The purpose of this article is to discuss the relationship between the therapeutic bioactivity of basidial fungal polysaccharides (BFPs) BFPs and their structural characteristics and conformational features, as well as to characterize the mechanisms of action of BFPs in diseases of various origins. The review was conducted using the PubMed (Medline), Scopus, Web of Science and the Russian Science Citation Index databases. 8645 records were identified, of which 5250 were studies (86 were randomized controlled trials). The period covered is from 1960 to the present. The most significant studies conducted mainly in Southeast Asian countries were selected for the review. Based on clinical studies, as well as the results obtained on in vivo, in vitro and ex vivo models, it has been proven that BFPs have diverse and highly effective biological activity in the human body in various diseases. The production of BFPs-based vaccines is an innovative strategy from a clinical and biochemical point of view, since as potential immunoprotective and low-toxic biopolymers they have innate immune receptors in the body. Promising results have been obtained in the development of antidiabetic drugs, probiotic, renoprotective and neurodegenerative dietary supplements. The biological activity, mechanism of action and specific therapeutic effect of BFPs largely depend on their structural and physicochemical characteristics. BFPs as multifunctional macromolecular complexes with low toxicity and high safety are ideal as new powerful pharmaceuticals for the treatment and prevention of many diseases.
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