In the article “Three clinical effects of Ganoderma lucidum in improving viral hepatitis”, we have seen clinical studies that prove that Ganoderma lucidum can be used alone or in combination with conventional supportive and symptomatic drugs to help patients with viral hepatitis fight inflammation and virus and regulate imbalanced immunity. So, can Ganoderma lucidum and the commonly used clinical antiviral drugs also play a complementary role?
Before delving into this topic, we must understand that antiviral drugs cannot kill the virus but can inhibit the replication of the virus that has entered the “cell” and reduce the number of virus proliferation.
In other words, antiviral drugs have no effect on viruses that are still “outside the cell” looking for infectable targets. They must rely on the joint force of antibodies produced by the immune system and immune cells including macrophages to get rid of the virus.
This is why there is room for antiviral drugs and Ganoderma lucidum to work hand in hand – because Ganoderma lucidum is good at immune regulation, it can just make up for the deficiency of antiviral drugs; and Ganoderma lucidum‘s inhibitory effect on virus replication is also a big boost for antiviral drugs.
According to published clinical reports, whether used with antiviral drugs such as Lamivudine, Entecavir or Adefovir for more than a year, Ganoderma lucidum does not interfere with efficacy or cause adverse reactions. On the contrary, it can help chronic hepatitis B patients to achieve “faster” or “better” anti-inflammatory and antiviral effects, reduce the occurrence of drug resistance, and improve the common immune disorders. The effect of this one plus one is so great that there is no reason not to use them together.
One of the benefits of “Ganoderma lucidum + antiviral drugs” is not easy to develop drug resistance.
According to a clinical report issued by the Second Clinical College of Guangzhou University of Chinese Medicine in 2007, among patients with chronic hepatitis B who received 6 Ganoderma lucidum capsules per day totaling 1.62 grams (equivalent to 9 grams of Ganoderma lucidum fruiting bodies) combined with the antiviral drug lamivudine for one year, some of them were also treated with supportive and symptomatic drugs rather than other antiviral drugs.
As a result, hepatitis was relieved quickly, no viral DNA was detected in the patient’s blood (representing that the amount of virus was reduced to no longer spilling into the blood from the liver), and the chance of e antigen disappearing/turning negative was relatively high (the virus no longer vigorously reproduced). At the same time, the probability of drug resistance mutations in viral genes was greatly reduced.
As there were no clinical adverse reactions during the entire treatment, no adverse changes in blood routine and renal function tests, 2 cases of diarrhea in the pure antiviral group and only 1 case of mild headache in Ganoderma-treated group, but all these 3 cases were all able to spontaneously relieve, it indicated that the treatment of Ganoderma lucidum combined with antiviral drugs is not only effective but also safe.
Ganoderma lucidum can not only improve the efficacy of antiviral drugs but also provide patients with immunomodulatory effects that antiviral drugs do not have. A clinical report published in 2016 by the Clinical Laboratory Center of Huangshi City, Hubei Province found that after one year of treatment of chronic hepatitis B patients with 6 Ganoderma lucidum capsules made of Ganoderma lucidum fruiting body water extract totaling 1.62 grams (equivalent to 9 grams of Ganoderma lucidum fruiting body) per day and the antiviral drug Entecavir, the hepatitis index returns to normal, the virus decreases, the probability of virus replication becomes weaker, and Th17 cells related to inflammation in the blood are also lowered.The hepatitis B virus causes liver inflammation because the immune system has to attack liver cells in order to remove the virus hiding in the cells. When the war between virus and immunity never ends, the immune system is gradually losing ground between promoting inflammation (anti-virus) and suppressing inflammation (protecting cells). One of its specific indicators is the excessive production of Th17 cells in the helper T cells (Th cells) that command the immune system to fight.
Th17 cells are mainly used to promote inflammation and fight infection. When their number is too large, it will reduce the other group of Regulatory T (TReg) cells that are responsible for inhibiting inflammation. The combined use of Ganoderma lucidum and Entecavir can significantly reduce Th17 cells, which undoubtedly contributes to the improvement of liver inflammation – so the number of cases where the hepatitis index returns to normal will be more than that of Entecavir used alone.
As antiviral drugs can only inhibit virus replication and do not have the ability to regulate immunity, the reduction of Th17 is obviously related to Ganoderma lucidum; because the reduction of Th17 does not affect the virus suppression effect, Ganoderma lucidum should not only correct Th17 cells but also improve the overall immune imbalance of hepatitis B patients.
A clinical report published by the Sixth People’s Hospital of Shaoxing City, Zhejiang Province in 2011 also observed chronic hepatitis B patients treated with 100 ml of Ganoderma lucidum decoction (made from 50 grams of Ganoderma lucidum fruiting bodies and 10 grams of red dates and water) combined with the antiviral drug Adefovir for two consecutive years. This treatment not only has a better effect of relieving hepatitis or suppressing the hepatitis virus but also has the effect of regulating immunity, including increasing the proportion of natural killer cells, T cells and CD4+ T-cell subsets in lymphocytes, and through the increase of CD4+ to increase the ratio of CD4+/CD8+ T-cell subset, making it closer to the ideal health state.
Chronic hepatitis B patients often experience a decrease in overall T cells, a decrease in the proportion of CD4+ and an increase in the proportion of CD8+ as the course of the disease lengthens, resulting in a decrease in the ratio of CD4+/CD8+. CD4+ T cells with CD4+ molecular markers on the cell surface mainly contain “helper T cells” or “regulatory T cells”, which can command the entire immune army to fight (including ordering B cells to produce antibodies) and mediate inflammation in a timely manner; and CD8+ T cells with CD8+ molecular markers on the cell surface are mainly “killer T cells” that can personally kill virus-infected (and cancerized) cells. Both groups of T cells are differentiated from primitive T cells, so they affect each other in number. When the virus continues to infect cells, it induces a large number of T cells to differentiate into killer T cells (CD8+), which naturally affects the number of CD4+ and its command and coordination responsibilities. Such development will affect the immune system’s anti-viral and anti-inflammatory ability, and is detrimental to the treatment of hepatitis B.
Therefore, the combined use of Ganoderma lucidum and the antiviral drug adefovir dipivoxil can increase the number of T cells and the CD4+ in them, thereby increasing the CD4+/CD8+ ratio, and at the same time slightly increase the natural killer cells that are beneficial to anti-virus and anti-tumor. These are indicators of improvement in the immune function of patients with chronic hepatitis B, and the effect is significantly better than that of patients who are treated with antiviral drugs alone.
In addition, the clinical report also wrote that no rash, gastrointestinal reaction, creatine kinase (creatinine) increase and renal function abnormality occurred in all subjects during the treatment process, which further affirms the safety of Ganoderma lucidum in adjuvant antiviral therapy.Anti-viral and anti-inflammatory factors help prevent the liver from gradual hardening and canceration during repeated inflammation and repair, highlighting their importance to patients with chronic hepatitis B. Liver fibrosis is a prelude to liver cirrhosis. If the relevant indicators of liver fibrosis can be reduced during the treatment of hepatitis B, this can also be another proof that the treatment is effective.
A clinical report issued by the Fourth People’s Hospital of Panzhihua City, Sichuan Province in 2013, through the 48-week (approximately 1-year) treatment of chronic hepatitis B patients with 9 Ganoderma lucidum capsules totaling 2.43 grams per day (equivalent to 13.5 g of Ganoderma lucidum fruiting bodies) combined with antiviral drug Adefovir dipivoxil and liver-protecting, symptomatic and supportive drugs, found that the patient’s hepatitis indicators had been significantly improved, and the four indicators in the patient’s blood related to liver fibrosis had also dropped from beyond normal to normal or close to normal. These conditions indicated that the complementary effects of Ganoderma lucidum and antiviral drugs can also be expressed in preventing liver disease.
It is worth mentioning that among the 60 patients who received both Ganoderma lucidum and adefovir dipivoxil treatment, 3 patients (5%) had no detectable hepatitis B virus (HBsAg negative conversion) and produced antibodies to the virus (Anti-HBs positive conversion) after the treatment was completed. Such a treatment effect is not easily obtained compared to the goal that only 1% of hepatitis B patients receiving antiviral drug treatment can realize surface antibody negative conversion every year. Ganoderma lucidum can improve the efficacy of antiviral drugs, which has also been proven again.Ganoderma lucidum fruiting body water extract can regulate all aspects of immunity.Good immunity can prevent infection, chronic illness and recurrence.
The above four clinical reports not only show the benefits of Ganoderma lucidum in assisting antiviral drugs in the treatment of chronic hepatitis B but also show the feasibility of using Ganoderma lucidum and other antiviral drugs in combination.
The Ganoderma lucidum capsules and Ganoderma lucidum decoction used in the research are both water extracts of Ganoderma lucidum fruiting bodies.
The active ingredients obtained by extracting the fruiting bodies of Ganoderma lucidum with water are mainly polysaccharides including polysaccharide peptides and glycoproteins, and a little triterpenoids. These ingredients are the active source of Ganoderma lucidum to regulate immune function. The combination of triterpenoids that can inhibit abnormal inflammation and inhibit virus replication will undoubtedly fully explain the bonus effect of Ganoderma lucidum in assisting antiviral drugs.
In fact, the most important key to treating viral diseases and even preventing various viral infections is the immune system. When the immune system gets well regulated in the whole process from the discovery of the virus, the listing of the virus as the wanted, the production of antibodies, the elimination of the virus… to the final formation of immune memory and the termination of inflammation, we may not get easily infected in the tug of war with the virus, and we can eliminate the virus and avoid recurrence even if we get infected.
Don’t forget, even if the hepatitis B virus is cleared and can not be found in the body (HBsAg negative conversion), its genetic material is still likely to be embedded in the liver cell nucleus or chromosomes. As long as it catches the chance of weak immunity, it may make a comeback. The virus is so cunning, how can we not continue eating Ganoderma lucidum?References
1.Chen Peiqiong. Clinical observation of Lamivudine combined with Ganoderma lucidum capsules in the treatment of 30 cases of patients with chronic hepatitis B. New Chinese Medicine. 2007; 39(3): 78-79.
2. Chen Duan et al. The effect of entecavir combined with Ganoderma lucidum capsules in the treatment of Th17 cells in the peripheral blood of patients with chronic hepatitis B. Shizhen Guoyi Guoyao. 2016; 27(6): 1369-1371.
3. Shen Huajiang. Ganoderma lucidum decoction combined with adefovir dipivoxil in the treatment of chronic hepatitis B and its effect on immune function. Zhejiang Journal of Traditional Chinese Medicine. 2011; 46(5):320-321.
4. Li Yulong. Clinical study of adefovir dipivoxil combined with Ganoderma lucidum capsules in the treatment of chronic hepatitis B. Sichuan Medical Journal. 2013; 34(9): 1386-1388.
About the author/ Ms. Wu Tingyao
Wu Tingyao has been reporting on first-hand Ganoderma lucidum information since 1999. She is the author of Healing with Ganoderma (published in The People’s Medical Publishing House in April 2017).
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