Cordyceps Fungi: Medicinal Insights
Cordyceps Fungi: Medicinal Insights
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                                 Abstract
                                 Objectives Parasitic Cordyceps fungi, such as Cordyceps sinensis, is a parasitic complex
                                 of fungus and caterpillar, which has been used for medicinal purposes for centuries
                                 particularly in China, Japan and other Asian countries. This article gives a general idea
                                 of the latest developments in C. sinensis research, with regard to the active chemical
                                 components, the pharmacological effects and the research and development of products in
                                 recent years.
                                 Key findings The common names for preparations include DongChongXiaCao in Chinese,
                                 winter worm summer grass in English. It has many bioactive components, such as
                                 30-deoxyadenosine, cordycepic acid and Cordyceps polysaccharides. It is commonly used to
                                 replenish the kidney and soothe the lung, and for the treatment of fatigue. It also can be used
                                 to treat conditions such as night sweating, hyposexuality, hyperglycaemia, hyperlipidaemia,
                                 asthenia after severe illness, respiratory disease, renal dysfunction, renal failure, arrhythmias
                                 and other heart disease and liver disease. Because of its rarity and outstanding curative effects,
                                 several mycelia strains have been isolated from natural Cordyceps and manufactured by
                                 fermentation technology, and are commonly sold as health food products. In addition, some
                                 substitutes such as C. militaris and adulterants also have been used; therefore, quality control
                                 of C. sinensis and its products is very important to ensure their safety and efficacy.
                                 Summary Recent research advances in the study of Cordyceps, including Cordyceps
                                 mushrooms, chemical components, pharmacological functions and developmental pro-
                                 ducts, has been reviewed and discussed. Developing trends in the field have also been
                                 appraised.
                                 Keywords chemical components; Cordyceps; development products; pharmacological
                                 functions
                                 Introduction
                                 Cordyceps sinensis (Bark) Sacc. Link (Claviceptaceae) (Ascomycetes) is an insect
                                 parasitizing fungus. The name Cordyceps comes from the Latin words cord and ceps,
                                 meaning ‘club’ and ‘head’, respectively. ‘DongChongXiaCao’ (DCXC), Chinese
                                 caterpillar fungus, is the Chinese name given to the complex of larvae and fungi, which
                                 is found at high altitudes on the Qinghai-Tibetan plateau. This fungus lives primarily on the
                                 head of the larva of one particular species of moth, Hepialus armoricanus, but is also
                                 occasionally found growing on other moth species.[1] It is generally called ‘DCXC’ in
                                 Chinese and ‘Tockukaso’ in Japanese, meaning ‘winter-insect and summer-plant’ because
                                 of the growing process: the fungus first parasitizes the larva of some species Hepiaidae,
Correspondence: Professor        forming a parasitic complex that comprises the remains of the caterpillar and the stroma of
Xuanwei Zhou, Plant
                                 the fungus. Because the larvae are infected by fungi in the summer and autumn seasons,
Biotechnology Research Center,
School of Agriculture and        and consumed by mycelia and turned into ‘stiff worms’ in winter, they are called ‘winter
Biology, Fudan-SJTU-             worms’ (DongChong). In the spring and summer season of the following year, the stroma
Nottingham Plant Biotechnology   emerges from the ground, growing from the head of the larva, and is known as ‘summer
R&D Center, Shanghai Jiaotong    grass’ (XiaCao).[2,3] C. sinensis is an invigorant in Chinese tradition and was honoured as
University, Shanghai 200240;
P.R. China. E-mail:
                                 one of the three greatest invigorants together with Panax and Pilose antlers. It has a history
xanweizhou@sjtu.edu.cn           of hundreds of years in medicine. Its name was first seen from ‘Bei Cao Cong Xin’ written
or xuanweizhou@163.com           by Yiluo Wu in the Qing dynasty, 1757 AD and ‘Ben Cao Gang Mu Shi Yi’ written by
                                                                                                                                    279
280      Journal of Pharmacy and Pharmacology              2009; 61: 279–291
Xueming Zhao in 1765 AD. The French mycology scientist               be found in China (Zhang, 2003).[9] More than 400 Cordyceps
proved that C. sinensis is a type of Ascomycetes which               species have been described worldwide and approximately
parasitizes insect larvae, grows and gradually changes into          90 Cordyceps species are distributed in China;[10] C. militaris
a fruit body.[4] It is the combination of fungus and larva.          can be used to replace C. sinensis. A number of macroscopically
However, it is more difficult for authors in the scientific          similar species have been described, which are either considered
literature to define a formal name. The preparation has been         as being homogeneous with C. militaris, or are simply unnoticed
considered to have healing properties for the body and mind;         among large collections from a variety of hosts and life-cycle
DCXC is still revered by some people. The preparation                stages.[11–13] Much research into the chemical composition,
does indeed contain certain bioactive ingredients (such as           pharmacological efficiency and clinical application of
30-deoxyadenosine, cordycepic acid, cordycepic polysacchar-          C. sinensis and its substitutes, such as Hirsutella spp.,
ides) that might be beneficial for the prevention and                Paecilomyces spp. and C. militaris, is underway.[4] However,
treatment of a variety of ailments, such as respiratory              in therapeutic practice and literature citations, the term
disease, renal dysfunction, hyposexuality and cancers. Many          Cordyceps always refers to the species C. sinensis.
of the related biomedical investigations have been conducted             In the early 1980s, many scientific institutes began to study
predominantly in China, Japan, Korea and the US, and are             the cultivation of C. sinensis. Previous work, over the course of
extensive.                                                           a decade, was mainly focused on the anamorphic fungi related
    Modern experimental methods in biochemistry have                 to C. sinensis. Shen Nanying made a success of culturing
proved that C. sinensis consists of active constituents such         fruit bodies in 1985. The Sichuan TCM Institute also achieved
as mannitol, nucleosides, ergosterol, aminophenol and trace          the artificial cultivation of C. sinensis, although commercial
elements.[5] It has a broad medical effect, and its function of      production has not been carried out because of the high cost
immunity regulation plays an important role in antitumour            and low stability.[14] Up to now, in fact, the artificial cultivation
effects, organ transplantation and the prevention of kidney,         of this valuable fungus has not been successfully achieved;
liver and heart disease.[6,7] The Chinese Pharmacopoeia              only a product made using a C. sinensis anamorph has been
(2005) records that the main functions of C. sinensis are            made by fermentation methods.[15] Subsequently, production of
replenishing the kidney, soothing the lung, staunching               C. sinensis, mostly added to traditional Chinese medicine
bleeding and dispersing phlegm. It can also be used to               (TCM) patent prescriptions, has developed rapidly, particularly
treat continuous cough caused by fatigue, asthma, haemo-             in China. Nevertheless, only C. militaris, producing
ptysis, impotence, spermatorrhoea and aches in abdomen and           30-deoxyadenosine, has similar pharmacological activity to
knee.[8] Previous studies mostly focused on aspects such as          C. sinensis, whose biological characteristics were studied early
the resources of C. sinensis, its active chemical components         in the 1950s.[16] Compared with C. sinensis, the artificial
and its pharmacological effects. Recently people have paid           cultivation of C. militaris was easier and successfully achieved
more attention to protecting the resource and seeking                in the early 1980s.[17] At that time the multi-product batch
substitutes, and they hope to sustainably utilize this precious      manufacture had been achieved; now the mycelia may grow in
medical epiphyte. This article gives a general overview of           rice (or kernel) medium and produce fruiting bodies. The
the latest developments in C. sinensis research, with regard         process of producing C. militaris fruiting bodies is the same as
to the active chemical components, the pharmacological               for other cultivated edible mushrooms and can be divided into
effects and the research and development of products in              two major stages. The first involves the preparation of the
recent years.                                                        fruiting culture, stock culture, mother spawn and planting
                                                                     spawn, while the second entails the preparation of growth
Related Species and Artificial Cultivation                           substrates for mushroom cultivation.[18,19] Currently, the
                                                                     method most widely adopted for commercial production is
C. sinensis is a complex of larva and parasitic fungus. Many         the cooked rice in bottle procedure (for cultivation details, see
species in this genus are valuable medicinal fungi with broad        Zhang[19], Ren et al.,[20] Wen et al.[21]).
development potential. The parasitic complex of the fungus
and caterpillar, well known as ‘DCXC’, is only found in the
prairie soil at an elevation of 3500–5000 m. It is mostly            Natural Products
distributed in Tibet, Qinghai, Sichuan, Yunnan and Gansu
province in China. The fungus and caterpillar complex is             According to chemical analysis, C. sinensis contains crude fats,
limited to C. sinensis and Hepialus armoticamus Oberthur,            proteins, fibre, carbohydrate, cordycepin, cordycepic acid,
while complexes consisting of other species of fungi and             polysaccharide and a series of vitamins, etc. The therapeutic
insects are called ‘ChongCao’, not ‘DCXC’.[9]                        applications of Cordyceps centered primarily on the key
   Cordyceps encompasses several Cordyceps species, which are        effects of increased oxygen utilization and ATP production,
widely used for medicinal purpose (e.g., C. liangshanensis           and as well the stabilization of blood sugar metabolism.
Zhang, Liu et Hu, C. taishanensis Liu et Cao, C. shanxiensis Liu,    Cordycepin, cordycepic acid and the polysaccharides, vitamins
Rong et Jin, C. gansuensis Zhang, Wang et Yan, C. grasspara          and trace elements may be, at least partially, the cause of these
Zang, Yang et Li, C. kangdingensis Zang et kingjo,                   well-known effects.
C. guizhouensis Liu, Liang et Liu, and so on). In addition to
C. militaris, C. nutans Pat. and C. tricentri Yasuda, some species   Cordycepin and Cordycepic Acid
such as C. gunnii (Berk.) Berk. and C. Roberts (Hook.) Gray,         Although the pharmacologically active components of
which are usually distributed on the Australian mainland, may        C. sinensis are still unresolved, at least two chemical
Cordyceps fungi                                                                                       Xuanwei Zhou et al.          281
                                                                                              HO           COOH
                        NH2
                N
                                                             O
                                                N
                        N                                                            HO                             OH
HO CH2OH OH
constituents, cordycepin and cordycepic acid, have been                density is 1.489 (20∞C) and its boiling point is 290–295∞C
identified and proposed as important active constituents.[1,22]        (467 kPa). Mannitol, as a functional polyol with notable
It is now believed that cordycepic acid is, in fact, D-mannitol,       properties, has been widely used in the medicine and food
and that cordycepin is 30-deoxyadenosine (30-dA), a purine             industries. The content of mannitol varies with the original
alkaloid, a derivative of the nucleoside adenosine, differing          habitat. In general, there is about 29–85 mg/g in Cordyceps
from the latter by the absence of oxygen in the 30 position of         fruiting bodies; the mannitol content in the mycelia of
its ribose part (Figure 1). Early in 1950 cordycepin was first         Cordyceps is higher than in fruiting bodies.[33]
isolated from C. militaris and its structural formula was
confirmed as 30-deoxyadenosine.[23,24] Subsequently, by                Polysaccharides
means of nuclear magnetic resonance (NMR) and infrared                 Cordyceps contains a large amount of polysaccharides,
(IR) spectroscopy, cordycepin as a bioactive component was             which can be in the range of 3–8% of the total weight,[34,35]
extracted from the fruiting bodies and cultured mycelium of            and usually comes from the fruiting bodies, the mycelium
C. sinensis and the configuration elucidated. The molecular            of solid fermentation submerged cultures and the broth.
weight of cordycepin, C10H13N5O3, is 251. Its melting point is         Cordyceps polysaccharide (CP), one of the main bioactive
230–231∞C, and maximum absorption is at 259 nm. It can be              components, represents a class of structurally diverse
dissolved in saline, warm alcohol or methanol, but not in              biological macromolecules with wide-ranging physiochem-
benzene, ether or chloroform, so many researchers in                   ical properties. The anti-tumour and immunomodulating
laboratories used sterilized saline and phosphate-buffered             activity of the medicinal mushrooms has already been
saline (PBS) as solvent.[25] In general, the content of 30-dA in       brought to scientific and commercial attention.[36,37] Since
the mycelia fermentation preparations (40.8 mg/g)[26] is more          1977, much of scientific investigation in Japan and China has
than that in the fruiting bodies of C. sinensis (< 5.4 mg/g).[27,28]   been performed to discover possible functional polysacchar-
    Cordycepic acid, an isomer of quinic acid, is one of the           ides; many CPs and their components have been isolated and
main active medicinal components. The chemical constituents            characterized from wild and cultivated Cordyceps species
of C. sinensis were first studied in 1957, when a crystalline          (Table 1).
substance was isolated and the structure was imprecisely                   CP is a multi-branched galactomannan. Based on activity-
concluded to be 1,3,4,5-tetrahydroxycyclohexane-1-carboxylic           guided fractionation, a water-soluble protein-containing
acid.[29] Subsequently, the structure of the crystalline substance     galactomannan was isolated from the sodium carbonate
named ‘cordycepic acid’ was identified by Sprecher and                 extract of Cordyceps, and its molecular weight was estimated
Sprinson[30] as D-mannitol. Mannitol is a major bio-product            by gel filtration to be 23 kDa. The isolated compound is
with important biological activity, and exists in the wild in the      composed of D-mannose and D-galactose in a molar ratio of
roots, stems and leaves of plants, while more is found in edible       3 : 5, and contains a small proportion of protein. It is a highly
fungus, carrot and lichens. In general, the content of cordycepic      branched structure and composed of (1!6)- and (1!2)-linked
acid in DCXC is 7–29%, differing in the various growing stages         a-D-mannopyranosyl residues in the main chain.[56] Cai et al.[60]
of the fruiting bodies.[31] It is used not only in injections as       developed a method to study the topography of CP by using an
raw material, but also as a supplement in other medicines.[32]         atomic force microscope (AFM). The result showed that CP has
Chemically, mannitol is an alcohol and a sugar, or a polyol; it        a multi-branched structure and a variety of different linkages
is similar to xylitol and sorbitol. However, mannitol has a            between adjacent monosaccharides, which make up the small
tendency to lose hydrogen ions in aqueous solution, which              rings and helical structures. However, a neutral mannoglucan
causes the solution to become acidic. For this reason, it is not       with a molar mass of approximately 7700 g/mol was obtained
uncommon to add a substance to adjust its pH, such as sodium           recently from CP, which consisted of Man and Glc units
bicarbonate. The chemical formula of mannitol is C6H14O6, its          in the molar ratio of 1 : 9. Analysis showed that it had an
molecular weight is 182, its melting point is 166∞, its relative       alpha-D-glucan backbone with (1!4)- and (1!3) linkages, and
Table 1 Cordyceps polysaccharides and their physical and chemical characteristics
                                                                                                                                                                                                       282
No.      Name        Molecular    Glycosyl residue composition               Glycosyl linkage and branches (characteristic signals)                                         Source
                      weight             (molar ratio)
1      P70-1     4.2 ¥ 104       Man:Gal:Glc = 3.12:1.45:1.00    P70-1 has a backbone of 1,6-linked a-D-mannopyranosyl residues with branching          Fruiting bodies of cultured C. militaris[38]
                                                                   points at O-3 composed of 1,4-linked a-D-glucopyranosyl and 1,6-linked
                                                                   b-D-galactopyranosyl residues, and terminated with b-D-galactopyranosyl
                                                                   residues and a-D-glucopyranosyl residues
2      P70-2     2.6 ¥ 104       Man:Gal:Glc = 1.75:1.31:1.00
3      P50-1     5 ¥ 104         Man:Gal:Glc = 2.80:2.62:1.00
4      SCP-I     1.84 ¥ 105      Glu                             SCP-I possesses a backbone of 1,4-linked a-D-glucosyl residues and carries             Fruit mycelium of C. sinensis[39]
                                                                   a single (1,6)-linked a-D-glucosyl residue as side chain
                 a
5      PC I       3.5 ¥ 105 Man:Gal:Glu = 1:0.65:0.30                                                                                                   Mycelia of C. sinensis[40]
                 a
6      PCA I      5.56 ¥ 105 Man:Gal = 1:1                       PCA I possesses a backbone of 1,4-linked mannopyranosyl residues with branches
                                                                   of O-2, O-3, O-6, etc of mono- or oligosaccharide composed of galactofuranosyl
                                                                   residues
                 a
7      PCA II     1.67 ¥ 103 Man:Gal:Glu = 1:0.71:0.42           PCA II possesses 6 pyranosyl or furanosyl monosaccharide consisting
                                                                   of 3 mannosyl residues, 2 galactosyl residues and 1 glucosyl residue,
                                                                   which is a non-linear linked heterogeneous oligosaccharide
                 a
                                                                                                                                                                                                       Journal of Pharmacy and Pharmacology
8      PCB I      6 ¥ 104        Man:Gal = 1:0.73                PCB I possesses a backbone of 1,4-linked mannopyranosyl residues with side
                                                                   chains mainly composed of galactofuranosyl residues and also a few
                                                                   mannopyranosyl and galactopyranosyl residues
                 a
9      PCB II     6 ¥ 104        Man:Gal:Glu = 1:0.51:0.50       PCB II possesses 2 mannosyl residues, 1 galactosyl residue and 1 glucosyl residue
                                                                   connected by a (1,3) linkage
                 a
10     PCC I      5.7 ¥ 104
11     PCC II
                 a
12                2.01 ¥ 104 Ara:Man:Gal:Glc =                   Composed of a (1,3)-b-D-glucan backbone substituted at O-6 with side chains of         Fermentation broth of C. dipterigena[41]
                               1.86:29.08:25.86:43.05              (1,6)-b-D-glucopyranosyl units, (1,3)-galactan and (1,2)- mannan
                                                                                                                                                                                                       2009; 61: 279–291
                                                              a-glycoside linkage
25     CS-F3    4.5 ¥ 104    Gal: Glc: Man = 62:28:10                                                                                             Mycelia of C. sinensis[51]
26     CM-I     2.7 ¥ 104    Gal:Man = 6:5                  CM-I possesses a backbone of 1,2-linked b-mannosyl residues with branches of          Culture liquid of C. militaris[52]
                                                              1,6-linked b-galactofuranosyl residues at the C-4 and C-6 of galactosyl residues
                                                              in the main chian
27     CS-     4.3 ¥ 104     Man:Gal:Glc = 10.3:3.6:1       Consists of a backbone of 1,6-linked mannopyranosyl residues with branches of         Fermentation medium of C. sinensis[53]
         81002                                                1,3-linked galactofuranosyl residues, 1,4-linked glucofuranosyl residues and
                                                              1,4-linked or 1,2-linked mannopyranosyl at the C-3 and C-2 of mannosyl residues
                                                              of the main chain in a molar ratio of 6:4
28     CI-P     2.5 ¥ 104    Man:Gal = 1:0.85 with          CI-P composed of a backbone of 1,6-linked a-D-mannopyranosyl residues                 Insect-body portion of the fungal preparation
                              traces of D-glucose             substituted at O-2 with single a- or b-D-galactofuranosyl groups, short chains of     C. cicadae[54]
                                                              1,2-linked b-D-galactofuranosyl residues, or chains of 1,2-linked
                                                              a-D-mannopyranosyl residues
29     CI-A     2.5 ¥ 104    Man:Gal = 1:0.57 with          CI-A possesses nearly same structure as CI-P but fewer and shorter
                              traces of D-glucose             D-galactofuranosyl side-chains and longer 1,2-linked a-D-mannopyranosyl side
                                                              chains than CI-P
30     Ch-1     4.3 ¥ 104    Mannose and gaIactose          Both polysaccharides possess backbones of 1,4-linked b-galactosyl and                 Fruit body of C. hawkesii[55]
                                                              b-mannosyl residues with 1,3-linked and 1,2-linked side chains substituted at O-6
31     Ch-2     4 ¥ 103
32     CT-4N    2.3 ¥ 104    Man:Gal = 3:5                  Composed of a backbone of 1,6-and 1,2-linked a-D-mannopyranosyl residues with         C. sinensis[56]
                                                              short chains of a large proportion of 1,5-linked b-D-galactofuranosyl residues
                                                              and a small proportion of 1,6-linked a-D-galactopyranosyl residues at O-2, O-4
                                                              and O-6, with the nonreducing terminal groups of a large proportion of
                                                              a-D-mannopyranosyl groups
33     CO-1     6.32 ¥ 105   Glu                            CO-1 composed of a backbone of 1,3-linked b-D-glucopyranosyl residues with            The product formed on incubation of the
                                                              a b-D-glucopyranosyl group attached to O-6 of every second D-glucopyranosyl           culture filtrate of C. ophioglossoides[57]
                                                              residue of the main chain
34     C-3      2.7 ¥ 104    Man:Gal = 4:3                  C-3 composed of 1,2-linked and 1,6-linked a-D-mannopyranosyl residues                 Ascocarps of C. cicadae[58]
                                                              substituted at O-6 and O-2 with terminal b-D-galactofuranosyl and
                                                              a-D-mannopyranosyl groups, and with short chains of 1,2-linked
                                                              b-D-galactofuranosyl residues
35     CS-I                  Gal:Man = 1:1                  CS composed of a backbone of 1,2-linked D-mannofuranosyl residues with side
                                                              chains of 1,3-linked 1,5-linked and 1,6-linked D-galactofuranosyl residues and
                                                              1,4-linked D-galactopyranosyl residues and with nonreducing terminal groups of
                                                                                                                          [59]
                                                              D-galactofuranosyl residues and D-mannopyranosyl residues
36     CS-II
a
The component is a proteoglycan or a glycoprotein.
                                                                                                                                                                                                  Xuanwei Zhou et al.
                                                                                                                                                                                                   283
284      Journal of Pharmacy and Pharmacology           2009; 61: 279–291
the side chains of alpha-D-(1!6)-mannopyranose (Manp) were        Crude protein and amino acids
attached to the backbone via the O-6 of alpha-(1!3)-              Previous papers have reported that the content of crude protein
glucopyranosyl (Glcp) residues.[61] The study showed that the     was in the range 29.1–33%.[27,33,66] The protein was composed
pharmacological activity of the polysaccharide was correlated     of 18 amino acids, including aspartic acid, threonine, serine,
with its characteristics such as molecular weight. It has         glutamate, proline, glycine, valine, methionine, isoleucine,
been reported that polyglucans with higher molecular weight       leucine, tyrosine, phenylalanine, lysine, histidine, cystine,
(10–1000 kDa) tend to have greater water solubility and           cysteine and tryptophan. The content of amino acids after
therefore have a more effective antitumour activity. The          hydrolysis is mostly reported as 20–25%, the lowest being
anticancer effects of fungal polysaccharides arise from the       5.53%, the highest being 39.22%. The highest contents are
enhancement of the body’s immune system rather than direct        glutamate, arginine and aspartic acid, and the major pharmaco-
cytocidal effects.[62]                                            logical components are arginine, glutamate, tryptophan and
    The physicochemical properties of an aqueous solution of      tyrosine.[67] The content of amino acids in the commercial
crude CP have been analysed, and the result showed some           preparation of Cordyceps is significantly higher than in the
good properties, such as thickening and thixotropic properties,   mycelia of C. sinensis, which is similar to the content in the fruit
salt and heat resistance and stability over a wide pH range.      body of C. sinensis. The content of amino acids in C. sinensis
The dynamic viscosity of CP varies little over the pH range       and related products are shown as in Table 2.
of 4–14. There was a positive relationship between CP oral
dosage and its therapeutic effects (the lowest effective dosage   Fatty acids and metal elements
of CP is 180 mg per day).[40] In addition it is colourless and    Fatty acids are composed of carbon, hydrogen and oxygen
odourless and has good solubility and stability in water.[63]     and are the major component of lipids, phospholipids and
                                                                  glycolipids; they can be classified as saturated or unsaturated
Other Bioactive Components                                        fatty acids. In Cordyceps, the unsaturated fatty acid content
Nucleotides                                                       reaches 57.84%, including Cl6:1, Cl7:1, Cl8:l and Cl8:2. The
Nucleotides (including adenosine, uridine and guanosine) are      linoleic acid content is the highest at 38.44%, followed by the
effective components in Cordyceps mushrooms. Investiga-           oleic acid, which is 17.94%. The saturated fatty acid content
tions show that guanosine has the highest content of all in       is 42.16%, including Cl4, Cl5, Cl6, Cl7, Cl8, C20 and C22. The
natural and artificial Cordyceps.[64] The content of nucleo-      palmitic acid and the octadeca acid contents are the highest,
tides in artificial Cordyceps is obviously higher than            and are 21.86% and 15.78%, respectively. Unsaturated fatty
in natural Cordyceps. This may be related to the rapid            acid is an effective physiologically active component, which
metabolism of artificial cultures. A remarkable variation in      has the unique function of decreasing blood lipids and
the adenosine content is found in artificial Cordyceps, with      protecting against cardiovascular disease. The content of
the highest concentration being over six times that of the        unsaturated fatty acid is higher than that of saturated fatty
lowest. The content of adenosine in freshly acquired natural      acid in commercial preparations of Cordyceps, and the linoleic
Cordyceps is too low to quantity, but the content of the          acid and oleic acid contents are significantly higher than others.
nucleotide in a preparation stored for a long time is higher.
This shows that nucleotides in natural Cordyceps derive from      Table 2 Amino acid levels in Cordyceps sinensis mycelia fermentation
degradation of the nucleoside during the storage process.         preparations and two samples of fruit body
Subsequent research found that dampness and warmth can
                                                                  Amino acid      Mycelium    Mycelia    Fruit body A    Fruit body B
significantly increase the nucleotide content in Cordyceps.
                                                                  composition     powders
At a temperature of 40∞C and relative humidity of 75%,
Cordyceps were stored for 10 days, when the content of            Asp               2.47        1.05          1.67            1.84
nucleotides increased 1–10 fold, while in artificial Cordyceps    Thr               0.95        0.65          1.47            0.83
adenosine, uridine and guanosine showed no obvious change         Ser               0.82        0.49          1.51            0.78
in content. This suggests that the nucleotides in natural and     Glu               3.55        1.12          3.44            2.66
artificial Cordyceps are to some extent different.[5]             Pro               0.90        0.72          0.96            0.95
                                                                  Gly               1.19        0.58          1.25            0.73
Ergosterol                                                        Ala               1.21        0.75          1.40            0.95
                                                                  Cys               0.25                      0.43
Ergosterol is a sterol unique to fungi and is an important
                                                                  Val               1.42        0.63          1.13            0.80
precursor of vitamin D2, which has important medicinal            Met               0.47        0.18          0.25            0.18
value. The content of free ergosterol from natural and            Ile               1.14        0.44          0.62            0.53
artificial Cordyceps has been compared. The result showed         Leu               1.84        0.69          1.20            0.95
that the content of free ergosterol in different natural          Tyr               0.89        0.31          0.88            0.67
Cordyceps varies significantly, but is evidently higher than      Phe               1.84        0.51          0.71            0.61
than in the mycelia of Cordyceps. The content of ergosterol       Lys               1.27        0.81          1.66            1.15
in the artificial fruit body of C. militaris is very high, only   His               0.58        0.28          1.71            1.13
lower than that of natural Cordyceps in Tibet, and higher         Arg               1.47        0.04          2.88            1.6
than that in Qinghai and Sichuan. Li et al.[65] reported that     Total content    21.59        9.23         23.15           16.40
the content of ergosterol in the mycelia of Cordyceps was         The amino acid level in the C. sinensis fermentation preparations were
1.44 mg/g, much lower than that in the fruit bodies of            more than those in the C. sinensis fruit body.
Cordyceps (10.68 mg/g).
Cordyceps fungi                                                                                              Xuanwei Zhou et al.            285
   Investigations show that Cordyceps contains many metal                 and adenosine. The antitumour action of CP has been proved
elements, and the content significantly depends on different              extensively,[40,59,78,79] and that of sterols and adenosine is
species and metal elements (Table 3).[26,68,69] Many metal                a hot research topic in Cordyceps.[80,81] New antitumour
elements, Zn, Mg, Mn and so on, are of great significance to              compounds have been continually isolated, and the effects of
the development and maintenance of function of the gonads.                Cordyceps extract on tumour growth have been evaluated.[82,83]
Zn is effective in the kidney at preventing cadmium from                  For instance, Zhang et al.[84] compared the antitumour effects
damaging the nephrons.[70] High contents of Zn, Mg, Mn                    and chemical components of the extracts of cultivated
play an important role in warming and tonifying the kidney                C. sinensis with natural C. sinensis. The Cordyceps was
yang effectively, aiding kidney recovery and improving the                extracted with petroleum ether (PE), ethyl acetate (EtOAc),
essence of life.[71]                                                      ethanol (EtOH) or water. The cytotoxicity of all the
                                                                          extracts was observed with MTT assay on a breast cancer
                                                                          cell line (MCF-7), a mouse melanoma cell line (B16), a human
Pharmacological Function                                                  premyelocytic leukaemia cell line (HL-60) and a human
Fungi are an important source of material in TCM. Medicinal               hepatocellular carcinoma cell line (Hep G2). The chemical
mushrooms have an established history of use in traditional               constituents in the extracts were analysed by HPLC. The results
oriental therapies. Extracts from about 200 species of fungi              showed that all of the extracts from the Cordyceps mushroom
have been shown to stimulate immunoreactivity and inhibit                 had much stronger cytotoxicity on the B16 cell line and the
the growth of different kinds of tumours.[72–75] According to             EtOAc extract had the most potent activity; the chemical
the theory of TCM, the main effects of Cordyceps are                      components of all the extracts were analysed and ergosterol and
enriching the lung yin and yang, which includes treating                  adenosine were found to be potential compounds.[84] We still
chronic lower back pain, sensitivity to cold, over abundance              do not know the mechanism by which Cordyceps inhibits
of mucus and tears, chronic cough and wheezing, blood in                  the growth of various cancer cells; inhibition might occur by
phlegm from consumption due to kidney yang (shenyangxu),                  one of several means, summarized as follows: (1) enhancing
etc. Based on Western medicine, Cordyceps has an                          immunological function and non-specific immunity;[85]
antibacterial function, and reduces asthma, lowers blood                  (2) selectively inhibiting RNA synthesis, thereby affecting the
pressure and strengthens the heart beat. In the public domain,            protein synthesis;[86] (3) restricting the sprouting of blood
people often add it into hen or duck soup to strengthen                   vessels;[87] (4) inducing tumour cell apoptosis;[88] (5) regulation
the body and ‘renew’ sick people.[3,76] Although there are                of signal pathways;[89] (6) antioxidation and anti-free radical
300 species of Cordyceps, the research into its pharmacolo-               activity;[90] (7) anti-mutation effect; (8) interfering with the
gical effect has focused only on two species, C. sinensis and             replication of tumour-inducing viruses; (9) inducing nucleic
C. militaris.                                                             acid methylation.[91]
Table 3 Amount of metal elements in mycelial fermentation preparations and fruit body of Cordyceps sinensis
Metal element Mycelium powder (mg/kg) Fruit body (mg/kg) Metal element Mycelium powder (mg/kg) Fruit body (mg/kg)
The major immunomodulating effects of the active substances         so on.[100] In recent years, significant progress has been
derived from these mushrooms include mitogenicity and               made in the prevention of liver disease. For instance, to find an
activation of immune cells, such as the lymph proliferative         effective drug to cure patients with chronic hepatitis B, Gong
response, natural killer (NK) cell activity and phytohaemagglu-     et al.[101] have treated 25 patients with C. sinensis.
tinin (PHA)-stimulated interleukin-2 (IL-2) and tumour              T lymphocyte subsets (CD4, CD2), hyaluronic acid (HC)
necrosis factor-a (TNF-a) production on human mononuclear           and precollagen type III (PC III), were observed before and
cells (HMNC),[6] resulting in the production of cytokines. The      after treatment. After 3 months of treatment, CD4 and CD4/
therapeutic effects of the mushrooms, such as suppression of        CD2 ratio increased significantly (P < 0.05), while HA and
autoimmune diseases and allergy, have been associated in many       PC III decreased significantly (P < 0.05) compared with the
cases with their immunomodulating effects.[95–97]                   control. These results suggested that beneficial effects might
    While it is known that Cordyceps extracts have                  be obtained by using C. sinensis to adjust the T lymphocyte
immunomodulatory activity, the standard approach has                subset levels and to treat hepatic fibrosis in patient with
been to isolate, characterize and administer the pure active        chronic hepatitis B.[101]
constituents. However, different components in a Cordyceps              Bioactive components of cordyceps for liver protection are
species extract may have synergistic activity. There are            mostly CPs. The CPs can improve the immunological functions
several reports of mushrooms containing more than one               of organic cells, removing harmful components and thus
polysaccharide with immunomodulatory activity. For exam-            reducing the injury to liver cells. However the content and
ple, Yu et al.[98] used components I, II, III and IV of             efficacy of CPs vary with the species.[102,103] The effects of
polysaccharide groups and a negative control group. Admin-          CPs in protecting the liver were presented as follows:[104]
istration of C. sinensis polysaccharides to NIH mice lasted         (1) protective effect on immune liver injury; (2) effect on
for five days at a dose of 35 mg/kg by intraperitoneal and          patients with chronic hepatitis B; (3) effect on patients with
subcutaneous injection. They investigated the pharmaco-             hepatocirrhosis after hepatitis;[105] (4) protective effect on liver
dynamics of immune activity of different components,                fibrosis.[101]
measured the weight of thymus and spleen of mice injected               The key to treating liver disease is to inhibit and clear the
intraperitoneally, and then calculated the viscera index for        virus from the liver of patients, regulate the immunological
those injected subcutaneously. The results indicated that           function of the organism, and reverse the developing process
different components of C. sinensis polysaccharides could           of liver fibrosis, etc. C. sinensis and its related products
enhance the immune response, spleen index, thymus index             obviously act to hasten macrophage phagocytosis, and
and the phagocytic function of monocyte-macrophages.[98]            enhance the immune function of organisms and possess a
The response to different polysaccharides is likely to be           strong capacity to clear the virus.[106]
mediated by different cell surface receptors, which may be
present only on specific subsets of cells and may trigger           Protection of kidney
distinct downstream responses. A combination of such                Nephrosis is a kidney disease, always considered to be
responses involving different cell subsets could conceivably        serious, which is harmful to the health of the urinary system.
provide greater tumour inhibition than that which could be          It can recur easily and acutely, while it is difficult to cure.
induced by a single polysaccharide.[78] On the other hand,          The modern method of treatment still lacks a satisfactory
latest reports show that Cordyceps has an anti-rejection effect     curative effect. The medical treatment for the disease mainly
in the experimental research of organ transplantation. For          uses glucocorticoids and an immunodepressant. The Chinese
example, Guan and Yu[99] studied the prevention of rejection        native medicinal treatment for nephrosis has a rapid effect,
of transplanted kidney by artificial cultured Cordyceps in          and the side effects are also very small, so it is given
rats; the results showed that Cordyceps powder can markedly         prominence.[107]
prolong rat renal allograft survival.                                   In DCXC, there are about 19 amino acids, alcoholic
                                                                    components, nucleotides, trace elements and vitamins as
                                                                    previously stated. The effects in protecting the kidney are
Protective effects on human organs                                  mainly presented as three aspects: (1) a therapeutic effect on
Protection of liver                                                 toxic kidney injury; (2) protecting against chronic renal
Liver disease is one of the major diseases that is seriously        function failure; (3) reversing the effect of glomerulone-
harmful to human health and affects quality of life. The            phritis in an animal model.[7] These have been proved by a
incidence of primary liver cancer is continuously rising in the     series of experiments.
world, and about 50 000 people die of this disease every year,
of which about 40% are in China, which may be related to            Protection of heart and antihypertensive effects
hepatitis virus infection. Thus effort has concentrated on          C. sinensis extracts were tested on myocardial ischaemia/
preventing liver disease using TCM, and Cordyceps is one of         reperfusion injury in rat isolated hearts. Xu et al.[108] reported
the various materials of TCM.                                       that the alcoholic extracts had a protective effect on
   Animal tests and clinical research data show that                myocardial injury induced by adriamycin in rats. The
Cordyceps has a protective effect in liver patients, including      mechanism was suggested to be that mannitol, amino acids
those with viral hepatitis A, chronic hepatitis B, chronic          and polysaccharides in the extracts played an important
hepatitis C, hepatic fibrosis, etc. It enhances organic cell        role; all the substances had the effect of nourishing the
immunological function, reverts HBeAg-positive to HBeAg-            myocardium and enhancing its anti-injury capacity.[108] With
negative, improves liver function, inhibits hepatic fibrosis, and   the same experimental methods, Gu et al.[109] reported that
Cordyceps fungi                                                                               Xuanwei Zhou et al.         287
Lungfit (C. sinensis compounds) could be beneficial for         Dietetic Chinese drugs
myocardial ischaemia/reperfusion injury as well. However,       Dietetic Chinese drugs are also known as ‘edible Chinese
both alcohol and water extracts had obviously protective        drugs’, ‘dietetic material medicine’ or ‘medicinal food’,
effects on the rat isolated heart.                              although the word ‘drug’ could be misinterpreted in the
    On the other hand, C. sinensis has an inhibitory effect     West. The basic theories of the Chinese medicated diet
on arrhythmias induced by aconitine, barium chloride and        (CMD) arose from the main theories of herbal medicine in
adrenaline, and can increase nutritional myocardial blood       TCM.[117] Accordingly, the homologous culture of medicine
flow, thereby improving myocardial ischaemia.[110] Some         and food are an important part of TCM theory; there is a
other papers reported similar findings, but isolates came       saying: ‘food is your medicine, and medicine is your food’.
from different extraction methods.[111] Considering antihy-     Much Chinese herbal medicine not only involves the
pertensive effects, Wu et al.[112,113] observed the effect of   treatment of disease, but also includes very good food,
C. sinensis on blood pressure in renal hypertensive rats. The   such as daily vegetables and fruits, which have the dual role
results showed that the renal hypertension could be prevented   of being food and drug at the same time. C. militaris, as
significantly by treatment with C. sinensis since the cardiac   healthy green food, could be used in stir-fries or be added
hypertrophy and vascular remodelling were reversed. There-      to stewed chicken or duck, cooking soup, hot pot and tea.
fore, they came to the conclusion that C. sinensis has a        Especially, cooking soup with Cordyceps is very popular.
curative role in renal hypertension.[112,113]                   Now the Guangdong Academy of Agricultural Sciences
    In short, C. sinensis has many effects on the cardiovas-    Institute of Sericulture and Insects has developed a series of
cular system, such as having a negative frequency, reducing     tea herbs. What’s more, the Chengdu JinCao Company has
myocardial oxygen consumption, improving myocardial             prepared food with C. militaris which is aimed for mass
ischaemia, anti-platelet aggregation and anti-arrhythmic        consumption, such as Cordyceps-Saussurea, Cordyceps-Aloe
effects, etc. On the haematopoietic system, C. sinensis has     and Cordyceps-Dictyophora soup.[118]
a protective effect on mice platelet reduction and platelet
ultrastructural damage.                                         Health food
Protection of other organs                                      Health food, also called ‘functional food’, is used widely and
C. sinensis also has obvious effects on other organ             designed as foods or food components that help to modulate
systems.[114–116] For example, on the central nervous system,   the human body and cure or prevent diseases. Many other
C. sinensis has sedative, anticonvulsant and cooling effects.   terms, such as ‘medical foods’, ‘nutraceuticals’, ‘nutritional
On the respiratory system, C. sinensis has a significant        foods’ and ‘designed foods’, as well as their definitions, have
relaxant role in the bronchi, markedly increases adrenaline     also emerged. Health foods need to be approved by the
secretion from the adrenal glands and also has a role in        SFDA (State Food and Drug Administration) in China
tracheal contraction caused by histamine; it also has an        and before marketing. Therefore, developing health food is
antitussive, expectorant and anti-asthmatic action and          another important way to develop Cordyceps products
prevents pulmonary emphysema. On the endocrine system,          directed to different people and different physiological states
C. sinensis has effects as a male hormone; CP can increase      with different demands of nutrition and health. There has
plasma corticosterone levels, etc.                              been some C. militaris health food on the market, such as
                                                                oral liquid Cordyceps tonic, tonic Cordyceps wine for kidney
                                                                reinforcing,[119] Cordyceps health beer, Cordyceps capsules
Developmental Products                                          (such as AiMei soft capsule, using the tradename ‘Xinkeqi’,
In recent years, functional foods, also known as nutraceu-      which has the unique function of immunomodulation
ticals, medical foods or nutritional foods, are driving food    and delaying senility, produced by Jilin Xinkeqi Health
markets around the world and are expected to be one of the      Food Co., Ltd), and so on.[120] These have been used mainly
emerging trends for the food industry in the new millennium.    by the following groups: young people, the elderly, pregnant
Cordyceps are important raw sources. As the prices of           women, people with nutritional imbalance and so on.
Cordyceps are rising fast, many people harvest them.            Focused design like this not only influences physiological
Meanwhile animal husbandry is developing rapidly, which         regulation, but also regulates the nutrition and senses.
destroys the ecological equilibrium, reducing the wild              It is worth noting that, in recent years, as increasing
Cordyceps resources. To increase the yields of Cordyceps        attention is given to the function of C. militaris, foreign
and meet medicinal demand, researchers have tried to obtain     manufacturers have shown an interest, and export volumes
the purified mycelium of Cordyceps from the artificial          are increasing. Presently Japan, Korea, Malaysia and other
fermentation of the stroma of Cordyceps since the 1970s.        countries are increasing their research and development of
Due to their similarity in biological activity and chemical     Cordyceps functional food.[10]
composition, there will be a trend towards replacing natural
Cordyceps resources. So far many fungi have been studied        Developing the ‘drugs’
further, including Cephalosporium sinensis, Paecilomyces        The most bioactive components extracted from Cordyceps,
hepiali, P. sinensis, Scydalium spp. and C. militaris, and      such as cordycepin, cordycepic acid and CP, which have
many different improved productions have appeared on the        anti-aging and sleep regulating effects, have been authorized
market.[13] At present, the development of Cordyceps and its    as new medicinal resources by the SFDA of China.
substitutes is mainly focused on the following three areas.     Therefore, using Cordyceps (including its extracts) and
288      Journal of Pharmacy and Pharmacology              2009; 61: 279–291
adding other TCM materials or other nutrient resources, we           Shanghai, Shanxi, Jiangxi and Qinghai provinces, after the
can develop many products through modern technology.                 national science committee put research into C. sinensis in the
These products have many functions that are mainly focused           Spark Plan Project. Subsequently, the research and development
on the following aspects: enhancing physique, anti-aging,            of Cordyceps has been listed as a key project to be pursued in the
protecting the heart, improving sleep, increasing appetite,          science and technology area for three continuous five-year plans
increasing immunity, etc. For example, ‘C. militaris mycelia         (1986–2000), from the seventh five-year plan (1986–1990)
powder and the capsule of C. militaris mycelia powder’ had           to the ninth five-year plan (1996–2000). For example, ‘wild
been authorized as a Chinese national drug in April 2003;            cultivation, research and development of C. sinensis in the Naqu
Jilin Northeast Tiger Pharmaceutical Co., Ltd reported to the        District of Tibet’, China Key Science Program in the national
State Ministry of Health to declare classes of new drugs,            ninth five-year plan, strongly supports the cultivation of
which have been approved and called Xinkeqi Capsules.                C. sinensis by simulating its naturally growing environment,
Meanwhile, ‘C. sinensis polysaccharide liposomal oral                and exploiting its production in the north Tibet altiplano.[4] ‘The
liquid’ (Guangzhou Xingqun Pharmaceutical Co., Ltd),[121]            R&D of cordycepin polysaccharide’ (No. 96-C03-01-03), which
and ‘Bailing Capsules’ (Hangzhou Eastchina Pharmaceutical            was listed in the key project of the ninth five-year plan, is not
Co., Ltd),[122] have also been approved for entry into the           only a breakthrough in the theoretical research of Cordyceps, but
market. So far, there are approximately twenty types of              it also has an active significance for the development of
TCM preparation related to Cordyceps, many of which are              Cordyceps products.[127] During recent decades, as the findings
polysaccharide products.[123]                                        of new uses for Cordyceps and development of Cordyceps
                                                                     preparations continues, some correlative products have rapidly
Concluding Remarks                                                   appeared one after another, such as Cordyceps capsule,
                                                                     Cordyceps oral liquid, Cordyceps drink and so on. The
Cordyceps, one of the well-known TCMs, consists of the dried         development of the curative and health-care products from
fungus C. sinensis growing on caterpillar larvae. These larvae       Cordyceps is more and more favourable among people in China.
include about 20 species of five genera, Hepialus, Hepialiscas,      Meanwhile, we are facing an arduous task. C. sinensis, with its
Napialus, Forkalus and Bipectilus, which are classified as           long history and remarkable efficacy, cannot continue to serve
Hepialidae. Among them, Hepialus armoricanus, H. obilfur-            for the health of human beings, so we must be clearly aware of
cus, H. baimaensis and H. renzhiensis are predominant hosts of       this and make efforts to discover a substitute for C. sinensis. It is
C. sinensis.[124] The parasitic complex of the fungus and the        delightful that the eleventh five-year-plan annual emphasis item
caterpillar is found in the soil of the prairie at an elevation of   of 2007 in the medicine technology field of 863 Program
3500–5000 m.[122] It is commonly used in China to replenish          (Hi-tech research and development program of China) also
the kidney and soothe the lung, for the treatment of fatigue,        strongly supports the research on C. militaris as a substitute for
night sweating, hyposexuality, hyperglycaemia, hyperlipidae-         C. sinensis. It is credible that a substitute having the same
mia, asthenia after severe illness, respiratory disease, renal       efficacy as C. sinensis will appear in the near future and well
dysfunction and renal failure, arrhythmias and other                 serve the human being’s health project.
heart disease and liver disease. The natural Cordyceps (wild
C. sinensis) is rare and expensive in the local market;              Acknowledgment
researchers in China have extensively observed its life cycle        The authors wish to thank Director Xin Wang and Guojun
with the aim of developing techniques for isolating fermentable      Wang (Heilongjiang Xinyisheng Pharmaceutical Co., Ltd,
strains of C. sinensis. Several mycelial strains have been           China) for their help collecting product information.
isolated from natural Cordyceps and manufactured in large
quantity by fermentation technology. At present, cultured            Conflict of interest
Cordyceps mycelia are commonly sold as health-food products          The Author(s) declare(s) that they have no conflicts of
in South East Asia.[125]                                             interest to disclose.
    According to incomplete statistics, at present there are
about 100 scientific research institutes working on the              Funding
research and development of medicinal fungi. More than
200 factories are engaged in producing fungus preparations.          This research is financially supported by the Shanghai
In China, there are more than 30 kinds of medicinal fungus           Science and Technology Committee, and Heilongjiang
that are used for obtaining their active component or                Xinyisheng Pharmaceutical Co., Ltd, China.
mycelium and fermentation production by solid-state fer-
menting or deep-seated fermenting. This provides abundant            References
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