One of the reasons that Korean Red Ginseng is considered a pharmacological wonder as alternative treatment for nearly 1,000 years is its value as a tonic for hepatic disorders. Liver disorder is a major health issue worldwide and occupies a staggering ninth position among the leading causes of death. Conventional treatment has so far shown limited efficacy, notorious side effects, and costly to treat. Conventional treatment of diseases like cirrhosis, fatty liver, and chronic hepatitis has remained problematic, whereas ginseng extracts have had a huge impact on such ailments. This makes ginseng a prime candidate great choice amongst remedies for various hepatic disorders.

Saponins, generically known as ginsenosides, are the principal constituents and also the key players behind the multifarious benefits of ginseng. There exist more than 40 types of ginsenosides that have been isolated from ginseng extracts. These ginsenosides show a wide plethora of treatment such as acute/chronic hepatotoxicity, hepatic fibrosis/cirrhosis, hepatitis, hepatocellular carcinoma in multiple mechanisms and pathways. Studies have shown that ginsenoside saponins contain triterpendiol glycosides of dammarane, which consists of glucose, arabinose, xylose, and rhamnose among other substances. Korean Red Ginseng is basically steamed and dried roots of white ginseng, and this procedure supposedly undergoes a biochemical transformation in peptides, ginsenosides, polysaccharides, polycatelynic alcohols, and fatty acids. Besides being a hepatoprotective substance, ginseng is also an antidiabetic, antiobesity, and antihyperlipidemic in nature.

Ginsenosides

Ginsenosides are the active components in ginseng that provide a therapeutic effect on animal and human bodies and are the basic components of Korean Red Ginseng. Other than its effects of hepatic disorders, ginsenosides also alleviate blood pressure, metabolic disorders, and immune functions, thereby reducing chances of liver infection and other anomalies related to human gastro-anatomy. Korean Red Ginseng contains more than 40 types of ginsenosides..2 The major components among them are:

1. Ginsenoside Rb1

A major ginseng saponin, which protects hepatocytes against t-BHP and CCL4 by coordinating inductive hepatic enzymes of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Ginsenoside Rb1 may also be associated with liver cytochrome P450 and protein phosphorylation. It also significantly suspends liver fibrosis at an early stage.

2. Ginsenoside Rg1

It is one of the abundant ginsenosides that are available in the herb, and is a primary component of ginseng. Experiments have come to the conclusion that this ginsenoside improves the extent of liver fibrosis in rats abating the serum levels of fibrotic markers of ALT, AST, and alkaline phosphatase and hepatic hydroxyproline content.

3. Ginsenoside Rd

Constricts alcoholic fatty-liver by regulating AMP-activated protein kinase (AMPK) and mitogen-activated protein kinase (MAPK) pathways in alcoholic-fed ICR mice.

4. Ginsenoside Re

Recently found to inhibit TNF-α-mediated NF-kB transcriptional activity in HepG2 cells.

5. Ginsenoside Ro

An oleanane-type ginsenoside exhibits positive effects on GalN and CCl4-induced acute hepatitis in rats.

6. Ginsenoside Rg2 and Rg3

Major components of Korean Red Ginseng.

7. Ginsenoside M1

Commonly known as compound K, it is an intestine bacterial metabolite of ginseng protopanaxadiol-type saponins. It is known to display chemoprotective effect in cancer patients.

Ginseng Extract Efficacies

  • General hepatotoxicity: Excessive exposure to drugs and alcohol, acute/chronic hepatotoxicity, contamination or poisoning may lead to cirrhosis/fibrosis, liver hepatitis, and hepatocellular carcinoma (HCC). Ginseng administration has been proven to be hepatoprotective in in vitro rats and liver injury in varied animals and models clinically induced by hydrogen peroxide (H2O2), alcohol, carbon tetrachloride (CCL4), alphatoxin B1, fumonisins, tert-butylchloride (t-BHP), cadmium chloride (CdCl2), radiation, viral hepatitis, and so on.

  • Liver regeneration and transplantation: Exhibits efficacy in treatment of acute graft-versus-host disease, a scarce complication related to liver transplantation accompanied with a very poor prognosis. Ginseng is also effective in regeneration of liver post partial hepatectomy in rats (70%) and dogs (40%). It increases liver weight and accelerates hepatocyte proliferation.

  • Fatty-liver and liver glycogen: Researches have found that ginseng is highly appeasing for lipid and sugar levels, in the metabolism of which the liver and adipose tissues have a key role to play. Ginseng extracts seem to decrease hepatic cholesterol and triglyceride contents and increase phospholipid in fat diet-fed rats. The hepatoprotective effect of ginseng is closely associated with its antioxidant and anti-inflammatory properties. It suppresses the inflammatory cytokines and chemokines.

  • Inhibition of cytochrome p450: Ginseng and ginsenosides exhibit selectively inhibitory effect on cytochrome p450 activities.

  • Chronic liver disease (CLD): A common and deleterious hepatic disorder that can be defined as a progressive destruction of hepatic parenchyma over a period of 6 months, eventually leading to fibrosis and cirrhosis. Excessive alcohol consumption or chronic viral hepatitis of B or C variant may cause CLD.

  • Fatty-liver: The liver in which more than 50% of the mass consists of triglycerides accumulated in hepatocytes (alcoholic or non-alcoholic), the condition is known as fatty-liver. It is mainly of two kinds:

1) Non-alcoholic Fatty-liver Disease (NAFLD): Mostly caused due to obesity, insulin resistance, and metabolic syndrome. It has been considered the most prevalent cause of liver anomalies globally. Several studies implicate the beneficiary effect of Korean Red Ginseng against NAFLD.

2) Alcoholic Fatty-liver Disease (AFLD): One of the leading causes of liver-related anomalies worldwide. Prolonged exposure of alcohol to liver increase de novo lipogenesis, inhibit mitochondrial fatty acid β-oxidation, and decrease, in very low density, the lipoprotein secretion by the liver. AFLD encompasses most of the serious liver issues like steatosis, cirrhosis, steatohepatitis, and HCC.

Conclusion

Liver function disorders are one of the most dreaded anomalies, which accompanied by an unhealthy lifestyle, may prove to be fatal. Therefore liver-related therapies must be made more effective and economic, for which Korean Red Ginseng may be a primary alternative. An increasingly vast majority of people (65% in US) at present prefer medicinal herbs over synthetic chemicals for treating a wide array of diseases. Ginseng’s hepatoprotective profile may be considered an alternative remedy for a great number of pharmacological complexities related to liver and the entire gastro-anatomy in various pathways.

Citations:

1. Kim, Young Ho and Yukihiro Shoyama. “ Pharmacological Effects of Ginseng on Liver-Functions and Diseases: A Minireview.” September 2012.
https://www.researchgate.net/publication/230895895
2. Park, Tae Young; Meegun Hong; Hotaik Sung; Sangyeol Kim; Ki Tae Suk. “Effect of Korean Red Ginseng in chronic liver disease.” January 2017.
http://www.sciencedirect.com/journal/journal-of-ginseng-research