Journal of Ginseng Research

The Korean Society of Ginseng (고려인삼학회)
권호 표지
DOI QR코드

DOI QR Code

Korean Red Ginseng exhibits no significant adverse effect on disease activity in patients with rheumatoid arthritis: a randomized, double-blind, crossover study

  • Cho, Soo-Kyung (Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases) ;
  • Kim, Dam (Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases) ;
  • Yoo, Dasomi (Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases) ;
  • Jang, Eun Jin (Department of Information Statistics, Andong National University) ;
  • Jun, Jae-Bum (Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases) ;
  • Sung, Yoon-Kyoung (Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases)
  • Received : 2016.10.01
  • Accepted : 2017.01.13
  • Published : 2018.04.15
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Panax ginseng is a well-known immune modulator, and there is concern that its immune-enhancing effects may negatively affect patients with rheumatoid arthritis (RA) by worsening symptoms or increasing the risk of adverse effects from other drugs. In this randomized, crossover clinical trial, we evaluated the impact of Korean Red Ginseng (KRG) on disease activity and safety in RA patients. Methods: A total of 80 female RA patients were randomly assigned to either the KRG (2 g/d, n = 40) treatment or placebo (n = 40) groups for 8 wk, followed by crossover to the other treatment group for an additional 8 wk. The primary outcome was the disease flare rate, defined as worsening disease activity according to the disease activity score 28 joints-erythrocyte sedimentation rate (DAS28-ESR). The secondary outcomes were development of adverse events (AEs) and patient reported outcomes. Outcomes were evaluated at baseline and 8 wk and 16 wk. The outcomes were compared using the Chi-square test. Results: Of the 80 patients, 70 completed the full study. Their mean age was 51.9 yr, and most exhibited low disease activity (mean DAS28-ESR $3.5{\pm}1.0$) at enrollment. After intervention, the flare rate was 3.7% in each group. During KRG treatment, 10 AEs were reported, while five AEs were developed with placebo; however, this difference was not statistically significant (p = 0.16). Gastrointestinal- and nervous system-related symptoms were frequent in the KRG group. Conclusion: KRG is not significantly associated with either disease flare rate or the rate of AE development in RA patients.

Keywords

References

  1. Gabriel SE. The epidemiology of rheumatoid arthritis. Rheum Dis Clin North Am 2001;27:269-81. https://doi.org/10.1016/S0889-857X(05)70201-5
  2. Choy EH, Panayi GS. Cytokine pathways and joint inflammation in rheumatoid arthritis. N Engl J Med 2001;344:907-16. https://doi.org/10.1056/NEJM200103223441207
  3. Whalley D, McKenna SP, de Jong Z, van der Heijde D. Quality of life in rheumatoid arthritis. Br J Rheumatol 1997;36:884-8. https://doi.org/10.1093/rheumatology/36.8.884
  4. Alvarez-Hernandez E, Cesar Casasola-Vargas J, Lino-Perez L, Burgos-Vargas R, Vazquez-Mellado J. Complementary and department for the first time. Analysis of 800 patients. Reumatol Clin 2006;2:183-9 [Article in Spanish]. https://doi.org/10.1016/S1699-258X(06)73044-3
  5. Setty AR, Sigal LH. Herbal medications commonly used in the practice of rheumatology: mechanisms of action, efficacy, and side effects. Semin Arthritis Rheum 2005;34:773-84. https://doi.org/10.1016/j.semarthrit.2005.01.011
  6. Efthimiou P, Kukar M. Complementary and alternative medicine use in rheumatoid arthritis: proposed mechanism of action and efficacy of commonly used modalities. Rheumatol Int 2010;30:571-86. https://doi.org/10.1007/s00296-009-1206-y
  7. Ramos-Remus C, Raut A. Complementary and alternative practices in rheumatology. Best Pract Res Clin Rheumatol 2008;22:741-57. https://doi.org/10.1016/j.berh.2008.05.001
  8. Han M, Sung YK, Cho SK, Kim D, Won S, Choi CB, Bang SY, Cha HS, Choe JY, Chung WT, et al. Factors associated with the use of complementary and alternative medicine for Korean patients with rheumatoid arthritis. J Rheumatol 2015;42:2075-81. https://doi.org/10.3899/jrheum.141447
  9. Kiefer D, Pantuso T. Panax ginseng. Am Fam Physician 2003;68:1539-42.
  10. Choi S, Kim T, Shin Y, Lee C, Park M, Lee H, Song J. Effects of a polyacetylene from Panax ginseng on Na(+) currents in rat dorsal root ganglion neurons. Brain Res 2008;29:75-83.
  11. Na JY, Kim S, Song K, Lim KH, Shin GW, Kim JH, Kim B, Kwon YB, Kwon J. Antiapoptotic activity of ginsenoside Rb1 in hydrogen peroxide-treated chondrocytes: stabilization of mitochondria and the inhibition of caspase-3. J Ginseng Res 2012;36:242-7. https://doi.org/10.5142/jgr.2012.36.3.242
  12. Choi YS, Kang EH, Lee EY, Gong HS, Kang HS, Shin K, Lee EB, Song YW, Lee YJ. Joint-protective effects of compound K, a major ginsenoside metabolite, in rheumatoid arthritis: in vitro evidence. Rheumatol Int 2013;33:1981-90. https://doi.org/10.1007/s00296-013-2664-9
  13. Kim HA, Kim S, Chang SH, Hwang HJ, Choi YN. Anti-arthritic effect of ginsenoside Rb1 on collagen induced arthritis in mice. Int Immunopharmacol 2007;7:1286-91. https://doi.org/10.1016/j.intimp.2007.05.006
  14. Jhun J, Lee J, Byun JK, Kim EK, Woo JW, Lee JH, Kwok SK, Ju JH, Park KS, Kim HY, et al. Red ginseng extract ameliorates autoimmune arthritis via regulation of STAT3 pathway, Th17/Treg balance, and osteoclastogenesis in mice and human. Mediators Inflamm 2014;2014:351856.
  15. Prevoo ML, van Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 1995;38:44-8. https://doi.org/10.1002/art.1780380107
  16. Cella D, Yount S, Sorensen M, Chartast E, Sengupta N, Grober J. Validation of the Functional Assessment of Chronic Illness Therapy Fatigue scale relative to other instrumentation in patients with rheumatoid arthritis. J Rheumatol 2005;32:811-9.
  17. Bae SC, Cook EF, Kim SY. Psychometric evaluation of a Korean Health Assessment Questionnaire for clinical research. J Rheumatol 1998;25:1975-9.
  18. Kim MH, Cho YS, Uhm WS, Kim S, Bae SC. Cross cultural adaptation and validation of the Korean version of the EQ-5D in patients with rheumatic diseases. Qual Life Res 2005;14:1401-6. https://doi.org/10.1007/s11136-004-5681-z
  19. Kang S, Min H. Ginseng, the 'Immunity Boost': the effects of Panax ginseng on immune system. J Ginseng Res 2012;36:354-68. https://doi.org/10.5142/jgr.2012.36.4.354
  20. Hwang I, Ahn G, Park E, Ha D, Song JY, Jee Y. An acidic polysaccharide of Panax ginseng ameliorates experimental autoimmune encephalomyelitis and induces regulatory T cells. Immunol Lett 2011;138:169-78. https://doi.org/10.1016/j.imlet.2011.04.005
  21. Kim Y, Kim S, Markelonis G, Oh T. Ginsenosides Rb1 and Rg3 protect cultured rat cortical cells from glutamate-induced neurodegeneration. Neurosci Res 1998;54:123. https://doi.org/10.1002/(SICI)1097-4547(19981001)54:1<123::AID-JNR13>3.0.CO;2-8
  22. Radad K, Gille G, Liu L, Rausch W. Use of ginseng in medicine with emphasis on neurodegenerative disorders. J Pharmacol Sci 2006;100:175-86. https://doi.org/10.1254/jphs.CRJ05010X
  23. Shin Y, Jung O, Nah J, Nam K, Kim C, Nah S. Ginsenosides that produce differential antinociception in mice. Gen Pharmacol 1999;32:653-9. https://doi.org/10.1016/S0306-3623(98)00239-0
  24. Rhim H, Kim H, Lee D, Oh T, Nah S. Ginseng and ginsenoside Rg3, a newly identified active ingredient of ginseng, modulate Ca2+ channel currents in rat sensory neurons. Eur J Pharmacol 2002;436:151-8. https://doi.org/10.1016/S0014-2999(01)01613-2

Cited by

  1. Effects of Red Ginseng Extract on the Pharmacokinetics and Elimination of Methotrexate via Mrp2 Regulation vol.23, pp.11, 2018, https://doi.org/10.3390/molecules23112948
  2. Ginsenoside Rg1 as a Potential Regulator of Hematopoietic Stem/Progenitor Cells vol.2021, pp.None, 2018, https://doi.org/10.1155/2021/4633270
  3. Practical Implementation of Artificial Intelligence-Based Deep Learning and Cloud Computing on the Application of Traditional Medicine and Western Medicine in the Diagnosis and Treatment of Rheumatoid vol.12, pp.None, 2018, https://doi.org/10.3389/fphar.2021.765435