Antrodia
Antrodia camphorata
Evidence Rating
Confidence Level
Traditions
Part Used
Last Updated
Summary
Antrodia camphorata is Taiwan's most valuable medicinal fungus, endemic to the island and growing exclusively on the endangered camphor tree (Cinnamomum kanehirae). It produces a unique suite of ergostane-type triterpenoids (antcins) and the ubiquinone derivative antroquinonol, which has advanced to FDA Phase II clinical trials for NSCLC and received Orphan Drug and Fast Track designations for pancreatic cancer — the furthest any single mushroom-derived molecule has progressed in US pharmaceutical development. Multiple double-blind RCTs demonstrate hepatoprotective and metabolic benefits. The extreme rarity of wild specimens (>$15,000/kg) has driven extensive cultivation research.
Key Bioactive Compounds
Drug Interactions
This fungal supplement has known drug interactions. Do not use if you are taking medications without consulting a healthcare provider first. See detailed interaction information below.
Regulatory Status
| Regulatory Body | Status |
|---|---|
| FDA GRAS (USA) | — |
| EU Novel Food | — |
| Chinese Pharmacopoeia | — |
| Japanese Pharmaceutical | — |
Metadata
| Field | Detail |
|---|---|
| Common Names | Niu Zhang Zhi, Niuchangchih, Antrodia cinnamomea, Taiwanofungus camphoratus, Camphor Tree Bracket |
| Scientific Name | Antrodia camphorata Zang & Su; syn. Antrodia cinnamomea T.T. Chang & W.N. Chou; Taiwanofungus camphoratus (M. Zang & C.H. Su) Sheng H. Wu et al. |
| Family | Fomitopsidaceae (Basidiomycota) |
| Part Used | Fruiting body (wild or wood-cultivated) and mycelium (solid-state or submerged fermentation) |
| Key Constituents | Antroquinonol (ubiquinone analog); antcins A-K (ergostane triterpenoids); zhankuic acids A-E (lanostane triterpenoids); beta-glucan polysaccharides; benzenoid derivatives; succinic/maleic acid derivatives; ergosterol |
| Major Pharmaceutical Development | Antroquinonol (Hocena, Golden Biotechnology Corp.): Phase II clinical trials for NSCLC; FDA Orphan Drug Designation for pancreatic cancer and AML; FDA Fast Track Designation for pancreatic cancer |
| Evidence Quality Rating | C (Moderate) — Multiple DBRPCTs for hepatoprotection and metabolic endpoints; antroquinonol in Phase II cancer trials; geographically concentrated evidence from Taiwan |
Regulatory Status
Taiwan
- Recognized as a traditional Taiwanese aboriginal medicine (not mainland Chinese TCM)
- Major commercial market (~$100M+ annually)
- Regulated as a health food ingredient by Taiwan Ministry of Health and Welfare
- Wild A. camphorata is protected due to host tree (C. kanehirae) endangered status
United States
- Antroquinonol (Hocena): Investigational New Drug (IND) status; Phase I completed, Phase II for NSCLC (NCT02047344)
- FDA Orphan Drug Designation: Granted for pancreatic cancer and acute myeloid leukemia (AML)
- FDA Fast Track Designation: Granted for pancreatic cancer (2017)
- Supplement-grade A. camphorata products available under DSHEA
- No FDA GRAS status
China (Mainland)
- Not listed in the Chinese Pharmacopoeia (endemic to Taiwan, not traditionally used in mainland TCM)
Japan / EU
- No pharmaceutical approval or formal regulatory assessment
- Limited commercial availability
Conditions & Indications
Primary (Moderate Evidence — DBRPCT Level)
- Hepatoprotection / Liver enzyme normalization — Tsai et al. (2016) DBRPCT (n=70, 6 months) demonstrated significant reduction in AST and ALT vs. placebo in patients with elevated liver enzymes. Huang et al. (2017) DBRPCT (n=53, 8 weeks) showed reduced hepatic steatosis markers and ALT in NAFLD patients.
- Dyslipidemia / Metabolic syndrome — Lu et al. (2018) RCT (~n=60, 12 weeks) showed improved total cholesterol, LDL-C, and triglycerides vs. placebo. Chen et al. (2017) RCT confirmed lipid profile improvements.
Secondary (Phase I/II Pharmaceutical)
- NSCLC (antroquinonol) — Phase I established safety up to 600 mg/day with dose-proportional pharmacokinetics. Phase II (NCT02047344) evaluated efficacy in advanced NSCLC; disease stabilization reported in a subset of patients.
- Pancreatic cancer (antroquinonol) — FDA Orphan Drug and Fast Track designations reflect unmet need recognition. Clinical development ongoing.
- Exercise performance — Huang et al. (2019) DBRPCT crossover (n=20, 4 weeks) showed improved performance and reduced exercise-induced oxidative stress in healthy male athletes.
Emerging/Preclinical
- Anti-inflammatory: Potent NF-kB, iNOS, COX-2 inhibition by triterpenoids
- Neuroprotection: Amyloid-beta toxicity reduction and oxidative stress protection in cell/animal models
- Antiviral: In vitro activity against HBV, HCV; investigated for SARS-CoV-2
Mechanism of Action
Primary Mechanisms
-
Triterpenoid-mediated hepatoprotection: Antcins and zhankuic acids suppress NF-kB activation in hepatocytes and Kupffer cells, reducing iNOS, COX-2, TNF-alpha, and IL-6. They upregulate Nrf2/ARE antioxidant response (SOD, catalase, glutathione peroxidase), inhibit hepatic stellate cell activation (TGF-beta1/Smad suppression, reduced collagen deposition), and provide direct cytoprotection against ethanol, acetaminophen, and CCl4.
-
Antroquinonol multi-target anticancer mechanism:
- Ras/MAPK inhibition: Inhibits farnesyl transferase, blocking Ras prenylation and downstream RAF/MEK/ERK signaling
- PI3K/Akt/mTOR suppression: Reduces Akt phosphorylation, suppressing mTOR-mediated growth
- AMPK activation: Creates anti-growth metabolic state
- Apoptosis induction: Bax/Bcl-2 modulation, cytochrome c release, caspase-9/3 activation
- Cell cycle arrest: G1 and G2/M arrest via p21/p27 upregulation
- Anti-angiogenesis: VEGF suppression
-
Polysaccharide immune modulation: Beta-1,3/1,6-glucans activate Dectin-1 and CR3 on macrophages, DCs, and NK cells; NF-kB-mediated cytokine production.
Secondary Mechanisms
- Metabolic modulation: AMPK activation and SREBP-1c suppression reduce hepatic lipogenesis; enhanced insulin sensitivity via GLUT-4 translocation; alpha-glucosidase inhibition.
- Antioxidant: Direct radical scavenging by polyphenolic benzenoids plus indirect Nrf2-mediated enzyme induction.
Chemotaxonomic Significance
The ergostane-type triterpenoids (antcins) are genuinely unique to A. camphorata — no other medicinal mushroom produces them. Antroquinonol (ubiquinone-related) is also structurally unique in the fungal kingdom.
Clinical Evidence Summary
RCTs and Controlled Trials
| Trial | Design | n | Duration | Key Results |
|---|---|---|---|---|
| Tsai et al. (2016) | DBRPCT | 70 | 6 months | Significant AST/ALT reduction vs. placebo; improved oxidative stress markers |
| Huang et al. (2017) | DBRPCT | 53 | 8 weeks | Reduced hepatic steatosis; significant ALT reduction; improved lipid profiles in NAFLD |
| Lu et al. (2018) | RCT | ~60 | 12 weeks | Improved TC, LDL-C, triglycerides vs. placebo |
| Chen et al. (2017) | RCT | ~50 | 8-12 weeks | Improved lipid profile; reduced oxidative stress |
| Huang et al. (2019) | DBRPCT crossover | 20 | 4 weeks | Improved exercise performance; reduced oxidative stress |
Antroquinonol Pharmaceutical Development
| Trial | Phase | Indication | Key Information |
|---|---|---|---|
| Phase I (USA) | I | Advanced solid tumors | Safety to 600 mg/day; dose-proportional PK; no DLTs |
| NCT02047344 | II | NSCLC (3rd line+) | Disease stabilization in subset; mixed primary endpoint |
| FDA Orphan Drug | — | Pancreatic cancer | Designation granted |
| FDA Fast Track | — | Pancreatic cancer | Granted 2017 |
| FDA Orphan Drug | — | AML | Designation granted |
Evidence Limitations
- Geographic concentration: Nearly all trials from Taiwanese institutions
- Product heterogeneity: Different preparations (fruiting body, mycelium, submerged fermentation, purified antroquinonol) across studies
- Small sample sizes: Most trials <100 participants
- Limited international replication
- Publication bias: Strong commercial interest in Taiwan may skew toward positive results
- Form-dependent bioactives: Wild fruiting body (15-45% triterpenoids) vs. submerged fermentation (<5%) differ dramatically
Safety Profile
General Assessment
Generally favorable safety profile in clinical trials. Tsai et al. (2016) 6-month RCT reported no serious adverse events. Phase I antroquinonol established safety to 600 mg/day.
Toxicology
- Oral LD50 >5,000 mg/kg in mice
- 90-day repeated dose: no adverse effects at 2,000 mg/kg/day in rats
- Ames test negative; chromosomal aberration and micronucleus tests negative
Drug Interactions
| Drug Class | Mechanism | Severity |
|---|---|---|
| CYP3A4/CYP2C9 substrates | In vitro CYP modulation; clinical significance uncertain | Low-moderate (theoretical) |
| Anticoagulants/antiplatelets | In vitro antiplatelet activity of some triterpenoids | Low-moderate |
| Hypoglycemic agents | Additive glucose-lowering effect | Low-moderate |
| Immunosuppressants | Polysaccharide immunostimulation may antagonize | Moderate (theoretical) |
Side Effects
- Common: Generally well-tolerated; mild GI discomfort occasional
- Uncommon: Mild headache, skin rash
- Rare: No serious adverse events in clinical trials
Clinical Dosage
Mycelium Extract (Supplement)
- Standard: 1,000-2,000 mg/day dried mycelium extract, divided 2-3 doses
- Clinical trial: 1,080 mg/day (Tsai et al. 2016)
- Standardization: 10-30% total triterpenoids; >15% beta-glucans
Fruiting Body Extract
- Standard: 300-600 mg/day concentrated extract (higher triterpenoid concentration)
- Extremely expensive; most supplements use mycelium
Antroquinonol (Pharmaceutical, Investigational)
- Phase I range: up to 600 mg/day
- NOT available as dietary supplement — investigational drug only
Traditional
- Fruiting body decoction: 3-10 g dried, simmered 30-60 min (extremely bitter)
- Rice wine infusion: pieces soaked weeks-months, consumed 20-30 mL
Quality Considerations
- Form matters dramatically: wild fruiting body vs. wood-cultivated vs. solid-state vs. submerged fermentation all differ in bioactive profile
- Triterpenoid content is the primary quality marker distinguishing A. camphorata from other medicinal mushrooms
- Adulteration risk is high due to extreme value of wild specimens; DNA authentication recommended
Sources
Clinical Trials
- Tsai MC, Song TY, Shih PH, Yen GC. Anti-inflammatory and antioxidant activities of Antrodia camphorata mycelium. J Food Drug Anal. 2016;24(2):308-318
- Kumar KJS, et al. Antroquinonol protects hepatic cells from ethanol-induced oxidative stress through Nrf2 activation. J Ethnopharmacol. 2011;136(1):168-177
Antroquinonol Development
- Yu CC, et al. Antroquinonol induces cross talk between apoptosis, autophagy and senescence in pancreatic carcinoma cells. J Nutr Biochem. 2012;23(7):900-907
- Ho CL, et al. Antroquinonol blocks Ras and Rho signaling via inhibition of protein isoprenyltransferase. Biomed Pharmacother. 2014;68(8):1007-1014
- ClinicalTrials.gov: NCT02047344 (Phase II antroquinonol in NSCLC)
Reviews
- Geethangili M, Tzeng YM. Review of pharmacological effects of Antrodia camphorata. Evid Based Complement Alternat Med. 2011;2011:212641
- Ao ZH, et al. Niuchangchih (Antrodia camphorata) and its potential in treating liver diseases. J Ethnopharmacol. 2009;121(2):194-212
- Hseu YC, et al. Anti-inflammatory potential of Antrodia camphorata through NF-kappaB pathway. Int Immunopharmacol. 2005;5(13-14):1914-1925
Connections
- Compare with Reishi — both produce lanostane triterpenoids, but Antrodia’s ergostane-type antcins are unique; antroquinonol has advanced further in FDA drug development than any reishi compound
- Compare with Poria — both used for liver-related TCM applications; Poria has 2,000+ years of documentation while Antrodia is specific to Taiwanese indigenous medicine
- Antroquinonol’s FDA Phase II + Orphan Drug + Fast Track trajectory is unprecedented in the medicinal mushroom field
- Form-dependent bioactive variability is more extreme for Antrodia than any other medicinal mushroom
- Host specificity to endangered Cinnamomum kanehirae creates unique sustainability and conservation challenges
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