Ginseng, an ancient and famous medicinal herb in the Orient, has been used as a valuable tonic and for the treatment of various diseases including hepatic disorders. Ginseng saponins, commonly known as ginsenosides, are principal constituents and have believed to be responsible for multiple ginseng health benefits. There are more 40 ginsenosides isolated from ginseng. To date, treatment options for common liver diseases such as cirrhosis, fatty liver, and chronic hepatitis remain problematic. In this regard, ginseng extracts and individual ginsenosides have shown a wide array of beneficial role in the regulation of regular liver functions and the treatment of liver disorders of acute/chronic hepatotoxicity, hepatitis, hepatic fibrosis/cirrhosis, hepatocellular carcinoma, and so on in various pathways and mechanisms. In this paper, we first outline the pharmacological effects of ginseng and ginsenosides on the liver functions.
Botanical medicines have been applied for the treatment of various human diseases with thousands of years of history in Asia and are sharing a large market in the form of drugs, dietary supplements, and foods. In the west, botanical medicines are categorized as complementary/alternative medicines, dietary supplements, or foods. Ginseng, referred to as the root of Panax ginseng C.A. Meyer (Araliaceae), is one of the most valuable medicinal plants, particularly in Korea, China, and Japan .
Ginseng has been used as a valuable tonic and for the treatment of various diseases [1, 2]. Traditionally, ginseng has been processed to make white ginseng (air-drying after harvest) and red ginseng (steaming or heat process) to enhance its preservation and efficacy. In which, red ginseng is more common as an herbal medicine than white ginseng because steaming induces changes in the chemical constituents and enhances the biological activities of ginseng [1, 2]. The pharmacological properties of ginseng are mainly attributed to ginseng saponins, commonly called ginsenoisdes, the major and bioactive constituents [3, 4]. With the development of modern chromatography, there are more 40 ginsenoisdes such as ginsenoisdes Rb1, Rb2, Rg1, Rd, and Re identified from ginseng up to date [4, 5]. Except for ginsenoisde Ro and polyacetylene ginsenoisde Ro belonging to oleanane-type saponins, other ginsenoisdes are of dammarane-type saponins and classified into protopanaxadiol and protopanaxatriol groups depending on whether or not hydroxyl group at C-6 of aglycon moieties exist (Figure 1). On the other hand, ginseng and ginsenoisdes have been found to exhibit multiple pharmacological activities via different mechanisms and pathways in vitro, in vivo, and clinical models [2–4]. Having been well documented, there are hundreds of research papers as well as extensive reviews spotlighted on individual topics, that is, cardiovascular [6, 7], central nervous , and immune systems [9, 10]. However, the pharmacological effects of ginseng/ginsenoisdes on liver disorders have not been systematically reviewed. The purpose of this paper is to introduce the multifaceted pharmacological effects and related mechanisms of ginseng/ginsenoisdes on hepatic functions.
Ginseng and its principal components, ginsenoisdes, have shown a wide array of pharmacological activities including beneficial role in the regulation of liver functions and the treatment of liver disorders of acute/chronic hepatotoxicity, hepatitis, hepatic fibrosis/cirrhosis, liver hepatectomy, liver transplantation, and even liver failure and HCC. The possible activity pathways of the actions have been also investigated. There is increasing attention to the effects of ginseng on the liver functions. However, more detailed molecular mechanisms of the activities of ginseng/ginsenoisdes as well as further efficacy and safety studies remain to be explored.
It is another important area for further research and development to combine ginseng with other liver active drugs to investigate their possible synergic efficacy and preferably pharmacological properties.
Taken together, accumulating evidence supports the potential of ginseng in the treatment of the hepatic diseases and further studies will facilitate their application so far.