ginseng

Authors:

DAVID KIEFER, M.D., TRACI PANTUSO, B.S.

Findings:

The text introduces Panax Ginseng's historical use and mentions the goal of evaluating its efficacy and safety.

Authors:

Coon J.T., Ernst E.

Findings:

Clinical trials suggest Panax ginseng monopreparations have an adverse event incidence similar to placebo, with common mild events being headache, sleep, and gastrointestinal disorders. While serious events are indicated in some reports (case reports, spontaneous reporting), causality is often unclear, especially for combination products containing other ingredients. Possible interactions with warfarin, phenelzine, and alcohol have been reported, but overall, monopreparations appear rarely associated with significant adverse events or interactions, and those documented are usually mild and transient.

Study Quality Assessment:

Systematic review; Systematic searches in five electronic databases; Reference list checking; Inclusion of all original data articles; Information requested from 12 manufacturers, WHO spontaneous reporting schemes, and national drug safety bodies; No language restrictions imposed; Data from clinical trials suggest incidence similar to placebo; Limitations noted regarding difficulty determining causality in isolated case reports/spontaneous reporting schemes and interpretation of combination product cases.

All Effects:

Findings:

Subjects administered Panax ginseng powder for 6 months showed significant improvement on the Rey Complex Figure Test (RCFT) immediate recall and 20-min delayed recall compared to the placebo group. No serious adverse events were reported. The results suggest Panax ginseng has a cognition-enhancing effect.

Participants:

A total of 90 Korean volunteers with mild cognitive impairment.

Dosage:

3g of Panax ginseng powder daily for 6 months.

Study Quality Assessment:

Randomized, double-blind, placebo-controlled clinical trial. N=90. Duration: 6 months. Assessments: Korean version of the Mini-Mental Status Examination (K-MMSE), Korean version of Instrumental Activities of Daily Living (K-IADL), Seoul Neuropsychological Screening Battery (SNSB). Analysis: per-protocol (PP) and intention-to-treat (ITT). Conflict of interest statement provided (Nothing to declare).

All Effects:

Findings:

This review summarizes evidence suggesting Panax ginseng and its active components (like ginsenosides) exert antidepressant effects. The proposed mechanisms include modulation of the monoamine neurotransmitter system (5-HT, NA, DA), upregulation of neurotrophic factors (especially BDNF and its signaling pathways like TrkB/CREB), regulation of the hypothalamic-pituitary-adrenal (HPA) axis function (e.g., modulating CORT levels), and anti-inflammatory actions (e.g., inhibiting pro-inflammatory cytokines and microglial activation). Similar mechanisms are discussed for traditional herbal formulae containing ginseng, such as Kai Xin San (KXS), Shen Yuan Gan (SYG), and Xiaochaihu Decoction (XD).

Participants:

The review summarizes studies primarily conducted on experimental models, including animal models (rats, mice) subjected to various depression paradigms (e.g., CUMS, CMS, LPS-induced, CORT-induced, CRS, CSDS, alcohol withdrawal) and various cell lines (e.g., PC12, SHSY-5Y, N9 microglia, BV2, B35, RAW264.7, BON cells, primary cortical neurons, NSCs, astrocytes).

Dosage:

The review cites various dosages from experimental studies, summarized in Table 4. Examples include: Ginseng total saponins (GTS) at 10-1000 mg/kg in rats or 12.5-100 mg/kg in mice; Ginsenoside Rb1 at 4-16 mg/kg in rats or 2.5-10 mg/kg in mice; Ginsenoside Rg1 at 2.5-40 mg/kg in mice/rats; Ginsenoside Rg3 at 10-40 mg/kg in mice; Gintonin at 50-200 mg/kg in mice. In vitro concentrations are also listed (µg/mL or µmol/L).

Study Quality Assessment:

The text is a review article published in 'Cell Proliferation' (doi: 10.1111/cpr.12696, PMCID: PMC6869450). It systematically reviews numerous experimental studies, summarizing methods (e.g., FST, TST, OFT, SPT, MWM, Western blotting, qPCR, neurotransmitter/hormone/cytokine measurements) and findings in tables. The article is open access, acknowledges funding sources (NSFC, Jilin Science and Technology Agency, Jilin University), and declares no conflict of interest.

All Effects:

Findings:

Ginsenosides (e.g., Rb1, Rb2, Rd, Rg1, Rg2, compound K) exert neuroprotective effects against neurological conditions like stroke, Alzheimer's disease, Parkinson's disease, and brain/spinal cord injuries. These effects involve multiple molecular mechanisms, including anti-inflammatory, antioxidant, and anti-apoptotic actions via pathways such as PI3K/Akt, TLR4/NF-κB, ROS/TXNIP/NLRP3, HO-1/Nrf2, Wnt/β-catenin, and Ca2+. The review highlights the need for more clinical trials.

Study Quality Assessment:

Identified as a 'Review' summarizing research from the 'last decade'. Acknowledges a limitation: 'less evidence in the existing clinical studies'. Mentions specific mechanisms reviewed (anti-inflammatory, antioxidant, anti-apoptotic) and signaling pathways (PI3K/Akt, TLR4/NF-κB, ROS/TXNIP/NLRP3, HO-1/Nrf2, Wnt/β-catenin, Ca2+ pathway). Funding sources mentioned: 'Research Support, Non-U.S. Gov't', '2021-SW (reserve)-08/Kunming Health Science and Technology "Thousand Project" Talents Project', '2024J0277/Scientific Research Fund Project of Education Department of Yunnan Province'.

All Effects: