Talk:Medicinal mushroom

Created page

Here is the medicinal mushroom page. I believe mushrooms may play a role in future medicine, either by supplementation or via a drug company isolating compounds from one of the many mushrooms listed.Jatlas (talk) 22:53, 4 May 2009 (UTC)

Notes

That is a brutally immense article. Here are some quick notes:

1. Citations need some serious work. They are all over the place and need to be formatted uniformly. I suggest the {{cite web}}, {{cite news}}, {{cite journal}} and {{cite book}} templates be employed.
2. There are a large number of short paragraphs that need to be merged together. I would spend several sessions going through this and performing a major cleanup of the prose.
3. The section headings are too long, you need to shorten them. Look over WP:Headings on how to do this and I would personally use WP:Common names guidelines to rename them.
4. Reorder the sections, create on level 2 (== ==) heading for the various cultivars and another level 2 headings for the research. Place all of the cultivars and research under their appropriate heading using level 3 (=== ===) notations.

I hope this helps, --Jeremy (blah blah) 20:18, 3 June 2009 (UTC)

As at the Agaricus blazei article, this one too ignores WP:MEDRS. Most of the cited sources here are primary works, when they should at least be reviews. Alternatively the medical claims should be deleted, something that would, in this article, amount to removing the mention entirely. I've marked several of the offenders.LeadSongDog come howl 21:54, 17 June 2009 (UTC)

LeadSongDog- You are correct and incorrect... There are some stand alone primaries, however most of the primaries are inlcuded in reviews for example many are in this review... Hetland G, Johnson E, Lyberg T, Bernardshaw S, Tryggestad AM, Grinde B (2008). "Effects of the medicinal mushroom Agaricus blazei Murill on immunity, infection and cancer". Scand. J. Immunol. 68. doi:10.1111/j.1365-3083.2008.02156.x.. PMID 18782264. {{cite journal}}: Check |doi= value (help); Unknown parameter |Issue= ignored (|issue= suggested) (help); Unknown parameter |Pages= ignored (|pages= suggested) (help)CS1 maint: multiple names: authors list (link)

However being new to wikipedia, and being previously unaware of the WP:MEDRS protocol, I thought it would be nice for people to be able to directly get to those articles. So, again thank you for pointing that out. You are more than welcome to make changes you think are appropriate for the page as well as make further suggestions to me. Jatlas (talk) 23:36, 19 June 2009 (UTC)

• Well, as you can read at Talk:Agaricus_subrufescens, you were told. Repeatedly. You were also asked not to add these unsuitable sources where better ones were available and even identified. Do you think it's fair and reasonable to leave it up to others to clean up now?LeadSongDog come howl 04:19, 20 June 2009 (UTC)

• Ok you got me... But I wasn't deliberately trying to add primary sources, to go against WP:MEDRS, I just moved the information of that page to this one. After writing all the information I am not going to go through and weed out those primary sources. And I am not trying to be a burden to other people for having to edit those out (if need be) because I started the page so I feel like I have done my part for this page, other people can make it better... Jatlas (talk) 04:34, 20 June 2009 (UTC)

• I'd also like to point out I am not adding as many primary articles as you might think... For example on the Agaricus blazei page (as well as this one) you flagged citations 15-18 as primary results (73-76 on this page), however these papers are included in the review by Hetland. So please remove those notes, or let me do so in the future. Jatlas (talk) 17:06, 23 June 2009 (UTC)
  • You seem to be misunderstanding. Hetland is a review paper, and is suitable for inclusion. That doesn't make all the content of all the papers Hetland reviewed suitable for inclusion in WP. But the question "Which part of the content in the reviewed papers is notable?" is answered by the reviewers (in this case Hetland et al), not by WP editors. Hetland's review is the verifiable reliable source that gives our readers objective evidence they need in order to know that a subject matter expert considers the research to be significant. We expect that reviewers will in most cases mention just a small part of the primary papers they review. That's a good thing. We rely on it. It also saves us a great deal of pointless work. Please stop.LeadSongDog come howl 14:21, 24 June 2009 (UTC)

• No I understand perfectly... To cite material the information must be peer reviewed in a published scientific journal, then must be included in a published scientific review, and then out of the review only information you think is important is allowed to make it on to the page. Jatlas (talk) 23:09, 24 June 2009 (UTC)

That is not at all what WP:MEDRS says. Please read it.00:22, 25 June 2009 (UTC)

It states, "In general, Wikipedia's medical articles should be based upon published, reliable secondary sources whenever possible. Reliable primary sources can add greatly to a medical article, but must be used with care because of the potential for misuse. For that reason, edits that rely on primary sources should only describe the conclusions of the source, and should describe these findings clearly so the edit can be checked by editors with no specialist knowledge." I am using secondary sources as much as I can. When primary sources are used I do my best to fairly report the results. If you think I am using these primary sources to make wild claims, please edit them out (if you strongly think that). But please, you do not need to keep nagging me. (I will do my best to not add primary sources). Lets both keep up the good work on wikipedia... and get rid of this stupid conversation! your friend, Jatlas (talk) 00:28, 26 June 2009 (UTC)

I think you'll find that Borcher or Lull, C.; Wichers, J.; Savelkoul, F. (Jun 2005). "Antiinflammatory and Immunomodulating Properties of Fungal Metabolites". Mediators of Inflammation (Free full text). 2005 (2): 63–80. doi:10.1155/MI.2005.63. ISSN 0962-9351. PMC 1160565. PMID 16030389.{{cite journal}}: CS1 maint: unflagged free DOI (link) (both reviews, the latter not presently cited in the article but having free full text available in PMC) can cover off most of the immunoactivity claims without resorting to older, primary sources. LeadSongDog come howl 16:04, 23 July 2009 (UTC)

Thank you for the reference. I will go through it and hopefully I can make some page improvements. Jatlas (talk) 18:30, 23 July 2009 (UTC)

Zhang et al

I've reworded the interpretation of this one based on its abstract. If there's something stated in the body of the article that clearly supports the 64% and 90% numbers, it may need a direct quote in the citation (I'd use the |quote= | parameter). My read was quite different from the prior text. LeadSongDog come howl 13:42, 2 October 2009 (UTC) Thanks for the update and article improvement. I am currently trying to make the citations more descriptive as well :) Jatlas (talk) 18:07, 4 October 2009 (UTC)

Problematic edits

After encountering some edits by User:Jatlas at HIV, I found that Jatlas has been inserting into multiple articles a graph labeled as "own work". Per WP:NOR, original research is deprecated. See also WP:NOT#OR. Jatlas has also been citing primary research frequently, especially research by the Shiuan Chen group at Beckman Research Institute of City of Hope.

If the original research was indeed performed, as claimed, by Jatlas, then the editor would also do well to consider WP:CONFLICT and avoid self-citing and practising self-promotion on Wikipedia. Keepcalmandcarryon (talk) 16:20, 10 October 2009 (UTC)

I added that information to the other articles to let those editors decide what to do with it. It doesn't matter to me whether the information stays or gets deleted, just thought it was interesting... Also I never claimed to have preformed that research... just created the image... BTW the information from that image was obtained from Mycellium Running (Stamets 2005) where it was cited as research preformed by Shiuan Chen (1997). Jatlas (talk) 16:11, 12 October 2009 (UTC)

Concerns with WP:OR and WP:POV

The article is full of unfounded medical claims. For example

1. The section "Medicinal properties" would imply that we have studies look at there medicinal use in humans. Most is in animal models and petri dishes.
2. Claims that it improves the immune system. The immune system is found in an animal not a petri dish on which this claim is based.

Doc James (talk · contribs · email) 19:50, 15 December 2009 (UTC)

Clinical and animal research is included in this article. It is not a page simply with petri dish research.Jatlas (talk) 20:04, 15 December 2009 (UTC)

Yes but a number of the immune system claims make reference to petri dish studies. Doc James (talk · contribs · email) 20:07, 15 December 2009 (UTC)

And yes, you make a good point about the "Medicinal properties" title. This actually was the result of the page being reformatted by another wikipedia user. A more appropriate title should be worked out. I will attempt to do this when I have time. Jatlas (talk) 18:12, 16 December 2009 (UTC)

It appears from this CIMER research summary that there has been only a single high-quality (blinded randomized controlled) human study published, and that it was both small (N=34) and negative. See: Tsang KW, Lam CL, Yan C, Mak JC, Ooi GC, Ho JC; et al. (2003 Jun). "Coriolus versicolor polysaccharide peptide slows progression of advanced non-small cell lung cancer". Respir Med. 97 (6): 618–24. {{cite journal}}: Check date values in: |year= (help); Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link) CS1 maint: year (link) Somehow, this hasn't made it into the article. It should.LeadSongDog come howl 17:47, 18 January 2010 (UTC)

LeadSongDog, I already pointed out in the article there is only a single blinded randomized controlled human study which has been published, because like you I believe this is important. Secondly, the results were not negative. Read the title of the study,"Coriolus versicolor polysaccharide peptide slows progression of advanced non-small cell lung cancer". Here are some quotes from the abstract of the study[1], "After 28-day treatment, there was a significant improvement in blood leukocyte and neutrophil counts, serum IgG and IgM, and percent of body fat among the PSP, but not the control, patients", "there were significantly less PSP patients withdrawn due to disease progression, than their control counterparts", and "PSP treatment appears to be associated with slower deterioration in patients with advanced NSCLC.". Jatlas (talk) 18:15, 18 January 2010 (UTC)

What's missing is, from the CIMER analysis of that study, "Tumor response was evaluated on 58 patients who attended reassessment at four weeks and none of the patients in either group were found to have complete or partial clinical response." LeadSongDog come howl 04:45, 21 January 2010 (UTC)

As much as I respect the gold-standard randomized, double- blind, placebo-controlled trial, it's fairly well understood that alternative/complimentary medicines sometimes are unable to adhere to the rigorous standards at least in preliminary/pilot studies. For example, it's very difficult for researchers to fund clinical trials on obscure compounds, irrespective of how useful or effective they may be; running RCTs is extremely expensive, and if you don't have an interested company or government, funding is short. As an added factor, many of the studies which are related to a certain traditional medicine (e.g. traditional Chinese medicine) are published in languages other than English. For example, the Natural Standards monograph (a decent starting place when investigating alternative and complimentary therapies) has an extensive list of randomized controlled trials related to Coriolus versicolor, and many of them show improved survival rates in patients taking the supplement compared to controls. So, with complete respect, I very much disagree that there is only one good study out about medicinal mushrooms and that it had negative results. On Coriolus versicolor alone I see approximately forty clinical trials (of moderate to good quality), although not all are published in English.

And studies which are not clinical trials can still be useful. Regulators in Canada, for example, accept in vitro studies (referred to as petri dish studies above) in certain instances as evidence for making health claims that are difficult to prove in vivo. An example of this is the anti-oxidant activity of some compounds such as anthocyanins. In this respect, I disagree with Doc James: while it's true that the immune system is found in animals and not in petri dishes, human cell cultures are extremely useful in examining immunomodulatory effects. For example, a study by Maruyama et al. (2009) in the journal Biomedical Pharmacotherapy PMID 18848763 found a direct increase in the product of IgM antibodies in a human cell culture when exposed to the coriolus polysaccharide extract PSK; use of the same compound was shown to increase immunity in healthy volunteers (Wong et al. 2004 International Immunopharmacology 4(2): 201-211) PMID 14996412. In vitro evidence is an important tool to help determine the mechanism of action of a host of biomedical and alternative remedies, and its veracity should not be summarily dismissed for simply taking place in a petri dish.

That all said, I do think some of the phrasing in this article is a bit lacking as far as NPOV is concerned. Definitely a few instances of praise-words being used where they shouldn't be. I'll try to work on a few of the sections in the next week or so and hopefully we can come to a consensus and get rid of the NPOV tag. Best regards, Jhfortier (talk) 06:55, 17 February 2010 (UTC)

Jhfortier- Thank you for your very insightful comments. Regarding the phrasing problems, which there are indeed some, please correct or point them out. Jatlas (talk) 05:31, 23 February 2010 (UTC)

I'll work on it a bit today; mostly I'm going to try and reorganize some of the sections pertaining to specific mushrooms to increase the readability. IMHO, while the lists within the text are very useful, they don't help the readability of the article, so I'll try to format the lists (where appropriate) into prose. Also, I may remove some of the details that are a bit too in-depth for an encyclopedic article (e.g. listing the number of subjects in the trials). Converting phrases like "proven to have this effect" to something along the lines of "study suggests that they have this effect" may help remove the NPOV tag. Jhfortier (talk) 18:50, 23 February 2010 (UTC)

Sorry, but the requirement for reviews at WP:MEDRS is particularly important for CAM articles. Since anyone can publish a study somewhere, even if it is of very low quality or very low significance, we need proper reviews precisely in order to avoid inserting our own judgement on the relative merits of primary studies. The two studies that Jhfortier mentions above are both primary works. The Natural Standards site places its content behind an egregious registration wall. Please provide citations to the actual papers rather than to that host site so they can be discussed without resort to using that site. User:LeadSongDog come howl 19:22, 23 February 2010 (UTC)

My apologies LeadSongDog, I accessed the Natural Standard site via a University proxy and was not aware that they had registration requirements. Given the number of primary references already in the article, I doubt adding more will help to solve the POV issue (although this meta-analysis might be helpful: Sakamoto, J., Morita, S., Oba, K., Matsui, T., Kobayashi, M., Nakazato, H., and Ohashi, Y. Efficacy of adjuvant immunochemotherapy with polysaccharide K for patients with curatively resected colorectal cancer: a meta-analysis of centrally randomized controlled clinical trials. Cancer Immunol.Immunother. 2006;55(4):404-411). PMID 16133112

Do you agree with my suggestion above, that ensuring more careful wording ("suggested" instead of "proven") would help alleviate some of the concern with NPOV and OR? Or do you have additional suggestions for how we can resolve the possible POV issues? Jhfortier (talk) 20:22, 23 February 2010 (UTC)

Yes, how can we resolve these POV issues? I think the article could be skimmed down to in vivo and clinical research only. Or does every claim have to be cited only by a review which is not what Wikipedia says should be the case for medical articles. (WP:MEDRS, "Reliable primary sources can add greatly to a medical article). Jatlas (talk) 03:30, 25 February 2010 (UTC)

Against all advice above, Jatlas has loaded this and related articles with an absurdly long list of citations to every primary source in sight, even when secondary sources were identified. He now seeks to make them acceptable by cherry-picking a line out of WP:MEDRS to reverse its intent. Even I can't see a way to stretch WP:AGF this far. The only way to fix this article is to get serious about weeding out the vast number of primary references. Don't waste energy on trying to justify their use.User:LeadSongDog come howl 05:04, 6 March 2010 (UTC)

User:LeadSongDog I think that leaving only helpful in vivo and human clinical primary references would be a very fair resolution to this POV issue. Thank you for making the suggestion. I do have to agree that this article has become burdened with excessive references. Given the vast number of primary references, I'm thinking there must be at least a few review papers which would help to summarize things in a peer-reviewed fashion. I'll do my best to look some up tonight or tomorrow. Jatlas, what do you think about removing the animal studies so that only in vivo and human trials are included, and reviews are used in their stead when appropriate?Jhfortier (talk) 23:42, 6 March 2010 (UTC)

I didn't want to slash and burn at this point, but I've just spent several hours marking a small portion of the primary sources that should never have been used in the first place. There is almost never a good reason to do so. Wikipedia is not the place for publishing a literature review, yet that is what this article has effectively become. I don't particularly care whether the statement being supported pertains to clinical results, rat studies, or in-vitro analyses, so long as the article correctly describes them as such. WP has room for all that. On the other hand the reliability of the references concerns WP greatly. Primary studies are written by the same people making the observations. It is not reasonable to consider them objective about the accuracy, relevance, or significance of their own work: they are too invested in it. That is why WP:MEDRS insists on secondary sources in almost all cases. In the meantime, the least we can do is identify to readers that the sources are substandard. User:LeadSongDog come howl 02:19, 7 March 2010 (UTC)

Why should primary sources "never be used"? No wikipedia guidelines agree with your statement that they should never be used, sorry. Furthermore, when you look at reviews they often say this or that was observed in a primary study. They are not giving their full seal of approval that everything reported is 100% accurate. Do you understand that? You can rid all the primary sources of this page as you want. However, since the majority of these primary studies are included in reviews, please find the corresponding reviews to replace them with. This discussion page has led to very little progress. So I do not plan on responding to LSD's comments much longer. Edit the page as you see fit. But slashing and burning material? I hope other users will prevent you from doing that. I can also no longer assume good faith with you BTW.Jatlas (talk) 03:32, 7 March 2010 (UTC)

Clearly you still have not read and understood WP:MEDRS after all this discussion. Please do so. While you are at it, you might also take the time to read WP:Burden of proof. User:LeadSongDog come howl 04:54, 7 March 2010 (UTC)

LSD- "Primary studies are written by the same people making the observations. It is not reasonable to consider them objective about the accuracy, relevance, or significance of their own work." Have you forgotten these are published in peer reviewed journals?!!! Do you understand that? Why would they be published by respected scientific journals if they had no accuracy, relevance or significance???Jatlas (talk) 05:31, 7 March 2010 (UTC)

If you want to change WP:MEDRS the place to make your case is Wikipedia talk:MEDRS, not in an article talkpage. Good luck with that. User:LeadSongDog come howl 07:03, 7 March 2010 (UTC)

LeadSongDog- Another thing. Today you wrote when editing the Antioxidant activity section, "mark primary sources - this section completely lacks secondary sources". Do you realize every fruit and vegetable has antioxidant activity? Do you realize vitamin C is considered an antioxidant? Why are you so skeptical about things like these, and the quality of references, when it seems you do not even have an understanding of the topic? I'm not trying to be a jerk, but come on... Jatlas (talk) 09:35, 7 March 2010 (UTC)

The question isn't what I recognize (we write WP for a general audience) but yes I do. I've just added one review source to support that statement. We shouldn't even consider using primary sources until we've first looked for secondary ones. It isn't scepticism so much as insistence on using the best quality sources possible. I can't understand why you are so resistant to doing this the right way, it's actually easier than doing it the way you have been. Try it!User:LeadSongDog come howl 17:00, 7 March 2010 (UTC)

LeadSongDog- Great antioxidant reference! Thanks!Jatlas (talk) 19:21, 7 March 2010 (UTC) Actually, let me take that back. Now we have a review for "wild mushrooms" (which may not include any of the mushrooms on this page) and it is unreadable unless purchased. This is a case in point, in which a review is not a better and more trusted reference. A review is only better if it actually references what is being talked about. I am still glad that you found it however.Jatlas (talk) 00:45, 8 March 2010 (UTC)

Jatlas, in defense of LeadSongDog's preference for secondary sources, there are two huge advantages to secondary sources; there has been adequate time to evaluate the propriety and scientific rigour of the work (especially if the assays used are novel), and there is also (usually) a cumulative body of evidence. I'm sure you've seen from the dozens of studies available for medicinal mushrooms that there are often papers following the same method in peer reviewed journals that come to vastly different conclusions. Perhaps a great deal of LeadSongDog's concerns about primary sources are that both sides are often not presented adequately when a particular health claim is being suggested. A review or meta-analysis provides an excellent, compact summary of all of the findings (both positive and negative). This is why they're such valuable resource for a place like Wikipedia; they're often a very balanced presentation of the facts.

I'm really trying to think of an amiable way that we can all agree on this. I thought the suggestion to limit primary studies to in vitro and human clinical trials was a valid one, because (and do correct me if I'm wrong) consensus on Wikipedia is often more highly valued that the rules per se. Jatlas, if you don't agree with that suggestion, could you perhaps give an alternative one? I think this article is so important; I work in natural health product research, and the number of mushroom-related products is steadily increasing. Presenting the benefits of medicinal mushrooms in a balanced way is going to be very important, and inevitably people will use this a a reference page. Jhfortier (talk) 23:02, 8 March 2010 (UTC)

The general rule is to apply the best sources available, and where it is necessary to use lower quality sources to do so in an appropriately guarded manner so the reader understands them to be so. In this area, however, there are more than ample recent high quality review sources on the topic that have not been used! Consider:

• Mohammad-Fata Moradali, Hossein Mostafavi, Shirin Ghods, and Ghorban-Ali Hedjaroude (2007 June). "Immunomodulating and anticancer agents in the realm of macromycetes fungi (macrofungi)". Int Immunopharmacol. 7 (6): 701–24. PMID 17466905. {{cite journal}}: Check date values in: |date= (help); Text "doi: 10.1016/j.intimp.2007.01.008" ignored (help)CS1 maint: multiple names: authors list (link)
• Paterson RR (2006 Sep). "Ganoderma - a therapeutic fungal biofactory". Phytochemistry. 67 (18): 1985–2001. PMID 16905165. {{cite journal}}: Check date values in: |date= (help)
• Paterson RR (2008 May). "Cordyceps: a traditional Chinese medicine and another fungal therapeutic biofactory?". Phytochemistry. 69 (7): 1469–95. PMID 18343466. {{cite journal}}: Check date values in: |date= (help)

These three could and should be used to replace many of the lower quality (primary) references used in the article.User:LeadSongDog come howl 16:09, 16 March 2010 (UTC)

Encyclopaedia or...

I congratulate Jatlas on the impressive amount of work that's clearly been placed into this article. At the same time, I feel that in some sections of the article there may be a level of detail inconsistent with what Wikipedia is. The number of patients in every clinical trial for a mushroom-derived compound may be of interest to some, but would seem to be more suited to the scientific literature. Perhaps here it would suffice to indicate which mushrooms/compounds have undergone clinical trials and reference a representative review for each. Keepcalmandcarryon (talk) 17:22, 18 January 2010 (UTC)

Editors can not avoid actually tackling problematic points. Point by point. Review sources for the claims, discuss, and from dialogue, distill the 'truth-value'. – Just talking about guidelines will get you an article about guidelines. Casimirpo (talk) 05:08, 11 March 2010 (UTC)

Medicinal mushrooms research

As a user I wish to comment on the merits of this article. I use Wiki as a first base for research and this article was one of the best I have come across. I urgently needed evidenced-based research for a patient who has no further options within western medicine and because of this article he is still alive and well a year later. When I read the Talk page I understood why valuable research can take 20 + years to reach the patients and their doctors! Medicinal mushrooms have been used alongside conventional medicine for many years and take 25% of the budget for oncology treatment in Japan. As users we are capable of assessing the research data and the information we aquire from Wiki and I agree that some vigilance is accecptable and necessary but to carry on this "discussion" since June 2009 is counterproductive and should be stopped. 24/03/10 NutritionalMedicineNurse (talk) 17:35, 24 March 2010 (UTC)

Would be interested in seeing the reference for the 25% of oncology budget. I know food is expensive in Japan but... --Doc James (talk · contribs · email) 04:47, 3 May 2010 (UTC)

6/16/10 Take a look at http://www.mskcc.org/aboutherbs - cancer-centric, but this provides information both to consumers and to researchers about herbal remedies (including mushrooms, which I wouldn't necessarily qualify as herbs) using medical literature, and is reviewed by a staff of physicians, herbalists and pharmacists before being published on the hospital website. Lenrodman (talk) —Preceding undated comment added 16:11, 16 June 2010 (UTC).

Neutrality and article issues

Ok, the debate on this article has gone a bit stale, but I really think it's important to re-open the discussion and to seek arbitration if necessary. I work in the field of natural health products, and more and more companies are trying to capitalize on medicinal mushrooms. Although they should speak to a health care practitioner, many people will only look on Wikipedia, and make decisions based on articles such as this one.

One of the most difficult things about this article are the sheer number of references. While it's SO important to have citations, one of the facts in this article (relating to animal research on cholesterol) has fourteen citations. I really think that's a bit much. One or two citations to the best of those journal article would probably be more appropriate. Not only is it a bit insane-looking to have 14 citations, it also makes editing the article incredibly difficult, and discourages many newer editors from contributing. Would anybody be willing to help me trim down the number of citations?

Another issue is making clear differentiations between the in vitro and in vivo researcher, and between the animal and human research. I don't know a single governmental regulatory agency that accepts animal researcher or in vitro studies as proof that something has a medicinal effect on humans. There's no reason not to mention it as a possible effect, but I think when there is no human research on an effect, the article needs to explicitly say so. For example, "X mushroom has been examined for its effect on Y in both cellular assays and murine trials. However, there has been no conclusive research on humans with respect to this effect, and so the efficacy of X mushroom is still unproven." Jatlas how does this sound to you? I realize that you have been at odds with some of the other editors for this article, but I know you've also put a LOT of effort into expanding and improving this article. By including that explicit statement, we are still keeping many of the possible mushroom effects, but we're being clear to the most casual reader (who might not understand enzyme assays) that the effect isn't yet proven in humans? Thoughts? Ideas? Jhfortier (talk) 02:21, 3 May 2010 (UTC)

Clinical studies in humans

This trial does not seem to be mentioned:

The antitumor efficacy of a shiitake mushroom extract was tested in an open-label study in which 62 men with advanced prostate cancer received oral extracts of shiitake mushroom daily for six months [99]. The clinical endpoint was the tumor marker, serum prostate specific antigen (PSA). By six months, 23 patients had a rising PSA, while 38 remained stable. No patient had a conventional PSA response, defined as a reduction of ≥50 percent of serum PSA over baseline. The authors concluded that shiitake mushroom extract alone was an ineffective treatment for men with clinical advanced prostate cancer.

PMID 12385925 Doc James (talk · contribs · email) 04:56, 3 May 2010 (UTC)

Uptodate

Uptodate has this to say

All of these therapies have evolved through a strikingly similar life cycle; initially they were aggressively promoted by interested parties based on anecdotal evidence. Mainstream oncologists eventually succumbed to mounting pressure, conducting rigorous clinical trials. When these turned out to be negative, proponents claimed that the studies were flawed and that a conspiracy was underway to discredit a valuable therapy. In the end, each of these therapies submerged into a medical subculture, and cancer patients continued to be attracted to them despite negative scientific evidence.

Doc James (talk · contribs · email) 04:59, 3 May 2010 (UTC)

Sorry Doc James, I believe the American Cancer Society, Sloan-Kettering, Cancer Research UK, and MD-Anderson have a bit more authority on the subject than you. However, the article is far from perfect and many parts do need re-working.

1. American Cancer Society: "Available scientific evidence does not support claims that the raw mushroom itself is an effective anti-cancer agent in humans. But there is some scientific evidence that substances derived from parts of the mushroom may be useful against cancer. Clinical trials suggest that PSK may help people with certain types of cancer by increasing survival rates and lengthening periods of time without disease, without causing major side effects. PSK is commonly used with other cancer treatments in Japan." [2]

2. Sloan-Kettering: "Bottom Line: There is some proof showing Agaricus extract may benefit patients with certain cancers." [3]

3. MD-Anderson: "After an in-depth review of the available literature, M.D. Anderson Cancer Center reported that PSK is a "promising candidate for chemoprevention due to the multiple effects on the malignant process, limited side effects and safety of daily oral doses for extended periods of time." [4] Jatlas (talk) 22:04, 5 May 2010 (UTC)

Ah I am not sure why you are mentioning my authority. This is from the website uptodate.com which is a reliable medical source.Doc James (talk · contribs · email) 22:44, 5 May 2010 (UTC)

I think we can all agree that different medical sources have differing opinions on many areas of medicine and medical treatment. As long as this article is representative of the published literature, it should be just fine. Jhfortier (talk) 22:49, 5 May 2010 (UTC)

References

Currently this article is based on primary research article. The page needs to be written using reviews rather than primary research.Doc James (talk · contribs · email) 05:17, 3 May 2010 (UTC)

Switching to large reviews rather than primary articles would also help to reduce the excessive number of citations that this article has. Probably a good idea; I'll start looking for reviews on the various topics (let's hope they're not too hard to come by on PubMed!). Jhfortier (talk) 06:31, 3 May 2010 (UTC)

I'm so happy to see someone else say this. It is a point I've tried to make repeatedly, to the evident annoyance of one editor with great enthusiasm for the topic and its field. Many quality reviews were identified. His response was usually to use them as a source of primary papers rather than in lieu of them. LeadSongDog come howl 17:17, 3 May 2010 (UTC)

LeadSongDog, I understand that there has been a lot of frustration with this article; I also took a break, finding consensus elusive, and editing extremely difficult due to the excessive references. However, no single editor should be in control of an article, and I think that having three or four good minds will help improve the readability and credibility of this one! While I fully support noting the evidence that is there (e.g. if there's a lot of animal evidence, we should say so, and if there are clinical trials in the works, we should mention them), I think it's SO important that we not make claims for human health effects without human studies. I'm sure with a bit of work, though, we could really make this a reliable resource. Jhfortier (talk) 17:43, 3 May 2010 (UTC)

Pubmed lists 284 reviews on mushrooms. There is one published in 2010 but it is in German and I do not have access to it. Anyone PMID: 20184262 Doc James (talk · contribs · email) 17:47, 3 May 2010 (UTC)

If we can find reviews that cover the topics adequately, by all means I think they should be added. And if a review covers many of the primary sources already listed in the article, I see no reason why the review shouldn't replace the primary citations. However, if there are primary citations and no review, I think (on a case-by-case basis) that any deletion of material should be discussed on this page. While I agree that in most cases reviews are more reliable than primary sources, primary sources are not completely unreliable, especially if they come from rather reputable journals. Given the amount of scientific/medical expertise that I'm sensing in the involved editors, I'm sure we can come to reasonable agreements on content and reliability of certain primary sources when appropriate secondary sources are unavailable. Jhfortier (talk) 06:07, 5 May 2010 (UTC)

That seems a reasonable next step in cutting the problem down to size. I've gone to some length to mark each ref (primary source), (in-vitro), (mouse study) etc for quick identification, though it's probable I've missed some. LeadSongDog come howl 06:26, 5 May 2010 (UTC)

Recent edits re antiviral (esp re anti-HIV) activity are likely to prove controversial. I'd suggest that replacing those primary references with the Lindequist et al. (2005) review should at least partly address this section. A pubmed search for "lentinan HIV review" came up with just a solitary 1992 paper, PMID 1426662. LeadSongDog come howl! 18:01, 16 September 2010 (UTC)

Coming back to this topic, the accumulation of primary sources has been continuing, far beyond any reasonable level. It's time to start applying a hard line on this, to winnow these out and replace them with a much smaller number of reviews. I'd propose that we set a plan to go through one section at a time at a measured pace and eliminate the primary sources from medical assertions. Would one section per week be too much to handle? LeadSongDog come howl! 20:30, 8 March 2011 (UTC)

Missing content

It seems that this page is missing the negative effects of mushrooms such as Shiitake mushroom dermatitis.Doc James (talk · contribs · email) 05:24, 3 May 2010 (UTC)

This article isn't about eating Shiitake mushrooms that have not been cooked (or undercooked). So how is this "missing content"? Jatlas (talk) 03:03, 6 May 2010 (UTC)

Consistency in tables

Although I think the tables are a reasonably good way to present a lot of clinical trial information (although my personal preference is for prose) I think it's important that we keep the tables consistent. If we could perhaps keep the columns in threes (in vitro evidence, animal evidence, human evidence) and find some type of consistency for the rows (perhaps by type of cancer?). It's just a bit confusing when most of the rows are human cancer, and then we have "murine cancer" in there. I think animal studies and human studies must be clearly separated to ensure that people don't misinterpret the evidence. Thoughts? Jhfortier (talk) 05:32, 5 May 2010 (UTC) Agreed. The tables can be improved. I will fix this inconsistency in the table. Jatlas (talk) 20:26, 10 May 2010 (UTC)

Positive clinical trials

There was mention of positive clinical trials in the lead. What were these positive trials? Doc James (talk · contribs · email) 22:52, 5 May 2010 (UTC)

Yes on second thought that should not be in the introduction. I agree with you because most of the mushrooms in the article have not been clinically tested. However, what about Polysaccharide-K, isolated from Trametes versicolor? How is the clinical research listed for this substance irrelevant and invisible to you?
"Efficacy of adjuvant immunochemotherapy with polysaccharide K for patients with curative resections of gastric cancer". (June 2007) Cancer Immunology, Immunotherapy 56 (6): 905–11. doi:10.1007/s00262-006-0248-1. PMID 17106715. Jatlas (talk) 02:51, 6 May 2010 (UTC)

This would belong on the page dealing with polysaccharide K. Not on the page dealing with medicinal mushrooms IMO. When one says medicinal mushrooms I think of the pictures we have displaced here. When we talk about the benefits of ASA we do not add those studies to the page on willow bark even though willow bark dose contain ASA. BTW I think we all agree that most pharmaceuticals come from plants. But at some point in the processing of plants they are no longer plants and become drugs. Doc James (talk · contribs · email) 03:23, 6 May 2010 (UTC)

Isolates

That actually brings up a really interesting point; at what point does a substance stop being a mushroom and start being an isolate thereof? Doc James makes a good argument about the ASA; by the time it's aspirin, it bears little resemblance to the willow bark it was originally derived from. I'm assuming there isn't a Wiki policy on this, so we may have to find some common ground. Jhfortier (talk) 03:59, 6 May 2010 (UTC)

I would say that for a substance to count as a mushroom it would have to contain hundreds of chemical compounds rather than a single chemical isolates. Doc James (talk · contribs · email) 05:40, 6 May 2010 (UTC)

This sounds like a pretty reasonable idea. Shall we say that if the study is on the whole mushroom or a concentrated extract of the mushroom, it belongs here. If, however, it's a singular isolated compound, perhaps a short sentence stating "compound X is isolated from this species of mushroom" and a link to the individual page (either for the mushroom, or for the compound)? Jhfortier (talk) 16:44, 6 May 2010 (UTC)

So willow bark is not a drug? Doc James have you heard of Assalix? No offense, but if you were my doctor I would quickly find another to replace you. ("Assalix study"Jatlas (talk) 20:24, 10 May 2010 (UTC)

Jatlas, personal attacks like that have no place on any talk pages. Please be civil. Doc James' point was that willowbark is an entirely different compound from than the ASA which is derived from it. He's absolutely right on that point; by the same token, lycopene is an entirely different substance than tomatoes, and studies on lycopene and different than studies on tomatoes. I think there has been a very reasonable suggestion made: if it's a study on an isolate, it belongs on the isolate's main page. If it's on the entire mushroom, it belongs here. Do you have anything to add to that? Jhfortier (talk) 23:18, 10 May 2010 (UTC)

Having heard nothing on this topic in a couple of days, I've gone ahead and removed the detailed information regarding the isolate Polysaccharide-K from this article. I meant to move it to the individual article page (Polysaccharide-K), but found that the information was already there, nearly verbatim. Saved me the edit :)

I'm going to go through and begin checking references to ensure that this page focuses on the whole mushrooms, not so much the individual isolates. Jhfortier (talk) 06:53, 14 May 2010 (UTC)

Maitake (Grifola frondosa) is also done; the information related only to the d-fraction was removed/relocated to the appropriate mainpage, a link to said mainpage was added, and the table was cleaned up in the process. NB: I did leave one article which used both the D-fraction AND whole Maitake powder (the researchers note that both substances are compared in the abstract). Jhfortier (talk) 07:12, 14 May 2010 (UTC)

Removed subsection specifically on the shiitake isolate: added line to shiitake section about it, and linked to the isolate's more-than-adequate article. Jhfortier (talk) 23:18, 16 May 2010 (UTC)

"lycopene is an entirely different substance than tomatoes". "willowbark is an entirely different compound from than the ASA" This is incorrect. Lycopene is contained in tomatoes and ASA is contained in willowbark. Jhfortier please give careful consideration to logic as well as edits for this article. Please do not be persuaded by Doc James, he has formally called this topic snake oil and is extremely against the potential for these safe food products to impact anyone's health. BTW I appreciate your interest and work on this article.Jatlas (talk) 04:14, 17 May 2010 (UTC)

With all due respect, Jatlas, I somewhat resent the implication that I am being persuaded by anybody. We're working to compromise and achieve consensus. Lycopene is different from a tomato: you do not make lycopene salads. Lycopene is a chemical constituent of tomatoes, which can be isolated and purified for a specific medicinal use. Lycopene can be absorbed by eating tomatoes, but that does not mean that they're the same thing. This is quite logical, I believe, although if you disagree I would be happy to debate that point with you. Active ingredients are different from the whole foods that contain them, and I doubt you'll find a nutritionist or a chemist who argues otherwise.

This subsection of the talkpage was meant to discuss the difference between an isolate of a mushroom and the whole entity itself (be that fresh fruiting body, dried powder, or concentrated extract). I'm more than willing to say that the extracts and dried powders should be counted as medicinal mushroom products, but purified isolates are a completely different beast. Nearly every mushroom on this page has its own separate article, and in every case where the isolate was emphasized, it is now alluded to (with links to the separate article spaces).

No information has been lost, but the summary style is being employed more judiciously. I'm sorry that you disagree, but rather than just state what we're doing that you don't like, could you perhaps make suggestions of what you'd like to see done with this article? Jhfortier (talk) 04:44, 17 May 2010 (UTC)

Collapsing tables

I decided to be bold and employ collapsible tables for the clinical data which is laid out in table form. Many of the tables are quite large, they obstruct the text a bit if your browser isn't wide enough, etc etc. The tables are clearly labelled, so that people can expand them if they wish to view the information in tabular form. I hope this is ok with everyone. Jhfortier (talk) 04:53, 15 May 2010 (UTC)

This is an improvement.Jatlas (talk) 03:31, 17 May 2010 (UTC)

Definition of "Medicinal Mushroom"

I feel like I'm flooding the talk page this evening, but during my recent edits I've come across another possible issue. At what point can we call something a medicinal mushroom? For example, the mushroom Fomes fomentarius has only one (very poor) animal study (e.g. 1-page paper, unspecified number of animals, no extensive protocols given). Can that really be considered a medicinal mushroom? It has no use in humans that I can find, not even in traditional Chinese medicine texts, so why would we consider it a medicinal mushroom?

Just wondering if anyone else has thoughts on this? DocJames, I'd be particularly interested in your take, as you came up with a reasonable solution to the whole mushroom vs. isolate issue above, and you're quite familiar with the Wiki standards for medicine-related articles. Jhfortier (talk) 06:26, 15 May 2010 (UTC)

I agree for something to be a medicinal mushroom it must be one "a mushroom" and two have documentation of "medicinal use". As we discussed previously if it is a single component which may have started as a mushroom it does not count. Also if no medicial use documented it would not be appropriate here.Doc James (talk · contribs · email) 15:57, 15 May 2010 (UTC)

That's generally what I was thinking. If it doesn't have use in TCM or another traditional medicinal paradigm, and there are no human studies of its use, I believe it should not be classified as a medicinal mushroom. Perhaps I'll wait a day and hope that Jatlas can add to this discussion before I make the changes? Jhfortier (talk) 16:55, 15 May 2010 (UTC)

Using these criteria, the mushroom Agaricus bisporus (common white mushroom) might be removed from the article; While there are ongoing human studies, there are no completed human trials or traditional use as a medicine. Flammulina velutipes (enokitake) may also be cut, for similar reasons; epidemiologically there may be a link between these mushrooms and lower cancer rates, but they are consumed as a food, not a medicine. Same goes for Pleurotus eryngii (king oyster mushrooms), Agrocybe aegerita, Formes fomentarius (I'm going to be bold and remove this one because there is no evidence it's a medicinal mushroom; the others should be debated and a consensus will hopefully be reached). Jhfortier (talk) 23:15, 16 May 2010 (UTC)

Please tell me we aren't going to delete everything by placing highly restrictive qualifications for what is a "medicinal mushroom". Technically this article is about fungi, medicine, and potential health benefits of edible mushrooms. Please, I repeat, please do not delete stuff cause it is not a "mushroom". If this is what is contested lets find a better title instead of butchering the article. IMO Doc James is just looking for technicalities to cut down the article. On a former discussion page Doc James referred to this topic as "snake oil". Considering how organizations like The American Cancer Society disagree, I do not think he should be directing this page.Jatlas (talk) 03:36, 17 May 2010 (UTC)

Nobody is going to be deleting everything: there is good clinical research on some of these mushrooms for various health reasons, and absolutely nobody is suggesting that we blank this page/destroy it. A lot of excellent hard work has gone into this article, lots of research, and we're only hoping to improve the article and its credibility. I don't think the qualifications we're suggesting/discussing for these mushrooms are all that restrictive. If I can sum it up briefly, our criteria are only as follows:

• Must be a mushroom/fungus of some kind
• Must have traditional medicinal use (TCM, Herbalism, etc) OR clinical trials in humans.

The 'medicinal' in the title, in my mind, suggests that it is a human medicine. In order to be a human medicine, we need at least some indication that they are used in humans as a medicine. I thought this was pretty reasonable, and most of the mushrooms on this page would still be here. There would be a couple of mushrooms which could be removed, but their article pages would still exist; no information would be lost. I'm wondering if you really read the suggestions above, because removing things that "weren't mushrooms" was never even suggested. The isolates are being moved (as discussed in the subsection above) but the key word is moved, not deleted.

DocJames is not directing the page, consensus (and editors discussing ideas) are. In his defence, most of the deleting-editing has been mine. If you have alternate ideas and suggestions, I'm sure that we would all be interested in discussing them. Best regards, Jhfortier (talk) 04:54, 17 May 2010 (UTC)

Enough is enough...remove the "not neutral" tag

I have been involved in higher ed research for over 14 years, in one way or another.

The article is fine....all this whining seems to be about personality conflict...and given my newness to the site, a non-neutral POV of some folks "casting stones." I came to this article and was really impressed; especially with all of the citations (they should stay, btw, as they give us places to go to work on further research. The author did a good job of surveying the knowledge base, to his abilities; and says: "have at it, guys; improve it as you will." Seems fair to me. I had no confusion reading the article and differentiating between proven scientific human trials, animals, or petri dishes.

What I find fascinating about the article is something the drug companies probably don't want people to know: "Our drug is based on something as simple as a mushroom you might want to eat instead" (with the clear caveat that studies need to be done to verify the indicators). Who do you think is suppressing those studies? Its the same reason we spent 30 years running incredibly inefficient cars (and ruining the environment) when there were solid designs for highly fuel efficient engines.....someone is making A LOT of money, by keeping knowledge stifled. Welcome to the world of academic research; where everything they want you to know is supported handsomely.

Wiki provides a great service; providing accurate information on a topic (well, mostly; Colbert jokes aside ;-) So? Sometimes all that knowledge has to be allowed to be uncovered.....pooled, bit by bit. The author did a great job setting the stage here; so I suggest using your talents to help add more to the article than to nickpick it to death (aka "death by committee" in academic circles, when they want something or someone suppressed.)

The "not neutral" tag needs to be removed; and improvements allowed. Since Dec 2009? Cummon.

PatrickJmahoney (talk) 09:19, 19 October 2010 (UTC)

You misunderstand. The objections are not against the inclusion of the statements. They are against the use of questionable references to back them up, when in almost all cases there are high quality sources that are much more suitable and encyclopedic. We have clear guidance on the selection of reliable sources for medical assertions that one editor here has routinely flaunted.LeadSongDog come howl! 20:27, 25 October 2010 (UTC)

LSD is technically correct. Reviews are superior to primary sources. However, primary sources are not banned, and are welcome on Wikipedia. Furthermore, the reviews (there are many on the page) contain the vast majority of primary citations on the page. Removing all the primary citations and leaving just the reviews would make it tremendously difficult to track down all the specific experiments. I am much happier (and I think all readers would agree) with all primary citations marked with "primary source" or "unreliable medical source?". LSD what are your thoughts on removing the neutrality tag? Jatlas (talk) 01:27, 26 October 2010 (UTC) O yeah, thanks for your input PatrickJmahoney, it is much appreciated. Jatlas (talk) 01:29, 26 October 2010 (UTC)

I think I have made my position abundantly clear. Relying on primary sources should only be done when it is the only possible option. In the case of this article that is very far from being the case. The tag should remain until the article is fixed. That means actively removing primary sources and replacing them with reviews. wp:MEDRS is very clear about this. LeadSongDog come howl! 06:18, 26 October 2010 (UTC)

Dose and route

Can we get some simple information about dose and route in this article? I'm thinking that what's needed is a section along the lines of "You'd have to eat ___ pounds of this mushroom to consume the amount of the active substance used in the study—and even that wouldn't work, because the compound gets digested in the stomach." I'm sure that nobody here wants people to think, "Oh, mushrooms cure cancer. Great, I'll get some mushrooms on my pizza tonight."

Also—Wikipedeia is not a directory of primary studies. We need to replace many of these small studies with reviews that evaluate them. The goal is a summary, not a detailed exposition. WhatamIdoing (talk) 18:29, 21 December 2010 (UTC)

WAID - Thanks for the great recent edits. Your question about dose and route is already contained in the article. Clinical studies in the article list this information. However the "goal is a summary, not a detailed exposition" so this information remains in the research listed in references. As for your comments about pizza and cancer, I am sure you realize many types of cancer do not have a "cure". In addition, clinical research shows mushrooms do not "cure" cancer but rather inhibit it to varying degrees in a percentage of patients. Jatlas (talk) 14:31, 22 December 2010 (UTC)

For the beta-glucans dose discussion see this excellent review, which should be able to replace much of what is currently referenced to older, lower quality, primary sources. LeadSongDog come howl! 17:43, 22 December 2010 (UTC)

Thanks, LeadSongDog. I'll read it some time.

Jatlas, I don't think you're quite grasping what I want. Perhaps I've explained it badly. Try this: Go read Medicinal mushrooms#Mushroom_polysaccharides.2C_the_immune_system.2C_and_cancer. It describes "patients" (so we're talking human studies, which is good) and an "extract". Now, in simple terms, tell me: How did those patients take that extract (in a spoon? Cooked into food? Through an IV line?)? And how much did they take?

I don't want exact doses, but if the answer is "the equivalent of eating a hundred pounds of mushrooms, four times a day" or "the equivalent of what a person might realistically eat in one meal", then we can, and probably should, communicate that in general terms. I don't see anything in that section that communicates any information on either of these points, and I think that they are important points for helping the reader place this information in its proper context. WhatamIdoing (talk) 03:35, 27 December 2010 (UTC)

WAID, I do understand, however I thought that information would be too detailed for wikipedia. I do like your questions, and I think they are important. I'll try to extract some of the information you have requested in the near future. Also, I noticed some of the drugs isolated from fungi were deleted by you. Your reasoning was sound, so I am not trying to revert that. However, I would like to place the fact that certain fungi can create taxol somewhere. Jatlas (talk) 23:34, 28 December 2010 (UTC)

Does the class of "certain fungi" include (1) a fungus that could be called a mushroom with a straight face that (2) produces taxol naturally? Or is this a code phrase for "taxol can be produced in genetically engineered yeasts"? WhatamIdoing (talk) 07:14, 29 December 2010 (UTC)

Well considering you deleted that information I figured you would know already. It is neither a mushroom nor a "genetically engineered yeast". Researchers found various strains of natural fungi living of the yew tree (where the drug was originally found) that produce the drug. [5] I think this information should be included somewhere. Jatlas (talk) 13:39, 29 December 2010 (UTC)

I deleted taxol because it's produced (as far as I know) in plant cells, and because the "natural fungi" you mention is a mold, not a mushroom. I don't think that it is appropriate to include non-mushroom molds in this (already large) article. WhatamIdoing (talk) 19:25, 29 December 2010 (UTC)

Ok fine :/ I am not making a distinction between mushrooms and other non-mushroom fungi because mushrooms are only a reproductive instrument of the fungus. Mushrooms usually constitute only a small percentage of the fungus while most is alive as mycelium. To me, the article is really about "medicinal fungi", however I started the article as "medicinal mushrooms" because it sounds better. Anyways, keep up the good work WIAD...Jatlas (talk) 22:44, 29 December 2010 (UTC)

FYI, Japanese papers typically cite 3 grams per day of PSK (Krestin), orally, in conjunction with other chemotherapy. I've seen 6 grams per day mentioned in 1-2 extremely advanced cancer case studies. In addition to enhancing immune function, it is now also recognized by Western researchers to reduce the side effects from chemo.--Stageivsupporter (talk) 13:40, 3 January 2011 (UTC)

Little firm evidence

The source named at the end of that sentence doesn't support the exception you want to make. It says things like "There is, at present, no scientific basis for the use of either mushrooms or mushroom extracts in the treatment of human patients" and cites papers that use phrases like "still rather limited" to describe the current situation. I see Lentinan mentioned in the context of in vitro work, mice, and broiler chicks—hardly a collection of studies that show efficacy in humans.

I see no possible way to reconcile the source's contents with your implicit that "much" (rather than "little") firm evidence for effectiveness exists in humans. In fact, saying that there is even "little firm evidence" may be overstating the source's view: It might be more accurate to say there is no firm evidence of practical efficacy, and that everything is consequently still in the research phase. WhatamIdoing (talk) 00:30, 30 December 2010 (UTC)

Also you saying, "I see Lentinan mentioned in the context of in vitro work, mice, and broiler chicks—hardly a collection of studies that show efficacy in humans" is laughable. Jatlas (talk) 21:16, 30 December 2010 (UTC)

My quick scan found no meta-analysis in the Borchers paper; if I've overlooked it, I'd be happy to have you provide the name of the lead authors.

Feel free also to provide any direct quotations from Borchers that you believe support a claim of substantial evidence of human efficacy. I keep finding quotations like "no scientific basis" and "clinical studies are rare, often include small numbers of subjects, frequently are not randomized, mostly are not placebo-controlled, and hardly ever are double blind. Most disappointingly, the research is not systematic." WhatamIdoing (talk) 22:49, 30 December 2010 (UTC)

(July 2009). "Individual patient based meta-analysis of lentinan for unresectable/recurrent gastric cancer". Anticancer Research 29 (7): 2739–45. PMID 19596954.Jatlas (talk) 03:54, 31 December 2010 (UTC)

Oba's 2009 paper isn't in Borchers (2008). The assertion that firm evidence for lentinan's effectiveness exists is simply not present in the named source.

The same appears to be true for PSK. WhatamIdoing (talk) 21:48, 31 December 2010 (UTC)

"Phase I, II and III clinical trials mainly in Japan and China...Lentinan has been approved as a drug in Japan and is considered an important adjuvant treatment for several cancers."[6] Lentinan is not PSK, a different mushroom is extracted.--Stageivsupporter (talk) 12:51, 3 January 2011 (UTC)

edit fragment

After reading Borchers and several papers, I am moving this sentence out of the intro "It has been noted that high doses of mushrooms may have less or no effect.^{<ref name=Borchers/>}". Needs a contextual edit and maybe find a home in the detailed sections below.--Stageivsupporter (talk) 11:57, 6 January 2011 (UTC)

This statement, The effect, when any is present, may be to increase or decrease aspects of the immune response.<Borchers] concerns the dose, route and sequelae for individual preparations, or perhaps clusters of preparations with some common limitation or other basis. Those issues might be better addressed in the main body details of individual mushrooms' application.--Stageivsupporter (talk) 08:52, 7 January 2011 (UTC)

Regulation of lentinan

About this:

Are you asserting that the warning, which says, "# This product is regulated by the FDA as a dietary supplement. Unlike approved drugs, supplements..." [are not required to do anything] (emphasis added) supports the claim that lentinan is a properly approved, regulated medication somewhere in the world? WhatamIdoing (talk) 01:57, 30 December 2010 (UTC)

"In some countries, parenteral lentinan is classified as an antineoplastic polysaccharide and is available for clinical use." - Sloan-Kettering [7]. You are only a wikipedia editor, Sloan-Kettering is one of the best hospitals in the nation, lets take their word and not your opinion. Jatlas (talk) 21:02, 30 December 2010 (UTC)

Yeah, but they don't say that it's a properly approved, regulated medication. They say it is "available for clinical use". Pencils are "available for clinical use". Hamburgers are "available for clinical use". Where's the sentence that says Lentinan has formal, regulatory approval as a medication? WhatamIdoing (talk) 22:40, 30 December 2010 (UTC)

Ok, change it in the article then. As long as it mentions "available for clinical use".Jatlas (talk) 03:57, 31 December 2010 (UTC)

Why should it? Unless a given mushroom is actually illegal to possess or sell, then every mushroom on the page is "available for clinical use". Being approved by a regulatory agency is a big deal; being legal for sale in a country is trivial. Why should this apparently trivial status be called out in the lead? WhatamIdoing (talk) 21:43, 31 December 2010 (UTC)

You - "Being approved by a regulatory agency is a big deal..." American cancer society on PSK, "In the 1980s, the Japanese government approved the use of PSK for treating several types of cancer." So by your definition, it IS a big deal... [8]Jatlas (talk) 21:03, 2 January 2011 (UTC)

Is Lentinan exactly the same thing as PSK? Because if it is, then I'm happy to mention it—but only once under one name, not once under each of two names. If it's not exactly the same thing, then we need a source that directly says lentinan is an approved drug, or we need to remove lentinan. A source that says PSK is an approved drug doesn't help us with a claim that lentinan is an approved drug.

Perhaps I have been unclear: I favor naming PSK as an approved drug (with an appropriate source). The problem is 100% about the sources for making an identical claim for Lentinan. WhatamIdoing (talk)00:47, 3 January 2011 (UTC)

"Many of the mushroom polysaccharides have proceeded through Phase I, II and III clinical trials mainly in Japan and China but now in US. Lentinan (L.edodes) has demonstrated strong anti-tumour activity in a wide range of xenographty and with human clinical trials where it has proved successful in prolonging the survival especially those patients with gastric and colorectal cancer. Lentinan has been approved as a drug in Japan and is considered an important adjuvant treatment for several cancers." Cancer Research UK "Medical Mushrooms and Cancer"(2002), monograph's Executive Summary,point 19, repeated from my note above[9].--Stageivsupporter (talk) 13:19, 3 January 2011 (UTC)

major monograph

Perhaps I missed it, but I did not see this Cancer Research UK Medical Mushrooms and Cancer monograph(2002) used as a reference in this article. It seems like a legitimate, potential secondary source with a Western view. It looks like an extensive resource.--Stageivsupporter (talk) 13:05, 3 January 2011 (UTC)

Thanks, that's very helpful. Now all we need to do is to get that ref added to the lead, so that if someone wants to verify that information, they won't be stuck with a source that doesn't mention it at all (which is what we're doing to the reader right now). WhatamIdoing (talk) 19:25, 3 January 2011 (UTC)

Thanks, you're welcome. For those that are interested enough, the Cancer Research UK monograph can be downloaded and searched if you have the storage capacity, for a 54.5 MB pdf at monograph.--Stageivsupporter (talk) 16:58, 9 January 2011 (UTC)

moving

I have moved the pov tag closer to the sources in contention. The Intro has no primary sources, the tag there seems unwarranted and interfering with basic accessibility. The Intro section real estate is already scarce with the Index box.--Stageivsupporter (talk) 17:01, 7 January 2011 (UTC)

Mushrooms and non-mushroom fungi

Jatlas, I know that the distinction between a fungus that is considered a mushroom and a fungus that is not generally considered a mushroom is arbitrary, but it's an arbitrary distinction that is made by the sources, and we need to follow their lead. Penicillium chrysogenum is not a medicinal mushroom, it is never included in reliable sources as an example of a medicinal mushroom, and we shouldn't pretend otherwise on this page. It would only make Wikipedia look silly in the eyes of anyone with any expertise at all.

There's room in Wikipedia for an article on Medicinal molds or Non-mushroom fungi used for medicinal purposes, but this article isn't it. WhatamIdoing (talk) 22:29, 31 January 2011 (UTC)

Hmmmm. Yes, I thought about that after the previous edit you reverted. I am not trying to pass off Penicillium chrysogenum as a "medicinal mushroom". However, instead of fragmenting the article with a new "medicinal molds" page, I want this article to be all-inclusive for fungi. Do you have any other suggestions for clarity besides fragmenting the page? What about a "medicinal molds" section on the page? I am glad you realize "the distinction between a fungus that is considered a mushroom and a fungus that is not generally considered a mushroom is arbitrary".Jatlas (talk) 17:15, 1 February 2011 (UTC)

Our sources don't conflate the two, and we've already got WP:SIZE warnings on this page. For example, this page is (I'm told) four times the maximum size that someone could edit on a mobile device/smart phone. "Fragmentation" (along the fault line identified by the sources) is probably the right choice.

The other major option is to hack half the information out of this page to make room for information about molds. I'm not really excited about that option. WhatamIdoing (talk) 19:37, 1 February 2011 (UTC)

I really want to avoid breaking up the article. What if this page had it's title changed to something like "medicinal fungi"? Also, wikipedia guidelines are great, but this article is really not that large. Jatlas (talk) 22:49, 1 February 2011 (UTC)

The article title is not the critical issue, since it could be changed easily. The critical points are size and sources.

There are things we can do to address the size issues, at least in part. For example, we can be more aggressive about replacing the many instances of multiple primary sources with one decent secondary source.

However, I don't think that the division in the sources can be overcome. Changing the article title (and the page's subject) to "medicinal fungi" would not make the high-quality sources treat the medicinally useful extracts from Penicillium chrysogenum and from Shiitake mushrooms as basically the same things. WhatamIdoing (talk) 23:20, 1 February 2011 (UTC)

I like the article overall, I do wish the sub-section titles, text and photos were a little better co-ordinated, without the glaring white gaps.

I don't favor expanding the scope of this article. I would only favor links, e.g "see also" or a 2-3 line subsection or two with links, to related important subjects. Several major "alsos" directions that many readers might follow from this article: "medicinal molds", and/or other glucan-glycan related articles about immunotherapies, generally, or for cancer. Several natural source glycans come to mind. Biothera's yeast based Imprime PGG (beta glucan), starting phase III trials, seems to be an emerging US competitor to Japan's oral PSK, that might be formally FDA approved. It would be good if readers could follow their different threads of interest and gain a broader view of their core interest for common subjects of importance (cancer, therapeutic glycans).--Stageivsupporter (talk) 07:09, 3 February 2011 (UTC)

@WhatamIdoing... I suppose your right. When I have some free time I will create the medicinal molds article and clean this article of non mushroom forming fungi.Jatlas (talk) 21:12, 3 February 2011 (UTC)

Review sources

There are recent reviews available that could supplant many of the primary sources and older secondary sources cited in the article.

• Ramberg JE, Nelson ED, Sinnott RA (2010 Nov 18). "Immunomodulatory dietary polysaccharides: a systematic review of the literature". Nutr J. 9: 54. PMC 2998446. PMID 21087484. CONCLUSIONS: Taken as a whole, the oral polysaccharide literature is highly heterogenous and is not sufficient to support broad product structure/function generalizations. Numerous dietary polysaccharides, particularly glucans, appear to elicit diverse immunomodulatory effects in numerous animal tissues, including the blood, GI tract and spleen. Glucan extracts from the Trametes versicolor mushroom improved survival and immune function in human RCTs of cancer patients; glucans, arabinogalactans and fucoidans elicited immunomodulatory effects in controlled studies of healthy adults and patients with canker sores and seasonal allergies. This review provides a foundation that can serve to guide future research on immune modulation by well-characterized polysaccharide compounds. {{cite journal}}: Check date values in: |date= (help)CS1 maint: multiple names: authors list (link)
• Lull C, Wichers HJ, Savelkoul HF (2005 Jun 9). "Antiinflammatory and immunomodulating properties of fungal metabolites". Mediators Inflamm. 2005 (2): 63–80. PMC 1160565. PMID 16030389. Abstract
  We discuss current information on the ability of extracts and isolated metabolites from mushrooms to modulate immune responses. This can result in a more enhanced innate and acquired disease resistance. The major immunomodulating effects of these active substances derived from mushrooms include mitogenicity and activation of immune effector cells, such as lymphocytes, macrophages, and natural killer cells, resulting in the production of cytokines, including interleukins (ILs), tumor necrosis factor alpha (TNF)-alpha, and interferon gamma (INF)-gamma. In particular, the ability of selective mushroom extracts to modulate the differentiation capacity of CD4(+) T cells to mature into T(H)1 and/or T(H)2 subsets will be discussed. As a consequence these extracts will have profound effects in particular diseases, like chronic autoimmune T(H)1-mediated or allergic T(H)2-mediated diseases. Immunosuppressive effects by mushroom components have also been observed. The therapeutic effects of mushrooms, such as anticancer activity, suppression of autoimmune diseases, and allergy have been associated with their immunomodulating effects. However, further studies are needed to determine the molecular mechanisms of the immunomodulating effects of mushrooms metabolites both individually and in complex mixtures, for example, extracts. {{cite journal}}: Check date values in: |date= (help)CS1 maint: multiple names: authors list (link)
• Murphy EA, Davis JM, Carmichael MD (2010 Nov). "Immune modulating effects of β-glucan". Curr Opin Clin Nutr Metab Care. 13 (6): 656–61. Perhaps the most promising evidence to date in human trials has come from recent studies on a benefit of β-glucan on quality of life and survival when given in combination with cancer treatment. We identify the need for future studies that compare purified forms of β-glucans from different sources to further the understanding of the mechanisms of action and aid in the development of clinical studies. SUMMARY: β-Glucans appear to be effective at enhancing immune function and reducing susceptibility to infection and cancer. A better understanding of the mechanisms of β-glucan recognition and subsequent immune activation is necessary for the design of effective treatment approaches in future clinical trials. {{cite journal}}: Check date values in: |date= (help)CS1 maint: multiple names: authors list (link)

Any objection to getting on with these? LeadSongDog come howl! 20:56, 8 March 2011 (UTC)

No objections. I will try to insert these reviews and replace primaries. However, like I said before, I want to be cautious about erasing primaries with a review that does not include described data. Jatlas (talk) 20:42, 9 March 2011 (UTC)

Thank you. On the cheerier side, the statements supported by reviews can be treated as authoritative unless there is evidence to the contrary. We don't need to couch them as "A 2010 review by Murphy et al. found that...", we can simply state "Trials of β-glucan, combined with cancer treatment, have shown promise." LeadSongDog come howl! 22:18, 9 March 2011 (UTC)

mushrooms made of chitin ?

@ Jatlas - it appears you see this page as your personal project ? It is a verifiable fact that mushrooms are made of chitin and it is a fact that humans cannot digest chitin (and will not benefit from eating raw mushrooms or derivatives thereof). It has nothing to do with medical matters.

read e.g. this: http://www.mssf.org/cookbook/part_4.html - not a Pubmed publication, but that is not needed here. —Preceding unsigned comment added by Chemicus 234 (talk • contribs) 19:57, 10 May 2011 (UTC)

Don't worry about my view of the page... Thanks for your interest in the page, lets work together. OK, the first part of your intro is good, I will restore it.

"Mushrooms cells are build of chitin, which humans cannot digest properly. In order to benefit from the active components locked inside the mushroom cell walls, an extraction process involving heat is needed (hot water / ethanol extraction is the most common) to break the chitin and make the active ingredients available for ingestion. Brewing tea for a long time can be considered a form of extraction."

However the following statement is problematic. "Extracts can be distinguished from mushroom powder because they list the percentage of polysaccharides on their label, which can only be determined after extraction." Extracts can only be distinguished from powders because of labels on bottles? Also citations are there because they are trusted sources. Your citation is not a trusted source so there is no need for it. Jatlas (talk) 20:25, 10 May 2011 (UTC)

Sourcing is unreliable and of questionable notability

This article needs to be referenced to review articles. I am seeing an increase in primary research and a worsening of the content over time. As these primary sources are of questionable notability and thus this article is of questionable notability. Doc James (talk · contribs · email) 13:26, 2 June 2011 (UTC)

By the way, this article has just been mentioned here as an example of unbalanced article that is based mostly on primary sources.

If there is a text sourced only to primary sources (clinical tests), then it needs to be either deleted, or reworked using secondary sources (reviews of clinical tests, and also meta-reviews) --Enric Naval (talk) 14:42, 2 June 2011 (UTC)

If there are no clinical tests, then it's impossible to comply with that standard. Wikipedia has room for some encyclopedic description of current research and non-human research. It is not just the "encyclopedia of substances proven to treat diseases in humans".

That said, it's also not a catalog of primary studies. I have removed many WP:REFSPAM-like citations in the past, and more of that needs to be done. Whenever the desired text can be supported by any secondary source, the primaries should be entirely removed. WhatamIdoing (talk) 16:59, 2 June 2011 (UTC)

This issue is that there are good source "review articles" just that they are not used here. This article does not represent main stream scientific opinion or give it due wait. It is a compilation of positive interpretations of selected positive trials. Thus little more then dressed up WP:OR. Doc James (talk · contribs · email) 22:06, 2 June 2011 (UTC)

Since no objections have been raise, I suggest we just get on with it.LeadSongDog come howl! 18:01, 7 July 2011 (UTC)

I love how articles in the US library of medicine are "untrustworthy". Also love how only primary studies concerning important drugs are removed first by leadsongdog. Jatlas2 (talk) 19:52, 7 July 2011 (UTC) Keep making false statements like "no reviews in article" I am not going anywhere.

There's no need to get insulting. WP:MEDRS is the clearly supported basis for those edits, as discussed above. I left reviews in place, removing primary sources. Pubmed marks reviews very clearly, it is not at all difficult to do this right.LeadSongDog come howl! 20:28, 7 July 2011 (UTC)

Regarding the most recent addition to the article [10], here's a URL that points to the full text of the study noted. I don't want to have any edit conflicts (others are in the middle of editing the article), or I'd add it myself: http://onlinelibrary.wiley.com/doi/10.1002/ijc.23134/full. JoeSperrazza (talk) 22:18, 7 July 2011 (UTC)

Yes, but it's a primary source. If we're going to even mention the fact that these kinds of studies are done, we really ought to be able to find a secondary source (like a literature review article) that says people are doing epidemiological research, and here's the kinds of results that are generally seen. The alternative appears to be cherry-picking the handful of studies that give the most favorable impression of the efficacy. WhatamIdoing (talk) 23:49, 7 July 2011 (UTC)

You make a good point. In addition, as I understand it, while Primary Sources are OK initially, when no secondary sources are available, if no secondary sources are available after a period of time, then the text added based on a Primary Source should be removed. JoeSperrazza (talk) 00:48, 8 July 2011 (UTC)

Fair notice: this addition of primary sources has to end, it is out of control. Until this article gains some semblance of respect for secondary sources, we should revert on sight the addition of primary ref'd content. LeadSongDog come howl! 14:56, 19 July 2011 (UTC)

Many of the primary sources can and should be replaced by these two reviews:

• Wasser SP (2011 Mar). "Current findings, future trends, and unsolved problems in studies of medicinal mushrooms" (PDF). Appl Microbiol Biotechnol. 89 (5): 1323–32. PMID 21190105. {{cite journal}}: Check date values in: |date= (help)
• Ferreira IC, Vaz JA, Vasconcelos MH, Martins A (2010 Jun). "Compounds from wild mushrooms with antitumor potential" (PDF). Anticancer Agents Med Chem. 10 (5): 424–36. PMID 20545620. {{cite journal}}: Check date values in: |date= (help)CS1 maint: multiple names: authors list (link)

Please give them a careful read. LeadSongDog come howl! 02:56, 28 July 2011 (UTC)

Ok, this has been way too long. I've just removed this collection of primary sources for medical assertions. Please do not reinsert until you find a secondary MEDRS.LeadSongDog come howl! 13:12, 11 May 2012 (UTC)

Mushrooms are (almost) animals

I see that we have a statement "Genetic research has indicated mushrooms are much more closely related to animals than plants." It is supported by http://www.nytimes.com/1993/04/16/us/animals-and-fungi-evolutionary-tie.html which is a 1993 newspaper report on a primary study. The study is PMID 8469985. As far as I can make out, the word "mushroom" doesn't appear anywhere in the source, which seems far more interested single-cell fungi and is based solely on the rather narrow subject of ribosomal RNA.

Additionally, the fact that somebody once published a paper making this claim doesn't actually prove that this is the accepted view. In fact the cited NYT article suggests that it may not be: ""Mitch Sogin's results aren't significant and he's over-interpreting his data," said Arend Sidow, a graduate student working at Berkeley on molecular evolution. But Mr. Sidow's results have yet to be published and thus scientists said it was impossible to judge the merits of his claim."

This work was published 18 years ago. If this is real, then we shouldn't have any trouble turning up a textbook or other high-quality source that makes this claim. WhatamIdoing (talk) 22:00, 7 July 2011 (UTC)

An exclusive clade, known as Opisthokonta, contains both animal and fungi. Jatlas (talk) 03:19, 21 July 2011 (UTC)

Which is nice, but irrelevant: Either the exact claim being made in this article can be supported with a decent source, or it needs to be removed. WhatamIdoing (talk) 05:02, 21 July 2011 (UTC)

"This includes the widely accepted hypothesis that animals are related most closely to fungi" (here is a review as a citation[11]). Jatlas (talk) 20:25, 24 August 2011 (UTC)

You might find this review more useful, and it is more current to boot. LeadSongDog come howl! 20:50, 24 August 2011 (UTC)

"Fungi" is not exactly the same thing as "medicinal mushrooms". I fail to see the relevance to an article about medicinal mushrooms. Why should we be including this trivial fact in this particular article (rather than, say, in Fungi?) Is this supposed to suggest that medicinal mushrooms are likely to be more effective at treating diseases in animals than plant-based medicines because mushrooms' DNA is more similar to animals' than plants' DNA is? WhatamIdoing (talk) 22:33, 24 August 2011 (UTC)

But all "medicinal mushrooms" are "fungi"... Second, it does not suggest anything, it is just the currently accepted scientific theory.Jatlas (talk) 00:08, 25 August 2011 (UTC)

Apologies

...for the recent error edit on my part. I was editing using a portable device, and the combination of small screen, wide fingers and slow network led me to accidentally press the wrong link and revert when I didn't mean to. I self-reverted (incidentally wrongly marked by me as vandalism, again due to small screen/wide fingers). Once again, sorry! JoeSperrazza (talk) 22:03, 29 July 2011 (UTC)

No problem! I've made similar mistakes using portable devices. Happy editing! Jatlas (talk) 01:33, 1 August 2011 (UTC)

Mushrooms vs beta-glucans

This was definitely an improvement. Thank you. I'm still not sure that the point is grasped, though. We have a source that says beta glucans have an effect. It also says they are present in mushrooms. Fine. But there are similar sources saying they are present in common cereals too. What makes the mushrooms noteworthy as a source in preference to (for instance) the widely publicised oat fibre? Is there a wp:MEDRS that says the mushrooms' beta glucans are more available? Cheaper? Smaller? More effective? Better? Or is it just "one of" the various ways to get them? LeadSongDog come howl! 23:05, 3 August 2011 (UTC)

How about if we mention the compounds are not unique to mushrooms? Will that suffice? Jatlas (talk) 16:08, 18 August 2011 (UTC)

The same kind of question applies to the nutritional components of UV-exposed mushrooms. Is this really a "medicinal" use? Why should we care about the presence of nutritional components in an article about medicine? WhatamIdoing (talk) 22:59, 24 August 2011 (UTC)

The beta glucans from any source are varied, many of little use, and specific molecules or classes of molecules modulate different sets of receptors, cytokines or interleukins. Some of the modulations are pronounced, and important, even life saving. Sometimes the sources are highly erratic, with a major manufacturing impact on separation, grading and quality control burden for a given type of product. For cancer treatments with mushrooms and other beta glucans sources, one will hear of patients using 5-10 different extract sources to modulate various benefits, or "cover the bases". From a more observational point, the trick is to find biomarkers that can be routinely monitored for significant changes, like the RBC, WBC, platelets or other blood parameters being jumped up, without having to sponsor a whole new lab a la Rockefeller or Eastman.--Stageivsupporter (talk) 21:25, 22 December 2012 (UTC)

Dole

Taking a commercial company's marketing materials at face value is not sufficiently reliable sourcing to repeat without attribution. While Dole's website may say their product contains that much vitamin D, and that it is "the only" vegan source of it, we cannot just accept that as accurate. Either in-text attribution to them or a verifiable citation to a wp:RS is necessary. They have an obvious vested interest, and WP is not their advertising platform. We have other, better, sources saying that D is available from certain mushrooms exposed to ultraviolet light. That directly contradicts Dole's claim of being "the only" vegan source. I've restored my wording in the meantime.LeadSongDog come howl! 16:05, 18 August 2011 (UTC)

This product is a rare vegan source of vitamin D. This is a fact. Secondly, products in the USA do not get to guess the nutritional contents of their products, so we do not have to worry about the claim. Thirdly, the product is very unique so it should be allowed to be in the article, and not viewed as an advertisement. We could remove Dole as a brand name, if need be, but the fact that this is being sold shouldn't be ignored.Jatlas (talk) 16:11, 18 August 2011 (UTC)

Also, why did you convert 150DV/tsp to 30DV/ml? It is a food product, tsp is a MUCH better measurement than 1ml when it comes to food... Jatlas (talk) 17:35, 18 August 2011 (UTC)

The Dole page you link to is an advertisment. It uses the words "the only", not "rare", so while your assertion "rare" is uncited, Dole's assertion "the only" serves to demonstrate that their website cannot be taken as a wp:RS. If there is a formally published nutritional analysis, that might be a better choice. It does seem odd to imply that particular mushroom is rare: it has been available in nearly every grocery store that I've ever been in. Even that company markets them as vitamin D fresh produce. For nutritional labling in the US, the teaspoon is legally defined as 5ml. Outside of North America, the teaspoon is no longer widely recognized, and Wikipedia is written for a wp:Worldwide audience. I would have no objection to providing both US and SI units.

A better source would be p.992 of the USDA National Nutrient Database for Standard Reference (Group 23: Vegetables and Vegetable Products), which gives 13.1mcg of D2 per 100g of "Mushrooms, portabella, exposed to ultraviolet light, grilled", though on p.983 we see that "Mushrooms, maitake, raw" have 28.1 mcg of D2 per 100g. The US and Canadian DRI (which assumes minimal sunlight exposure) for adults under 70 and children over 1 year is now 15 mcg per day. No mysterious, proprietary, and expensive powders needed. LeadSongDog come howl! 19:14, 18 August 2011 (UTC)

As a vegan source of vitamin D, it IS rare. Of course I was not saying the mushroom itself is rare. That is just a blatant misinterpretation, look at the article.Jatlas (talk) 03:41, 19 August 2011 (UTC)

There you go again, forgetting to AGF. To say that one particular form of preparation (chopping and drying) is rare, but the whole mushrooms are not rare is obviously nonsensical. In any case it misses the point. Vegans can get all the D they need from sunlight, just like anyone else. And that is far from rare. LeadSongDog come howl! 06:56, 19 August 2011 (UTC)

I am close to positive this is not true "vegans can get all the D they need from sunlight". Also, I will make an effort to AGF!Jatlas (talk) 18:33, 22 August 2011 (UTC)

Well, perhaps I shouldn't have been so specific: vegan or not makes little difference to needed sun levels. Have a look at PMID 18348447, PMID 19138020, PMC 3051847 and particularlyPMC 2836430 (see the final section therein). They make it clear that the endogynous production in skin responding to sunlight can be far more than what is safely taken orally as food or supplements and that supplementation is not an entirely safe substitute for sunlight, as "It has been shown that, without adequate sun exposure, vitamin D-precursors turn to cholesterol instead of the vitamin." Still, as "Michael Holick reported previously, we have learned that at most latitudes such as Boston, USA, very short and limited solar UV-exposure is sufficient to obtain “adequate” vitamin D-levels." LeadSongDog come howl! 21:27, 22 August 2011 (UTC)

Let me take your word for it. We are drifting off topic. This mushroom powder is a rare vegan source of vitamin d2. This is a fact. Whether or not vitamin d2 is inferior to vitamin d3, whether or not someone needs vitamin d supplementation is not what we were initially talking about, nor are they topics on this page... Jatlas (talk) 17:59, 24 August 2011 (UTC)

What about the powdering process makes the common mushrooms become rare? It's Dole's blatant marketeering.LeadSongDog come howl! 18:16, 24 August 2011 (UTC)

Your killing me LSdog! It is rare because it is a vegan source of vitamin d! Most vitamin d is either synthesized or obtained through animal products. Find me another source of VEGAN vitamin d in large concentrations, don't worry I'll wait. Jatlas (talk) 20:16, 24 August 2011 (UTC)

See my posts of 19:14, 18 August 2011 and of 21:27, 22 August 2011 (UTC) immediately above.LeadSongDog come howl! 20:20, 24 August 2011 (UTC)

This looks like basic miscommunication. Jatlas doubtless means that vegans refuse to eat most of the foods that naturally contain Vitamin D. Of the few foods they are willing to eat, almost none naturally contain Vitamin D. UV-exposed mushrooms is one of them.

Jatlas, basically the only people who say that sunlight is inadequate as a sole source for Vitamin D are people trying to sell Vitamin D supplements (Dole, for example). Sunlight is definitely a vegan-compatible, major, wholly sufficient source of Vitamin D.

LeadSongDog, while sunlight is adequate, people who refuse to expose themselves to it need a dietary source for Vitamin D. The typical solution for vegans, though, is food enriched with torula yeast, not UV-exposed mushrooms. WhatamIdoing (talk) 22:47, 24 August 2011 (UTC)

Maybe I'm using the wrong words. It is a rare vegetarian source of concentrated vitamin d.Jatlas (talk) 00:18, 25 August 2011 (UTC)

Thanks for the intervention WAID. I suppose that vegans/vegetarians who are coincidentally also albinos, vampires or photophobes might need a dietary supplement. Of course hardline vegans would want to be sure that no animal products (such as manure) were used to feed the mushrooms. But for the life of me, I don't understand how this relates to the topic of "medicinal mushrooms". LeadSongDog come howl! 05:48, 25 August 2011 (UTC)

Summary style

I am delighted with the improvements Jatlas and other editors have brought to the article. It has evolved into a comprehensive, and, for the most part, attractive overview of the uses of medicinal mushrooms. There is an exception, however. I find the lists of "Edible species" and "Extractive species" somewhat less attractive. At 128 Kb, the article is also getting fairly long (which could hinder it reaching GA or FA status). One thing that could be done is to adopt summary style for some of the sections (for e.g., the two aforementioned, which would lend themselves to subarticles). What do you think? Sunray (talk) 02:17, 27 October 2011 (UTC)

I agree, a sub article with both lists on it would be appropriate for this page. And it would make it a bit shorter, which would help it reach GA or FA status.MilkStraw532 (talk) 01:11, 29 October 2011 (UTC)

Is this getting any better?

Since 19 May, you've made hundreds of edits, almost entirely without an edit comment. The net effect is this. There are still huge numbers of medical assertions that lack wp:MEDRS sources. Do you have any intention of addressing them? LeadSongDog come howl! 04:07, 3 October 2012 (UTC)

Referencing convention here?

Does each mushroom description needs to be fully referenced or - when there is a main article - is the convention to use WP:Summary style here since the main article will carry the requisite references? Alexbrn ^{talk|contribs|COI} 06:25, 26 August 2013 (UTC)

Improperly-sourced health information

I am concerned that User:Jatlas has now twice reverted content to remove[12] high-quality biomedical content sourced to Cancer Research UK (stating "there is currently no evidence that any type of mushroom or mushroom extract can prevent or cure cancer") and to re-instate[13] content using a primary study to imply that a particular mushroom (Enokitake) is associated with "lower cancer rates" (a suggestion which is also out-of-WP:SYNC with the main article on this mushroom).

It is vital that, as WP:MEDRS states, Wikipedia relays only reliable health information. Alexbrn ^{talk|contribs|COI} 13:09, 28 August 2013 (UTC)

I agree that we shouldn't remove this source. It is a secondary source, and it shouldn't be overriden by primary sources (see WP:MEDRS#Respect_secondary_sources).

And I don't agree with weakening the statement by digging up a review that was issued by the own organization. We can assume that Cancer Research UK can assess itself the significance of its own reviews, and that it has done so in its statement. We shouldn't be second guessing these statements. --Enric Naval (talk) 21:40, 28 August 2013 (UTC)

Note the dates. It's a current review vs. an eleven year old one from the same organization. Clearly the writers of the current one had access to and were aware of the older one.LeadSongDog come howl! 04:57, 29 August 2013 (UTC)

I think this answers Jatlas' objection that "why can Cancer Research UK be quoted for 1 thing, and not another?". --Enric Naval (talk) 11:52, 29 August 2013 (UTC)

I find this discussion, above, very POVish, or out of context, including the source. The UK Cancer Research "...no evidence any type of ...mushroom extract can prevent or cure cancer" statement above appears to studiously misdirect from the common uses and claims for at least PSK, the leading anticancer mushroom extract in Japan. PSK is used in combination with chemotherapies to reduce recurrences and to prolong life. Not this overdramatic single or magic bullet "cure" stuff that sounds more like competitive advertising putting misrepresentative words in competitors' mouths. The simple facts are that PSK does have recent reviews that cite human evidence for improved survival for a number of cancers as a part of multimodulated therapies.--Stageivsupporter (talk) 23:27, 15 September 2013 (UTC)

Your comment prompted me to take a look at the Polysaccharide-K article. Lo and behold - it's another one crammed full of poorly-sourced biomedical claims. Alexbrn ^{talk|contribs|COI} 04:54, 16 September 2013 (UTC)

(Add) The claims seem to be largely the work of Jatlas; I have now removed them, but notice this article has had its problems creeping back now too. Alexbrn ^{talk|contribs|COI} 05:01, 16 September 2013 (UTC)

I disagree with your text removal and deprecation of sources about PSK. Jatlas used legitmate secondary sources with his text that you removed and it was not Original Research as claimed either (e.g. Jatlas' research or ideas). Rather it reflects more mainstream thinking (and papers) in Japan, where they are decades ahead in (pre)clinical experience with beta glucans. The table that you removed reflects the published summary of many papers from preclinical research presented in a legit secondary source.(--talk) 08:34, 17 September 2013 (UTC)

more recent sources

FYI, some more current sources on PSK:

Biological mechanism and clinical effect of protein-bound polysaccharide K (KRESTIN®): review of development and future perspectives (2012)

Recent developments in mushrooms as anti-cancer therapeutics: a review (2012)

Trametes versicolor Mushroom Immune Therapy in Breast Cancer (2010)

Neoadjuvant chemoradiation therapy in patients with surgically treated esophageal cancer. (2001)

--Stageivsupporter (talk) 08:34, 17 September 2013 (UTC)

A table stating that PSK leads to "increased survival time" sourced to a 1995 paper research runs blatantly counter to WP:MEDRS (and I notice you have just restored this). The shopping list of primary studies being used to push PSK is also problematic. Yes, there is some secondary research that states there is promise here, but making Wikipedia "jump the gun" (on the OR assumption that Japan is "leading the world") is simply not neutral.

I am beginning to think there are some issues around the editing of this article (and PSK) which will need some higher-level attention. Alexbrn ^{talk|contribs|COI} 08:52, 17 September 2013 (UTC)

You mean warping MEDPRS into "I don't like it" and ignoring the rest of WP:RS? The table in the PSK article is from a secondary source. Perhaps this additional detail in the table header will assuage your concern about potential reader misinterpretation.

Also, I did list two more recent secondary sources, above, in essence inviting your collaboration. As for "jumping the gun", WP is dragging its arse here. The Japanese have hundreds of research and review articles on PSK, somewhat limited by language and abstracts. That the Japanese lead in deployment of therapeutic beta glucans, particularly PSK, 2-3 decades is a simple matter of fact. Even Western medical competitors on record in leading journals acknowledge the therapeutic nature of PSK. They sometimes merely play misleading word games like "platinumplus kills more cells overnight" rather than admit others rational priority for a safe, additive biomodulator that functions in different ways.--Stageivsupporter (talk) 06:46, 19 September 2013 (UTC)

Simply put, Wikipedia should be neutrally noting that Japan is distinctive in using this therapy, and not taking the position that the West is "dragging its arse" or that Western "competitors" are "playing misleading word games" and failing to "admit" PSK's worth (all curious choices of words). In the PSK article I fail why we need to have a big table tabulating the results of 18-year animal research bigging-up PSK's anti-cancer potential. This is giving undue weight to it, as well as falling foul - at least - of WP:MEDDATE. Alexbrn ^{talk|contribs|COI} 07:32, 19 September 2013 (UTC)

• ...Wikipedia should be neutrally noting that Japan is distinctive in using this therapy

Distinctive but not unique. This article hasn't been "neutrally noting" a lot of things lately.

• About "the 'West' is dragging...," you misquote me, I said "WP [Wikipedia] is dragging its arse here". Some parts of the West are doing something with PSK.
• As for "competitors", I've seen a lot of political posturing and economic conflict with social engineering in supposedly pristine technical fora. It annoys me in life or death situations.
• Regarding restoration of the PSK article's table for discussion, I find the table clumsy with redundant phrases. I think you, the English Lit PhD, might have the first shot at reducing it to 1-2 quality sentences about animal studies in a few lines and that could reduce the "bigging up" effect. It's been a few years since I read a number of PSK papers, but I plan to try to summarize some of the human studies with PSK with 1-2 more recent references.--Stageivsupporter (talk) 22:46, 19 September 2013 (UTC)

Point taken on WP; you've totally lost me on "competitors" and "social engineering". The table is badly sourced and needs to go. Why can't we source PSK stuff to a reliable secondary instead? We shouldn't be summarizing studies ourselves ... Alexbrn ^{talk|contribs|COI} 04:23, 20 September 2013 (UTC)

Myko san

A related topic. In the next paragraph, those products are not "registered anticancer X". They are registered only in Croatia, and only as a dietary supplement, with description "a preparation for immunity strengthening and general health improvement". The source is a paper written by Doctor Myko San, owner Health from Mushrooms the company that sells those supplements. I don't know what is the quality level for the journal International Journal of Medicinal Mushrooms, but the abstract of the paper reads a bit like advertisement for his products. I would like to see third-party research of these components. --Enric Naval (talk) 14:16, 28 August 2013 (UTC)

Whoah, their facebook page says "used for cancer, HIV/AIDS, hepatitis, herpes cures"[14]??? Their official website also says it "(...) we should, in the effort to avoid HIV infection and contracting AIDS (besides avoiding high-risk activities), reach for a harmless boost of immune system from medicinal mushrooms." [15]. What the heck, this is very out of line with commonly accepted knowledge in mainstream medicine??? --Enric Naval (talk) 14:45, 28 August 2013 (UTC)

Hmm yes, there is definitely an implication about human health in this article content, and the reference is weak. I would support removing this material completely. Alexbrn ^{talk|contribs|COI} 14:50, 28 August 2013 (UTC)

This article has had absolutely wild violations of MEDRS for ages. I just have never had the mental energy to take on the fight. I wholeheartedly support removing non-MEDRS compliant info from this article, even if it means cutting out wild chunks of it. Kevin Gorman (talk) 23:30, 28 August 2013 (UTC)

The Myko San (Dr. Jakopovich's) article doesn't just refer to the registration of Myko San products. It is also a source regarding the use of PSK as official anti-tumour therapy. I've looked at the abstract and the entire article; it is a peer-reviewed article published in the leading specialist journal in the field whose editorial board consists of leading global scientists in the field, including Professor Chang. The main editor is a leading Israeli-Ukrainian academic Professor Solomon P. Wasser. A peer-reviewed article in a leading journal in the field can hardly be characterised as an "advert".

In passing, this entire article, like so many others, is being hijacked by the big Pharma stooges trying to suppress everything they don't know much about. Both Sloane-Kettering (the leading cancer hospital in the United States) and Cancer Research UK (the largest anti-cancer charity in the world with a budget of over £1 billion) openly state on their website that research shows medicinal mushrooms have been proven in numerous studies to have strong anti-cancer properties and effects. Over 400 clinical studies have also supported these statements. Medicinal mushrooms have been proven to be much stronger than many official chemotherapies in combating cancer, but they cannot be patented or synthetically produced (especially in the case of blended extracts of various mushrooms species, which work best). In addition, they require large amounts of raw material (mushrooms), so the profit margins just aren't interesting enough for oligopolistic pharmaceutical corporations, which use paid and unpaid stooges to attack scientifically-based rival approaches to anti-cancer treatment. They also buy off and pressurise politicians (through lobbyists and undemocratic government quango's filled with big Pharma officials with a conflict of interest) to introduce repressive legislation favouring big Pharma. It's all very ugly, and Wikipedia shouldn't allowed itself to become used for these kinds of repressive corporate and scholastic (as opposed to genuinely scientific) attempts.

Yes, the sourcing has long been problematic. Certainly medical assertions sourced to COI sources should be stricken. The primary sources without corroborating reviews should be stricken.LeadSongDog come howl! 04:57, 29 August 2013 (UTC)

Okay, I've had a go at reforming the first half of the article, in particular rewording much of it in line with WP:MTAU. All the exact same sources are still there (often bundled), but I hope now properly caveated and weighted according to their significance.

But what to do about the "big list" that is the second half of the article. One thought is maybe to have a matrix table with mushrooms on one axis and "field of research" on another, with relevant studies anchored in their correct cells. This wouldn't lose any information but wouldn't give any claims undue prominence either... ? Thoughts? Alexbrn ^{talk|contribs|COI} 10:00, 29 August 2013 (UTC)

I am not opposed, but I warn you that big tables are much more difficult to edit that the current sections. It would discourage new editors, specially when trying to add new mushrooms (you need to add a new row, with all those unfamiliar "|" and "|-" getting in the middle of simply adding information). --Enric Naval (talk) 11:52, 29 August 2013 (UTC)

A good point. However having just made a pass of this list, I'm now wondering if a cleaner solution might just be to delete it entirely. It seems only one mushroom-derived substance (lentinan) is actually used as a medicine (I have mentioned it high up accordingly), everything else looks like speculation based on research. Perhaps this article would have been better named "Medicinal mushroom speculation"!? Alexbrn ^{talk|contribs|COI} 11:57, 29 August 2013 (UTC)

I don't mind speculative research, as long as it's well sourced and in context. If an extract has only been tested in vitro, it should say so in the article, etc. It should be very well separated from extracts that have been officially approved as working medicines over the world (currently, no mushroom extract has this category?). --Enric Naval (talk) 14:53, 30 August 2013 (UTC)

I think the question is: how to present it. I am thinking perhaps of expanding the bullet list in the "Research" section and mentioning that research is taking place for some particular potential effects (e.g. diabetes medicine, immunotherapy, etc.) and then cite some relevant primaries to support that assertion. I think the problem with the second half of the article at the moment is that it's a kind of miscellany of mushroom-related research, which gives a lot of primary material of questionable notability undue prominence. Alexbrn ^{talk|contribs|COI} 15:06, 30 August 2013 (UTC)

Ah, yes, the article is padded with lots of primary sources. Lots of in vitro and animal tests, a few trials on humans. With no secondary sources, its impossible to which tests are promising and which are dead-ends.

See this non-sequitur. Inonotus obliquus contains betulin, but betulin is already extracted from a tree species. The only source is about using chromatography to find steroids on mushrooms[16] in the Chinese Journal of Chromatography (Se Pu). Jatlas has used this same source to claim that there is "ongoing research into the anti-cancer potential of mushrooms". That source is very inadequate for such statement. There is no mention of anyone extracting betulin from mushrooms.

I agree that we should leave only the notable research, as covered by secondary sources. And leave only statements that are clearly supported by good-quality sources. I don't want to see the article falling back to the previous state. --Enric Naval (talk) 17:26, 1 September 2013 (UTC)

And just in cue, this week's Signpost Despite policy, only just over half of Wikipedia sources are secondary. --Enric Naval (talk) 13:10, 2 September 2013 (UTC)

Lentinan, PSP and PSK as adjuvants in which countries?

The sources says "In Japan, two types of β-glucans, krestin [PSK] and lentinan, are licensed as drugs for gastric cancer treatment. Krestin, a protein-bound polysaccharide K (PSK) containing β-(1, 3)-glucan, is derived from Coriolus versicolor.". I think that "some countries" is confusing language and should be removed. In countries other than Japan, it's only approved as a dietary supplement, not as an adjuvant? In Cancer Research UK's page about Coriolus Versicolor, talks about PSP and PSK, and only mentions PSK in Japan:

"Available scientific evidence does not support claims that the raw mushroom itself is an effective anti-cancer agent in humans. But there is some scientific evidence that substances derived from parts of the mushroom may be useful against cancer. Clinical trials suggest that PSK may help people with certain types of cancer by increasing survival rates and lengthening periods of time without disease, without causing major side effects. PSK is commonly used with other cancer treatments in Japan. PSP and VPS have not been studied as thoroughly. (...) In the 1980s, the Japanese government approved the use of PSK for treating several types of cancer. In Japan, PSK is a best-selling anti-cancer drug where it is currently used as a cancer treatment along with surgery, chemotherapy, and radiation therapy. PSP was discovered more recently and has been studied mainly in China."

Jatlas says that PSP has been "approved for human use in China"[17], but he provided no source. Is it approved as an anti-cancer adjuvant, as a dietary supplement, or as something else?

Memorial Sloan-Kettering Cancer Center [18] "Polysaccharide-K (PSK), a proprietary product derived from Coriolus, was developed for cancer treatment in Japan. When used as an adjuvant, PSK appears to improve survival rates in patients with gastric (1) (2) and colorectal (3) (4) (5) cancers. Other Coriolus extracts, such as polysaccharide-peptide (PSP) and VPS, are available as dietary supplements."

This PSK (PolySaccharide-Kureha) was discovered and isolated for the first time in 1969 and after several years of research and clinical trials was ratified as an official medicine under the brandname Krestin in 1977 by the Japanese Ministry of Health. Five years later the Chinese managed to isolate an even more potent variation from a different strain of mycelia; PSP (poly-saccharo-peptide). In 1992/93 PSP was ratified as an official medicine by the Chinese authorities.

In the rest of the world both Krestin and PSP are not acknowlegded as official medication, not because they do not work, but, to quote the Spanish Health authorities when they rejected the registration request: 'due to the lack of a single identifiable active ingredient which could define the "mechanism of action"'. The American FDA shared this opinion a little bit later.

— [19] (not a reliable source, but looks very complete

Looks like in all other countries, they are only approved as dietary supplements or as Novel_food#European_Union, and they are not allowed to make anti-cancer claims? --Enric Naval (talk) 13:20, 30 August 2013 (UTC)

Our article on PSK used to say that PSK is used as an adjuvant only in Australia, China and Japan, but Jatlas removed the list and the only explanation was "reformatting". Jatlas already made the "some countries" claim using the same source as in this article, he was called out by other editor[20] and Jatlas reverted him without giving any new source[21].

As far as I am concerned, PSK is only approved in Japan, and PSP/PSK in China are only herbal supplements (the company that distributes PSP/PSK in China and Japan calls them "health supplements"[22])

From the company that sells PSP:

"Yun Zhi polysaccharopeptide and its capsules were successfully approved by the Ministry of Health as "the first grade herb and the second grade clinical trial" in 1992. In June 1993, the Ministry of Health issued a new medicine certificate for PSP (Certificate No. 93) Health Medicine, Hygienic Medicine Certificate Z-32 )."[23]

--Enric Naval (talk) 14:34, 30 August 2013 (UTC)

August page repairs

medicinal mushrooms information DELETED outright by other users recently

Collapse copy/paste from historical version of the article

Cholesterol biosynthesis inhibitors Pleurotus creates the statin lovastatin.[5] A study noted an unidentified statin in Agaricus bisporus.[6] Zaragozic acids were discovered in fungi, and the pravastatin precursor mevastatin, was discovered in Penicillium. Red yeast rice fungus Monascus purpureus creates lovastatin, mevastatin, and the simvastatin precursor monacolin J. Mushroom isolate eritadenine, as well as 3-deaza derivatives of eritadenine, have hypocholesterolemic activity in vivo. Anticancer activities Lentinan, PSK, and PSP, are registered anticancer immunologic adjuvants/BRMs.[8] Irofulven and acylfulvene are anticancer derivatives of illudin S. Mushroom isolate clavaric acid is a reversible farnesyltransferase inhibitor with an IC50 of 1.3 microM. Inonotus obliquus creates betulinic acid precursor betulin.[9] Flammulina velutipes creates asparaginase. Agaricus creates conjugated linoleic acid. Vitamin D and ergothioneine Mushrooms exposed to UV-light create significant amounts of vitamin D1, vitamin D2, and vitamin D4.[10][11] This is notable, as non-animal sources of vitamin D are practically nonexistent. Although ergothioneine is synthesized only by mushrooms, other forms of fungi, and certain bacteria, human gene SLC22A4 ensures accumulation. Antihyperglycemic activities Mushrooms have antihyperglycemic activity in vivo. Inonotus obliquus creates DPP-4 inhibitors. Grifola frondosa creates α-glucosidase inhibitors.[12] Trametes versicolor creates α-amylase inhibitors, and the antihyperglycemic cyclic heptapeptide ternatin. Psychotropic activities Over 200 species of mushrooms synthesize psilocybin, and its degradation product psilocin. Due to a chemical resemblance to serotonin, psilocin is a non-selective, partial serotonin agonist. Claviceps isolates and/or derivatives were used to develop the headache medications cafergot, dihydroergotamine, methysergide, methylergometrine, the dementia medications hydergine, nicergoline, the Parkinson's disease medications lisuride, bromocriptine, cabergoline, pergolide, and the controlled substance lysergic acid diethylamide. Pleurotus isolate lovastatin has neuroprotective activity. The mycorrhizal mushroom Polyozellus multiplex synthesizes prolyl endopeptidase inhibitors polyozellin, thelephoric acid, and kynapcins.[13][14][15][16] The mycorrhizal mushroom Boletus badius synthesizes theanine.[17] Hericium erinaceus isolates promote nerve growth factor synthesis in vitro. Other activities Mushrooms have prebiotic activity and contain ACE inhibitor peptides. Lovastatin, cordycepin, inotilone, quercinol, antcin A, and benzocamphorin F are mushroom anti- inflammatory compounds. Pholiota squarrosa contains xanthine oxidase inhibitors. 1-aminocyclopropanol, a metabolite of Coprinopsis atramentaria, inhibits the enzyme acetaldehyde dehydrogenase. Mushroom extracts inhibit 5-alpha reductase and/or aromatase in vitro. Other researched fungal isolates include, integrasone, ergosterol peroxide, enniatins, oudenone, velleral, peptaibols, kojic acid, beauvericin, pullulan, lichenin, gliotoxin, and asperlicin. Defensive activities Mushrooms have antimicrobial, antiviral, and nematicidal, activities in vitro. Antibiotics retapamulin, tiamulin, and valnemulin are derivatives of the mushroom isolate pleuromutilin. Plectasin is a mushroom-derived defensin antibiotic. Immunosuppressants ciclosporin, mycophenolic acid, mizoribine, antibiotics penicillin, cephalosporins, fusafungine, usnic acid, fusidic acid, fumagillin, brefeldin A, verrucarin A, alamethicin, and antifungals griseofulvin, echinocandins, strobilurin, azoxystrobin, caspofungin, micafungin were discovered in fungi that do not produce mushrooms. Codinaeopsin is an antimalarial fungal isolate. Sanofi uses fungi to manufacture the antimalarial precursor artemisinin.[1]

It was not an "attack". Editors undertook to fix problems that you've too long ignored, despite repeated requests to respect wp:MEDRS sourcing. Now you are reinserting your wp:OR, which is definitely not cool. PMID 23092289 says nothing at all about PSP. LeadSongDog come howl! 13:32, 30 August 2013 (UTC)

Months later, the article is still packed with sources that don't comply with WP:MEDRS.... --Enric Naval (talk) 14:40, 29 January 2014 (UTC)

In fact, you might say they've mushroomed (also see Medicinal molds). Alexbrn ^{talk|contribs|COI} 14:44, 29 January 2014 (UTC)

Biting the bullet

I have boldly deleted a large proportion of this article because ... well, it simply wasn't an encyclopedia article in accord with the Wikipedia project's goals. Articles should be based on secondary sources and digest information in a way which makes it accessible to the general reader. This article was more as a miscellany of primary research materials assembled into an unreadable morass.

The External links section contains some links to resources (like articles from the American Cancer Society) which could useful be used to re-expand the article in better shape. Strange these were't being used before ... Alexbrn ^{talk|contribs|COI} 05:21, 19 April 2014 (UTC)

Jatlas please come and talk. This article is indeed in need of revision - it relies far too heavily on primary sources in violation of WP:MEDRS and makes really strong statements that are not supportable. It is going to need a haircut. Jytdog (talk) 20:11, 20 April 2014 (UTC)