Medicinal Fungi Evidence Update

Peer-reviewed RCT · newly indexed 13 October 2026 · very small pilot.

Population and outcomes. Adults aged 20–50 with 2–5 mm minor recurrent aphthous ulcers. Daily pain visual analogue scale, ulcer area on days 1, 3, 5 and 7, and epithelialisation by 3% hydrogen peroxide test.

Result. The active gel had mean VAS 3.10 versus 3.93 with placebo and 2.40 with triamcinolone. Mean epithelialisation was 5.4 days with xLr, 6.8 with placebo and 6.0 with triamcinolone, but between-group differences were not significant. No adverse events were reported. The steroid comparator produced the largest pain and ulcer-size reductions.

Quality and bias. Double-blind, randomised, parallel design, but severely underpowered. The article reports 21 participants yet lists arm sizes of 6, 7 and 5 (total 18), leaving attrition or exclusion unclear in the accessible record. The trial ran February 2023–February 2024 but was first registered in May 2025, after completion. Registry results were not posted; no IPD sharing is planned. The product supplier is identified, but funding and author conflicts were not available in the indexed record.

No qualifying new systematic review or meta-analysis was identified. Peer-reviewed critical narrative review · published 30 September; newly indexed.

Izah and colleagues searched PubMed, publisher databases, DOI records and backward citations through 10 September 2026. The review explicitly separates beta-glucans, heteropolysaccharides, polysaccharide-protein complexes, crude fractions, modified derivatives and multicomponent extracts. This is methodologically aligned with an intervention-specific manuscript.

Human evidence signal. The review preserves the negative phase III result for purified lentinan in advanced gastric cancer: 154 received S-1 alone and 155 received S-1 plus lentinan; median overall survival was 13.8 versus 9.9 months (p=0.208), time to treatment failure 4.3 versus 2.6 months (p<0.001), and response 22.3% versus 18.7%. Historical PSK benefits are confined to dated chemotherapy settings. It found no direct clinical evidence with checkpoint inhibitors, therapeutic antibodies or cancer vaccines.

Limits. The authors call the method a structured critical narrative review: no PRISMA flow, protocol registration, uniform risk-of-bias tool or meta-analysis. Heterogeneity is a reason not to pool, but selection remains vulnerable to reviewer judgement. No financial support or commercial conflicts were declared.

Peer-reviewed animal + mechanistic study · online 14 October 2026.

The accessible indexed record does not report the shiitake strain, tissue, extraction/purity specification, route, dose, sex, group sizes, randomisation or blinding; these omissions prevent a full chain-of-custody and ARRIVE assessment.

Result and causal strength. Lentinan reduced plaque progression, lipid peroxidation and macrophage ferroptosis while improving glutathione homeostasis and SR-B1-linked cholesterol efflux. The effect was substantially lost in SLC7A11-deficient mice. Binding and mutation experiments implicated FUBP1 threonine-559 O-GlcNAcylation, nuclear translocation and relief of p53-mediated SLC7A11 repression. Genetic loss-of-function makes this stronger than pathway correlation alone.

Interpretation. This is one laboratory's mechanistic model, not replication and not clinical evidence for shiitake foods, powders or other lentinan preparations. The indexed declaration reports no competing interests; funding was not reported there.