College of Pharmacy, Liaoning University of Traditional Chinese Medicine, 77 Life One Road, DD Port, Dalian, 116600, PR China.
College of Pharmacy, Liaoning University of Traditional Chinese Medicine, 77 Life One Road, DD Port, Dalian, 116600, PR China.
J Ethnopharmacol. 2022 Jun 12;291:115113. doi: 10.1016/j.jep.2022.115113. Epub 2022 Feb 22.
Ginseng has been used for thousands of years, it is described as both a tonic for restoration of strength and a panacea. However, the adverse effect is also reported clinically. In the theory of Traditional Chinese Medicine, the occurrence of adverse reactions is closely related to warm property of ginseng, which can easily lead to fireness (, in Chinese). Several presumptions indicated that fireness of ginseng may be associated with the pathophysiology of inflammation, imbalance of metabolism, the disorder of hypothalamus-pituitary-adrenal axis, and hypothalamus-pituitary-thyroid axis.
The tonifying effect of ginseng medicines was always focused on with little attention for their adverse effects. We selected red ginseng (RG), ginseng (GS), American ginseng (AG), and ginseng leaves (GL) as typical ginseng medicines to clarify correlations of adverse effect and tonifying effect of ginseng medicines.
The RG, GS, AG, and GL decoctions were orally administered to rats for 30 days consecutively. The appearance indicators such as saliva secretion, urinary output, fecal moisture, heart rate were determined, and hair condition, nose color were also observed. Furthermore, some biochemical indexes such as IL-6, T3, T4, TSH, ACTH, CORT, Ach, DA, EPI, NE, SP, VIP, cAMP, cGMP, AQP-5, AMPK, and the activity of SOD, GSH-PX, Na-K-ATPase were measured by biochemical reagent kits or enzyme-linked immunosorbent assay (ELISA). The metabolites profile was analyzed by UPLC-QTOF-MS. Finally, the diversity of gut microbiota was also analyzed with the 16S rDNA sequencing.
The study revealed the tonifying effects of ginseng medicines mainly on exciting nervous system, promoting immunity and antioxidative ability. While, the adverse effects were mainly associated with the abnormal nervous system, thyroid system, adrenal system, and oxidative stress. The GS group showed fireness symptoms, such as vertical and dirty hair, epistaxis, higher rectal temperature, lower salivary secretion, lower urinary output, lower fecal moisture. While the GL group showed the opposite symptoms. The levels of hormones, activities of the antioxidative enzyme, and Na-K-ATP enzyme were changed differently. From the second week to the fourth week, the levels of T3, T4, TSH, ACTH, CORT, and the activity of SOD, GSH-PX, Na-K-ATP enzymes were first increased, then decreased, and finally recovered to normal levels. We also found that the ginseng medicines mainly adjust the amino acid and TCA cycle metabolism exhibiting their tonifying and adverse effects. Meanwhile, GS and AG can modulate gut microbiota imbalance by increasing the gut microbial diversity as well as selectively promoting some probiotic populations, including Lactobacillus and Bifidobacterium.
This is the first time to report the correlations between tonifying effects and adverse effects of four ginseng medicines. The present study demonstrated that the adverse effects of ginseng medicines mostly depended on their dosages, the higher dosage is, the more serious the adverse effects are. The adverse effects of ginseng and ginseng leaves are much more serious than red ginseng and American ginseng. The tendency of water regulation of ginseng and ginseng leaves was opposite may be related to their nature property.
人参已经使用了几千年,它被描述为一种既能恢复体力的滋补品,也是一种万灵药。然而,临床上也有不良反应的报道。在中医理论中,不良反应的发生与人参的温性密切相关,这容易导致燥热(中医术语)。有几种假设表明,人参的燥热可能与炎症的病理生理学、代谢失衡、下丘脑-垂体-肾上腺轴和下丘脑-垂体-甲状腺轴的紊乱有关。
人参药物的滋补作用一直受到关注,而对其不良反应的关注较少。我们选择红参(RG)、人参(GS)、西洋参(AG)和人参叶(GL)作为典型的人参药物,以阐明人参药物的不良反应与滋补作用之间的关系。
连续 30 天给 RG、GS、AG 和 GL 煎剂灌胃大鼠。测定唾液分泌、尿量、粪便湿度、心率等外观指标,观察毛发状况、鼻色。此外,通过生化试剂盒或酶联免疫吸附试验(ELISA)测定白细胞介素-6(IL-6)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)、促甲状腺激素(TSH)、促肾上腺皮质激素(ACTH)、皮质醇(CORT)、乙酰胆碱(Ach)、多巴胺(DA)、肾上腺素(EPI)、去甲肾上腺素(NE)、血管活性肠肽(VIP)、环磷酸腺苷(cAMP)、环磷酸鸟苷(cGMP)、水通道蛋白-5(AQP-5)、AMP 激活蛋白激酶(AMPK)等生化指标的活性。采用 UPLC-QTOF-MS 分析代谢物谱。最后,通过 16S rDNA 测序分析肠道微生物群的多样性。
研究表明,人参药物的滋补作用主要表现在兴奋神经系统、促进免疫和抗氧化能力上。而不良反应主要与神经系统、甲状腺系统、肾上腺系统和氧化应激异常有关。GS 组表现出燥热症状,如毛发竖起、肮脏、鼻出血、直肠温度较高、唾液分泌减少、尿量减少、粪便湿度较低。而 GL 组则表现出相反的症状。激素水平、抗氧化酶活性和 Na-K-ATP 酶活性发生了不同的变化。从第二周到第四周,T3、T4、TSH、ACTH、CORT 水平以及 SOD、GSH-PX、Na-K-ATP 酶的活性先升高,然后降低,最后恢复正常水平。我们还发现,人参药物主要通过调节氨基酸和 TCA 循环代谢来发挥其滋补和不良反应。同时,GS 和 AG 可以通过增加肠道微生物多样性以及选择性促进某些益生菌群(包括乳酸杆菌和双歧杆菌)来调节肠道微生物群失衡。
这是首次报道四种人参药物的滋补作用与不良反应之间的相关性。本研究表明,人参药物的不良反应主要取决于其剂量,剂量越高,不良反应越严重。人参和人参叶的不良反应比红参和西洋参严重得多。人参和人参叶的水调节趋势相反,这可能与它们的自然属性有关。