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The Cochrane Database of Systematic... Nov 2022Radiotherapy and chemotherapy are used to improve survival in colorectal cancer but adverse effects can be a problem. Severe adverse effects may result in dose reduction... (Review)
Review
BACKGROUND
Radiotherapy and chemotherapy are used to improve survival in colorectal cancer but adverse effects can be a problem. Severe adverse effects may result in dose reduction or cessation of treatment, which have an impact on survival. Coriolus versicolor (Trametes versicolor or 'Turkey Tail') mushroom and its extracts have been used by cancer patients to help with adverse effects.
OBJECTIVES
To assess the effects of adjunctive Coriolus versicolor (Trametes versicolor) and its extracts on adverse effects and on survival during colorectal cancer treatment (chemotherapy and radiotherapy) compared with no adjunctive treatment.
SEARCH METHODS
We searched databases including CENTRAL, MEDLINE, Embase, AMED and CINAHL, Chinese and Japanese databases, and trials registers to 12th April 2022 without restriction of language or publication status. We screened reference lists and attempted to contact researchers in the field to identify additional studies.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) investigating the efficacy and safety of Coriolus versicolor and its extracts in adult participants with a confirmed diagnosis of colorectal cancer, in addition to conventional treatment. Interventions included any preparation of Coriolus versicolor (raw, decoction, capsule, tablet, tincture, extract, injection), any part of the fungus (cap, stem, mycelium or whole), in any dose or regimen. Outcomes included adverse events rates, survival, disease progression and recurrence, response rates and quality of life.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened and selected studies, extracted outcome data, and assessed risk of bias. We evaluated the overall certainty of evidence using the GRADE approach.
MAIN RESULTS
We included seven parallel RCTs (1569 participants). Six studies (1516 participants) were conducted in Japan and one study (53 participants) in China. Studies included both male and female participants with colorectal cancer (five studies), colon cancer (one study) or rectal cancer (one study). Participants were diagnosed with cancer ranging from stage II to stage IV. Coriolus was used in the form of an extract in all seven studies and was generally used after curative resection, although in one study it was used preoperatively. Duration of treatment with the extract varied between four weeks and three years. Chemotherapeutic regimens in six studies consisted of an oral fluoropyrimidine which was preceded by weekly intravenous 5-Fluorouracil (5-FU) in one study, by mitomycin C in two studies, and which was combined with folinic acid (Leucovorin) in two studies and with radiotherapy preoperatively in one study. XELOX (oxaliplatin intravenous infusion and capecitabine) was used in the remaining study. We found very low-certainty evidence of little to no effect of adjunctive treatment with Coriolus (in the form of an extract, polysaccharide-Krestin, PSK) on withdrawal from treatment due to adverse events (risk ratio (RR) 1.03, 95% confidence interval (CI) 0.45 to 2.34; 703 participants; 3 studies;). We are uncertain whether adjunctive Coriolus versicolor and its extracts compared to usual care alone resulted in a difference in adverse events including neutropenia (RR 0.41, 95% CI 0.24 to 0.71; 133 participants; 3 studies; very low certainty), oral cavity disorders such as oral dryness and mucositis (RR 0.37, 95% CI 0.13 to 1.03; 1022 participants; 5 studies; very low certainty), nausea (RR 0.73, 95% CI 0.44 to 1.22; 969 participants; 4 studies; very low certainty), diarrhoea (RR 0.77, 95% CI 0.32 to 1.86; 1022 participants; 5 studies; very low certainty), and fatigue (RR 0.76; 95% CI 0.33 to 1.78; 133 participants; 3 studies; very low certainty). We found low-certainty evidence of a small effect of adjunctive Coriolus on improved survival at five years compared with no adjunctive care (RR 1.08, 95% CI 1.01 to 1.15; 1094 participants; 3 studies; number needed to benefit (NNTB) = 16 (95% Cl 9 to 70). The effect at earlier time points was unclear.
AUTHORS' CONCLUSIONS
Due to the very low certainty of evidence, we were uncertain about the effect of adjunctive Coriolus (in the form of an extract PSK) on adverse events resulting from conventional chemotherapy for colorectal cancer. This includes effects on withdrawal of treatment due to adverse events and on specific adverse outcomes such as neutropenia and nausea. The uncertainty in the evidence also means that it was unclear whether any adverse events were due to the chemotherapy or to the extract itself. While there was low-certainty evidence of a small effect on overall survival at five years, the influence of reduced adverse effects on this could not be determined. In addition, chemotherapy regimens used in assessing this outcome do not reflect current preferred practice.
Topics: Adult; Female; Humans; Male; Agaricales; Colorectal Neoplasms; Drug-Related Side Effects and Adverse Reactions; Nausea; Neutropenia; Trametes; Randomized Controlled Trials as Topic
PubMed: 36445793
DOI: 10.1002/14651858.CD012053.pub2 -
Clinical Toxicology (Philadelphia, Pa.) Nov 2022poisoning causes severe liver damage which may be potentially fatal. Several treatments are available, but their effectiveness has not been systematically evaluated. We... (Review)
Review
BACKGROUND AND AIMS
poisoning causes severe liver damage which may be potentially fatal. Several treatments are available, but their effectiveness has not been systematically evaluated. We performed a systematic review to investigate the effect of the most commonly used therapies: N-acetylcysteine (NAC), benzylpenicillin (PEN), and silibinin (SIL) on patient outcomes. In addition, other factors contributing to patient outcomes are identified.
METHODS
We searched MEDLINE and Embase for case series and case reports that described patient outcomes after poisoning with amanitin-containing mushrooms. We extracted clinical characteristics, treatment details, and outcomes. We used the liver item from the Poisoning Severity Score (PSS) to categorize intoxication severity.
RESULTS
We included 131 publications describing a total of 877 unique cases. The overall survival rate of all patients was 84%. Patients receiving only supportive care had a survival rate of 59%. The use of SIL or PEN was associated with a 90% (OR 6.40 [3.14-13.04]) and 89% (OR 5.24 [2.87-9.56]) survival rate, respectively. NAC/SIL combination therapy was associated with 85% survival rate (OR 3.85 [2.04, 7.25]). NAC/PEN/SIL treatment group had a survival rate of 76% (OR 2.11 [1.25, 3.57]). Due to the limited number of cases, the use of NAC alone could not be evaluated. Additional analyses in 'proven cases' (amanitin detected), 'probable cases' (mushroom identified by mycologist), and 'possible cases' (neither amanitin detected nor mushroom identified) showed comparable results, but the results did not reach statistical significance. Transplantation-free survivors had significantly lower peak values of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total serum bilirubin (TSB), and international normalized ratio (INR) compared to liver transplantation survivors and patients with fatal outcomes. Higher peak PSS was associated with increased mortality.
CONCLUSION
Based on data available, no statistical differences could be observed for the effects of NAC, PEN or SIL in proven poisonings with amanitin-containing mushrooms. However, monotherapy with SIL or PEN and combination therapy with NAC/SIL appear to be associated with higher survival rates compared to supportive care alone. AST, ALT, TSB, and INR values are possible predictors of potentially fatal outcomes.
Topics: Humans; Amanitins; Mushroom Poisoning; Amanita; Alanine Transaminase; Acetylcysteine; Silybin; Penicillin G
PubMed: 36129244
DOI: 10.1080/15563650.2022.2098139 -
Critical Reviews in Food Science and... 2023Interest in plant-based diets and vegetarianism is increasing worldwide, however, a concern for total vegetarians is vitamin B12 (B12) deficiency. We conducted a...
Interest in plant-based diets and vegetarianism is increasing worldwide, however, a concern for total vegetarians is vitamin B12 (B12) deficiency. We conducted a systematic review to investigate non-animal food sources of B12. Databases were PubMed, LILACS, Cochrane, Embase and Google Scholar, up to September 9, 2020. Quality of the eligible studies were assessed. We identified 25 studies which assessed B12 content in seaweeds, mushrooms, plants and fermented foods. Initial studies were microbiological bioassay, ELISA and HPLC. In the last decade, more sensitive method for real B12 determination was used, the liquid chromatography-electrospray ionization tandem mass spectrometry chromatograms. Real B12 content varied from mean () mcg/portion size of seaweed hijiki 3 × 10/7 g to nori 1.03 - 2.68/sheet; mushroom white button cap 2 × 10(7 × 10)/20 g dry weight (dw) to shiitake 0.79(0.67)-1.12 (0.78)/20 g dw; and fermented foods from soy yogurt 20/cup. It is possible that daily recommendations for B12 can be met by a varied diet containing non-animal B12 food sources. Future research should consider different methods of storage, preparation, fermented foods and standardization of the production of certain foods.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2022.2053057.
Topics: Vitamin B 12; Vitamin B 12 Deficiency; Diet, Vegetarian; Vegetables; Agaricales; Seaweed; Edible Seaweeds; Sargassum; Porphyra
PubMed: 35343314
DOI: 10.1080/10408398.2022.2053057 -
Biomedicine & Pharmacotherapy =... Mar 2022Mushroom consumption has grown extraordinarily owing to their high nutritional value, desirable taste, and aroma. Mushrooms continue generating lots of interest chiefly...
Mushroom consumption has grown extraordinarily owing to their high nutritional value, desirable taste, and aroma. Mushrooms continue generating lots of interest chiefly in their consumption as food, as a cure for different ailments, as well as important goods for commerce throughout the globe owing to their dietary, antioxidant, and therapeutic values. Higher Ascomycetes and Basidiomycetes mushrooms have different properties with anticancer and immunological potential. They as well provide vital health benefits and display a wide-ranging continuum of pharmacological effects. The antioxidant activity of different mushrooms was reviewed for different radicals including DPPH, ABTS, OH, Nitrite, metals, and lipid peroxidation. The present review presents pharmacological activities of different species of edible and medicinal mushrooms. This review provides tangible evidence that these mushrooms are an excellent source of natural constituents and antioxidants with potential application in pharmaceuticals and in treating and managing different diseases.
Topics: Agaricales; Antioxidants; Functional Food; Humans
PubMed: 35026489
DOI: 10.1016/j.biopha.2022.112621 -
Advances in Nutrition (Bethesda, Md.) Oct 2021Mushrooms are rich in bioactive compounds. The potential health benefits associated with mushroom intake have gained recent research attention. We thus conducted a... (Meta-Analysis)
Meta-Analysis
Mushrooms are rich in bioactive compounds. The potential health benefits associated with mushroom intake have gained recent research attention. We thus conducted a systematic review and meta-analysis to assess the association between mushroom intake and risk of cancer at any site. We searched MEDLINE, Web of Science, and Cochrane Library to identify relevant studies on mushroom intake and cancer published from 1 January, 1966, up to 31 October, 2020. Observational studies (n = 17) with RRs, HRs, or ORs and 95% CIs of cancer risk for ≥2 categories of mushroom intake were eligible for the present study. Random-effects meta-analyses were conducted. Higher mushroom consumption was associated with lower risk of total cancer (pooled RR for the highest compared with the lowest consumption groups: 0.66; 95% CI: 0.55, 0.78; n = 17). Higher mushroom consumption was also associated with lower risk of breast cancer (pooled RR for the highest compared with the lowest consumption groups: 0.65; 95% CI: 0.52, 0.81; n = 10) and nonbreast cancer (pooled RR for the highest compared with the lowest consumption groups: 0.80; 95% CI: 0.66, 0.97; n = 13). When site-specific cancers were examined, a significant association with mushroom consumption was only observed with breast cancer; this could be due to the small number of studies that were conducted with other cancers. There was evidence of a significant nonlinear dose-response association between mushroom consumption and the risk of total cancer (P-nonlinearity = 0.001; n = 7). Limitations included the potential for recall and selection bias in case-control designs, which comprised 11 out of the 17 studies included in this meta-analysis, and the large variation in the adjustment factors used in the final models from each study. The association between higher mushroom consumption and lower risk of cancer, particularly breast cancer, may indicate a potential protective role for mushrooms in the diet.
Topics: Agaricales; Breast Neoplasms; Case-Control Studies; Diet; Female; Humans; Risk; Risk Factors
PubMed: 33724299
DOI: 10.1093/advances/nmab015 -
The Cochrane Database of Systematic... Mar 2021This is a updated version of our Cochrane Review published in Issue 6, 2012. Sexually-transmitted infections (STIs) continue to rise worldwide, imposing an enormous... (Meta-Analysis)
Meta-Analysis
BACKGROUND
This is a updated version of our Cochrane Review published in Issue 6, 2012. Sexually-transmitted infections (STIs) continue to rise worldwide, imposing an enormous morbidity and mortality burden. Effective prevention strategies, including microbicides, are needed to achieve the goals of the World Heath Organization (WHO) global strategy for the prevention and control of these infections.
OBJECTIVES
To determine the effectiveness and safety of topical microbicides for preventing acquisition of STIs, including HIV.
SEARCH METHODS
We undertook a comprehensive search of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, LILACS, CLIB, Web of Science, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, and reference lists of relevant articles up to August 2020. In addition, we contacted relevant organisations and experts.
SELECTION CRITERIA
We included randomised controlled trials of vaginal microbicides compared to placebo (except for nonoxynol-9 because it is covered in related Cochrane Reviews). Eligible participants were sexually-active non-pregnant, WSM and MSM, who had no laboratory confirmed STIs.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened and selected studies, extracted data, and assessed risks of bias in duplicate, resolving differences by consensus. We conducted a fixed-effect meta-analysis, stratified by type of microbicide, and assessed the certainty of the evidence using the GRADE approach.
MAIN RESULTS
We included eight trials from the earlier version of the review and four new trials, i.e. a total of 12 trials with 32,464 participants (all WSM). We did not find any eligible study that enrolled MSM or reported fungal STI as an outcome. We have no study awaiting assessment. All 12 trials were conducted in sub-Saharan Africa, with one having a study site in the USA, and another having a site in India. Vaginal microbicides tested were BufferGel and PRO 2000 (1 trial, 3101 women), Carraguard (1 trial, 6202 women), cellulose sulphate (2 trials, 3069 women), dapivirine (2 trials, 4588 women), PRO 2000 (1 trial, 9385 women), C31G (SAVVY) (2 trials, 4295 women), and tenofovir (3 trials, 4958 women). All microbicides were compared to placebo and all trials had low risk of bias. Dapivirine probably reduces the risk of acquiring HIV infection: risk ratio (RR) 0.71, (95% confidence interval (CI) 0.57 to 0.89, I = 0%, 2 trials, 4588 women; moderate-certainty evidence). The other microbicides may result in little to no difference in the risk of acquiring HIV (low-certainty evidence); including tenofovir (RR 0.83, 95% CI 0.68 to 1.02, cellulose sulphate (RR 1.20, 95% CI 0.74 to 1.95, BufferGel (RR 1.05, 95% CI 0.73 to 1.52), Carraguard (RR 0.89, 95% CI 0.71 to 1.11), PRO 2000 (RR 0.93, 95% CI 0.77 to 1.14), and SAVVY (RR 1.38, 95% CI 0.79 to 2.41). Existing evidence suggests that cellulose sulphate (RR 0.99, 95% CI 0.37 to 2.62, 1 trial, 1425 women), and PRO 2000 (RR 0.95, 95% CI 0.73 to 1.23) may result in little to no difference in the risk of getting herpes simplex virus type 2 infection (low-certainty evidence). Two studies reported data on tenofovir's effect on this virus. One suggested that tenofovir may reduce the risk (RR 0.55, 95% CI 0.36 to 0.82; 224 participants) while the other did not find evidence of an effect (RR 0.94, 95% CI 0.85 to 1.03; 1003 participants). We have not reported the pooled result because of substantial heterogeneity of effect between the two studies (l = 85%). The evidence also suggests that dapivirine (RR 1.70, 95% CI 0.63 to 4.59), tenofovir (RR 1.27, 95% CI 0.58 to 2.78), cellulose sulphate (RR 0.69, 95% CI 0.26 to 1.81), and (Carraguard (RR 1.07, 95% CI 0.75 to 1.52) may have little or no effect on the risk of acquiring syphilis (low-certainty evidence). In addition, dapivirine (RR 0.97, 95% CI 0.89 to 1.07), tenofovir (RR 0.90, 95% CI 0.71 to 1.13), cellulose sulphate (RR 0.70, 95% CI 0.49 to 0.99), BufferGel (RR 0.97, 95% CI 0.65 to 1.45), Carraguard (RR 0.96, 95% CI 0.83 to 1.12), and PRO 2000 (RR 1.01, 95% CI 0.84 to 1.22) may result in little to no difference in the risk of acquiring chlamydia infection (low-certainty evidence). The evidence also suggests that current topical microbicides may not have an effect on the risk of acquiring gonorrhoea, condyloma acuminatum, trichomoniasis, or human papillomavirus infection (low-certainty evidence). Microbicide use in the 12 trials, compared to placebo, did not lead to any difference in adverse event rates. No study reported on acceptability of the intervention. AUTHORS' CONCLUSIONS: Current evidence shows that vaginal dapivirine microbicide probably reduces HIV acquisition in women who have sex with men. Other types of vaginal microbicides have not shown evidence of an effect on acquisition of STIs, including HIV. Further research should continue on the development and testing of new microbicides.
Topics: Acrylic Resins; Adenine; Administration, Intravaginal; Agaricales; Anti-HIV Agents; Anti-Infective Agents, Local; Bias; Cellulose; Female; HIV Infections; Humans; Naphthalenesulfonates; Placebos; Polymers; Pyrimidines; Seaweed; Sexually Transmitted Diseases; Tenofovir
PubMed: 33719075
DOI: 10.1002/14651858.CD007961.pub3 -
The American Journal of Medicine May 2021Edible mushrooms have a great nutritional value including high protein, essential amino acids, fiber, vitamins (B, B, B, C, and D), minerals (calcium [Ca], potassium...
INTRODUCTION
Edible mushrooms have a great nutritional value including high protein, essential amino acids, fiber, vitamins (B, B, B, C, and D), minerals (calcium [Ca], potassium [K], magnesium [Mg], sodium [Na], phosphorus [P], copper [Cu], iron [Fe], manganese [Mn], and selenium [Se]), low fatty foods, and sodium. The objective of this systematic review was to determine the relationship between edible mushroom consumption and overall cardiovascular risk.
METHODS
We systematically searched Ovid MEDLINE, Embase, Ovid Cochrane Database of Systematic Reviews, Scopus, and Web of Science from database inception from 1966 through August 2020 for observational studies that reported the association between edible mushroom consumption and cardiovascular risk. Two investigators independently reviewed data. Conflicts were resolved through consensus discussion.
RESULTS
Of 1479 studies, we identified 7 prospective studies. Edible mushroom consumption may have favorable effects on lipid profiles by changing some metabolic markers such as low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, total cholesterol, and triglycerides. Moreover, edible mushroom consumption is probably associated with reduced mean blood pressure. The beneficial overall cardiovascular risk, stroke risk, and coronary artery disease of edible mushroom consumption are not consistent.
CONCLUSIONS
Edible mushroom consumption has not been shown to conclusively affect cardiovascular risk factors to date. However, potential health benefits may exist, including a favorable alteration of lipid profiles and blood pressure reduction.
Topics: Agaricales; Blood Pressure; Cardiovascular Diseases; Heart Disease Risk Factors; Humans; Lipids
PubMed: 33309597
DOI: 10.1016/j.amjmed.2020.10.035 -
The Journal of Nutritional Biochemistry Oct 2020There is evidence from both in vitro and animal models that the consumption of edible mushrooms has beneficial effects on health. It is unclear whether similar effects...
There is evidence from both in vitro and animal models that the consumption of edible mushrooms has beneficial effects on health. It is unclear whether similar effects exist in humans and which bioactive compounds are present. This review synthesises the evidence on the world's most commonly consumed mushroom, Agaricus bisporus to (i) examine its effect on human health outcomes; and (ii) determine the nutrient density of its bioactive compounds, which may explain their health effects. A systematic literature search was conducted on the consumption of A. bisporus, without date and study design limits. Bioactive compounds included ergosterol, ergothioneine, flavonoids, glucans and chitin. Two authors independently identified studies for inclusion and assessed methodological quality. Beneficial effects of A. bisporus on metabolic syndrome, immune function, gastrointestinal health and cancer, with the strongest evidence for the improvement in Vitamin D status in humans, were found. Ultraviolet B (UVB) exposed mushrooms may increase and maintain serum 25(OH)D levels to a similar degree as vitamin D supplements. A. bisporus contain beta-glucans, ergosterol, ergothioneine, vitamin D and an antioxidant compound usually reported as flavonoids; with varying concentrations depending on the type of mushroom, cooking method and duration, and UVB exposure. Further research is required to fully elucidate the bioactive compounds in mushrooms using vigorous analytical methods and expand the immunological markers being tested. To enable findings to be adopted into clinical practice and public health initiatives, replication of existing studies in different population groups is required to confirm the impact of A. bisporus on human health.
Topics: Agaricus; Animals; Biological Products; Ergosterol; Ergothioneine; Flavonoids; Glucans; Humans
PubMed: 32653808
DOI: 10.1016/j.jnutbio.2020.108453 -
Nutrients Apr 2020Cardiometabolic diseases are a leading global health challenge. Their incidence as well as progression is strongly affected by diet. Consumption of ), an edible oyster...
Cardiometabolic diseases are a leading global health challenge. Their incidence as well as progression is strongly affected by diet. Consumption of ), an edible oyster mushroom rich in functional ingredients (e.g., β-glucans), may improve glucose and lipid metabolism, blood pressure, body weight and appetite sensations. Hence, this systematic review aimed to provide an overview on the effects of intake on cardiometabolic parameters from clinical trials, taking into account risk of bias (RoB). Relevant studies were investigated for details with consideration of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The Cochrane Collaboration's tool was used to assess the RoB. In total, eight trials included observed beneficial effects of intake on glucose metabolism (reduction in fasting and/or 2 h postprandial glucose) and lipids (decrease in total cholesterol, LDL-cholesterol and/or triglycerides), and some found a reduction in blood pressure. In contrast, body weight did not change. Appetite sensations were not assessed. In most studies, the RoB was high or unclear due to methodological weaknesses and/or inadequate reporting. Thus, intake may improve cardiometabolic health, but evidence for this is low. Hence, further clinical trials with an adequate study design are warranted to validate these suggestions.
Topics: Blood Pressure; Cardiovascular Diseases; Clinical Trials as Topic; Dietary Supplements; Glucose; Humans; Lipid Metabolism; Nutritional Physiological Phenomena; Pleurotus; beta-Glucans
PubMed: 32316680
DOI: 10.3390/nu12041134 -
Current Medicinal Chemistry 2020Bioactive compounds derived from mushrooms have been shown to present promising potential as cosmeceutical or nutricosmetic ingredients. Scientific data reviewed herein...
Bioactive compounds derived from mushrooms have been shown to present promising potential as cosmeceutical or nutricosmetic ingredients. Scientific data reviewed herein showed that extracts prepared from medicinal and edible mushrooms and their individual metabolites presented antiinflammatory, antioxidant, photoprotective, antimicrobial, anti-tyrosinase, anti-elastase, and anticollagenase activities. These metabolites can be utilised as ingredients to suppress the severity of Inflammatory Skin Diseases, offer photoprotection to the skin, and correct Hyperpigmentation. However, studies regarding the molecular mechanism behind the mentioned bioactivities are still lacking. Challenges associated with the use of mushroom extracts and their associated metabolites as cosmeceutical and nutricosmetic ingredients include several steps from the fruiting bodies to the final product: extraction optimization, estimation of the efficacy and safety claims, the use of micro and nanocarriers to allow for controlled release and the pros and cons associated with the use of extracts vs individual compounds. This systematic review highlights that mushrooms contain diverse biomolecules that can be sustainably used in the development of nutricosmetic and cosmeceutical formulations. Reports regarding stability, compatibility, and safety assessment, but also toxicological studies are still needed to be considered. Furthermore, some of the constraints and limitations hindering the development of this type of ingredients still require long-term studies to achieve major breakthroughs.
Topics: Agaricales; Anti-Inflammatory Agents; Antioxidants; Biological Products; Cosmeceuticals; Dietary Supplements; Humans; Skin Diseases
PubMed: 32238131
DOI: 10.2174/0929867327666200402100157