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Mesima Royal is a dietary supplement developed and manufactured by the South Korean company Han Kook Shin Yak. [9, 10] It is marketed for its immune-supporting properties. [1, 9] The primary active ingredient is derived from the mycelium of the *Phellinus linteus* mushroom, which is also known as Mesima or Sang-Hwang in Korea. [1, 7, 14] The product contains proteoglycans (protein-polysaccharides) which are believed to exert their effects by acting as immunomodulators, activating immune cells such as macrophages, T-lymphocytes, B-lymphocytes, and Natural Killer (NK) cells. [3, 6, 11] While sold as an immune support supplement in the US, in South Korea, a related product named "Mesima" is approved as a prescription anti-cancer immuno-stimulating agent used to improve immune function in cancer patients post-surgery. [8, 14, 15]
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