Antrodia cinnamomea ( Ac ), also known as "Niu-Chang-Chih" in Chinese, is a valuable fungus that has been widely used as medicine and food among indigenous people in Taiwan. Ac is rich in polysaccharides ( Ac -PS), making it a promising candidate for adjunctive therapy in cancer and inflammation conditions. There are two types of Ac -PS: general (non-sulfated) PS ( Ac -GPS) and sulfated PS ( Ac -SPS). This review highlights that both Ac -GPS and Ac -SPS possess immunomodulatory, anti-inflammatory, and anticancer properties. Each type influences interleukin signaling pathways to exert its anti-inflammatory effects. Ac -GPS is particularly effective in alleviating inflammation in the brain and liver, while Ac -SPS shows its efficacy in macrophage models. Both Ac -GSP and Ac -SPS have demonstrated anticancer effects supported by in vitro and in vivo studies, primarily through inducing apoptosis in various cancer cell lines. They may also synergize with chemotherapy and exhibit antiangiogenic properties. Notably, Ac -SPS appears to have superior anticancer efficacy, potentially due to its sulfate groups. Furthermore, Ac -SPS has been more extensively studied in terms of its mechanisms and effects on lung cancer compared with Ac -GPS, highlighting its significance in cancer research. In addition, Ac -SPS is often reported for its ability to activate macrophage-mediated responses. Clinically, Ac -GPS has been used as an adjunctive therapy for advanced lung cancer, as noted in recent reports. However, given the numerous studies emphasizing its anticancer mechanisms, Ac -SPS may exhibit greater efficacy, warranting further investigation. This review concludes that Ac -derived Ac -GPS or Ac -SPS have the potential to be developed into functional health supplements or adjunctive therapies, providing dual benefits of anti-inflammatory and anticancer effects.
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