycelium of G. lucidum from Northeast Portugal: a comparative study of the antioxidant potential of phenolic and polysaccharidic extracts. Food Res Int, 46: 135-140.

Hleba L, Vuković, Petrová J, Kačániová M. 2014. Antimicrobial activity of crude methanolic extracts from Ganoderma lucidum and Trametes versicolor. Anim Sci Biotechno, 47: 89-93.

Hyde KD, Bahkali AH, Moslem MA. 2010. Fungi–An unusual source for cosmetics. Fungal Divers, 43: 1-9.

Jia J, Zhang XI, Hu YS, Wu Y, Wang QZ, Li NN, Guo QC, Dong XC. 2009. Evaluation of in vivo antioxidant activities of G. lucidum polysaccharides in STZ-diabetic rats. Food Chem, 115: 32-36.

Kana Y, Chen T, Wu Y, Wu J. 2015. Antioxidant activity of polysaccharide extracted from Ganoderma lucidum using response surface methodology. Int J Biol Macromol, 72: 151- 157.

Kao CHJ, Jesuthasan AC, Bishop KS, Glucina MP, Ferguson LR. 2013. Anti-cancer activities of Ganoderma lucidum: active ingredients and pathways. Functional Foods in Health and Disease, 3(2): 48-65.

Karthikeyan M, Radhika K, Bhaskaran R, Mathiyazhagan S, Velazhahan R. 2009. Rapid detection of Ganoderma lucidum and assessment of inhibition effect of various control measures by immunoassay and PCR. Afr J Biotechnol, 8: 2202-2208.

Khastini RO, Wahyuni I, Saraswati I. 2018. Ethnomycology of bracket fungi in Baduy Tribe Indonesia. Biosaintifika: J Biol Educ, 10(2): 424-432.

Khatian N, Aslam M. 2018. A review of Ganoderma lucidum (Reishi): A miraculous medicinal mushroom. Inventi Rapid: Ethnopharmacology, 2018(4): 1-6.

Kim SD, Nho HJ. 2004. Isolation and characterization of alphaglucosidase inhibitor from the fungus G. lucidum. J Microbiol, 42(3): 223-227.

Kirar V, Nehra S, Mishra J, Rakhee R, Saraswat D, Misra K 2017. Lingzhi or Reishi medicinal mushroom, Ganoderma lucidum (Agaricomycetes), as a cardioprotectant in an oxygendeficient environment. Int J Med Mushrooms, 19(11): 1009- 1021.

Kumari K, Prakash V, Rana S, Sagar A. 2016. In vitro antioxidant activity of methanolic extract of G. lucidum (Curt.) P. Karst. IJASR, 1(5): 51-54.

Lai T, Gao Y, Zhou SF. 2004. Global marketing of medicinal Ling Zhi mushroom Ganoderma lucidum (W.Curt.: Fr.) Lloyd (Aphyllophoromycetideae) products and safety concerns. Int J Med Mush, 6: 189-194.

Li J, Chen W, Li XY, Cheng F. 2011. Ganoderma yogurt and changes in colonies, physical and chemical properties during storage. China Dairy Ind, 5: 18.

Li J, Zhang J, Chen H, Chen X, Lan J, Liu C. 2013. Complete mitochondrial genome of the medicinal mushroom Ganoderma lucidum. Plos One, 8(8): e72038.

Li N, Hu YL, He CX, Hu CJ, Zhou J, Tang GP, Gao JQ. 2010. Preparation, characterisation and anti-tumour activity of Ganoderma lucidum polysaccharide nanoparticles. J Pharm Pharmacol, 62(1): 139-44.

Li S, Dong C, Wen HA, Liu X. 2016. Development of Ling-zhi industry in China–emanated from the artificial cultivation in the Institute of Microbiology, Chinese Academy of Sciences (IMCAS). Mycology, 7: 74-80.

Lindequist U, Niedermeyer TH, Jülich WD. 2005. The pharmacological potential of mushrooms. Evid Based Complement Alternat Med., 2(3): 285-299.

Lisiecka J, Rogalski J, Sobieralski K, Siwulski M, Sokol S, Ohga S. 2015. Mycelium growth and biological efficiency of Ganoderma lucidum on substrate supplemented with different organic additives. J Fac Agr, Kyushu Univ, 60(2): 303-308.

Liu J, Shimizu K, Konishi F, Kumamoto S, Kondo R. 2007. The anti-androgen effect of ganoderol B isolated from the fruiting body of Ganoderma lucidum. Bioorganic Med Chem, 15(14): 4966-4972.

Loyd AL, Richter BS, Jusino MA, Truong C, Smith ME, Blanchette RA, Smith JA. 2018. Identifying the “Mushroom of Immortality”: Assessing the Ganoderma Species Composition in Commercial Reishi Products. Front. Microbiol., 9: 1557.

Lu CC, Hsu YJ, Chang CJ, Lin CS, Martel J, Ojcius DM, Ko YF, Lai HC, Young JD. 2016. Immunomodulatory properties of medicinal mushrooms: differential effects of water and ethanol extracts on NK cell-mediated cytotoxicity. Innate Immun, 22(7): 522-533.

Ma HT, Hsieh JF, Chen ST. 2015. Anti-diabetic effects of Ganoderma lucidum. Phytochemistry, 114: 109-113.

Mau JL, Lin HC, Chen CC. 2001. Non-volatile components of several medicinal mushrooms. Food Res Int, 34(6): 521-526.

Mehta S. 2014. Studies on genetic variability and bioactive molecules production by Ganoderma species. Ph.D. Thesis, Shoolini University of Biotechnology and Management Sciences Bajhol, Solan (HP), India.

Morales D, Ruiz-Rodriguez A, Soler-Rivas C. 2018. The use of pressurized fluid technologies to obtain commercially interesting compounds from edible mushrooms. (Taylor, ed.). Advances in Chemistry Research. New York. Nova Science Publishers, Inc. pp. 1-42.

Nahata A. 2013. Ganoderma lucidum: A potent medicinal mushroom with numerous health benefits. Pharmaceut Anal Acta, 4: e159.

Nakagawa T, Zhu Q, Tamrakar S, Amen Y, Mori Y, Suhara H, Kaneko S, Kawashima H, Okuzono K, Inoue Y, Ohnuki K, Shimizu K. 2018. Changes in content of triterpenoids and polysaccharides in Ganoderma lingzhi at diferent growth stages. J Nat Med, 72: 734-744.

Oyetayo OV. 2011. Medicinal uses of mushrooms ın Nigeria: towards full and sustainable exploitation. Afr J Tradit Complement Altern Med, 8(3): 267‐274.

Paterson RRM. 2006. Ganoderma-A therapeutic fungal biofactory. Phytochem, 67: 1985-2001.

Pekşen A, Yakupoğlu G. 2009. Tea waste as a supplement for the cultivation of Ganoderma lucidum. World J of Microbiol and Biotech, 25(4): 611-618.

Perumal K. 2009. Indigenous technology on organic cultivation of Reishi. AMM Murugappa Chettiar Research Centre, 1-12.

Rathore H, Prasad S, Sharma S. 2017. Mushroom nutraceuticals for improved nutrition and better human health: A review. PharmaNutrition, 5: 35-46.

Reis FS, Martins A, Vasconcelos MH, Morales P, Ferreira ICFR. 2017. Functional foods based on extracts or compounds derived from mushrooms. Trends Food Sci Techn., 66: 48-62.

Roy S, Ara M, Jahan A, Das KK, Munshi SK, Noor R. 2015. Artificial cultivation of Ganoderma lucidum (Reishi Medicinal Mushroom) using different sawdusts as substrates. American J BioSci, 3(5): 178-182.

Sanodiya BS, Thakur GS, Baghel RK, Prasad GBKS, Bisen PS. 2009. Ganoderma lucidum: A potent pharmacological macrofungus. Curr Pharm Biotechnol, 10: 717-742.

Sesli E, Denchev CM. 2014. Checklists of the myxomycetes, larger ascomycetes, and larger basidiomycetes in Turkey. 6th edn. Mycotaxon Checklists Online (http://www.mycotaxon.com/resources/checklists/sesliv106- checklist.pdf): 1-136.

Sharma C, Bhardwaj N, Sharma A, Tuli HS, Katyal P, Beniwal V, Gupta GK, Sharma AK. 2019. Bioactive metabolites of Ganoderma lucidum: Factors, mechanism and broad spectrum therapeutic potential. J Herbal Med, xx(x): xx-xx.

Sliva D, Sedlak M, Slivova V, Valachovicova T, Lloyd FP Jr, Ho NW. 2003. Biologic activity of spores and dried powder from Ganoderma lucidum for the inhibition of highly invasive human breast and prostate cancer cells. J Altern Complement Med, 9: 491-497.

Sohretoglu D, Huang S. 2018. Ganoderma lucidum polysaccharides as an anti-cancer agent. Anticancer Agents Med Chem, 18: 667-674.

Stojkovic DS, Barros L, Calhelha RC, Glamočlija J, Ćirić A, Van Griensven LJLD, Soković M, Ferreira ICFR. 2014. A detailed comparative study between chemical and bioactive properties of Ganoderma lucidum from different origins. Int J Food Sci Nutr, 65(1): 42-47.

Sudheer S, Alzorqi I, Manickam S, Ali A. 2018. Bioactive compounds of the wonder medicinal mushroom “Ganoderma lucidum”. (Mérillon, Ramawat, eds.). Bioactive Molecules in Food, Reference Series in Phytochemistry. Switzerland. Springer International Publishing AG. 31 p. Online ISBN: 978-3-319-54528-8.

Taofiq O, González-Paramás AM, Martins A, Barreiro MF, Ferreira ICFR. 2016. Mushrooms extracts and compounds in cosmetics, cosmeceuticals and nutricosmetics–A review. Ind Crop Prod, 90: 38-48.

Thyagarajan A, Zhu J, Sliva D. 2007. Combined effect of green tea and Ganoderma lucidum on invasive behavior of breast cancer cells. Int J Oncol, 30(4): 963-9.

Tibuhwa, DD. 2018. Edible and medicinal mushrooms sold at traditional markets in Tanzania. Res J For, 12: 1-14.

Tokul-Olmez O, Kaplaner E, Ozturk M, Ullah Z, Duru ME. 2018. Fatty acid profile of four Ganoderma species collected from various host trees with chemometric approach. Biochem Sys and Ecol, 78: 91–97.

Turfan N, Karadeniz M, Ünal S. 2016. Doğadan toplanan ve portakal kütüğünde yetiştirilen Ganoderma lucidum (Curtis.) P. Karst mantar türünün bazı kimyasal içeriklerinin karşılaştırılması. Turkish JAF Sci Technol, 4(3): 158-162.

Turfan N, Pekşen A, Kibar B, Ünal S. 2018. Determination of nutritional and bioactive properties in some selected wild growing and cultivated mushrooms from Turkey. Acta Sci Pol Hortorum Cultus, 17(3): 57-72.

Valverde ME, Hernández-Pérez T, Paredes-López O. 2015. Edible mushrooms: Improving human health and promoting quality life. Int J Microbiol, 2015: 1-14.

Veljović S, Nikićević N, Nikšić M. 2019. Medicinal fungus Ganoderma lucidum as raw material for alcohol beverage production. (Grumezescu and Holban, eds.). Alcoholic Beverages. Volume 7: The Science of Beverages. Elsevier / Woodhead Publish. pp. 161-197.

Wachtel-Galor S, Yuen J, Buswell JA, Benzie IFF. 2011. Ganoderma lucidum (Lingzhi or Reishi): A medicinal mushroom. (Benzie and Wachtel-Galor, eds.). Herbal Medicine, 2nd edition. Boca Raton (FL). CRC Press/Taylor&Francis. 53 p. ISBN-13: 978-1-4398-0713-2.

Wanachiwanawin D, Piankijagum A, Chaiprasert A, Lertlaituan P, Tungtrongchitr A, Chinabutr P. 2006. Ganoderma lucidum: a cause of pseudoparasitosis. Southeast Asian J Trop Med Public Health, 37: 1099-102.

Wang JL, Gu T, Zhong JJ. 2012a. Enhanced recovery of antitumor Ganoderic Acid T from Ganoderma lucidum mycelia by novel chemical conversion strategy. Biotechnol Bioeng, 109(3): 754-762.

Wang XC, Xi RJ, Li Y, Wang DM, Yao YJ. 2012b. The species identity of the widely cultivated Ganoderma, ‘G. lucidum’ (Ling–zhi), in China. PLoS One, 7(7): e40857.

Wang YY, Chen ST, Lin CC, Wong CH, Lin CH. 2002. Studies on the immunomodulation and antitumor activities of G. lucidum (Reishi) polysaccharides: functional and proteomic analysis of fucose-containing glycoprotein fraction responsible for the activities. Bioorg Med Chem, 10: 1057- 1062.

Wanmuang H, Leopairut J, Kositchaiwat C, Wananukul W, Bunyaratvej S. 2007. Fatal fulminant hepatitis associated with Ganoderma lucidum (Lingzhi) mushroom powder. J Med Assoc Thai, 90: 179-181.

Wannasupchue W, Siriamornpun S, Huaisan K, Huaisan J, Meeso N. 2011. Effect of adding Ling-zhi (Ganoderma lucidum) on oxidative stability, textural and sensory properties of smoked fish sausage. Thai J Agric Sci, 5: 505-12.

Wiater A, Paduch R, Choma A, Pleszczyn´ska M, Siwulski M, Dominik J, Janusze G, Tomczyk M, Szczodrak J. 2012. Biological study on carboxymethylated (1→3)-α-D-glucans from fruiting bodies of Ganoderma lucidum. Int J Biol Macromol, 51: 1014-1023.

Wu GS, Guo JJ, Bao JL, Li XW. 2013. Anti-cancer properties of triterpenoids isolated from Ganoderma lucidum - A review. Expert Opin Investig Drugs, 22: 981-992.

Wu Y, Choi MH, Li J, Yang H, Shin HJ. 2016. Mushroom cosmetics: The present and future. Cosmetics, 3(3): 22.

Wu, DT, Deng Y, Chen LX, Zhao J, Bzhelyansky A, Li SP. 2017. Evaluation on quality consistency of Ganoderma lucidum dietary supplements collected in the United States. Sci. Rep. 7: 7792.

Xu X, Yan H, Chen J, Zhang X. 2011a. Bioactive proteins from mushrooms. Biotechnol Adv, 29(6): 667-674.

Xu Y. 2001. Perspectives on the 21st century development of functional foods: Bridging Chinese medicated diet and functional foods. Int J Food Sci Technol, 36: 229-242.

Xu Z, Chen X, Zhong Z, Cheny L, Wang Y. 2011b. Ganoderma lucidum polysaccharides: immunomodulation and potential anti-tumor activities. The Amer J Chine Medic, 39: 15-27.

Yan L. 2015. Gynostemma pentaphyllum (Thunb.) Makino (Jiaogulan, Five leaf Gynostemma). In: Liu Y, Wang Z, Zhang J. (Eds) Dietary Chinese Herbs Chemistry: Pharmacology and Clinical Evidence. Springer, London pp. 615-622.

Ye H. 2018. Healthy benefits of Ganoderma lucidum as herb medicinal mushroom. CPQ Nutrition, 1(5): 01-07.

Yıldız O, Can Z, Laghari AQ, Şahin H, Malkoç M. 2015. Wild edible mushrooms as a natural source of phenolics and antioxidants. J Food Biochem, 39: 148-154.

Yuen MF, Ip P, Ng WK, Lai CL. 2004. Hepatotoxicity due to a formulation of Ganoderma lucidum (lingzhi). J Hepatol, 41: 685-90.

Yuen WMJ, Gohel MDI. 2005. Anti-cancer effects of Ganoderma lucidum: A review of scientific evidence. Nutr Cancer, 53: 11-17.

Zeng P, Guo Z, Zeng X, Hao C, Zhang Y, Zhang M, Liu Y, Li H, Li J, Zhang L. 2018. Chemical, biochemical, preclinical and clinical studies of Ganoderma lucidum polysaccharide as an approved drug for treating myopathy and other diseases in China. J Cell Mol Med, 22: 3278-3297.

Zhang M, Cui SW, Cheung PCK, Wang Q. 2007. Antitumor polysaccharides from mushrooms: a review on their isolation process, structural characteristics and antitumor activity. Trends Food Sci Technol, 18(1): 4-19.

Zhang W, Tao J, Yang X, Yang Z, Zhang L, Liu H, Wu K, Wu J. 2014. Antiviral effects of two Ganoderma lucidum triterpenoids against Enterovirus 71 infection. Biochem Biophys Res Commun, 449(3): 307-12.

Zhao C, Zhang C, Xing Z, Ahmad Z, Li J-S, Chang M-W. 2019. Pharmacological effects of natural Ganoderma and its extracts on neurological diseases: A comprehensive review. Int J Biol Macromol, 121: 1160-1178.

Zhou XW, Lin J, Li QZ, Yin YZ, Sun XF, Tang KX. 2007. Study progress on bioactive proteins from Ganoderma spp. Nat Prod Res Develop, 19: 916-924.

Zhou XW, Su KQ, Zhang YM. 2012. Applied modern biotechnology for cultivation of Ganoderma and development of their products. Appl Microbiol Biotechnol, 93: 941-963.

Zhu Q, Bang TH, Ohnuki K, Sawai T, Sawai K, Shimizu K. 2015. Inhibition of neuraminidase by Ganoderma triterpenoids and implications for neuraminidase inhibitor design. Sci Rep, 5: 13194.

Zhu XL, Chen AF, Lin ZB. 2007. Ganoderma lucidum polysaccharides enhance the function of immunological effector cells in immunosuppressed mice. J Ethnopharmacol, 111: 219-226.