The use of dietary supplements by patients with cancer has increased significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the Internet, often receiving misleading information.
The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. We chose Maitake for this issue because of its increasing use as an immunostimulant by patients with cancer.
Compiled by Barrie R. Cassileth, PhD, and Jyothi Gubili, MS, Memorial Sloan Kettering Cancer Center. The free About Herbs website is managed by K. Simon Yeung, PharmD, MBA, LAc, Memorial Sloan Kettering Cancer Center.
Scientific name: Grifola frondosa
Common names: King of mushrooms, dancing mushroom, cloud mushroom, hen of the woods
Overview
Maitake is an edible mushroom native to northeastern Japan and China and an important ingredient in Asian cuisine. It is found at the base of oak, elm, and persimmon trees and is known to grow to more than 100 pounds, earning the reputation as “King of the Mushrooms.”
Maitake is consumed in fried or sautéed forms, whereas the dried mushrooms are used in soups and sauces. It is also highly valued for its health benefits and has been used in traditional medicine for centuries to promote health.
Studies conducted by Japanese researchers in the 1980s showed that maitake contains more bioactive polysaccharides than do other medicinal mushrooms, such as shiitake. This discovery spurred maitake research, and extracts containing the polysaccharides, known as beta-glucans, were identified and patented. The D-fraction showed stronger immunomodulating and antitumor effects.
Data from small clinical studies suggest that orally administered maitake extract stimulates the immune system and enhances the effectiveness of chemotherapy.1 Additional research is underway to determine the mushroom’s anticancer potential.
Maitake extracts are marketed as dietary supplements, in the form of liquid extracts, tablets, and capsules, to enhance immune function and to treat AIDS and cancer.
The Science
In vitro experimentation with maitake showed that it alleviates the inflammation associated with inflammatory bowel disease.2
Oral maitake extract promoted the maturation of hematopoietic cells to functionally active myeloid cells and enhanced peripheral blood leukocyte recovery following chemotoxic bone marrow injury.3 In mice models, it exhibited hypoglycemic effects.4 Preliminary data suggest that maitake may be useful in inducing ovulation in women with polycystic ovary syndrome.5
Investigations of the anticancer properties of maitake revealed antitumor effects,6 enhancement of bone marrow colony formation and reduction of doxorubicin toxicity,7 and inhibition of tumor metastasis in vitro.8
The novel polysaccharide MZF (maitake Z-fraction) was found to induce dendritic cell maturation and to improve antitumor response.9 Maitake also enhanced interferon activity against bladder cancer cells.10
Tumor regression or significant symptom reductions were observed in half of those subjects who used maitake extract in a small noncontrolled study.1 In another study, oral administration of maitake extract was shown to have immunomodulatory effects in postmenopausal breast cancer patients.11
Furthermore, oral maitake improved the function of neutrophils and monocytes in patients with myelodysplastic syndrome.12
Adverse Effects
Asymptomatic eosinophilia has been reported with the use of maitake.12
Herb-Drug Interactions
Hypoglycemic medications: Maitake may increase the effects of hypoglycemic agents.13
Warfarin: Maitake may interact with warfarin, resulting in an elevated international normalized ratio.14 ■
Disclosure: Ms. Gubili reported no potential conflicts of interest.
References
1. Kodama N, Komuta K, Nanba H: Can maitake MD-fraction aid cancer patients? Altern Med Rev 7:236-239, 2002.
2. Lee JS, Park SY, Thapa D, et al: Grifola frondosa water extract alleviates intestinal inflammation by suppressing TNF-alpha production and its signaling. Exp Mol Med 42:143-154, 2010.
3. Lin H, de Stanchina E, Zhou XK, et al: Maitake beta-glucan promotes recovery of leukocytes and myeloid cell function in peripheral blood from paclitaxel hematotoxicity. Cancer Immunol Immunother 59:885-897, 2010.
4. Hong L, Xun M, Wutong W: Anti-diabetic effect of an alpha-glucan from fruit body of maitake (Grifola frondosa) on KK-Ay mice. J Pharm Pharmacol 59:575-582, 2007.
5. Chen JT, Tominaga K, Sato Y, et al: Maitake mushroom (Grifola frondosa) extract induces ovulation in patients with polycystic ovary syndrome: A possible monotherapy and a combination therapy after failure with first-line clomiphene citrate. J Altern Complement Med 16:1295-1299, 2010.
6. Shomori K, Yamamoto M, Arifuku I, et al: Antitumor effects of a water-soluble extract from Maitake (Grifola frondosa) on human gastric cancer cell lines. Oncol Rep 22:615-620, 2009.
7. Lin H, She YH, Cassileth BR, et al: Maitake beta-glucan MD-fraction enhances bone marrow colony formation and reduces doxorubicin toxicity in vitro. Int Immunopharmacol 4:91-99, 2004.
8. Masuda Y, Murata Y, Hayashi M, Nanba H: Inhibitory effect of MD-Fraction on tumor metastasis: Involvement of NK cell activation and suppression of intercellular adhesion molecule (ICAM)-1 expression in lung vascular endothelial cells. Biol Pharm Bull 31:1104-1108, 2008.
9. Masuda Y, Ito K, Konishi M, Nanba H: A polysaccharide extracted from Grifola frondosa enhances the anti-tumor activity of bone marrow-derived dendritic cell-based immunotherapy against murine colon cancer. Cancer Immunol Immunother 59:1531-1541, 2010.
10. Louie B, Rajamahanty S, Won J, et al: Synergistic potentiation of interferon activity with maitake mushroom d-fraction on bladder cancer cells. BJU Int 105:1011-1015, 2010.
11. Deng G, Lin H, Seidman A, et al: A phase I/II trial of a polysaccharide extract from Grifola frondosa (Maitake mushroom) in breast cancer patients: Immunological effects. J Cancer Res Clin Oncol 135:1215-1221, 2009.
12. Wesa KM, Cunningham-Rundles S, Klimek VM, et al: Maitake mushroom extract in myelodysplastic syndromes (MDS): A phase II study. Cancer Immunol Immunother 64:237-247, 2015.
13. Konno S, Tortorelis DG, Fullerton SA, et al: A possible hypoglycaemic effect of maitake mushroom on Type 2 diabetic patients. Diabet Med 8:1010, 2001.
14. Hanselin MR, Vande Griend JP, Linnebur SA: INR elevation with maitake extract in combination with warfarin. Ann Pharmacother 44:223-224, 2010.
Guest Editor
Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance S. Rockefeller Chair in Integrative Medicine at Memorial Sloan Kettering Cancer Center, New York.
The Integrative Medicine Service at Memorial Sloan Kettering Cancer Center developed and maintains a free website—About Herbs (www.mskcc.org/aboutherbs)—that provides objective and unbiased information about herbs, vitamins, minerals, and other dietary supplements, and unproved anticancer treatments. Each of the close to 300 and growing number of entries offer health-care professional and patient versions, and entries are regularly updated with the latest research findings.
In addition, the About Herbs app, Memorial Sloan Kettering Cancer Center’s very first mobile application, can be downloaded at http://itunes.apple.com/us/app/about-herbs/id554267162?mt=8. The app is compatible with iPad, iPhone, and iPod Touch devices.
