Abstract
Natural compounds containing fungal β-glucans have been used to improve general health for thousands of years in China and Japan. Lentinan, the backbone of β-(1, 3)-glucan with β-(1, 6) branches, is one of the active ingredients purified from Shiitake mushrooms and has been approved as a biological response modifier for the treatment of gastric cancer in Japan. Despite recent advances in chemotherapeutic agents, unresectable or recurrent gastric cancer remains an incurable disease, with survival rates being far from satisfactory. Recent clinical studies have shown that chemo-immunotherapy using lentinan prolongs the survival of patients with advanced gastric cancer, as compared to chemotherapy alone. In addition, trastuzumab, an antibody against HER2/neu growth factor receptor, has been used for the treatment of gastric cancer in combination with cytotoxic chemotherapeutic agents. Lentinan may exert a synergistic action with anti-cancer monoclonal antibodies to activate complement systems through the mechanism of antibody-dependent cellular cytotoxicity and complement dependent cytotoxicity. Because a better understanding of its biological activities should enable us to use lentinan more efficiently in the treatment of gastric cancer, immunological effects provided by β-glucans, a possible mode of action of lentinan, and its clinical application including future potential uses are discussed in the present review.
Highlights
Gastric cancer is the second most common cause of cancerrelated death in the world [1, 2]
A number of fungal components have been implicated in these properties, -glucans were identified as biologically active constituents [6, 8]. -glucans are major cell wall structural components in fungi, yeast, certain bacteria, and cereal plants such as oats and barley [9, 10]. These polysaccharides are well known to be biological response modifiers (BRMs) which stimulate the immune system through activation of various immune cells including macrophages, dendritic cells, neutrophils, natural killer (NK) cells, and lymphocytes
The median overall survival (OS) was significantly longer in the group that received chemo-immunotherapy with lentinan than in the chemotherapy alone group (689 days [95% CI, 467–2324 days]) versus 565 days [95% CI, 323–662 days]), P = 0.0406) (Fig. 6)
Summary
Gastric cancer is the second most common cause of cancerrelated death in the world [1, 2]. -glucans are major cell wall structural components in fungi, yeast, certain bacteria, and cereal plants such as oats and barley [9, 10] These polysaccharides are well known to be biological response modifiers (BRMs) which stimulate the immune system through activation of various immune cells including macrophages, dendritic cells, neutrophils, natural killer (NK) cells, and lymphocytes. It might act synergistically with TLR to produce various cytokines such as interleukin (IL)-2 and IL-12 through activation of myeloid differentiation primary response gene 88 (MyD88) [35] Another signaling pathway is mediated by spleen tyrosine kinase (Syk) [36, 37], which in turn activates the caspase recruitment domain 9bcl10-malt complex (CARD9). Scavenger receptors located in myeloid and endothelial cells recognize a range of foreign cells, low density lipoprotein, and
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call