May 2026· Chinese Herbal Medicines· Vol 18, pp. 555 - 570· 0 citations· 137 references
Medicine
TL;DR
A review of recent advances in the basic and clinical research of ginseng-based medicines in the prevention and treatment of cardiac fibrosis suggests potential benefits in improving cardiac function and modulating fibrosis-related biomarkers in patients with hypertension, coronary heart disease, and heart failure.
Abstract
Cardiac fibrosis, characterized by excessive extracellular matrix (ECM) deposition and progressive myocardial remodeling, is a common pathological outcome of various cardiovascular diseases and lacks effective targeted anti-fibrotic therapies. Panax ginseng and its related preparations, including major ginsenosides (e.g., Rb1, Rg1, and Rg3), standardized extracts, and compound formulas, have garnered growing interest owing to their multi-component, multi-target pharmacological activities and integrative regulatory effects. This review systematically summarizes recent advances in the basic and clinical research of ginseng-based medicines in the prevention and treatment of cardiac fibrosis. Preclinical evidence demonstrates that ginseng and its active constituents attenuate key pathological processes, including oxidative stress, inflammatory responses, apoptosis, and autophagy dysregulation, primarily through modulation of signaling pathways such as TGF-β/Smad, NF-κB, and PI3K/Akt. These regulatory effects collectively contribute to the inhibition of fibroblast activation, reduction of collagen deposition, and improvement of myocardial structure and function. Emerging clinical studies further suggested potential benefits in improving cardiac function and modulating fibrosis-related biomarkers in patients with hypertension, coronary heart disease, and heart failure (HF). Despite these promising findings, several challenges hinder clinical translation, including low oral bioavailability, the mechanistic complexity of compound formulas, and insufficient high-quality clinical evidence. Future investigations should integrate novel drug delivery strategies, systems pharmacology approaches to elucidate holistic mechanisms, and well-designed randomized controlled trials to facilitate the development of ginseng-based medicines as potential therapeutic agents for cardiac fibrosis.
This review summarizes recent advances in the use of natural products for the treatment of renal fibrosis, with a particular focus on their underlying molecular mechanisms, current status of clinical translation, and the challenges that remain.
Yan Liu, Lei Gao, Hao Xu et al.· Renal Failure· 0 citations
Future directives necessitate rigorous botanical authentication, pharmacokinetic/pharmacodynamic profiling, and adoption of human-relevant models, such as induced pluripotent stem cell-derived cardiomyocytes, to bridge the bench-to-bedside gap.
Tian-Tian Long, Juncheng Ma, Wei-Jun Hu et al.· International Journal of Mol...· 0 citations
This PUF is considered as a potential integrative therapeutic approach for fibrosis-related diseases and for aggressive cancers with fibrosis, and is expected to target both tumour cells and the fibrotic tumour micro-environment, thereby integrating ethnopharmacological knowledge with molecular rationality.
Rithika Thangaraju, N. Kamlesh, M. Shipin et al.· Frontiers in Pharmacology· 0 citations
Inflammation is a pathological process central to many chronic diseases. Conventional anti-inflammatories, including NSAIDs and corticosteroids, are limited by adverse effects and suboptimal efficacy with long-term use. Ginsenosides from Panax ginseng have emerged as promising multi-target candidates with favorable safety profiles. This review systematically summarizes recent advances in research on the anti-inflammatory pharmacological effects and molecular mechanisms of ginsenosides, with particular emphasis on Rg1, Rb1, Rd, Re, and Rg3. Recent literature was collected and analyzed, and network pharmacology and bioinformatics approaches were employed to predict therapeutic targets and regulatory networks. Core anti-inflammatory mechanisms include suppression of pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6) and NF-κB signaling; modulation of TLR4/NF-κB and NLRP3 inflammasome activity; regulation of MAPK (ERK, JNK, and p38) phosphorylation; activation of Nrf2/HO-1 and Hippo-YAP/TAZ pathways; inhibition of COX-2 and iNOS expression; regulation of macrophage polarization; and modulation of membrane permeability and ion exchange. This study elucidates the association between ginsenosides and various inflammatory diseases, systematically consolidating their diverse molecular mechanisms underlying their treatment of typical inflammatory conditions. By integrating modern techniques such as network pharmacology and molecular docking, this review deepens our understanding of the efficacy of ginsenosides in the management of inflammatory diseases. It provides critical insights for further exploration of ginsenosides' pharmacological actions, the development of novel anti-inflammatory drugs, and the interpretation of the modern scientific basis underlying TCM concepts such as ginseng's "restorative and stabilizing" properties.
Bao-Nian Huang, Xin Guo, Yumin Wang et al.· The American Journal of Chin...· 0 citations
Fibrosis is the outcome of chronic diseases and manifests as an abnormal repair process in which normal parenchyma is progressively replaced by deposited extracellular matrix. It leads to organ dysfunction and is associated with high morbidity, disability, and mortality, thereby becoming a major public health concern. Traditional Chinese medicine shows multi-target, multi-pathway strategies with favorable safety profiles. Curcumin (CUR), a polyphenolic metabolite derived from Curcuma longa L. (Zingiberaceae), has been shown to modulate key fibrotic signaling pathways, including AMPK, autophagy, extracellular-regulated protein kinase (ERK), transforming growth factor β (TGF-β)/Smad, JNK, and Wnt/β-catenin. However, a critical analysis of more than 200 included studies reveals that the current evidence base is fundamentally descriptive rather than conclusive. The data show reproducible antifibrotic signals in acute chemical injury models (bleomycin (BLM), carbon tetrachloride (CCl4), and streptozotocin (STZ) when CUR is administered prophylactically. The data do not show (1) efficacy in chronic, progressive disease models that recapitulate human pathology; (2) a dose-response relationship linking achievable tissue concentrations to antifibrotic effects; (3) superiority over or an add-on benefit to standard-of-care antifibrotics; or (4) robust clinical efficacy beyond small, uncontrolled case series. Despite this promising preclinical evidence supporting CUR's antifibrotic efficacy, clinical translation remains constrained by several critical limitations. The majority of evidence derives from in vitro studies using supraphysiological concentrations that far exceed achievable human plasma levels and from animal models that incompletely recapitulate the chronic, progressive nature of human fibrotic diseases. Additionally, the inherently poor oral bioavailability of CUR-despite advances in formulation strategies-remains a persistent obstacle. A critical appraisal of the existing literature further reveals substantial heterogeneity in experimental designs, a predominance of positive results suggestive of publication bias, and insufficient mechanistic validation to establish causality. This review outlines the mechanisms of action, safety, adverse effects, drug interactions, and the application of CUR-related nanocomposite products, thereby providing a foundation for in-depth research on its antifibrotic properties and clinical application.
Ting Luo, Jia Gao, Qingzhi Liang et al.· Frontiers in Pharmacology· 0 citations
ABSTRACT Interstitial lung disease (ILD) encompasses a complex group of disorders primarily characterized by inflammation and fibrosis of the pulmonary interstitium. Affected individuals often present with dyspnea and cough, and their quality of life is markedly reduced. Given the limitations of current health management strategies, there is growing interest in exploring adjunctive supportive approaches based on functional foods. Ginseng, a traditional medicinal and edible plant, has a long history of consumption in East Asia. Studies have shown that ginseng and its major bioactive constituents, such as ginsenosides, exert beneficial regulatory effects on lung health by modulating key signaling pathways, including TGF‐β/Smad, NF‐κB, Nrf2/HO‐1, and MAPK. These effects primarily involve health‐promoting properties such as anti‐inflammatory, antioxidant, and immunomodulatory activities. From the perspective of food science and nutrition, this article systematically reviews the regulatory mechanisms through which ginseng and its active components influence pathological processes related to ILD. It also discusses its traditional use as a functional food, dietary exposure, safety, and intake considerations. Current evidence from preclinical studies and early‐stage population‐based investigations supports the potential of ginseng as a supportive dietary component for maintaining lung health. Future research should include well‐designed nutritional studies to clarify its specific role in health management and to establish appropriate intake regimens.
Jiahui Li, Gui Di, Haijiao Wang et al.· Food Science & Nutrition· 0 citations
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