DOI QR코드

DOI QR Code

Korean Red Ginseng Improves Vascular Stiffness in Patients with Coronary Artery Disease

  • Chung, Ick-Mo (Division of Cardiology, Ewha Womans University School of Medicine) ;
  • Lim, Joo-Weon (Department of Food and Nutrition, Brain Korea 21 Project, Yonsei University College of Human Ecology) ;
  • Pyun, Wook-Bum (Division of Cardiology, Ewha Womans University School of Medicine) ;
  • Kim, Hye-Young (Department of Food and Nutrition, Brain Korea 21 Project, Yonsei University College of Human Ecology)
  • Received : 2010.05.20
  • Accepted : 2010.07.20
  • Published : 2010.09.30

Abstract

Korean red ginseng (KRG) has been shown to enhance endothelium-dependent vasorelaxation in experimental animals; however, little is known about its pharmacological effects on vascular stiffness in patients with coronary artery disease (CAD). This randomized, double-blind, placebo-controlled crossover trial was carried out to determine whether KRG has beneficial effects on arterial stiffness, cardiovascular risk factors such as plasma lipid profiles and blood pressure (BP), and Rho-associated kinase (ROCK) activity. Twenty patients (mean age, 62.5 years) with stable angina pectoris were given KRG (2.7 g/day) and a placebo alternatively for 10 weeks. Blood biochemical analysis and pulse wave velocity (PWV) recording were performed on day 0 and after the completion of each treatment. ROCK activity was assessed based on the level of phospho-$Thr^{853}$ in the myosin-binding subunit of myosin light chain phosphatase, determined by Western blot analysis of peripheral blood mononuclear cells. KRG significantly decreased the systolic BP, brachial ankle PWV, and heart femoral PWV in the patients (all p<0.05), but did not significantly alter the serum lipid profiles, including triglycerides and total, high-density lipoprotein, and low-density lipoprotein cholesterol levels. The ROCK activity tended to decrease (p=0.068) following KRG treatment. The placebo did not significantly alter any of the variables. In conclusion, KRG decreased systolic BP and arterial stiffness, probably via the inhibition of ROCK activity, in patients with CAD, but had a neutral effect on serum lipid profiles. Our data suggest that KRG has a therapeutic effect on CAD.

Keywords

References

  1. Choi KT. Botanical characteristics, pharmacological effects and medicinal components of Korean Panax ginseng C A Meyer. Acta Pharmacol Sin 2008;29:1109-1118. https://doi.org/10.1111/j.1745-7254.2008.00869.x
  2. Kim EH, Lee MJ, Kim IH, Pyo SN, Choi KT, Rhee DK. Anti-apoptotic effects of red ginseng on oxidative stress induced by hydrogen peroxide in SK-N-SH cells. J Ginseng Res 2010;34:138-144. https://doi.org/10.5142/jgr.2010.34.2.138
  3. Kang SY, Schini-Kerth VB, Kim ND. Ginsenosides of the protopanaxatriol group cause endothelium-dependent relaxation in the rat aorta. Life Sci 1995;56:1577-1586. https://doi.org/10.1016/0024-3205(95)00124-O
  4. Min JK, Kim JH, Cho YL, Maeng YS, Lee SJ, Pyun BJ, Kim YM, Park JH, Kwon YG. 20(S)-Ginsenoside Rg3 prevents endothelial cell apoptosis via inhibition of a mitochondrial caspase pathway. Biochem Biophys Res Commun 2006;349:987-994. https://doi.org/10.1016/j.bbrc.2006.08.129
  5. Zhou W, Chai H, Lin PH, Lumsden AB, Yao Q, Chen CJ. Molecular mechanisms and clinical applications of ginseng root for cardiovascular disease. Med Sci Monit 2004;10:RA187-RA192.
  6. McLenachan JM, Williams JK, Fish RD, Ganz P, Selwyn AP. Loss of flow-mediated endothelium-dependent dilation occurs early in the development of atherosclerosis. Circulation 1991;84:1273-1278. https://doi.org/10.1161/01.CIR.84.3.1273
  7. Schachinger V, Britten MB, Zeiher AM. Prognostic impact of coronary vasodilator dysfunction on adverse long-term outcome of coronary heart disease. Circulation 2000; 101:1899-1906. https://doi.org/10.1161/01.CIR.101.16.1899
  8. Noma K, Oyama N, Liao JK. Physiological role of ROCKs in the cardiovascular system. Am J Physiol Cell Physiol 2006;290:C661-C668. https://doi.org/10.1152/ajpcell.00459.2005
  9. Noma K, Goto C, Nishioka K, Jitsuiki D, Umemura T, Ueda K, Kimura M, Nakagawa K, Oshima T, Chayama K, et al. Roles of rho-associated kinase and oxidative stress in the pathogenesis of aortic stiffness. J Am Coll Cardiol 2007;49:698-705. https://doi.org/10.1016/j.jacc.2006.06.082
  10. Cecelja M, Chowienczyk P. Dissociation of aortic pulse wave velocity with risk factors for cardiovascular disease other than hypertension: a systematic review. Hypertension 2009;54:1328-1336. https://doi.org/10.1161/HYPERTENSIONAHA.109.137653
  11. Nohria A, Grunert ME, Rikitake Y, Noma K, Prsic A, Ganz P, Liao JK, Creager MA. Rho kinase inhibition improves endothelial function in human subjects with coronary artery disease. Circ Res 2006;99:1426-1432. https://doi.org/10.1161/01.RES.0000251668.39526.c7
  12. Libby P. Inflammation in atherosclerosis. Nature 2002;420:868-874. https://doi.org/10.1038/nature01323
  13. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002;106:3143-3421.
  14. Han KH, Choe SC, Kim HS, Sohn DW, Nam KY, Oh BH, Lee MM, Park YB, Choi YS, Seo JD, et al. Effect of red ginseng on blood pressure in patients with essential hypertension and white coat hypertension. Am J Chin Med 1998;26:199-209. https://doi.org/10.1142/S0192415X98000257
  15. Han K, Shin IC, Choi KJ, Yun YP, Hong JT, Oh KW. Korea red ginseng water extract increases nitric oxide concentrations in exhaled breath. Nitric Oxide 2005;12:159-162. https://doi.org/10.1016/j.niox.2005.02.001
  16. Stavro PM, Woo M, Leiter LA, Heim TF, Sievenpiper JL, Vuksan V. Long-term intake of North American ginseng has no effect on 24-hour blood pressure and renal function. Hypertension 2006;47:791-796. https://doi.org/10.1161/01.HYP.0000205150.43169.2c
  17. Stavro PM, Woo M, Heim TF, Leiter LA, Vuksan V. North American ginseng exerts a neutral effect on blood pressure in individuals with hypertension. Hypertension 2005;46:406-411. https://doi.org/10.1161/01.HYP.0000173424.77483.1e
  18. Jovanovski E, Jenkins A, Dias AG, Peeva V, Sievenpiper J, Arnason JT, Rahelic D, Josse RG, Vuksan V. Effects of Korean red ginseng (Panax ginseng C.A. Mayer) and its isolated ginsenosides and polysaccharides on arterial stiffness in healthy individuals. Am J Hypertens 2010;23:469-472. https://doi.org/10.1038/ajh.2010.5
  19. Park JH. Analysis of chemical constituents in ginseng. In: Lee SD, ed. Reviews in ginseng research I. Seoul: Hanrimwon Co., 2007. p.53-70.
  20. Yim JS, Kim YS, Moon SK, Cho KH, Bae HS, Kim JJ, Park EK, Kim DH. Metabolic activities of ginsenoside Rb1, baicalin, glycyrrhizin and geniposide to their bioactive compounds by human intestinal microflora. Biol Pharm Bull 2004;27:1580-1583. https://doi.org/10.1248/bpb.27.1580
  21. Yamashina A, Tomiyama H, Arai T, Hirose K, Koji Y, Hirayama Y, Yamamoto Y, Hori S. Brachial-ankle pulse wave velocity as a marker of atherosclerotic vascular damage and cardiovascular risk. Hypertens Res 2003;26:615-622. https://doi.org/10.1291/hypres.26.615
  22. Oliver JJ, Webb DJ. Noninvasive assessment of arterial stiffness and risk of atherosclerotic events. Arterioscler Thromb Vasc Biol 2003;23:554-566. https://doi.org/10.1161/01.ATV.0000060460.52916.D6
  23. Guerin AP, Blacher J, Pannier B, Marchais SJ, Safar ME, London GM. Impact of aortic stiffness attenuation on survival of patients in end-stage renal failure. Circulation 2001;103:987-992. https://doi.org/10.1161/01.CIR.103.7.987
  24. Hartley CJ, Reddy AK, Madala S, Martin-McNulty B, Vergona R, Sullivan ME, Halks-Miller M, Taffet GE, Michael LH, Entman ML, et al. Hemodynamic changes in apolipoprotein E-knockout mice. Am J Physiol Heart Circ Physiol 2000;279:H2326-H2334. https://doi.org/10.1152/ajpheart.2000.279.5.H2326
  25. Bellien J, Favre J, Iacob M, Gao J, Thuillez C, Richard V, Joannides R. Arterial stiffness is regulated by nitric oxide and endothelium-derived hyperpolarizing factor during changes in blood flow in humans. Hypertension 2010;55:674-680. https://doi.org/10.1161/HYPERTENSIONAHA.109.142190
  26. Wang YX, Fitch RM. Vascular stiffness: measurements, mechanisms and implications. Curr Vasc Pharmacol 2004;2:379-384. https://doi.org/10.2174/1570161043385448
  27. Kwok HH, Ng WY, Yang MS, Mak NK, Wong RN, Yue PY. The ginsenoside protopanaxatriol protects endothelial cells from hydrogen peroxide-induced cell injury and cell death by modulating intracellular redox status. Free Radic Biol Med 2010;48:437-445. https://doi.org/10.1016/j.freeradbiomed.2009.11.013
  28. Leung KW, Cheng YK, Mak NK, Chan KK, Fan TP, Wong RN. Signaling pathway of ginsenoside-Rg1 leading to nitric oxide production in endothelial cells. FEBS Lett 2006;580:3211-3216. https://doi.org/10.1016/j.febslet.2006.04.080
  29. Nishida M, Tanabe S, Maruyama Y, Mangmool S, Urayama K, Nagamatsu Y, Takagahara S, Turner JH, Kozasa T, Kobayashi H, et al. G alpha 12/13- and reactive oxygen species-dependent activation of c-Jun NH2-terminal kinase and p38 mitogen-activated protein kinase by angiotensin receptor stimulation in rat neonatal cardiomyocytes. J Biol Chem 2005;280:18434-18441. https://doi.org/10.1074/jbc.M409710200
  30. Wolfrum S, Dendorfer A, Rikitake Y, Stalker TJ, Gong Y, Scalia R, Dominiak P, Liao JK. Inhibition of Rho-kinase leads to rapid activation of phosphatidylinositol 3-kinase/protein kinase Akt and cardiovascular protection. Arterioscler Thromb Vasc Biol 2004;24:1842-1847. https://doi.org/10.1161/01.ATV.0000142813.33538.82
  31. Somlyo AP, Somlyo AV. Signal transduction and regulation in smooth muscle. Nature 1994;372:231-236. https://doi.org/10.1038/372231a0
  32. Noma K, Rikitake Y, Oyama N, Yan G, Alcaide P, Liu PY, Wang H, Ahl D, Sawada N, Okamoto R, et al. ROCK1 mediates leukocyte recruitment and neointima formation following vascular injury. J Clin Invest 2008;118:1632-1644. https://doi.org/10.1172/JCI29226
  33. Sotaniemi EA, Haapakoski E, Rautio A. Ginseng therapy in non-insulin-dependent diabetic patients. Diabetes Care 1995;18:1373-1375. https://doi.org/10.2337/diacare.18.10.1373
  34. Yuan J, Guo W, Yang B, Liu P, Wang Q, Yuan H. 116 cases of coronary angina pectoris treated with powder composed of radix ginseng, radix notoginseng and succinum. J Tradit Chin Med 1997;17:14-17.
  35. Kim SH, Park KS. Effects of Panax ginseng extract on lipid metabolism in humans. Pharmacol Res 2003;48:511-513. https://doi.org/10.1016/S1043-6618(03)00189-0

Cited by

  1. Molecular Mechanism of Macrophage Activation by Red Ginseng Acidic Polysaccharide from Korean Red Ginseng vol.2012, pp.1466-1861, 2012, https://doi.org/10.1155/2012/732860
  2. Ginseng for Health Care: A Systematic Review of Randomized Controlled Trials in Korean Literature vol.8, pp.4, 2013, https://doi.org/10.1371/journal.pone.0059978
  3. RI and Dephosphorylation of ERK in Human Platelets vol.2015, pp.1741-4288, 2015, https://doi.org/10.1155/2015/764906
  4. Red Ginseng Saponin Fraction A Isolated from Korean Red Ginseng by Ultrafiltration on the Porcine Coronary Artery vol.35, pp.3, 2010, https://doi.org/10.5142/jgr.2011.35.3.325
  5. Trends in Ginseng Research in 2010 vol.35, pp.4, 2010, https://doi.org/10.5142/jgr.2011.35.4.389
  6. Inhibitory effects of total saponin from Korean red ginseng via vasodilator-stimulated phosphoprotein-Ser157 phosphorylation on thrombin-induced platelet aggregation vol.37, pp.2, 2010, https://doi.org/10.5142/jgr.2013.37.176
  7. Inhibitory Effects of Total Saponin Korean Red Ginseng on Thromboxane A2 Production and P-Selectin Expression via Suppressing Mitogen-Activated Protein Kinases vol.23, pp.4, 2010, https://doi.org/10.15616/bsl.2017.23.4.310