Lentinan is a purified extract of the shiitake mushroom Lentinus edodes, which has been used in Japan as an anti-cancer drug. In the test-tube it appears to be an immune-modulating drug that stimulates the function of T-helper cells and macrophages.

Lentinan is manufactured by the Ajinomoto Co Inc in Tokyo and its American subsidiary Leonti-Chemico Pharmaceutical Laboratory Inc.

Current use

Two phase I/II trials in the USA found no evidence of any clinical or laboratory benefits from lentinan, although participants reported side-effects of allergic reactions, shivers and severe back and lumbar pains. Elevated liver function tests, rash and mild chest pressure have been reported in some cancer patients receiving lentinan.

A trial of the combination of ddI and lentinan suggested that it produced better CD4 count increases than ddI monotherapy. Nothing further on the use of this compound in HIV infection has been reported since 1995.

Key research

Tochikura reported that in vitro lentinan had no anti-HIV effects but inhibited AZT's inhibition of viral replication in cell cultures.

Abrams enrolled 44 HIV-positive people (CD4 cell counts between 200-500) in a phase I/II double-blind placebo-controlled trial at San Francisco General Hospital. In lentinan-treated people, no significant change was noted in CD4 count, beta₂-microglobulin levels, neutrophil function activity, skin-test reactivity, or p24 antigen levels. Anaphylactic reaction, rigors and severe lumbar pain were reported.

In a similar study conducted by the CRI in New York, preliminary reports do not suggest any improvement in subjective symptoms, virologic or immunologic parameters.

Gordon enrolled 107 people with CD4 counts between 200 and 500 in a study of ddI (400 mg/day) with the addition at week 6 of lentinan (2 mg IV per week), for between 24 and 80 weeks. A control group received ddI monotherapy. ddI monotherapy recipients experienced CD4 count increases that remained significant to week 16, while CD4 count increases in the combination group remained significant to week 38.

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