IngredientsPhellinus linteus (Berkeley & M. A. Curtis) Teng is a famous oriental medicinal mushroom that belongs to Phellinus Quel., family Hymenochaetaceae, order Aphyllophorales, class Hymenomycetes, phylum Basidiomycetes, and is more commonly known as "sanghuang" in China, "meshimakobu" in Japan, and "sangwhang" in Korea. In English, it is most frequently called the "black hoof mushroom" or simply "mesima" — a name derived from its Korean commercial designation. The species epithet linteus is Latin for "linen-colored," alluding to the yellowish hue of the pore surface.
It had been long thought that the mushroom used in East Asian medicine is Phellinus linteus. The species Polyporus linteus was named by Miles Joseph Berkeley and Moses Ashley Curtis in 1860 from a specimen from Nicaragua, and was later renamed Phellinus linteus by Shu Chün Teng in 1963. Taxonomic work by Dai and Xu (1998) studying specimens from various East Asian regions found them morphologically different from American Phellinus linteus, concluding that Phellinus linteus sensu stricto is found in tropical America and Africa, not in East Asia. Despite this taxonomic complexity, the name Phellinus linteus remains in widespread use in the scientific literature to refer to the East Asian medicinal species, and commercial products sold under the name "Mesima" or "Sang-Hwang" continue to be marketed under this designation.
The orange/yellow-colored mushroom P. linteus is a perennial fungus that is selectively parasitic on the mulberry tree (Morus) and belongs to Hymenochaetaceae basidiomycetes, a family consisting of 220 known species of Phellinus mainly growing in tropical areas. Its basidiocarps are perennial, pileate, sessile, and usually horseshoe-shaped. The pileal surface is dark brown when fresh and becomes black when dried; the pore surface is rusty brown when fresh and becomes brown when dried; the context is brown, with the upper context forming a black carapace, and its tubes are cinnamon yellowish-brown when dried.
It is a wood-decay fungus that grows on the trunk of Populus Linn., Quercus Linn., Toxicodendron vernicifluum (Stokes) F. A. Barkley, and Morus alba Linn., with the best time for harvesting from April to May. Phellinus linteus is a yellow, bitter-tasting mushroom that grows on mulberry trees.
Unlike culinary mushrooms, Mesima is tough, woody, and deeply bitter, traditionally prepared as teas or extracts rather than eaten directly. Modern commercial preparations include hot-water extracts of the fruiting body, mycelium powder (often derived from submerged liquid fermentation), encapsulated powdered extracts, and standardized polysaccharide fractions. A variety of functional supplements made with P. linteus have been developed in China, Japan, and Korea.
Particularly popular in Korea, and uniquely among the medicinal mushrooms, the Chinese Pharmacopoeia describes Mesima's energy as Cold. Both fruiting body and mycelial preparations are used commercially. It is well established that the bioactive compounds in both fruiting bodies and mycelial extracts of P. linteus produce beneficial biological responses.
P. linteus is a famous medicinal polypore used throughout China, Japan, and Korea with a long history. Its first medicinal usage was recorded in the oldest Chinese medicinal book, Shennong's Compendium of Materia Medica, written under the name "sanger" (ear of Morus alba L.) during the Han Dynasty, approximately 2,000 years ago.
As a traditional Chinese medicine with a 2,000-year history, medicinal applications of Phellinus linteus mainly include treating hemorrhage, hemostasis, and diseases related to female menstruation according to Chinese clinical empirical practice. It was traditionally used to consolidate channels for hemostasis, remove blood-arthralgia consumption, relieve abdominal pain, and treat chronic diarrhea in China. Uniquely among medicinal mushrooms, the Chinese Pharmacopoeia describes the energy of P. linteus as Cold and ascribes to it an extensive range of indications, including cancer, diabetes, HIV, angina, leucorrhoea, diarrhea, and accelerated wound healing.
P. linteus has been used as a traditional medicine in Korea, China, Japan, and other Asian countries for the treatment of various diseases, including gastrointeric disorder, lymphatic diseases, and various cancers. Hispolon, isolated from Phellinus linteus, a traditional medicinal mushroom called Sanghwang in Korea, has been used to treat various pathologies, such as inflammation, gastroenteric disorders, lymphatic diseases, and cancers.
It also has traditional applications in the treatment of hemorrhage, hemostasis, and menstrual disorders. In traditional medicine in Asia it is often mixed with other medicinal mushrooms such as reishi and maitake, and promoted as an adjunctive treatment during cancer therapy.
Historically, the tough, woody fruiting body was prepared by decoction — prolonged simmering in water to extract water-soluble polysaccharides and small molecules — or by ethanolic maceration to capture phenolic constituents. Traditional Chinese medicine texts indicate that P. linteus could be used to alleviate sickness in humans by consolidating a channel for hemostasis, removing blood-arthralgia consumption, relieving abdominal pain, and treating chronic diarrhea, among other benefits. Preparations described in classical sources were typically administered as water-based decoctions, and the mushroom was often combined with other medicinal substances in compound formulas.
P. linteus comprises various bioactive components, such as polysaccharides, triterpenoids, phenylpropanoids, and furans, and has proven to be an effective therapeutic agent in traditional Chinese medicine for the treatment and prevention of various diseases. A comprehensive phytochemical inventory published in a 2019 peer-reviewed review (PMC6572527) identifies the following major categories:
Active principles identified in the literature include polysaccharides, polyphenols, proteoglycans, pyrones, terpenes, and other organic compounds such as caffeic acid, ergothioneine, davallialactone, 3,4-dihydroxybenzalactone, phellinulin A, atractylenolide I, hispidin, phenilfuropyranone, meshimakobnol A and B, hispolon, inoscavin A, and interfungins A.
The biologically active compounds isolated from P. linteus are polysaccharides, acidic proteo-heteroglycans with mixed α- and β-linkages, and a (1→6)-branched type (1→3)-glycan. A proteoglycan derived from the fruiting bodies of P. linteus contains mannose, galactose, glucose, arabinose, and xylose, with α and β glycosidic linkages and β-(1,3)-D-glucose as the backbone. The polysaccharides from P. linteus mainly contain glucose with minor proportions of mannose, galactose, xylose, arabinose, and rhamnose, with glycosidic linkages being mostly 1→3, 1→6, or 1→3,6.
Mushroom polysaccharides with β-glucans, β-(1→3) linkages, and water solubility exhibit more anticancer ability according to a series of studies. Phellinus linteus is a well-known Oriental medicinal fungus with a variety of biological activities, including immunomodulatory or direct antitumor activities; the activity of P. linteus and its extracts is associated with the presence of polysaccharides, their peptide/protein complexes, and other low molecular weight complexes.
Hispolon (6-(3,4-dihydroxyphenyl)-4-hydroxyhexa-3,5-dien-2-one; C₁₂H₁₂O₄) is a natural polyphenolic compound widely present in Phellinus genus mushrooms including P. linteus and is a main bioactive component responsible for numerous health-beneficial activities of P. linteus, including antidiabetic, anti-inflammatory, antioxidant, and anticancer properties. Hispolon fights against cancer via induction of apoptosis, halting of the cell cycle, and inhibition of metastasis by targeting various cellular signaling pathways including PI3K/Akt, MAPK, and NF-κB.
Hispidin from P. linteus exhibits quenching effects against DPPH radicals, superoxide radicals, and hydrogen peroxide in a dose-dependent manner; intracellular reactive oxygen species scavenging activity of hispidin was approximately 55% at a concentration of 30 μM. In addition, hispidin was shown to inhibit hydrogen peroxide-induced apoptosis and increased insulin secretion in hydrogen peroxide-treated cells. Hispidin (3, 10, 30 μM) of P. linteus could protect cardiomyoblast cells against H₂O₂-induced apoptosis through suppressing the Akt/GSK-3β and ERK1/2 signaling pathway by inhibiting the expression of caspase-3 and Bax and increasing the expression of Bcl-2 in H9c2 cardiomyoblast cells in a dose-dependent manner.
Terpenoids are also major bioactive constituents of the mycelium of P. linteus and are important secondary metabolites; to date, phytochemists have discovered 13 kinds of terpenoids from the mycelium of P. linteus with pharmacological activity. It was reported that phellilane L, phellidene E, and (−)-trans-γ-monocyclofarnesol exhibited antimicrobial activities against P. gingivalis. Phellinulin D through N, isolated from the mycelium of P. linteus, were indicated to have a hepatoprotective effect.
Other constituents such as interfungin A may help prevent protein modification in hyperglycemic states. Anticancer activities and their underlying mechanisms are mainly based on cancer cell proliferation inhibition, cell cycle arrest and apoptosis regulation, cell metastasis suppression, and immune cell activation; these effects are attributed to bioactive components including atractylenolide I, hispolon, and hispidin present in the mycelium and fruiting body.
P. linteus stimulated proliferation of T lymphocytes and activated B cells, and induced maturation of bone marrow-derived dendritic cells and the macrophage response. A proteoglycan (PG) isolated from P. linteus was found to induce the phenotypic and functional maturation of bone marrow-derived dendritic cells via Toll-like receptors (TLR) 2 and 4 in vitro; administration of PG in vivo strongly inhibited tumor growth, increased the ratio of CD8+ DC to CD8- DC, and enhanced IL-12 and IFN-gamma production and expression of surface molecules including MHC classes I, MHC II, CD80, and CD86.
P. linteus has established immune-improving functions, and has been reported to increase the activity of interleukin (IL)-12, interferon (IFN)-γ, and natural killer (NK) cells; PL extract increases immunity mediated by cells such as T lymphocytes, NK cells, macrophages, and B lymphocytes, and exhibits antitumor and antioxidant activities.
The proposed mechanism by which mushroom polysaccharides exert their antitumor effect includes cancer-preventing activity, immuno-enhancing activity, and direct tumor-suppressing activity. P. linteus inhibits proliferation (anchorage-dependent growth) as well as colony formation (anchorage-independent growth) of highly invasive human breast cancer cells; growth inhibition of MDA-MB-231 cells is mediated by cell cycle arrest at S phase through the upregulation of p27Kip1 expression. Phellinus linteus also suppressed invasive behaviour of MDA-MB-231 cells by inhibiting cell adhesion, cell migration, and cell invasion through the suppression of secretion of urokinase-plasminogen activator from breast cancer cells.
The immunomodulatory effects of acid polysaccharide isolated from P. linteus (APPL) have been correlated with increased production of nitric oxide (NO) and tumoricidal activity in murine peritoneal macrophages; genistein and staurosporine blocked NO production and tumoricidal activity in response to APPL in macrophages, suggesting that APPL activates protein tyrosine kinase (PTK) and/or protein kinase C (PKC) signaling.
In animal models, the polyphenolic constituent demonstrated anti-inflammatory properties, which may protect against injury and other syndromes involving infarcts, hematomas, or hemorrhages. The anti-inflammatory mechanisms of hispolon may be related to the decrease in the level of MDA in the edema paw by increasing the activities of SOD, GPx, and GRx in the liver; it probably exerts anti-inflammatory effects through the suppression of TNF-α and NO.
Research has confirmed that extracts of P. linteus exhibit strong antioxidative activity in vitro and in vivo; polysaccharides (0.0625 mg/mL) of P. linteus treated for 2 hours significantly attenuated tacrine-induced hepatotoxicity and mitochondria dysfunction by an antioxidant protective mechanism through reducing the production of ROS in HepG2 cells.
Hispidin, a compound from P. linteus, has attracted attention due to its antioxidant, anti-inflammatory, anti-mutagenicity, and cell-mediated immunity properties in addition to its ability to inhibit tumor growth and metastasis. Hispidin was shown to inhibit hydrogen peroxide-induced apoptosis and increased insulin secretion in hydrogen peroxide-treated cells, indicating that hispidin may act as an antidiabetic by preventing β-cells from the toxic action of reactive oxygen species. Exopolysaccharides extracted from P. linteus grown by liquid fermentation have demonstrated hypoglycemic and hypolipidemic effects and ameliorated liver damage in animal models.
In a preclinical study, Phellinus linteus polysaccharides (Phps) treatment effectively alleviated acetaminophen (APAP)-induced acute liver injury by reducing alanine transaminase (ALT) and aspartate aminotransferase (AST) levels in serum; Phps significantly attenuated myeloperoxidase (MPO) activity and glutathione (GSH) depletion; Phps remarkably alleviated histopathological changes; further research found that Phps promoted the AMPK pathway and up-regulated nuclear factor erythroid-2-related factor (Nrf2) transport into the nucleus.
Preclinical evidence (cell and animal): Complex polysaccharides from P. linteus have been detected in a variety of different mushroom species and linked to immunostimulatory and antitumor activities. Numerous in vitro and animal studies have documented activation of macrophages, NK cells, T lymphocytes, B cells, and dendritic cells.
Human/clinical evidence: P. linteus has previously been shown to exert immune-enhancing and anticancer effects. A clinical trial was designed to evaluate whether PL mycelium extract, cultured from the PL KCTC0399BP strain, can increase immune function as measured using blood-test indicators. The trial is a randomized, double-blinded, placebo-controlled trial in which 98 participants were enrolled and randomly divided into two groups: an experimental group receiving PL 1000 mg and a control group receiving placebo, administered for eight weeks with blood tests performed before and after the trial.
A separate pilot trial reported that it will evaluate whether PL improves immune functions in adults with reduced immunity and identify its effects on immunity factors; the study is a single-center, randomized, double-blinded, and placebo-controlled trial, with participants randomly allocated to three groups taking PL 1000 mg, PL 2000 mg, or placebo, with a total trial duration of 8 to 10 weeks.
Evidence strength: The majority of immunomodulatory evidence comes from in vitro and animal studies. Human randomized controlled trials (RCTs) have been registered and published as protocols, but the field lacks a large body of completed, peer-reviewed efficacy data from human subjects. The evidence supporting immune benefits in humans is therefore currently preliminary.
In vitro and animal evidence: P. linteus was identified by Ikekawa as having the highest anti-tumor activity of the hymenomycetes, and by Stamets as having the greatest macrophage activation of seven species surveyed; it has been heavily researched in the last decade, especially in Korea, showing broad immunostimulant activity, strong anti-cancer properties, and the ability to enhance the efficacy of existing chemotherapeutic drugs.
Polysaccharides isolated from Phellinus linteus were previously reported to strongly stimulate cell-mediated and humoral immunity; the polysaccharides alone significantly prolonged the survival rate of B16F10-implanted mice, inhibited tumor growth in NCI-H23-implanted nude mice, and reduced the frequency of pulmonary metastasis of B16F10 melanoma. Combination therapy with the polysaccharide fraction and adriamycin was more effective in inhibiting tumor growth, though PL did not induce direct toxicity in cancer cells, which is characteristic of immunotherapeutics.
P. linteus has potential anticancer effects on various cancers, including prostate, bladder, kidney, lung, breast, stomach, skin, blood, liver, and brain, according to the available literature.
A study demonstrated that human colon cancer HCT116 and HT29 cells became highly susceptible to cell death when co-treated with PLGL polysaccharides and a low dose of camptothecin11 (CPT11, a topoisomerase inhibitor-based drug), the efficacy of which was comparable to that generated by a high dose of CPT11 alone; however, the co-treatment, unlike high doses of CPT11, was not cytotoxic to control immortalized colon Caco-2 cells.
Human evidence: PL extracts have exhibited a variety of properties in human cancer cell lines. However, the findings emphasize the need for standardized methodologies, in-depth mechanistic studies, and human clinical trials to translate these bioactive compounds into viable nutraceutical and therapeutic applications.
Evidence strength: Anticancer evidence remains predominantly in vitro and in animal models. There are no large completed randomized clinical trials in humans establishing efficacy of P. linteus as a cancer treatment. All clinical anticancer applications should be regarded as unproven in humans at this time.
In vitro and animal evidence: A study indicates that the protective effect of water soluble extract of P. linteus in atopic dermatitis is mediated by inhibiting IgE production and expression of AD-associated pathogenic cytokines as well as chemokines, suggesting the beneficial effect of P. linteus in modulating allergic skin disease.
Oral administration of P. linteus ethanol extract significantly inhibited eosinophilic airway inflammation and airway hyperresponsiveness in OVA-challenged BALB/c mice in a preclinical asthma model.
Human/clinical evidence: A clinical trial was conducted in which Phellinus linteus grown on germinated brown rice (PBR) powder was orally administered for 12 weeks to atopic dermatitis patients at an average age of 7.3 years; the symptomatic effect was verified based on significantly decreased itching and objective SCORAD indices of the patients.
A 2007 study published in the Journal of the American Academy of Dermatology examined the immunomodulatory activity of a P. linteus extract grown on germinated brown rice in treating atopic dermatitis in children; researchers administered the oral extract to thirty-five patients ages two to fourteen with mild to moderate eczema. After twelve weeks of study, researchers observed significant reductions in mean severity and symptom scores; no adverse effects were observed aside from transient aggravation of skin lesions during the first four weeks of observation.
Evidence strength: The human data for atopic dermatitis are from a single small pediatric study. While results are encouraging, the evidence base is limited and further controlled trials are required to confirm these findings.
Preclinical evidence: Oral administration of a polysaccharide (100 mg/kg body weight/day) from P. linteus mycelia to diabetic mice significantly reduced the blood glucose level by 35.6%, suggesting the value of this mushroom compound as a functional food additive and a hypoglycemic agent.
P. linteus is rich in polysaccharides and other small molecules, and has well-documented anti-cancer, anti-oxidative, anti-inflammatory, hepatoprotective, and antibacterial effects. Preclinical research demonstrates that P. linteus mycelial extract from solid-state culture reduced hyperglycemia in rat models of type 2 diabetes, though evidence for human efficacy has not yet been established.
Evidence strength: All antidiabetic evidence is from in vitro cell studies and animal models. No human RCTs have been completed or published for the antidiabetic indication.
Preclinical evidence: Results from a cell study showed that P. linteus significantly reduced tacrine-induced ROS production, disruption of mitochondrial membrane potential, 8-OHdG formation in mitochondrial DNA, and cytotoxicity in HepG2 cells. In a mouse model, Phps treatment effectively alleviated APAP-induced acute liver injury by reducing ALT and AST levels in serum; Phps significantly attenuated myeloperoxidase (MPO) activity and glutathione (GSH) depletion; Phps remarkably alleviated histopathological changes.
Evidence strength: Hepatoprotective evidence is entirely preclinical (cell lines and rodent models). Human clinical data are absent.
A number of studies have reported that P. linteus possesses many biological activities useful for pharmacological applications, including anticancer, anti-inflammatory, immunomodulatory, antioxidative, and antifungal activities, as well as antidiabetic, hepatoprotective, and neuroprotective effects. The anti-inflammatory data are predominantly derived from in vitro and animal studies, and robust human clinical trials confirming anti-inflammatory benefit in specific disease states are not yet available.
In a murine rheumatoid arthritis model, polysaccharide extract from P. linteus fruiting body demonstrated effects on joint pathology. No human clinical trials specifically addressing rheumatoid arthritis have been located in the peer-reviewed literature as of this writing.
Water extracts (1.725 mL/kg/d) from the fruiting body of P. linteus were reported to exhibit a significant therapeutic effect on prostatitis after 30 days through inhibiting benign prostatic hyperplasia by suppressing the dihydrotestosterone activity of testosterone involved in the conversion by enzyme 5α-reductase in vivo compared with finasteride (1 mL/kg/d) as a positive control. This evidence is from an animal model; no equivalent human trial data were located.
The following dosages are reported directly from the scientific literature and should not be interpreted as clinical recommendations:
No established pharmacopoeial standard dose for Mesima in humans has been identified in official monographs accessible for this review. Dosing in supplement products varies widely and is not standardized.
Black hoof mushroom is possibly safe for most people when taken in doses of 1–2 grams daily for up to 8 weeks. The 2019 PMC review (Chen et al., Molecules) notes that the body of preclinical work suggests a favorable safety profile, though systematic human safety data are limited. In the pediatric atopic dermatitis study, no adverse effects were observed aside from transient aggravation of skin lesions during the first four weeks of observation.
A clinically documented case report from Korea represents the most significant safety signal identified in the peer-reviewed literature. A 36-year-old woman with stage IV adenocarcinoma of the lung was given oral gefitinib 250 mg/day as first-line chemotherapy; within 9 weeks she became progressively short of breath. She had simultaneously taken multiple complementary herbal medicines including ginseng, Fomes fomentarius, Inonotus obliquus, Phellinus linteus, and selenium along with gefitinib without notifying her physician; after all the complementary herbal medicines were withdrawn, her symptoms improved significantly. The mechanism underlying this interaction was not isolated to P. linteus alone, as multiple agents were used concurrently, but the case illustrates the potential clinical risk of concurrent use with targeted cancer therapies without medical supervision.
Because P. linteus exhibits measurable immunomodulatory activity — including activation of macrophages, NK cells, and lymphocytes — there is theoretical potential for interaction with immunosuppressive drugs (e.g., in organ transplant patients or autoimmune disease treatment). P. linteus also demonstrated anti-inflammatory effects in lipopolysaccharide-stimulated macrophages, illustrating a bidirectional (both immunostimulant and anti-inflammatory) action that may complicate predictions of its net effect when combined with immunomodulatory drugs.
Exclusion criteria identified in published Korean RCT protocols include clinically significant cardiovascular, immune, respiratory, hepatobiliary, renal and urological, nervous, musculoskeletal, psychological, infectious, and/or neoplastic diseases currently being treated; uncontrolled hypertension or diabetes mellitus; history of vaccination within 1 month of the study; elevated liver enzymes (AST or ALT over 120 IU/L); elevated creatinine; intake of health functional foods that may affect the immune system within 2 weeks of the study; severe gastrointestinal symptoms; pregnancy or breastfeeding; food allergies related to PL; and participation in other clinical trials.
Taxonomic research indicates that Phellinus linteus sensu stricto is found in tropical America and Africa, while the mushrooms used in East Asian medicinal practice are morphologically distinct species. This means that commercial products sold as "Phellinus linteus" may in fact contain related but botanically distinct species, and the degree to which phytochemical profiles match those studied in peer-reviewed literature may vary by product source. Consumers and researchers should be aware of this taxonomic uncertainty when evaluating or selecting products.
Health conditions that Mesima may help support.
Body systems that Mesima may help support.
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