A review on the medicinal potentials of ginseng and ginsenosides on cardiovascular diseases
Posted by Michael Burmeister on
Chang Ho Lee1 and Jong-Hoon Kim2
Abstract
Ginseng is widely used for its promising healing and restorative properties as well as for its possible tonic effect in traditional medicine. Nowadays, many studies focus on purified individual ginsenoside, an important constituent in ginseng, and study its specific mechanism of action instead of whole-plant extracts on cardiovascular diseases (CVDs). Of the various ginsenosides, purified ginsenosides such as Rb1, Rg1, Rg3, Rh1, Re, and Rd are the most frequently studied. Although there are many reports on the molecular mechanisms and medical applications of ginsenosides in the treatment of CVDs, many concerns exist in their application. This review discusses current works on the countless pharmacological functions and the potential benefits of ginseng in the area of CVDs. Results: Both in vitro and in vivo results indicate that ginseng has potentially positive effects on heart disease through its various properties including antioxidation, reduced platelet adhesion, vasomotor regulation, improving lipid profiles, and influencing various ion channels. To date, approximately 40 ginsenosides have been identified, and each has a different mechanism of action owing to the differences in chemical structure. This review aims to present comprehensive information on the traditional uses, phytochemistry, and pharmacology of ginseng, especially in the control of hypertension and cardiovascular function. In addition, the review also provides an insight into the opportunities for future research and development on the biological activities of ginseng.
1. Introduction
Cardiovascular disease (CVD) is the leading cause of death globally. According to the World Health Organization, CVD was responsible for 30% of all deaths in 2005. Although typically considered a disease of developed countries, its incidence is increasing in the developing world as well. CVD usually stems from vascular dysfunction, for example, as a result of atherosclerosis, thrombosis, or high blood pressure, which then compromises organ function. Most notably, the heart and brain can be affected, as in myocardial infarction and stroke, respectively. In the past few decades, major improvements have been made in treating some types of CVD. However, new treatment options are urgently needed for all types of CVD. Moreover, improving diagnosis is crucial, because by detecting the early stages of disease, the focus of therapy could be shifted from treatment to prevention [1]. CVD is the leading cause of morbidity and mortality in millions of people around the world, which include a variety of diseases such as peripheral vascular disease, coronary artery disease, heart failure, dyslipidemias, and hypertension [2]. People of all races, age, and gender suffer commonly from these diseases. Heart failure, myocardial rupture, or arrhythmia is a result of myocardial necrosis following infarction [3]. Myocardial infarction and sudden death continue to remain as one of the leading causes of morbidity and mortality in many countries, despite vast advances in the past five decades. In addition, risk factors such as cigarette smoking, elevated low-density lipoprotein cholesterol, low levels of high-density lipoprotein cholesterol, diabetes mellitus, and hypertension are the primary causes of CVD [4]. Recent studies elucidate that vascular inflammation may also manifest in atherosclerosis and coronary artery disease [5]. Endothelial dysfunction has been stimulated by risk factors involved in CVD, such as expression of adhesion molecules by these dysfunctional endothelial cells, which promote the binding and influx of T cells and mast cells [6]. An inflammatory condition within the arterial wall is created by interleukins, cytokines, and reactive oxygen species (ROS) produced by white blood cells. Low-density lipoprotein is an atherogenic lipoprotein that accesses the subendothelial space and undergoes oxidative modification when trapped in the intercellular matrix [7].
Panax ginseng is a traditional herbal medicine that has been used therapeutically for more than 2000 years. It is the most valuable of all medicinal plants, especially in Korea, China, and Japan. The name panax means “all healing,” and has possibly stemmed from traditional belief that the various properties of ginseng can heal all aspects of the illness encountered by the human body (i.e., it acts as a panacea for the human body). Among the ginseng species, Korean ginseng (P. ginseng), Chinese ginseng (Panax notoginseng), and American ginseng (Panax quinquefolius) are the most common throughout the world. Numerous studies focus on the research of individual ginsenosides instead of using whole ginseng extract against various diseases [8–13]. Of the various ginsenosides, Rb1, Rg1, Rg3, Re, and Rd are the most frequently studied [13].
This review describes the medicinal potentials of using ginseng and ginsenosides in the treatment of CVD. The review explores recent studies carried out to understand the mechanisms that lead to various diseases and discusses the implications of these advances for identifying new therapeutic targets and developing new therapeutic strategies, including the potential use of ginseng and its metabolite (i.e., ginsenosides) for treating CVD.
Concluding remarks
This review summarized current information about the efficacy of ginseng on major cardiovascular risk factors such as hypertension, cardiac disease, hyperlipidemia, oxidative stress, and ion regulation. Ginseng is a traditional herbal remedy whose antiquity stretches back to ancient times. The active constituent ginsenosides play a vital role in the medicinal effects of ginseng. Ginsenosides exhibit their vast range of activities on CVD through the inhibition of ROS production, stimulation of NO production, improvement in blood circulation, enhancement of vasomotor tone, and regulation of the lipid profile. However, the exact mechanisms of action of ginsenosides are still unidentified. In the future, each ginsenoside must be studied on its specific mechanism of action on CVD. The common use of ginseng as an herbal remedy requires strict investigations to assess both its efficacy and its safety.