Shiitake

Shiitake/Drug Interactions:

  • AntibioticsAntibiotics: According to in vitro evidence, shiitake inhibited S. aureus, E. faecalis, and E. coli O-114, and stimulated the growth of E. coli M-17 (20). Bifidobacteria and lactobacteria were resistant to shiitake juice (20). In other in vitro evidence, the culture fluid of Lentinula edodes mycelium, particularly the lenthionine component, is bacteriostatic against Streptococcus pyogenes, Staphylococcus aureus, and Bacillus megaterium albicans (21).
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: According to in vitro study, the lenthionine constituent and the aqueous dialysate of shiitake inhibit platelet aggregation (59). However, in animal study, the shiitake-fructo-oligosaccharide mixture (SK-204) was found to have antithrombotic action but not due to inhibition of platelet aggregation or coagulation. Rather, it was likely due to the promotion of fibrinolysis and thrombolysis (92).
  • AntifungalsAntifungals: In laboratory study, lentin, isolated from Lentinula edodes, inhibited mycelial growth in a variety of fungal species including Candida albicans,Physalospora piricola, Botrytis cinerea, and Mycosphaerella arachidicola (22; 20).
  • Anti inflammatory agentsAnti inflammatory agents: Based on historical use, shiitake may have anti-inflammatory properties, although clinical evidence in this area is lacking. Based on in vitro study, Lentinula edodes may inhibit 12-(S)-HHTrE production, a marker of cyclooxygenase activity (93).
  • Antilipemic agentsAntilipemic agents: In an animal model, shiitake reduced plasma levels of free cholesterol, triglycerides, and phospholipids (92). The lipid-lowering effects of shiitake may be due to eritadenine (94; 95), which modifies hepatic phospholipid metabolism in animal study (96). Earlier evidence suggests that eritadenine exerts its hypocholesterolemic action by increasing uptake of plasma lipoprotein cholesterol by tissues and/or decreasing secretion of plasma lipoprotein cholesterol from the liver (97; 98).
  • Antineoplastic agentsAntineoplastic agents: Oral and intravenous lentinan has been associated with hematologic toxicity, including thrombocytopenia, eosinophilia, granulocytopenia, and leukocytosis, in clinical study (60; 6; 61; 4; 62). Caution is warranted when using lentinan with chemotherapeutic agents.
  • Antiviral agentsAntiviral agents: According to in vitro study, the water-soluble lignin-rich fraction from shiitake has antiviral activity (99). It can inhibit the initial stages of the replication stage (100). Lentin, a protein from shiitake, has been found to inhibit HIV-1 reverse transcriptase (22; 101). According to in vitro study, lentinan may enhance the activity of zidovudine (AZT) (93). Lentinan may increase CD4 counts based on evidence from its use in combination with didanosine in HIV patients (7).
  • Hepatotoxic agentsHepatotoxic agents: The effects of shiitake on the liver are unclear. Based on clinical study in cancer patients, lentinan may elevate liver enzymes following treatment with lentinan (6). However, according to laboratory evidence, shiitake may have a protective effect (102; 103).
  • ImmunosuppressantsImmunosuppressants: Based on in vitro, animal, and clinical studies, shiitake may have immunomodulating effects (104; 19; 105; 106; 107; 108; 109; 110; 111; 112; 33; 113; 12; 18; 9; 114; 45; 46; 48; 115; 74; 116; 10; 11; 14; 15; 8; 117; 13; 16; 17; 118).
  • Photosensitizing agentsPhotosensitizing agents: Based on case study, lentinan may cause photosensitivity (84).
  • VaccinesVaccines: Pretreatment with lentinan enhanced the local immunohistological response to BCG vaccine in the lung and reduced the generalized side effects (19)

    • Shiitake/Herb/Supplement Interactions:

  • AntibacterialsAntibacterials: According to in vitro evidence, shiitake inhibited S. aureus, E. faecalis, and E. coli O-114, and stimulated the growth of E. coli M-17 (20). Bifidobacteria and lactobacteria were resistant to shiitake juice (20). Other in vitro evidence reported that the culture fluid of Lentinula edodes mycelium, particularly the lenthionine component, is bacteriostatic against Streptococcus pyogenes, Staphylococcus aureus, and Bacillus megaterium albicans (21).
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: According to in vitro study, the lenthionine constituent and the aqueous dialysate of shiitake inhibit platelet aggregation. However, in animal study, the shiitake-fructo-oligosaccharide mixture (SK-204) was found to have antithrombotic action but not due to inhibition of platelet aggregation or coagulation. Rather, it was likely due to the promotion of fibrinolysis and thrombolysis (92).
  • Anti inflammatory herbsAnti inflammatory herbs: Based on historical use, shiitake may have anti-inflammatory properties, although clinical evidence is currently lacking. Based on in vitro study, Lentinula edodes may inhibit 12-(S)-HHTrE production, a marker of cyclooxygenase activity (93).
  • AntifungalsAntifungals: In laboratory study, lentin, isolated from Lentinula edodes, inhibited mycelial growth in a variety of fungal species including Candida albicans,Physalospora piricola, Botrytis cinerea, and Mycosphaerella arachidicola (22; 20).
  • AntilipemicsAntilipemics: In an animal model, shiitake reduced plasma levels of free cholesterol, triglycerides, and phospholipids (92). The lipid-lowering effects of shiitake may be due to eritadenine (94; 95), which modifies hepatic phospholipid metabolism in animal study (96). Earlier study suggests that eritadenine exerts its hypocholesterolemic action by increasing uptake of plasma lipoprotein cholesterol by tissues and/or decreasing secretion of plasma lipoprotein cholesterol from the liver (97; 98).
  • Antineoplastic agentsAntineoplastic agents: Oral and intravenous lentinan has been associated with hematologic toxicity, including thrombocytopenia, eosinophilia, granulocytopenia, and leukocytosis, in clinical study (60; 6; 61; 4; 62). Caution is warranted when using lentinan with chemotherapeutic agents.
  • AntioxidantsAntioxidants: Based on in vitro study, lentinan may decrease superoxide dismutase activity of lymphocytes and erythrocytes (119).
  • AntiviralsAntivirals: According to in vitro study, the water-soluble lignin-rich fraction from shiitake has antiviral activity (99). It can inhibit the initial stages of replication (100). Lentin, a protein from shiitake, has been found to inhibit HIV-1 reverse transcriptase (22; 101)
  • CranberryCranberry: Based on in vitro study, beta-glucosidase from shiitake may release phenolic aglycones from cranberry (120).
  • Hepatotoxic herbs and supplementsHepatotoxic herbs and supplements: The effects of shiitake on the liver are unclear. Based on clinical study in cancer patients, treatment with lentinan may elevate liver enzymes (6). However, according to laboratory study, shiitake may have a protective effect (102; 103).
  • ImmunosuppressantsImmunosuppressants: Based on in vitro, animal, and clinical studies, shiitake may have immunomodulating effects (104; 19; 105; 106; 107; 108; 109; 110; 111; 112; 33; 113; 12; 18; 9; 114; 45; 46; 48; 115; 74; 116; 10; 11; 14; 15; 8; 117; 13; 16; 17; 118).
  • PhotosensitizersPhotosensitizers: Based on case study, lentinan may cause photosensitivity (84).

    • Shiitake/Food Interactions:

  • CranberryCranberry: Based on in vitro study, beta-glucosidase from shiitake may release phenolic aglycones from cranberry (120).

    • Shiitake/Lab Interactions:

  • AlbuminAlbumin: In clinical study, there was an increase in serum albumin in 58% of gastric cancer patients treated with lentinan plus tegafur (29). It is not known if this is due to lentinan use.
  • Blood cell countsBlood cell counts: Oral and intravenous lentinan has been associated with hematologic toxicity, including thrombocytopenia, eosinophilia, granulocytopenia, and leukocytosis, in clinical study (60; 6; 61; 4; 62).
  • Coagulation panelCoagulation panel: According to in vitro study, the lenthionine constituent and the aqueous dialysate of shiitake inhibit platelet aggregation. However, in animal study, the shiitake-fructo-oligosaccharide mixture (SK-204) was found to have antithrombotic action but not due to inhibition of platelet aggregation or coagulation. Rather, it was likely due to the promotion of fibrinolysis and thrombolysis (92).
  • Immune panelImmune panel: Based on in vitro, animal, and clinical studies, shiitake may have immunomodulating effects (104; 19; 105; 106; 107; 108; 109; 110; 111; 112; 33; 113; 12; 18; 9; 114; 45; 46; 48; 115; 74; 116; 10; 11; 14; 15; 8; 117; 13; 16; 17; 118).
  • Interleukins/tumor necrosis factorInterleukins/tumor necrosis factor: Based on human studies, shiitake may significantly increase cell-mediated immunity molecules (121; 10; 117; 122; 45; 74).
  • Lipid profileLipid profile: Based on animal study, shiitake may reduce plasma levels of free cholesterol, triglycerides, and phospholipids (92).
  • Liver function testsLiver function tests: The effects of shiitake on the liver are unclear. Based on clinical study in cancer patients, treatment with lentinan may elevate liver enzymes (6). However, according to laboratory study, shiitake may have a protective effect (102; 103).
  • ProlactinProlactin: Based on study in cancer patients, a combination of lentinan and surgical therapy may result in a decrease in blood levels of prolactin (123).
  • Serum IAPSerum IAP: Based on study in gastric cancer patients, lentinan plus tegafur may decrease serum IAP (29). It is not known if this is due to lentinan use.
  • Viral loadViral load: Based on clinical study, concomitant use of didanosine and lentinan may increase CD4 levels in HIV-positive patients (7). In cancer patients, levels of CD4+ cells recovered more quickly after lentinan use (12)