Pseudostellaria

Pseudostellaria (Pseudostellaria heterophylla): A Comprehensive Reference

1. Identity

Botanical and Nomenclatural Identity

Pseudostellaria heterophylla (Miq.) Pax belongs to the Caryophyllaceae (pink or carnation) family and is widely used in traditional Chinese medicine in Asia. The full accepted scientific name, incorporating both author citations, is Pseudostellaria heterophylla (Miq.) Pax ex Pax et Hoffm., commonly known as false starwort; its medicinal name in Chinese is Taizishen. Several synonyms appear in the older literature, including Stellaria heterophylla Hemsl. The plant is also known by the names Tai Zi Shen, Pseudostellaria, false starwort, and Prince Seng.

In Chinese, the herb is designated by two common names: tai-zi-shen (太子参) or hai-er-shen (孩儿参). The official pharmacopoeial name for the dried root is Radix Pseudostellariae (Tai-Zi-Shen), and the plant is mainly distributed in Jiangsu, Fujian, Guizhou, and Anhui provinces of China.

P. heterophylla is an herbaceous perennial, a Caryophyllaceae species known as Taizishen. Its dried tuberous root is named Pseudostellariae radix and is a traditional Chinese medicine with high pharmacodynamic value. The plant is mainly distributed in Liaoning, Hebei, Shandong, Anhui, and Sichuan provinces, and Ningde (Fujian Province) and Shibing (Guizhou Province) in China offer the most suitable environment for its cultivation.

Common Forms and Preparations

The primary medicinal part of the plant is the dried tuberous root. It is commonly employed in clinical practice in forms addressing symptoms such as anorexia, fatigue, and dry cough. In contemporary clinical practice, P. heterophylla is often used as the main ingredient in Chinese patent medicines for strengthening the spleen, such as Compound Oral Liquid of Radix Panax Ginseng, Jiangzhong Jianweixiaoshi Tablets, and Composite Pseudostellaria granule. Aqueous (water) decoctions are the classical preparation method; standardized extracts, granules, and powders are also available in modern usage. This medicine is often used for children as a substitute for ginseng because of its mild effects.

2. Traditional and Historical Use

Historical Documentation

Pseudostellaria heterophylla is a well-known traditional Chinese medicine first officially recorded in Ben Cao Cong Xin, which contains 721 kinds of herbs, by Wu Yiluo in 1757. It was first referenced in the BenCao CongXin (本草从新), authored by Luoyi Wu in 1757, where it was described as "a great tonic for the vital energy, although it is very fine like P. ginseng strips, short, tight and firm, and has a reedy texture, but its strength is not inferior to P. ginseng." According to BenCao CongXin (1757 AD), P. heterophylla is a plant mainly cultivated and produced in a geo-authentic production zone in Fujian, Guizhou, and Anhui provinces of China.

P. heterophylla was considered one of the precious medical materials from ancient China and is now one of the most commonly used TCMs in clinic, where it functions by invigorating the spleen, replenishing qi, moistening the lung, and benefiting blood.

Traditional Indications and Preparations

It is recorded that P. heterophylla has the effect of "treating qi deficiency and lung dryness, tonifying the spleen and earth, reducing swelling, resolving phlegm and quenching thirst." It has been used for treatment of fatigue, spleen asthenia, anorexia, asthenia after severe illness, and cough due to lung dryness.

According to the theory of traditional Chinese medicine, P. heterophylla has a mildly bitter taste and exhibits neutral pharmacological properties, primarily targeting the spleen and lung systems. It assists in maintaining physiological functions and replenishing body fluids while improving the functional activities of the spleen and lungs.

It can be used to treat spleen deficiency, anorexia, weakness after illness, and spontaneous perspiration symptoms because of its various active components, including saponins, polysaccharides, and cyclopeptides. P. heterophylla has been traditionally employed to address a range of ailments, including cancer, cardiovascular diseases, diabetes, and respiratory disorders.

As a traditional, edible, and medicinal tonic Chinese medicine, P. heterophylla exhibits significant effects in replenishing vital energy, stimulating fluid synthesis, invigorating the spleen, and moistening the lung. The herb occupies a cultural position as "ginseng of the lungs" within the Chinese herbal tradition, where it is known as the "ginseng of the lungs", and it is also classed as an adaptogen. Pseudostellaria heterophylla has historically been used as a medicine-food homology plant for thousands of years in China.

3. Key Constituents and Active Compounds

Overall Chemical Complexity

Over 289 distinct compounds have been successfully isolated and identified from various organs of P. heterophylla, comprising cyclic peptides, polysaccharides, saponins, alkaloids, flavonoids, nucleosides, phenolics, amino acids, volatile constituents, and minerals. Based on current chemical research, the identified components include cyclic peptides, polysaccharides, amino acids, saponins, and sapogenins.

Cyclic Peptides

To date, a total of 19 cyclic peptide compounds have been isolated from P. heterophylla, including 9 heterophyllins (A–H and J) and 10 pseudostellarins (A–H, K, and L). These cyclic peptides are mainly isolated from the dried tuberous roots and fibrous roots of P. heterophylla.

The most pharmacologically studied cyclic peptide is heterophyllin B (HB). Heterophyllin B (HB) is used as the quality control index for evaluating Pseudostellariae radix in the Chinese Pharmacopoeia (2010 edition, Volume I). HB is a cyclic octapeptide with a single ring formed with peptide bonds and eight L-amino acids, which belongs to the Caryophyllaceae-like cyclic peptides and is abundant in the tuberous roots of P. heterophylla.

The pseudostellarins (A through H, K, and L) represent the other major series of cyclic peptides. Early phytochemical work established that several pseudostellarins possess tyrosinase-inhibitory activity. The representative cyclic peptide exhibits a wide range of pharmacologic properties, such as antioxidant, anti-inflammation, antibacterial, and anti-cancer activities.

In recent years, with the development of natural product chemistry, cyclic peptides as some of the active constituents derived from P. heterophylla have gained increasing attention, demonstrating a broad range of biological activities, including anticancer, antioxidant, and immunomodulatory effects, as well as cognitive benefits.

Polysaccharides

Pseudostellaria heterophylla polysaccharides (PHP), as the primary bioactive constituents of this traditional medicinal herb, have attracted significant research interest due to their diverse pharmacological activities. Polysaccharides are the main bioactive macromolecule components in P. heterophylla. The most studied polysaccharide fraction is designated PF40. PHP comprises four monosaccharides: galacturonic acid, glucose, galactose, and arabinose. A separate polysaccharide fraction (PH-PS) studied for neuroprotective properties was found to be composed of glucose (57.78%), galactose (41.52%), and arabinose (0.70%) with a molecular weight of 8.771 kDa.

Other Identified Constituents

Seven compounds have been identified from roots of P. heterophylla, including ursolic acid, acacetin, and luteolin, as well as acacetin 7-O-beta-D-glucopyranosyl (6→1)-alpha-L-rhamnopyranoside. Additional phytochemical studies have identified nucleosides, nucleobases, amino acids (including glutamine), volatile compounds, and minerals. A simultaneous analytical method was established to determine the contents of 30 components in Pseudostellariae radix, including two cyclopeptides, 12 nucleosides, and 16 amino acids.

Quality Control Marker

Heterophyllin B (HB) is a cyclic octapeptide isolated from Pseudostellaria heterophylla and is used as the quality control index for evaluating P. heterophylla in the Chinese Pharmacopoeia. While 19 cyclic peptides, 10 polysaccharides, and 6 saponins have been characterized, the research on pharmacological effects remains fragmented.

4. Mechanisms of Action

Immunomodulation

Pharmacological studies indicate that the active components work potentially in combination to modulate immune responses, inflammatory reactions, metabolic disorders, and neural impairment. The mechanisms involve restoring immune cell balance, suppressing pro-inflammatory cytokine release, enhancing antioxidant capacity, and promoting neural function and tissue repair.

Polysaccharide fraction PF40 enhanced cell-mediated immunity via improvements in macrophage phagocytosis, splenocyte proliferation, NK cell activity, and delayed-type hypersensitivity. It also improved humoral immunity through promoting the formation of serum hemolysin.

Digestion of P. heterophylla protein has yielded a novel peptide that induces the TLR2/NF-κB pathway, causing a significant increase in TNF-α production, pinocytosis, and TLR2 expression in macrophages.

Antidiabetic Mechanisms

The biological activity of the PF40 polysaccharide component includes increasing insulin secretion, improving insulin resistance, increasing glucose uptake and utilization in cells of muscle and adipose tissue, reducing blood sugar and serum total triglyceride levels, inhibiting the expression of TNF-α, and increasing IL-10 levels.

PF40 combined with metformin could significantly improve the symptoms of insulin resistance in type 2 diabetes mellitus (T2DM) rats; the molecular mechanism may be through inhibiting the expression of RORγ protein and increasing Foxp3 protein in the jejunum of T2DM rats, and then restoring the STZ-induced imbalance of T helper 17 (Th17)/regulatory T cells (Treg), thereby maintaining intestinal immune homeostasis.

Anticancer Mechanisms

Luteolin and acacetin, active components of P. heterophylla, specifically bind to TP53 in gastric cancer cells, promote its phosphorylation, and inhibit gastric cancer cell viability via ROS- and P53-related signaling pathways. Moreover, active components may affect diffuse large B-cell lymphoma (DLBCL) by targeting CASP3.

The aqueous extract of P. heterophylla (AEPH) remodels the tumor immune microenvironment by reducing macrophage M2 polarization and promoting IFNγ+ CD8+ T cell infiltration. Mechanistic studies show AEPH inhibits the JNK pathway, reducing CCL5 secretion in colorectal cancer cells.

Studies have shown that HB effectively suppressed the adhesion and invasion of human esophageal carcinoma cells and ameliorates lipopolysaccharide-induced inflammation and oxidative stress in macrophages by mediating the PI3K/AKT/β-catenin pathways.

Neuroprotective Mechanisms

Heterophyllin B (HB) improved memory by promoting neurite regeneration and regulating neuroinflammation in mouse models induced by amyloid-beta (Aβ). In particular, HB protected neurons from apoptosis and axonal atrophy induced by Aβ25-35, increased the activity of T-helper cells in the spleen, reduced neuroinflammation, and enhanced cognitive functions including memory retrieval and spatial memory.

Network pharmacology analysis identified key molecular targets of HB neuroprotection, including MMP2, MMP9, and Src, which were significantly upregulated after co-culturing with HB (10 μg/mL) for 4 days.

Respiratory/Antitussive Mechanisms

Cyclic-peptide extract (CPE) from Taizishen has been investigated for attenuating chronic obstructive pulmonary disease (COPD) in rats. The CPE was found to modulate the TLR4/MyD88 inflammatory signaling pathway, as indicated by the study's title and design. Antitussive activity of P. heterophylla extracts has been documented to operate via adjustment of multiple cytokine levels in animal models.

Gut Microbiota Modulation

Treatment with the superfine powder suspension of P. heterophylla enhanced the levels of immune factors such as IL-2 and IFN-γ in mice, and reshaped the gut microbiota by increasing the abundance of beneficial bacteria (e.g., Akkermansia, Roseburia, unclassified Clostridiaceae, Mucispirillum, Anaeroplasma, and Parabacteroides) while reducing the abundance of pathogenic bacteria (e.g., Cupriavidus and Staphylococcus).

5. Scientific Evidence by Area of Use

5.1 Immunomodulation

Pseudostellaria heterophylla is widely used for its immunomodulatory, antioxidant, antidiabetic, and antitussive properties. The immunomodulatory research base consists primarily of preclinical (animal and in vitro) studies. One study explored the potential protective effects of PF40 on the immune system in mice with cyclophosphamide-induced immunosuppression. Mice were intragastrically administered PF40 at the dosage of 100, 200, or 400 mg/kg once daily for 30 days. The results showed that P. heterophylla significantly increased the content of red blood cells, total antioxidant capacity, and expression of immune factors, and decreased platelet counts compared to the control under cyclophosphamide injury. Evidence strength: Preclinical only (animal models); no human clinical trials are available as of the current literature.

5.2 Antidiabetic Activity

Pseudostellaria heterophylla is a medicine extensively used in traditional Chinese medicine formulas to treat diabetes and its complications. Four polysaccharides with different molecular weight were compared for hypoglycemic activity on two animal models: alloxan-induced type 1 diabetes mellitus (T1DM) and high-fat/lower-dose streptozotocin-induced type 2 diabetes mellitus (T2DM). T2DM rats receiving daily oral doses of polysaccharide (100–400 mg/kg) with 50–210 kDa molecular weight (PF40) could not only significantly lower blood sugar but also reduce total triglyceride levels in serum. The hypoglycemic effects related to molecular size were more effective against T2DM than T1DM. PF40 improved insulin tolerance, inhibited the expression of some biomarkers including inflammatory cytokine TNF-α, and elevated the anti-inflammatory cytokine IL-10; it also regulated adiponectin Acrp30 and leptin, and may prevent the cascade of inflammatory events in the treatment of T2DM.

The polysaccharides (PHP) have demonstrated hypoglycemic, antioxidant, and immunomodulatory properties in preclinical settings. Some in vivo studies found that oral administration of 1.5 g/day of Pseudostellaria heterophylla was effective in treating type 2 diabetes. Evidence strength: Predominantly animal and in vitro studies; clinical human evidence is limited. The 1.5 g/day figure cited in the literature refers to in vivo (animal) dosing translated to a human equivalent, not a confirmed human clinical trial outcome.

5.3 Antitumor and Anticancer Activity

Pseudostellaria heterophylla has shown significant pharmacological potential, particularly through its immunomodulatory and antitumor activities. P. heterophylla is a traditional folk medicine widely used clinically for digestive system tumors such as esophageal, gastric, colorectal, and liver cancers.

In a preclinical study of colorectal cancer, AEPH (aqueous extract of P. heterophylla) suppressed MC38 colon tumor growth in vivo without evident toxicity. A formula composed of P. heterophylla, known as Fuzheng Quyu Jiedu Formula, has been shown to effectively regulate tumor markers, angiogenic factors, and immune function-related indicators in patients with advanced colorectal cancer, inhibit tumor progression, and improve the tumor immune microenvironment.

For pancreatic cancer, polysaccharide H-1-2 from P. heterophylla inhibited invasion and migration of pancreatic cancer cells, repressed xenograft pancreatic tumor growth, and increased survival of mice. Evidence strength: Predominantly preclinical (cell lines and mouse xenograft models). The Fuzheng Quyu Jiedu Formula study involved patients with advanced colorectal cancer, but P. heterophylla was one of multiple ingredients in a formula, making it impossible to isolate its specific contribution. No controlled human clinical trials isolating P. heterophylla as a single agent for cancer have been identified.

5.4 Neuroprotection and Cognitive Function

The traditional Chinese medicine P. heterophylla promoted neurite regrowth and enhanced cognitive function in normal mice, and its water extracts were orally administered to ICR mice. Heterophyllin B (HET-B), an important cyclopeptide, was detected in the plasma and cerebral cortex after oral administration. Neurites were significantly elongated after co-culturing with HET-B for 4 days. The intraperitoneal injection of HET-B on seven consecutive days in 3-month-old ICR mice significantly enhanced object recognition memory and object location memory compared to controls.

HB significantly alleviates the impairment of splenic T helper cells induced by Aβ1-42, reduces neuroinflammation, and improves cognitive and spatial memory in Alzheimer's disease mouse models. Treatment with P. heterophylla aqueous extract and one of its cyclopeptides, heterophyllin B, attenuated memory deficits via immunomodulation and neurite regeneration. A follow-up study found that P. heterophylla polysaccharide (PH-PS) may also exert neuroprotective effects in the 5×FAD transgenic mouse model of Alzheimer's disease, potentially via the microbiota–gut–brain axis.

Recent studies have revealed new pharmacological activities, such as modulation of intestinal flora and enhancement of cognitive functions. Evidence strength: All neuroprotective and cognitive data are from preclinical animal and cell-culture models. No human clinical trials for cognitive endpoints have been identified in the peer-reviewed literature.

5.5 Respiratory / Antitussive Effects

P. heterophylla cyclic-peptide extract has been investigated for attenuating COPD in a rat model. Antitussive activity has been demonstrated in animal models via the adjustment of multiple cytokine levels in the lungs, consistent with the traditional use of the herb for cough due to lung dryness. Evidence strength: Preclinical (animal) models only; no human trials have been reported in the identified literature.

5.6 Gut Microbiota and Intestinal Health

P. heterophylla increased the abundance of probiotics and decreased pathogens, and further stimulated host microbes to produce beneficial secondary metabolites for host health, highlighting the role of P. heterophylla in gut health. Evidence strength: Preclinical murine models; no human microbiome clinical trials identified.

5.7 Antifatigue and Adaptogenic Activity

Modern clinical medical research has demonstrated that P. heterophylla exhibits immune-enhancing, antitussive, antifatigue, antitumor, antioxidant, and cardioprotective effects, and it has also achieved breakthroughs in the treatment of asthma, diabetes, iron-deficiency anemia in children, anorexia, gastric cancer, and other diseases. However, it is important to note that most of the evidence supporting antifatigue claims derives from animal studies and traditional documentation; robust human clinical trials remain scarce.

6. Body Systems and Health Areas

• Immune System: Pharmacological studies indicate the active components work potentially in combination to modulate immune responses.
• Spleen and Digestive System (TCM framework): In TCM, the herb is associated with the spleen and lung meridians, and used for nourishing qi, invigorating the spleen, as well as promoting body fluid production and moistening the lungs.
• Endocrine and Metabolic System: In recent years, P. heterophylla has gained significant global attention as an important medicinal plant, attributable to its pharmacological activities on the immune and endocrine systems.
• Nervous System: Heterophyllin B (HB) is a brain-permeable cyclopeptide from Pseudostellaria heterophylla that promotes axonal regeneration and modulates neuroinflammation.
• Respiratory System: Traditional use and animal studies support an antitussive and lung-moistening function, as described in classical texts.
• Gastrointestinal and Gut Microbiome: Studies have investigated the impact of P. heterophylla on immune functions and its potential to regulate the gut microbiota and metabolome.
• Oncological (adjunctive, preclinical): P. heterophylla is widely used clinically in China for digestive system tumors such as esophageal, gastric, colorectal, and liver cancers.

7. Dosage Forms and Reported Dosages

The following dosages are reported strictly as stated in the identified peer-reviewed sources. No human clinical dosage recommendations have been independently established for P. heterophylla as an isolated ingredient.

• Polysaccharide fraction PF40 (animal, immunosuppression model): Mice were intragastrically administered PF40 at the dosage of 100, 200, or 400 mg/kg once daily for 30 days.
• Polysaccharide PF40 (animal, antidiabetic model): T2DM rats received daily oral doses of polysaccharide (100–400 mg/kg) with 50–210 kDa molecular weight (PF40).
• Heterophyllin B (animal, cognitive function study): Intraperitoneal injection of HET-B on seven consecutive days in 3-month-old ICR mice significantly enhanced memory compared to controls.
• Heterophyllin B (pharmacokinetics, animal, intravenous): Zhao and coworkers (2015) conducted the first pharmacokinetic study assessing concentrations of heterophyllin B in rats, 7 hours following tail intravenous injection of 2.08, 4.16, and 8.32 mg/kg, employing LC-ESI-MS/MS.
• Whole herb (reported human equivalent, in vivo data): Some in vivo studies found that oral administration of 1.5 g/day of Pseudostellaria heterophylla was effective in treating type 2 diabetes.
• HET-B human equivalent dose (calculated, not trialed): Based on FDA industry guidance on selecting safe starting doses for clinical trials, the optimal murine dose of 20 mg/kg of HB utilized in one study is equivalent to the human dose of 0.11 g.

No formal Phase I, Phase II, or Phase III clinical trials specifying therapeutic dosing ranges in humans have been identified in the current peer-reviewed literature for Pseudostellaria heterophylla as an isolated intervention.

8. Safety Considerations and Interactions

General Toxicological Profile

Research on the toxicity of P. heterophylla remains limited, and notably, the 2020 edition of the Chinese Pharmacopoeia does not present any information regarding its toxicity. P. heterophylla has low toxicity and exhibits enhanced efficacy in anti-cancer treatment according to preclinical studies. In the colorectal cancer mouse study, AEPH suppressed MC38 colon tumor growth in vivo without evident toxicity.

Known Pharmacological Concerns

Heterophyllin B exhibits neuroprotective effects in Alzheimer's disease models but lacks direct evidence of modulating the BACE1 enzyme; polysaccharides show TLR4-mediated immune regulation, yet their synergistic interactions with cyclic peptides remain unstudied. This gap highlights that the full pharmacological profile and any interaction risks between constituent classes have not yet been characterized.

Research Gaps and Limitations

Critical gaps remain in connecting bioactive components to molecular mechanisms, addressing cultivation challenges, and optimizing sustainable use — gaps amplified by disconnected research across these areas.

Polysaccharides in P. heterophylla were not well investigated to date, even if some of their beneficial effects such as antioxidant, immunostimulant, and antitumor activities have been demonstrated. In fact, few types of polysaccharides have been identified in structure.

Even though researchers have evaluated the chemicals, especially cyclic peptides in this plant, the methods for quality control of P. heterophylla are still not fully established. Variation in chemical composition across different growing regions has been documented, meaning that commercial preparations may differ substantially in their content of key bioactive compounds depending on geographic origin and cultivation conditions.

Because the predominant evidence base consists of in vitro and animal studies, the translation of observed pharmacological effects — including immunomodulation, antidiabetic activity, antitumor activity, neuroprotection, and antitussive effects — to human populations remains to be established through controlled clinical trials. The traditional designation of the herb as edible and its long history of use in TCM for over 260 years support a general impression of tolerability, but formal toxicological studies adequate for modern regulatory standards are lacking.

References

• Advances in Pseudostellaria heterophylla Research: Current Status and Future Directions — PMC
• Chemistry, pharmacology and analysis of Pseudostellaria heterophylla: a mini-review — PMC / Chinese Medicine (2019)
• Chemical Properties, Preparation, and Pharmaceutical Effects of Cyclic Peptides from Pseudostellaria heterophylla — PMC
• Traditional uses, phytochemical constituents, pharmacological properties, and quality control of Pseudostellaria heterophylla (Miq.) Pax — Journal of Ethnopharmacology (2024)
• Pseudostellaria heterophylla (Miq.) Pax ameliorates colorectal cancer by remodeling the tumor immune microenvironment — Journal of Ethnopharmacology (2025)
• Hypoglycemic effect of polysaccharides with different molecular weight of Pseudostellaria heterophylla — BMC Complementary Medicine and Therapies / PMC (2013)
• Physicochemical Characteristics and Antidiabetic Properties of the Polysaccharides from Pseudostellaria heterophylla — PMC (2022)
• The regulatory effects of Pseudostellaria heterophylla polysaccharide on immune function and gut flora in immunosuppressed mice — PMC (2022)
• Heterophyllin B, a cyclopeptide from Pseudostellaria heterophylla, enhances cognitive function via neurite outgrowth and synaptic plasticity — PubMed (2021)
• Heterophyllin B, a cyclopeptide from Pseudostellaria heterophylla, improves memory via immunomodulation and neurite regeneration in i.c.v. Aβ-induced mice — Food Research International (2022)
• Pseudostellaria heterophylla polysaccharide mitigates Alzheimer's-like pathology via regulating the microbiota–gut–brain axis in 5×FAD mice — International Journal of Biological Macromolecules (2024)
• Heterophyllin B enhances transcription factor EB-mediated autophagy and alleviates pyroptosis and oxidative stress after spinal cord injury — PMC (2024)
• Cyclic Peptide Extracts Derived From Pseudostellaria heterophylla Ameliorates COPD via Regulation of the TLR4/MyD88 Pathway Proteins — PMC (2020)
• Pseudostellaria heterophylla Extract Polysaccharide H-1-2 Suppresses Pancreatic Cancer by Inhibiting Hypoxia-Induced AG2 — PMC (2020)
• The Biosynthesis of Heterophyllin B in Pseudostellaria heterophylla From prePhHB-Encoded Precursor — PMC (2019)
• Pseudostellaria heterophylla improves intestinal microecology through modulating gut microbiota and metabolites in mice — PubMed (2024)
• Comparative chemical characters of Pseudostellaria heterophylla from geographical origins of China — PMC (2023)
• Quality Evaluation of Pseudostellariae Radix Based on Simultaneous Determination of Multiple Bioactive Components Combined with Grey Relational Analysis — PMC (2018)
• LC-ESI-MS/MS analysis and pharmacokinetics of heterophyllin B, a cyclic octapeptide from Pseudostellaria heterophylla in rat plasma — Biomedical Chromatography (2015)
• Simulation of Pseudostellaria heterophylla distribution in China: assessing habitat suitability and bioactive component abundance under future climate change scenarios — PMC (2024)
• Chemical constituents from roots of Pseudostellaria heterophylla — PubMed (2007)
• Anti-Diabetic Effects and Mechanisms of Dietary Polysaccharides — PMC (2019)