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Lv N, Wang L, Zeng M, Wang Y, Yu B, Zeng W, Jiang X, Suo Y. Saponins as therapeutic candidates for atherosclerosis. Phytother Res 2024; 38:1651-1680. [PMID: 38299680 DOI: 10.1002/ptr.8128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 12/25/2023] [Accepted: 01/06/2024] [Indexed: 02/02/2024]
Abstract
Drug development for atherosclerosis, the underlying pathological state of ischemic cardiovascular diseases, has posed a longstanding challenge. Saponins, classified as steroid or triterpenoid glycosides, have shown promising therapeutic potential in the treatment of atherosclerosis. Through an exhaustive examination of scientific literature spanning from May 2013 to May 2023, we identified 82 references evaluating 37 types of saponins in terms of their prospective impacts on atherosclerosis. These studies suggest that saponins have the potential to ameliorate atherosclerosis by regulating lipid metabolism, inhibiting inflammation, suppressing apoptosis, reducing oxidative stress, and modulating smooth muscle cell proliferation and migration, as well as regulating gut microbiota, autophagy, endothelial senescence, and angiogenesis. Notably, ginsenosides exhibit significant potential and manifest essential pharmacological attributes, including lipid-lowering, anti-inflammatory, anti-apoptotic, and anti-oxidative stress effects. This review provides a comprehensive examination of the pharmacological attributes of saponins in atherosclerosis, with particular emphasis on their role in the regulation of lipid metabolism regulation and anti-inflammatory effects. Thus, saponins may warrant further investigation as a potential therapy for atherosclerosis. However, due to various reasons such as low oral bioavailability, the clinical application of saponins in the treatment of atherosclerosis still needs further exploration.
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Affiliation(s)
- Nuan Lv
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Luming Wang
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Miao Zeng
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yijing Wang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Bin Yu
- School of Medical Technology, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Wenyun Zeng
- Oncology Department, Ganzhou people's hospital, Ganzhou, China
| | - Xijuan Jiang
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yanrong Suo
- Traditional Chinese Medicine Department, Ganzhou people's hospital, Ganzhou, China
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The Efficacy of Ginseng (Panax) on Human Prediabetes and Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14122401. [PMID: 35745129 PMCID: PMC9227417 DOI: 10.3390/nu14122401] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 05/30/2022] [Accepted: 06/08/2022] [Indexed: 12/12/2022] Open
Abstract
Results from different clinical trials on the effects of ginseng on prediabetes and type 2 diabetes (T2DM) are still inconsistent. To fill this knowledge gap, we investigated the overall effects of ginseng supplementation on improving cardiometabolic biomarkers among these patients. A systematic literature search was conducted on PubMed/MEDLINE, Scopus, Web of Science, and Cochrane library. A random-effect model was applied to estimate the weighted mean difference and 95% CI for each outcome. Overall, 20 eligible RCTs were included. Meta-analyses revealed that ginseng supplementation significantly reduced serum concentration of FPG, TC, IL-6, and HOMA-IR values. It also increased HR and TNF-α levels. Ginseng supplementation changed HOMA-IR and HDL-C significantly based on dose and changed HOMA-IR and LDL-C significantly based on study duration in a non-linear fashion. Furthermore, meta-regression analyses indicated a linear relationship between ginseng dose and absolute changes in HDL-C. Moreover, subgroup analyses showed that ginseng supplementation changed TC and LDL-C when the supplementation dose was ≥2 g/day. Our findings suggest that ginseng supplementation may be an effective strategy for improving cardiometabolic profiles in individuals with prediabetes and T2DM.
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Jovanovski E, Smircic-Duvnjak L, Komishon A, Au-Yeung F(R, Sievenpiper JL, Zurbau A, Jenkins AL, Sung MK, Josse R, Li D, Vuksan V. Effect of coadministration of enriched Korean Red Ginseng ( Panax ginseng) and American ginseng ( Panax quinquefolius L) on cardiometabolic outcomes in type-2 diabetes: A randomized controlled trial. J Ginseng Res 2021; 45:546-554. [PMID: 34803424 PMCID: PMC8587487 DOI: 10.1016/j.jgr.2019.11.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 09/25/2019] [Accepted: 11/04/2019] [Indexed: 01/04/2023] Open
Abstract
Background Diabetes mellitus and hypertension often occur together, amplifying cardiovascular disease (CVD) risk and emphasizing the need for a multitargeted treatment approach. American ginseng (AG) and Korean Red Ginseng (KRG) species could improve glycemic control via complementary mechanisms. Additionally, a KRG-inherent component, ginsenoside Rg3, may moderate blood pressure (BP). Our objective was to investigate the therapeutic potential of coadministration of Rg3-enriched Korean Red Ginseng (Rg3-KRG) and AG, added to standard of care therapy, in the management of hypertension and cardiometabolic risk factors in type-2 diabetes. Methods Within a randomized controlled, parallel design of 80 participants with type-2 diabetes (HbA1c: 6.5–8%) and hypertension (systolic BP: 140–160 mmHg or treated), supplementation with either 2.25 g/day of combined Rg3-KRG + AG or wheat-bran control was assessed over a 12-wk intervention period. The primary endpoint was ambulatory 24-h systolic BP. Additional endpoints included further hemodynamic assessment, glycemic control, plasma lipids and safety monitoring. Results Combined ginseng intervention generated a mean ± SE decrease in primary endpoint of 24-h systolic BP (−3.98 ± 2.0 mmHg, p = 0.04). Additionally, there was a greater reduction in HbA1c (−0.35 ± 0.1% [–3.8 ± 1.1 mmol/mol], p = 0.02), and change in blood lipids: total cholesterol (−0.50 ± 0.2 mmol/l, p = 0.01), non-HDL-C (−0.54 ± 0.2 mmol/l, p = 0.01), triglycerides (−0.40 ± 0.2 mmol/l, p = 0.02) and LDL-C (−0.35 ± 0.2 mmol/l, p = 0.06) at 12 wks, relative to control. No adverse safety outcomes were observed. Conclusion Coadministration of Rg3-KRG + AG is an effective addon for improving BP along with attaining favorable cardiometabolic outcomes in individuals with type 2 diabetes. Ginseng derivatives may offer clinical utility when included in the polypharmacy and lifestyle treatment of diabetes. Clinical trial registration Clinicaltrials.gov identifier, NCT01578837;
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Affiliation(s)
- Elena Jovanovski
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Lea Smircic-Duvnjak
- School of Medicine University of Zagreb, University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Zagreb, Croatia
| | - Allison Komishon
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada
| | - Fei (Rodney) Au-Yeung
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - John L. Sievenpiper
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada
- Li KaShing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
- Division of Endocrinology & Metabolism, St. Michael's Hospital, Toronto, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Andreea Zurbau
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Alexandra L. Jenkins
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada
| | - Mi-Kyung Sung
- Department of Food and Nutrition, Sookmyung Women's University, Yongsan-gu, Seoul, Republic of Korea
| | - Robert Josse
- Division of Endocrinology & Metabolism, St. Michael's Hospital, Toronto, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Dandan Li
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Vladimir Vuksan
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada
- Li KaShing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
- Division of Endocrinology & Metabolism, St. Michael's Hospital, Toronto, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
- Corresponding author. Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, M5B 1M8, Canada.
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Antonelli M, Donelli D, Firenzuoli F. Ginseng integrative supplementation for seasonal acute upper respiratory infections: A systematic review and meta-analysis. Complement Ther Med 2020; 52:102457. [PMID: 32951718 PMCID: PMC7305750 DOI: 10.1016/j.ctim.2020.102457] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The aim of the review was to assess whether ginseng can be a useful supplementation for seasonal acute upper respiratory infections (SAURIs). METHODS All clinical studies investigating ginseng efficacy for the treatment or prevention of SAURIs were included in the review. Medline, EMBASE, Web of Science, Scopus, Cochrane Library, Google Scholar were systematically screened for relevant articles up to May 26th, 2020. The risk of bias was assessed with the Cochrane tool (RoB 2). RESULTS Nine articles (describing ten trials about P. ginseng or P. quinquefolius) were included in the review. Evidence globally indicated some useful activity of intervention when administered in adjunct to influenza vaccination. The results of our quantitative synthesis suggested a significant effect on SAURIs incidence (RR = 0.69 [95 % C.I. 0.52 to 0.90], p < 0.05), as well as a significant reduction of their duration if only studies with healthy individuals were included in the analysis (MD=-3.11 [95 % C.I.-5.81 to -0.40], p < 0.05). However, the risk of bias was high-to-unclear for most included trials, and publication bias couldn't be excluded. DISCUSSION Limitations of existing evidence don't allow to draw conclusions on the topic. Nevertheless, it is not excluded that ginseng supplementation in adjunct to influenza vaccination and standard care might be useful for SAURIs prevention and management in healthy adult subjects, but further high-quality trials are needed to support this hypothesis. OTHER This research was not funded. The protocol was registered in PROSPERO under the following code: CRD42020156235.
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Affiliation(s)
- Michele Antonelli
- Terme di Monticelli, Parma, Italy; Research and Innovation Center in Phytotherapy and Integrated Medicine (CERFIT), Careggi University Hospital, Florence, Italy; Institute of Public Health, University of Parma, Parma, Italy.
| | - Davide Donelli
- Terme di Monticelli, Parma, Italy; Research and Innovation Center in Phytotherapy and Integrated Medicine (CERFIT), Careggi University Hospital, Florence, Italy; AUSL-IRCCS Reggio Emilia, Italy
| | - Fabio Firenzuoli
- Research and Innovation Center in Phytotherapy and Integrated Medicine (CERFIT), Careggi University Hospital, Florence, Italy
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Jeon JH, Lee S, Lee W, Jin S, Kwon M, Shin CH, Choi MK, Song IS. Herb-Drug Interaction of Red Ginseng Extract and Ginsenoside Rc with Valsartan in Rats. Molecules 2020; 25:E622. [PMID: 32023909 PMCID: PMC7037682 DOI: 10.3390/molecules25030622] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/14/2020] [Accepted: 01/29/2020] [Indexed: 02/07/2023] Open
Abstract
The purpose of this study was to investigate the herb-drug interactions involving red ginseng extract (RGE) or ginsenoside Rc with valsartan, a substrate for organic anion transporting polypeptide (OATP/Oatp) transporters. In HEK293 cells overexpressing drug transporters, the protopanaxadiol (PPD)-type ginsenosides- Rb1, Rb2, Rc, Rd, Rg3, compound K, and Rh2-inhibited human OATP1B1 and OATP1B3 transporters (IC50 values of 7.99-68.2 µM for OATP1B1; 1.36-30.8 µM for OATP1B3), suggesting the herb-drug interaction of PPD-type ginsenosides involving OATPs. Protopanaxatriol (PPT)-type ginsenosides-Re, Rg1, and Rh1-did not inhibit OATP1B1 and OATP1B3 and all ginsenosides tested didn't inhibit OCT and OAT transporters. However, in rats, neither RGE nor Rc, a potent OATP inhibitor among PPD-type ginsenoside, changed in vivo pharmacokinetics of valsartan following repeated oral administration of RGE (1.5 g/kg/day for 7 days) or repeated intravenous injection of Rc (3 mg/kg for 5 days). The lack of in vivo herb-drug interaction between orally administered RGE and valsartan could be attributed to the low plasma concentration of PPD-type ginsenosides (5.3-48.4 nM). Even high plasma concentration of Rc did not effectively alter the pharmacokinetics of valsartan because of high protein binding and the limited liver distribution of Rc. The results, in conclusion, would provide useful information for herb-drug interaction between RGE or PPD-type ginsenosides and Oatp substrate drugs.
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Affiliation(s)
- Ji-Hyeon Jeon
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (J.-H.J.); (S.L.); (M.K.); (C.H.S.)
| | - Sowon Lee
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (J.-H.J.); (S.L.); (M.K.); (C.H.S.)
| | - Wonpyo Lee
- College of Pharmacy, Dankook University, Cheon-an 31116, Korea; (W.L.); (S.J.)
| | - Sojeong Jin
- College of Pharmacy, Dankook University, Cheon-an 31116, Korea; (W.L.); (S.J.)
| | - Mihwa Kwon
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (J.-H.J.); (S.L.); (M.K.); (C.H.S.)
| | - Chul Hwi Shin
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (J.-H.J.); (S.L.); (M.K.); (C.H.S.)
| | - Min-Koo Choi
- College of Pharmacy, Dankook University, Cheon-an 31116, Korea; (W.L.); (S.J.)
| | - Im-Sook Song
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea; (J.-H.J.); (S.L.); (M.K.); (C.H.S.)
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Review of Ginseng Anti-Diabetic Studies. Molecules 2019; 24:molecules24244501. [PMID: 31835292 PMCID: PMC6943541 DOI: 10.3390/molecules24244501] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/03/2019] [Accepted: 12/06/2019] [Indexed: 12/22/2022] Open
Abstract
Ginseng is one of the most valuable and commonly used Chinese medicines not only in ancient China but also worldwide. Ginsenosides, also known as saponins or triterpenoids, are thought to be responsible for the beneficial effects of ginseng. In this review, we summarize recent publications on anti-diabetic studies of ginseng extracts and ginsenosides in cells, animals, and humans. It seems that the anti-diabetic effect of ginseng is positive for type 2 diabetic patients but has no significant impact on prediabetes or healthy adults. Regulation of insulin secretion, glucose uptake, anti-oxidative stress, and anti-inflammatory pathways may be the mechanisms involved with ginseng's anti-diabetic effects. Taken together, this summary provides evidence for the anti-diabetes effects of ginseng extracts and ginsenosides as well as the underlying mechanisms of their impact on diabetes.
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Interactions of ginseng with therapeutic drugs. Arch Pharm Res 2019; 42:862-878. [PMID: 31493264 DOI: 10.1007/s12272-019-01184-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 08/26/2019] [Indexed: 02/08/2023]
Abstract
Ginseng is the most frequently used herbal medicine for immune system stimulation and as an adjuvant with prescribed drugs owing to its numerous pharmacologic activities. It is important to investigate the beneficial effects and interaction of ginseng with therapeutic drugs. This review comprehensively discusses drug metabolizing enzyme- and transporter-mediated ginseng-drug interaction by analyzing in vitro and clinical results with a focus on ginsenoside, a pharmacologically active marker of ginseng. Impact of ginseng therapy or ginseng combination therapy on diabetic patients and of ginseng interaction with antiplatelets and anticoagulants were evaluated based on ginseng origin and ginsenoside content. Daily administration of Korean red ginseng (0.5-3 g extract; dried ginseng > 60%) did not cause significant herb-drug interaction with drug metabolizing enzymes and transporters. Among various therapeutic drugs administered in combination with ginseng, adjuvant chemotherapy, comprising ginseng (1-3 g extract) and anticancer drugs, was effective for reducing cancer-related fatigue and improving the quality of life and emotional scores. Limited information regarding ginsenoside content in each ginseng product and plasma ginsenoside concentration among patients necessitates standardization of ginseng product and establishment of pharmacokinetic-pharmacodynamic correlation to further understand beneficial effects of ginseng-therapeutic drug interactions in future clinical studies.
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Szczuka D, Nowak A, Zakłos-Szyda M, Kochan E, Szymańska G, Motyl I, Blasiak J. American Ginseng ( Panax quinquefolium L.) as a Source of Bioactive Phytochemicals with Pro-Health Properties. Nutrients 2019; 11:E1041. [PMID: 31075951 PMCID: PMC6567205 DOI: 10.3390/nu11051041] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 05/06/2019] [Accepted: 05/07/2019] [Indexed: 12/12/2022] Open
Abstract
Panax quinquefolium L. (American Ginseng, AG) is an herb characteristic for regions of North America and Asia. Due to its beneficial properties it has been extensively investigated for decades. Nowadays, it is one of the most commonly applied medical herbs worldwide. Active compounds of AG are ginsenosides, saponins of the glycosides group that are abundant in roots, leaves, stem, and fruits of the plant. Ginsenosides are suggested to be primarily responsible for health-beneficial effects of AG. AG acts on the nervous system; it was reported to improve the cognitive function in a mouse model of Alzheimer's disease, display anxiolytic activity, and neuroprotective effects against neuronal damage resulting from ischemic stroke in animals, demonstrate anxiolytic activity, and induce neuroprotective effects against neuronal damage in ischemic stroke in animals. Administration of AG leads to inhibition of hypertrophy in heart failure by regulation of reactive oxygen species (ROS) in mice as well as depletion of cardiac contractile function in rats. It also has an anti-diabetic and anti-obesity potential as it increases insulin sensitivity and inhibits formation of adipose tissue. AG displays anti-cancer effect by induction of apoptosis of cancer cells and reducing local inflammation. It exerts antimicrobial effects against several pathogenic strains of bacteria. Therefore, AG presents a high potential to induce beneficial health effects in humans and should be further explored to formulate precise nutritional recommendations, as well as to assess its value in prevention and therapy of some disorders, including cancer.
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Affiliation(s)
- Daria Szczuka
- Institute of Fermentation Technology and Microbiology, Lodz University of Technology, Wolczanska 171/173, 90-924 Lodz, Poland.
| | - Adriana Nowak
- Institute of Fermentation Technology and Microbiology, Lodz University of Technology, Wolczanska 171/173, 90-924 Lodz, Poland.
| | - Małgorzata Zakłos-Szyda
- Institute of Technical Biochemistry, Lodz University of Technology, Stefanowskiego 4/10, 90-924 Lodz, Poland.
| | - Ewa Kochan
- Pharmaceutical Biotechnology Department, Medical University of Lodz, Muszynskiego 1, 90-151 Lodz, Poland.
| | - Grażyna Szymańska
- Pharmaceutical Biotechnology Department, Medical University of Lodz, Muszynskiego 1, 90-151 Lodz, Poland.
| | - Ilona Motyl
- Institute of Fermentation Technology and Microbiology, Lodz University of Technology, Wolczanska 171/173, 90-924 Lodz, Poland.
| | - Janusz Blasiak
- Department of Molecular Genetics, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236 Lodz, Poland.
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Karmazyn M, Gan XT. Ginseng for the treatment of diabetes and diabetes-related cardiovascular complications: a discussion of the evidence 1. Can J Physiol Pharmacol 2018; 97:265-276. [PMID: 30395481 DOI: 10.1139/cjpp-2018-0440] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Diabetes mellitus (DM) is a chronic metabolic disorder associated with elevated blood glucose levels due either to insufficient insulin production (type 1 DM) or to insulin resistance (type 2 DM). The incidence of DM around the world continues to rise dramatically with more than 400 million cases reported today. Among the most serious consequences of chronic DM are cardiovascular complications that can have deleterious effects. Although numerous treatment options are available, including both pharmacological and nonpharmacological, there is substantial emerging interest in the use of traditional medicines for the treatment of this condition and its complications. Among these is ginseng, a medicinal herb that belongs to the genus Panax and has been used for thousands of years as a medicinal agent especially in Asian cultures. There is emerging evidence from both animal and clinical studies that ginseng, ginseng constituents including ginsenosides, and ginseng-containing formulations can produce beneficial effects in terms of normalization of blood glucose levels and attenuation of cardiovascular complications through a multiplicity of mechanisms. Although more research is required, ginseng may offer a useful therapy for the treatment of diabetes as well as its complications.
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Qin Z, Jia C, Liao D, Chen X, Li X. Comparison of Serum Metabolite Changes of Radiated Mice Administered with Panax quinquefolium from Different Cultivation Regions Using UPLC-Q/TOF-MS Based Metabolomic Approach. Molecules 2018; 23:E1014. [PMID: 29701672 PMCID: PMC6102546 DOI: 10.3390/molecules23051014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 04/22/2018] [Accepted: 04/24/2018] [Indexed: 02/08/2023] Open
Abstract
Chemometric analysis of bioactive compounds revealed that American ginsengs (AGs) from different cultivation regions of China had a difference in quality, which indicates their possible pharmacological difference. A UPLC-Q/TOF-MS-based untargeted metabolomic approach was used to uncover serum metabolite changes in radiated mice pre-administered with AG root decoctions from seven cultivation regions and to further assess their quality difference. OPLS-DA revealed that 51 metabolites (ESI−) and 110 (ESI⁺) were differentially expressed in sera between the control and the radiated model mice. Heatmap analysis further revealed that AG could not reverse most of these radiation-altered metabolites, which indicates dietary supplement of AG before cobalt radiation had the weak potential to mediate serum metabolites that were altered by the sub-lethal high dose radiation. In addition, 83 (ESI−) and 244 (ESI⁺) AG altered metabolites were detected in radiated mice under radiation exposure. Both OPLS-DA on serum metabolomes and heatmap analysis on discriminant metabolites showed that AGs from different cultivation regions differentially influenced metabolic alterations in radiated mice, which indicates AGs from different cultivation regions showed the pharmacological difference in modulation of metabolite changes. AGs from Shandong, Shanxi, and Beijing provinces had more similar pharmacological effects than AGs from USA, Canada, Jilin, and Heilongjiang. Finally, 28 important potential biomarkers were annotated and assigned onto three metabolic pathways including lipid, amino acid, and energy metabolisms.
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Affiliation(s)
- Zhenxian Qin
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100193, China.
| | - Chan Jia
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100193, China.
| | - Dengqun Liao
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100193, China.
| | - Xiaofang Chen
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100193, China.
| | - Xian'en Li
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100193, China.
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Efficacy and safety of American ginseng (Panax quinquefolius L.) extract on glycemic control and cardiovascular risk factors in individuals with type 2 diabetes: a double-blind, randomized, cross-over clinical trial. Eur J Nutr 2018; 58:1237-1245. [PMID: 29478187 DOI: 10.1007/s00394-018-1642-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 02/17/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE Despite the lack of evidence, a growing number of people are using herbal medicine to attenuate the burden of diabetes. There is an urgent need to investigate the clinical potential of herbs. Preliminary observations suggest that American ginseng (Panax quinquefolius [AG]) may reduce postprandial glycemia. Thus, we aimed to evaluate the efficacy and safety of AG as an add-on therapy in individuals with type 2 diabetes (T2DM) controlled by conventional treatment. METHODS 24 individuals living with T2DM completed the study (F:M = 11:13; age = 64 ± 7 year; BMI = 27.8 ± 4.6 kg/m2; HbA1c = 7.1 ± 1.2%). Utilizing a double-blind, cross-over design, the participants were randomized to receive either 1 g/meal (3 g/day) of AG extract or placebo for 8 weeks while maintaining their original treatment. Following a ≥ 4-week washout period, the participants were crossed over to the opposite 8-week treatment arm. The primary objective was HbA1c, and secondary endpoints included fasting blood glucose and insulin, blood pressure, plasma lipids, serum nitrates/nitrites (NOx), and plasominogen-activating factor-1 (PAI-1). Safety parameters included liver and kidney function. RESULTS Compared to placebo, AG significantly reduced HbA1c (- 0.29%; p = 0.041) and fasting blood glucose (- 0.71 mmol/L; p = 0.008). Furthermore, AG lowered systolic blood pressure (- 5.6 ± 2.7 mmHg; p < 0.001), increased NOx (+ 1.85 ± 2.13 µmol/L; p < 0.03), and produced a mean percent end-difference of - 12.3 ± 3.9% in LDL-C and - 13.9 ± 5.8% in LDL-C/HDL. The safety profiles were unaffected. CONCLUSIONS AG extract added to conventional treatment provided an effective and safe adjunct in the management of T2DM. Larger studies using physiologically standardized ginseng preparations are warranted to substantiate the present findings and to demonstrate therapeutic effectiveness of AG. CLINICALTRIALS. GOV IDENTIFIER NCT02923453.
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de Araújo MFM, Veras VS, de Freitas RWJF, de Paula MDL, de Araújo TM, Uchôa LRA, Gaspar MWG, Cunha MDCDSO, Serra MAADO, Carvalho CMDL, Costa EC, Damasceno MMC. The effect of flour from the rind of the yellow passion fruit on glycemic control of people with diabetes mellitus type 2: a randomized clinical trial. J Diabetes Metab Disord 2017; 16:18. [PMID: 28428951 PMCID: PMC5392918 DOI: 10.1186/s40200-017-0300-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 04/05/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND The single or combined use of herbal and dietary products with medications has shown benefits in the metabolic modulation of carbohydrates, in the restoring of the function of pancreatic beta cells, and in insulin resistance. To analyze the effect of the use of flour made from the rind of the yellow passion fruit on the glycemic control of people with diabetes mellitus type 2. METHODS An open, prospective, randomized clinical trial was undertaken with 54 participants over an eight-week period. The participants from the case group were advised to ingest 12 g of the flour, three times daily; before breakfast, lunch and dinner. RESULTS After eight weeks of use of the flour made from the rind of the yellow passion fruit, we did not identify significant statistical differences in the values for capillary blood glucose (p = 0.562), fasting blood glucose (p = 0.268) or glycated hemoglobin (p = 0.229) between the study groups. In the case group, we identified an increase (29.6%-37%) of the people with normal HbA1c; however, this did not have statistical relevance (p = 0.274). DISCUSSION Based in our findings, we believe it is important to extend the time of exposure to the intervention and increase the rigor in the monitoring of adherence in future studies on this topic. Only in this way will we be able to make confident inferences in relation to the use of flour made from the rind of theyellow passion fruit as a therapeutic tool for glycemic and/or metabolic control in persons with DM 2. CONCLUSIONS In the sample in question, the use of the flour made from the rind of the yellow passion fruit, over an eight-week period, did not improve the glycemic control of people with type 2 diabetes. Trial registration: U1111.1187.3616. Registered 6 September, retrospectively registered, in the Brazilian Clinical Trials Registry.
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Affiliation(s)
- Márcio Flávio Moura de Araújo
- Professor of University for International Integration Lusophony Afro Brazilian, CE 060, Km 51, S/N, Acarape, CEP: 62785000 Ceará Brazil
| | - Vivian Saraiva Veras
- Professor of University for International Integration Lusophony Afro Brazilian, CE 060, Km 51, S/N, Acarape, CEP: 62785000 Ceará Brazil
| | | | | | - Thiago Moura de Araújo
- Professor of University for International Integration Lusophony Afro Brazilian, CE 060, Km 51, S/N, Acarape, CEP: 62785000 Ceará Brazil
| | - Lilian Raquel Alexandre Uchôa
- Professor of University for International Integration Lusophony Afro Brazilian, CE 060, Km 51, S/N, Acarape, CEP: 62785000 Ceará Brazil
| | - Maria Wendiane Gueiros Gaspar
- Professor of University for International Integration Lusophony Afro Brazilian, CE 060, Km 51, S/N, Acarape, CEP: 62785000 Ceará Brazil
| | | | | | - Carolina Maria de Lima Carvalho
- Professor of University for International Integration Lusophony Afro Brazilian, CE 060, Km 51, S/N, Acarape, CEP: 62785000 Ceará Brazil
| | - Edmara Chaves Costa
- Professor of University for International Integration Lusophony Afro Brazilian, CE 060, Km 51, S/N, Acarape, CEP: 62785000 Ceará Brazil
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Shi Y, Wan X, Shao N, Ye R, Zhang N, Zhang Y. Protective and anti-angiopathy effects of ginsenoside Re against diabetes mellitus via the activation of p38 MAPK, ERK1/2 and JNK signaling. Mol Med Rep 2016; 14:4849-4856. [DOI: 10.3892/mmr.2016.5821] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 08/09/2016] [Indexed: 11/06/2022] Open
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Gui QF, Xu ZR, Xu KY, Yang YM. The Efficacy of Ginseng-Related Therapies in Type 2 Diabetes Mellitus: An Updated Systematic Review and Meta-analysis. Medicine (Baltimore) 2016; 95:e2584. [PMID: 26871778 PMCID: PMC4753873 DOI: 10.1097/md.0000000000002584] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Few randomized clinical trials have evaluated the efficacy of ginseng in patients with type 2 diabetes mellitus (T2DM). The current meta-analysis evaluated the ginseng-induced improvement in glucose control and insulin sensitivity in patients with type-2 diabetes or impaired glucose tolerance.Randomized clinical trials comparing ginseng supplementation versus control, in patients with T2DM or impaired glucose tolerance, were hand-searched from Medline, Cochrane, and Google Scholar databases by 2 independent reviewers using the terms "type 2 diabetes/diabetes/diabetic, impaired glucose tolerance, and ginseng/ginsenoside(s)." The primary outcome analyzed was the change in HbA1c, whereas the secondary outcomes included fasting glucose, postprandial glucose, fasting insulin, postprandial insulin, insulin resistance Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), triglycerides, total cholesterol, low density lipoprotein (LDL), and high density lipoprotein (HDL).Of the 141 studies identified, 8 studies were chosen for the current meta-analysis. The average number of patients, age, and sex distribution among the groups were comparable. Results reveal no significant difference in HbA1c levels between the ginseng supplementation and the control groups (pooled standardized difference in means = -0.148, 95% CI: -0.637 to 0.228, P = 0.355). Ginseng supplementation improved fasting glucose, postprandial insulin, and HOMA-IR levels, though no difference in postprandial glucose or fasting insulin was observed among the groups. Similarly, triglycerides, total cholesterol, and LDL levels showed significant difference between the treatment groups, while no difference in HDL was seen. In addition, ginseng-related therapy was ineffective in decreasing the fasting glucose levels in patients treated with oral hypoglycemic agents or insulin.The present results establish the benefit of ginseng supplementation in improving glucose control and insulin sensitivity in patients with T2DM or impaired glucose intolerance.
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Affiliation(s)
- Qi-Feng Gui
- From the Department of Geriatrics, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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