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A placebo-controlled trial of a proprietary extract of North American ginseng (CVT-E002) to prevent acute respiratory illness in institutionalized older adults.

OBJECTIVES: To compare a proprietary extract of American ginseng, CVT-E002, with placebo in preventing acute respiratory illness (ARI) in an institutional setting during the influenza season. DESIGN: Two randomized, double-blind, placebo-controlled trials conducted late in the 2000 (8 week) and 2000-2001 (12 week) influenza seasons. SETTING: Long-term care setting that included nursing home and assisted living at three sites. PARTICIPANTS: Eighty-nine (2000) and 109 (2000-2001) enrolled subjects, average age 81 and 83.5, respectively; 74% women. Approximately 90% had received influenza vaccine in each of the 2 years. INTERVENTION: Oral twice-daily administration of a proprietary ginseng extract, CVT-E002, 200 mg or placebo. MEASUREMENTS: ARI was defined as two new respiratory symptoms or one with a constitutional symptom. Confirmation of viral ARI was by culture (influenza or respiratory syncytial virus (RSV)) or serology for influenza. Laboratory safety monitoring was done at 0, 4, and 8 or 12 weeks. RESULTS: An intent-to-treat analysis of pooled data corrected for drug exposure time showed that the incidence of laboratory-confirmed influenza illness (LCII) was greater in placebo- (7 cases/101 subjects) than CVT-E002-treated (1/97) groups (odds ratio (OR)=7.73, P=.033). Combined data for LCII and RSV illness were also greater in placebo- (9/101) than CVT-E002-treated (1/97) groups (OR=10.50, P=.009), for an overall 89% relative risk reduction of ARI in the CVT-E002 group. CONCLUSION: CVT-E002 was shown to be safe, well tolerated, and potentially effective for preventing ARI due to influenza and RSV.

Acute Disease↗

Antihyperglycemic effects of total ginsenosides from leaves and stem of Panax ginseng.

AIM: The antihyperglycemic effects of the total ginsenosides in Chinese ginseng (TGCG), extracted from leaves and the stem, were evaluated in diabetic C57BL/6J ob/ob mice. METHODS: Animals received daily intraperitoneal injections of TGCG (100 and 200 mg/kg) or oral administration (150 and 300 mg/kg) for 12 d. Fasting blood glucose levels and body weight were measured after fasting the animals for 4 h. Peripheral glucose use was also measured using an intraperitoneal glucose tolerance test. RESULTS: In the injection group, a high dose of TGCG (200 mg/kg) significantly lowered the fasting blood glucose levels in ob/ob mice on d 12 (153+/-16 mg/dL vs 203+/-9.8 mg/dL, P<0.01, compared to vehicle-treated group). In the oral group, blood glucose decreased notably with a dose of TGCG (300 mg/kg) on d 12 (169.1+/-12.6 mg/dL vs 211.6+/-13.8 mg/dL, P<0.05, compared to the vehicle-treated group). Glucose tolerance was also improved markedly in ob/ob mice. Furthermore, a significant reduction in bodyweight (P<0.05) was observed after 12 d of TGCG (300 mg/kg) treatment in mice from the oral group. CONCLUSION: The results indicated that in a diabetic ob/ob mouse model TGCG was endowed with significant anti-hyperglycemic and anti-obesity properties. Therefore, the total ginsenosides extracted from Chinese ginseng leaves and the stem may have some potential for treating diabetes.

Administration, Oral↗

The effects of ginseng, ephedrine, and caffeine on cognitive performance, mood and energy.

A variety of claims regarding the purported energy-enhancing properties of nutritional supplements and food constituents have recently been made. It appears that the supplements most frequently associated with such assertions are ginseng, ephedrine, and caffeine. Claims of increased energy are difficult to evaluate objectively because their meaning is not usually defined or specified. Often it is not clear whether the claims refer to physical or mental energy or both. Furthermore, an agreed upon scientific definition of either physical or mental energy enhancement does not exist. In spite of obvious differences in what the term physical energy, as opposed to mental energy implies, there is no clear scientific consensus on whether there is a difference between the two types of energy. Because the substances in question have been anecdotally associated with improvements in both physical and mental performance, their effects on both functions will be discussed, but with an emphasis placed on cognitive function and mood. Of the three substances discussed, caffeine's effects on cognitive and physical function, mood, and energy are best understood. It is clear that this food/drug enhances these functions when administered in moderate doses. Ephedrine may also enhance certain physical and mental functions related to "energy," but the evidence that ginseng has such properties is exceedingly weak.

Affect↗

Ginsenoside Re, a main phytosterol of Panax ginseng, activates cardiac potassium channels via a nongenomic pathway of sex hormones.

Ginseng root is one of the most popular herbs throughout the world and is believed to be a panacea and to promote longevity. It has been used as a medicine to protect against cardiac ischemia, a major cause of death in the West. We have previously demonstrated that ginsenoside Re, a main phytosterol of Panax ginseng, inhibits Ca(2+) accumulation in mitochondria during cardiac ischemia/reperfusion, which is attributable to nitric oxide (NO)-induced Ca(2+) channel inhibition and K(+) channel activation in cardiac myocytes. In this study, we provide compelling evidence that ginsenoside Re activates endothelial NO synthase (eNOS) to release NO, resulting in activation of the slowly activating delayed rectifier K(+) current. The eNOS activation occurs via a nongenomic pathway of each of androgen receptor, estrogen receptor-alpha, and progesterone receptor, in which c-Src, phosphoinositide 3-kinase, Akt, and eNOS are sequentially activated. However, ginsenoside Re does not stimulate proliferation of androgen-responsive LNCaP cells and estrogen-responsive MCF-7 cells, implying that ginsenoside Re does not activate a genomic pathway of sex hormone receptors. Fluorescence resonance energy transfer experiments with a probe, SCCoR (single cell coactivator recruitment), indicate that the lack of genomic action is attributable to failure of coactivator recruitment. Thus, ginsenoside Re acts as a specific agonist for the nongenomic pathway of sex steroid receptors, and NO released from activated eNOS underlies cardiac K(+) channel activation and protection against ischemia-reperfusion injury.

Animals↗

Ginseng--is there a use in clinical medicine?

Panax ginseng occupies an important place among the tonic remedies of Oriental medicine. Pharmacological investigations show that crude ginsenosides can increase non-specific resistance of an organism to various untoward influences. The effects of purified derived derivatives have only recently become better studied in immunological and cell growth studies in animals and in man. This has now provided some evidence to suggest that ginseng is a drug that contains many derivatives with different pharmacological properties, which could be useful in clinical medicine.

Animals↗

Effect of American ginseng extract (Panax quinquefolius) on formalin-induced nociception in mice.

Twenty-three ICR mice were force fed orally with American ginseng extract, Panax quinquefolius, (Cold FX) for 4 days. Another 20 mice were fed with water as placebo in a similar fashion. Formalin tests which yield typically two phases of pain behavior were done in both groups. Although there was no difference in the first phase between groups, mice treated with Cold FX spent significantly less time in licking and biting of the injured paws in the second phase. The data indicate that American ginseng may have analgesic effect in this chronic pain model.

Analgesics↗

Effects of American ginseng berry extract on blood glucose levels in ob/ob mice.

In this study, we evaluated antihyperglycemic effects of American ginseng berry extract in diabetic ob/ob mice. Animals received daily intraperitoneal (IP) injections of the extract 150 mg/kg for 12 days. On days 5 and 12, the extract-treated ob/ob mice had significantly lower fasting blood glucose levels compared to day 0 (both p < 0.05). Glucose tolerance improved significantly, which was shown by overall glucose excursion, calculated as area under the curve (AUC) during the two-hour IP glucose tolerance test. The AUC decreased by 31.8% on day 12 compared to day 0 (p < 0.01). In addition, after 12 days of the berry extract treatment, a significant reduction in body weight (p < 0.01 compared to day 0) and a significant increase in body temperature (p < 0.01 compared to day 0) was noticeable. Our results support in vivo antihyperglycemic and antiobese activity of American ginseng berry extract that may prove to be of clinical importance in the prevention and treatment of Type 2 diabetes.

Animals↗

Influence of ginseng on mating behavior of male rats.

Experiment on the mating behavior of male albino rats paired with receptive females established that in comparison with control animals, males under the influence of ginseng (a) began ejaculation earlier and repeated the action more often in a 45-minute observation period and (b) deposited more copulation plugs in 10 days. The data suggest that ginseng facilitates the mating behavior of male rats.

Animals↗

Plasma lipid-lowering and lipogenesis-stimulating actions of ginseng saponins in tumor-bearing rats.

Ascited hepatoma (AH41C or AH130) was transplanted to male rats Donryu strain. Plasma cholesterol, triglyceride (TG) and non-esterified fatty acid levels were reduced with oral administration of ginseng principle fraction 3 (saponin content, ca. 1/5). Incorporation of 1-[14C]-acetate into total lipids and fatty acids in adipose tissue was increased by fraction 3 administration in both normal and tumor-bearing rats. The incorporation increased in the earlier stage of tumor growth and decreased in the later one. Incorporation of 1-[14C]-acetate into total lipid, free and esterified cholesterol, TG and phospholipid in the liver was also enhanced by fraction 3 administration in both normal and tumor-bearing animals. In vitro addition of ginseng principle fraction 4 (saponin content, ca. 1/2) increased incorporation of 1-[14C]-acetate into lipid fractions in adipose tissue and liver. Incorporation of 1-[14C]-acetate into lipid fractions in ascites hepatoma cells remained unchanged with both oral administration of fraction 3 and in vitro addition of fraction 4. DNA and protein synthesis in the tumor cells was not changed with in vitro addition of fraction 4.

Adipose Tissue↗

Effects of standardized ginseng extract on learning, memory and physical capabilities.

Standardized ginseng extract (G115, Pharmaton, Lugano) was administered orally at doses of 3, 10, 30, 100 and 300 mg/kg for 10 days as ten rats were used with each dose. With the "shuttle-box" method for active avoidance most pronounced effect on learning and memory was obtained by the dose of 10 mg/kg. With the "step-down" method for passive avoidance the dose of 30 mg/kg significantly improved retention. In the staircase maze training with positive (alimentary) reinforcement only the dose of 10 mg/kg significantly improved learning and memory. The dose of 100 mg/kg greatly increased the locomotor activity of mice. The results show that ginseng at appropriate doses improves learning, memory and physical capabilities. Bell-shaped dose-effect curves, reported with other nootropic drugs, were obtained.

Animals↗

Effect of red ginseng on blood pressure in patients with essential hypertension and white coat hypertension.

The objective of this study is to evaluate the changes of diurnal blood pressure pattern after 8 weeks of red ginseng medication (4.5 g/day) by 24 hour ambulatory blood pressure monitoring. In 26 subjects with essential hypertension, 24 hour mean systolic blood pressure decreased significantly (p = 0.03) while diastolic blood pressure only showed a tendency of decline (p = 0.17). The decrease in pressures were observed at daytime (8 A.M.-6 P.M.) and dawn (5 A.M.-7 A.M.). In 8 subjects with white coat hypertension, no significant blood pressure change was observed. We suggest that red ginseng might be useful as a relatively safe medication adjuvant to current antihypertensive medications.

Adolescent↗

The effects of ginseng saponins on the growth and metabolism of human diploid fibroblasts.

The action of ginseng saponins on cell numbers, glucose uptake and lactate production and the activities of specific enzymes associated with glucose oxidation, was tested using a human diploid fibroblast strain. No augmentation of cell numbers was observed. There was a significant increase in the level of cellular lactate levels and in the specific activities of enzymes associated with an anaerobic shift in metabolism. The possible relationship between these findings and the reputed efficacy of ginseng administration in the elderly is discussed.

Fibroblasts↗

Ginseng--a root just like a carrot?

Ginseng has been used for thousands of years in the East as a 'tonic', and in recent years its use has extended to Western society. In the light of the current interest in complementary medicine, we summarize the effects and purported mechanisms of action of ginseng and present two vignettes of its use in relation to psychiatric patients, followed by a general discussion of the implications of the use of herbal products by these patients.

Adult↗

Ginseng-associated cerebral arteritis.

We report a 28-year-old woman who had a severe headache after ingesting a large quantity of ethanol-extracted ginseng. Cerebral angiograms showed "beading" appearance in the anterior and posterior cerebral and superior cerebellar arteries, consistent with cerebral arteritis. The close temporal association between intake of ginseng and cerebral arteries suggests a causal relationship.

Adult↗

Effects of ginseng in nephrectomized rats.

Ginseng extract and its active component, saponin, were administered orally to nephrectomized rats for 90 d, and changes in blood and urine parameters and renal tissue lesions were assessed. Rats given saponin showed a significant decrease in the concentrations of blood urea nitrogen, creatinine and methylguanidine and a significant increase in total protein and albumin in the blood, with reduce urinary excretion of protein. There was also slight amelioration of the degree of mesangial proliferation, the severity of extratubular lesions and glomerular sclerotic lesions, and the extent of tubular interstitial lesions. However, these histological changes were inconspicuous in nephrectomized rats given ginseng extract.

Administration, Oral↗

A random amplified polymorphic DNA (RAPD) primer to assist the identification of a selected strain, aizu K-111 of Panax ginseng and the sequence amplified.

Panax ginseng is widely used as a Chinese medicine, but it takes a long time to reach harvest and to establish its qualified strains. In the course of searching high quality Panax ginseng, we found a useful random amplified polymorphic DNA (RAPD) primer, which showed a 725 base pair band for a selected elite strain Aizu K-111 (now called Kaishusan) including its cultured tissues, while the other strains did not necessarily show this band. We sequenced the DNA fragment amplified and designed primers to improve electrophoretic profiles, based on the sequence.

Base Sequence↗

Protective effect of sun ginseng against diabetic renal damage.

The effect of sun ginseng (SG, heat-processed Panax ginseng C. A. MEYER at 120 degrees C) on diabetic renal damage was investigated using streptozotocin-induced diabetic rats. The diabetic rats showed loss of body weight gain, and increases in food and water intake and urine volume, while the oral administration of SG at a dose of 50 or 100 mg/kg body weight/d for 15 d attenuated water intake and urine excretion induced by diabetes. In addition, the diabetic rats given SG at a dose of 100 mg/kg body weight showed significant decreases in serum glucose, serum glycosylated protein and urinary protein levels, suggesting that SG improves the abnormal conditions that lead to oxidative stress. Furthermore, SG significantly reduced advanced glycation endproduct (AGE) formation and thiobarbituric acid-reactive substance levels elevated in the kidneys of diabetic rats. This implies that SG would alleviate the oxidative stress under diabetes through the inhibition of lipid peroxidation. SG also reduced the overexpression of cyclooxygenase-2 and inducible nitric oxide synthase in the kidney induced by hyperglycemia via deactivation the activation of nuclear factor-kappa B. Furthermore, treatment with SG decreased the levels of 3-nitrotyrosine, carboxymethyllysine and receptors for AGE which increase under diabetes. These findings indicate that oxidative stress is increased in the diabetic rat kidney and that SG can prevent renal damage associated with diabetes by attenuating the oxidative stress.

Animals↗

Protein chemotaxonomy. XIII. Amino acid sequence of ferredoxin from Panax ginseng.

The complete amino acid sequence of [2Fe-2S] ferredoxin from Panax ginseng (Araliaceae) has been determined by automated Edman degradation of the entire S-carboxymethylcysteinyl protein and of the peptides obtained by enzymatic digestion. This ferredoxin has a unique amino acid sequence, which includes an insertion of Tyr at the 3rd position from the amino-terminus and a deletion of two amino acid residues at the carboxyl terminus. This ferredoxin had 18 differences in its amino acid sequence compared to that of Petroselinum sativum (Umbelliferae). In contrast, 23-33 differences were observed compared to other dicotyledonous plants. This suggests that Panax ginseng is related taxonomically to umbelliferous plants.

Amino Acid Sequence↗