We thank Dr Claman1Claman H. Glucocorticoids in herbal formulas?.J Allergy Clin Immunol. 2002; 109: 1038Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar for his question. We also thank the editors for providing us with the opportunity to comment on the question. Ling zhi (Ganoderma lucidum ) does indeed contain several compounds such as ganoderic acid (shown on the Web site2Komota Y et al.Study of the main chemical components of Ganoderma lucidum.in: From: Proceedings of the 104th Annual Meeting of Pharmacological Society of Japan, 1984February 13, 2002http://www.reishi.com/ganolucd.htmlGoogle Scholar referred to by Dr Claman), as well as ganoderla A and lucidenic acids,3Wu TS Shi LS Kuo SC Cytotoxicity of Ganoderma lucidum triterpenes.J Nat Prod. 2001; 64: 1121-1122Crossref PubMed Scopus (135) Google Scholar all of which have 4-ring structures. These compounds are members of the triterpenoid family, an important class of plant products present in many foods and herbal medicines. Ling zhi and many food plants also contain phytosterols such as ergosterol (provitamin D2), which is converted to vitamin D2 by UV irradiation and which also has a 4-ring structure. However, none of these compounds has both the 4,5 double bonds and 3-keto group on ring A and the 11β hydroxyl group on ring C, which are essential for glucocorticoid activity. Therefore, it is not possible for the chemical structures of ling zhi components to act as corticosteroids. Furthermore, triterpenoids and sterols are hydrophobic, and water extracts such as FAHF-1 contain little of these compounds. Bao et al4Bao XF Wang XS Dong Q Fang JN Li XY Structural features of immunologically active polysaccharides from Ganoderma lucidum.Phytochemistry. 2002; 59: 175-181Crossref PubMed Scopus (245) Google Scholar have suggested that the immunomodulating activities of G lucidum might be due to polysaccharides. Their study showed that polysaccharides isolated from G lucidum increased IL-2, IFN-γ, and IL-1, but not TNF-α or IL-4, after Con A stimulation of murine spleen cells. In our publication, we noted that “in contrast to corticosteroids, which induce immune suppression, FAHF-1 suppressed peanut-specific TH2 responses without suppressing IFN-γ secretion by splenocytes from peanut-allergic mice, total serum IgG and IgA levels in naive mice, or IFN-γ production by splenocytes of naive mice.”5Li X Zhang T Huang C Srivastava K Teper A Zhang L et al.Food Allergy Herbal Formula-1 (FAHF-1) blocks peanut-induced anaphylaxis in a murine model.J Allergy Clin Immunol. 2001; 108: 639-646Abstract Full Text Full Text PDF PubMed Scopus (163) Google Scholar We recently reported that the immunomodulating herbal formula MSSM-002, which also contains ling zhi , did not induce apoptosis in vitro whereas dexamethasone did.6Li X Teper A Zou Z Srivastava K Schofield B Sampson H. The Chinese herbal formula, MSSM-002, can reverse the established Th2 phenotype, which is accompanied with down regulation of the Th2 transcription factor GATA-3 [abstract].J Allergy Clin Immunol. 2002; 109: S155Abstract Full Text PDF PubMed Google Scholar Although the means by which this herbal formula suppresses peanut allergic reactions requires further investigation, the chemical structure of known compounds in ling zhi differs from that of corticosteroids and the actions of the herbal formula on T and B cells differ from those of corticosteroids. Therefore, it is highly unlikely that “taking some Chinese (or other) herbal medicines is an ‘alternative' method of ingesting corticosteroids.”1Claman H. Glucocorticoids in herbal formulas?.J Allergy Clin Immunol. 2002; 109: 1038Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar However, caution needs to be taken regarding deliberate adulteration of corticosteroids in particular herbal creams.7Ernst E. Adverse effects of herbal drugs in dermatology.Br J Dermatol. 2000; 143: 923-929Crossref PubMed Scopus (214) Google Scholar, 8Keane FM Munn SE du VA Taylor NF Higgins EM Analysis of Chinese herbal creams prescribed for dermatological conditions.BMJ. 1999; 318: 563-564Crossref PubMed Scopus (102) Google Scholar This deliberate adulteration should be distinguished from traditional ingredients in traditional herbal medicines. We thank Dr Joseph Goldfarb, Department of Pharmacology, and Dr Zhong-Mei Zou, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, for their helpful discussion regarding this reply.