Poria cocos in traditional Chinese medicine: multifaceted insights

Abstract

Poria cocos (Fu Ling), a traditional medicinal fungus with more than two millennia of documented use, occupies a central role in East Asian medical practice. This review systematically examines its historical development as recorded in classical materia medica, emphasizing the evolution of its medicinal sources and the specific fungal parts employed. The representative chemical constituents - namely triterpenoids and polysaccharides - are thoroughly summarized with regard to their structural types and distinguishing characteristics. Building on classical therapeutic indications such as promoting diuresis, strengthening the spleen, and calming the mind, recent research is reviewed to elucidate the expanded pharmacological profile of P. cocos. A particular focus is given to its antitumor effects, immunomodulatory activity, anti-obesity properties, mitigation of metabolic dysfunction-associated steatotic liver disease, and enhancement of intestinal barrier function. Current mainstream quality evaluation methodologies are outlined, followed by an in-depth discussion of the pharmacokinetics of its principal bioactive components, with special emphasis on the microbial fermentation of polysaccharides into short-chain fatty acids by the gut microbiota. The synergistic role of P. cocos in polyherbal formulations, exemplified by Sijunzi Decoction, is analyzed to highlight its compatibility-enhancing effects. Contemporary applications in modern pharmaceuticals and functional foods are also summarized. Finally, key challenges and prospective directions for future research and industrial development are addressed. This review aimed to provide a comprehensive reference for basic research, product innovation, and clinical utilization of P. cocos.

Keywords

Poria cocos / Triterpenoids / Polysaccharides / Pharmacological activity / Gut microbiota / Short-chain fatty acids / Pharmacokinetics

Conflict of interest statement

The authors declare no conflict of interest.

Funding

This work was supported by the National Natural Science Foundation of China (NSFC) (82204748 and 82505171); Technology Project of Anhui Province (202423l10050002); the Anhui Science and Technology Commissioner Demonstration Project ([2024] No. 407); the High Level Key Discipline Construction Project of Traditional Chinese Medicine (zyyzdxk-2023095); and the Anhui province university scientific research plan project team project (2022AH010036); NSFC Regional Innovation and Development Joint Fund (U25A20173). Dr. Zhou is the recipient of a Research Career Scientist Award from the Department of Veterans Affairs, USA (IK6BX004477).

Author contributions

Yue Zhang, Nianjun Yu, and Daiyin Peng conceived and designed this original draft. Gaoxiong Rao, Xian Zhang, Jie Yu, and Jian Liu filtered the articles and performed the figures. Yanyan Wang, Lei Wang, and Weidong Chen participated in writing, editing, and funding acquisition. Huiping Zhouparticipated in editing. All of the authors have read and approved the published version of the manuscript.

Ethical approval of studies and informed consent

The work presented is based on a systematic analysis, synthesis, and evaluation of previously published scientific literature and does not involve any new human subject studies, animal experiments, or the collection of original clinical data.

Acknowledgments

None.

Data availability

All relevant data are within the manuscript.

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