Salvia miltiorrhiza

Salvia miltiorrhiza
Scientific classification
Kingdom: Plantae
(unranked): Angiosperms
(unranked): Eudicots
(unranked): Asterids
Order: Lamiales
Family: Lamiaceae
Genus: Salvia
Species: S. miltiorrhiza
Binomial name
Salvia miltiorrhiza
Bunge[1]

Salvia miltiorrhiza (simplified Chinese: 丹参; traditional Chinese: 丹參; pinyin: dānshēn), also known as red sage, Chinese sage, tan shen, or danshen, is a perennial plant in the genus Salvia, highly valued for its roots in traditional Chinese medicine.[2] Native to China and Japan, it grows at 90 to 1,200 m (300 to 3,940 ft) elevation, preferring grassy places in forests, hillsides, and along stream banks. The specific epithet miltiorrhiza means "red ochre root".

Description

S. miltiorrhiza is a deciduous perennial with branching stems that are 30 to 60 cm (0.98 to 1.97 ft) tall, with widely spaced leaves that are both simple and divided. The .3 m (0.98 ft) inflorescences are covered with hairs and sticky glands. Flowers grow in whorls, with light purple to lavender blue corollas that are approximately 2.5 cm (0.082 ft) long, with a dark purple calyx. Salvia miltiorrhiza prefers well draining soil, with about half a day of sunlight. It is hardy to approximately −10 °C (14 °F).[3] Most Salvia seeds have a higher germination rate when exposed to light, though it is not required.[4]

Uses

Salvia miltiorrhiza has been widely used in China and, to a lesser extent, in Japan, the United States, and European countries for the treatment of cardiovascular and cerebrovascular diseases. In China, Salvia miltiorrhiza (alone or combined with other Chinese herb medicine) was applied to the treatment of variety of diseases such as angina pectoris, myocardial infarction[33], hypertension[34], hyperlipidemia, and acute ischemic stroke.[5][6][7]

A patented Chinese herbal medicine has successfully completed Phase II clinical trials in the United States and will soon begin Phase III investigations, raising the possibility that it could become the first Traditional Chinese Medicine (TCM) product to obtain drug approval from the US Food and Drug Administration (FDA). The product, Compound Danshen Dripping Pill (also referred to as Cardiotonic Pill), is produced by Tianjin Tasty Pharmaceutical Co. Ltd. in Tianjin, China. It contains the extract of the root of danshen as well as extract of the root of notoginseng (Panax notoginseng; known as sanchi or tien-chi ginseng), and synthetic borneol, an active ingredient that replaces the more expensive natural borneol found in cardamom, ginger, and other spices.[8]

In traditional Chinese medicine

The outside of the taproot of Danshen, which is the part used in medicine is red.[9] Danshen is widely used in traditional Chinese medicine for treating chronic renal failure.[10] The root (Radix Salvia miltiorrhiza) is used with Kudzu root (Radix Puerariae lobata) for the treatment of coronary heart disease in Chinese medicine.[11]

Danshen is one of five ingredients in tangzhiqing (TZQ) used in traditional Chinese medicine for treating diabetes. In studies with mice and in vitro studies, TZQ and a modified formula known as TZQ-F have shown positive results.[12][13] The other ingredients of TZQ are red peony root, mulberry leaf, lotus leaf, and hawthorn leaf.[12]

Chemical constituents

An antioxidant called salvianolic acid (or salvianolic acid B) isolated from Danshen is under study for protection against cerebrovascular disorders.[10][14]

Dihydrotanshinone, tanshinone I, and tanshinone IIA are also under study for anti-cancer effects.[15][16]

Tanshinone IIA is one of the most abundant constituents of the root of Salvia miltiorrhiza which exerts antioxidant and anti-inflammatory actions in many experimental disease models in laboratory animals,[17][18] Tanshinone IIA (Tan IIA) has been widely used for various cardiovascular and cerebrovascular disorders[19] in Asian countries.[20] Tanshinone IIA might be a novel promising therapeutic agent for oxidative stress injury in neurodegenerative diseases.[21] Tanshinone IIA may improve renal dysfunction associated with chronic kidney disease.[22] Tan IIA was effective for attenuating the extent of brain edema formation in response to ischemia injury in rats.[23] Tanshinone IIA has been identified as a natural monoacylglycerol lipase (MAGL) inhibitor with an IC50 value of 48 nM. This has potential for the treatment of cardiovascular diseases and may be a good candidate for the treatment of Alzheimer's disease or other MAGL-associated diseases.[24]

Pharmacological mechanisms

Results from animal and human studies support the use of Danshen for circulatory disorders to some extent because it is known to decrease the blood's ability to clot in at least two ways. First, it limits the stickiness of blood platelets. It also decreases the production of fibrin, the threads of protein that trap blood cells to form clots. Both these effects help to improve blood circulation. In addition, chemicals in danshen may relax and widen blood vessels, especially those around the heart. In animal studies, chemicals in danshen may also have protected the inner linings of arteries from damage. Some other research suggests it may increase the force of heartbeats and slow the heart rate slightly.

In animal studies, Danshen has appeared to interfere with the development of liver fibrosis — the formation of scar-like fibers in the liver.[25] Because the nonfunctioning fibers crowd out active liver tissue, liver function decreases gradually as the amount of fibrous tissue increases. Having chronic hepatitis and habitually drinking large amounts of alcoholic beverages are the major causes of liver fibrosis, which could also result from exposure to chemicals or certain drugs. Danshen may also increase blood flow into the liver, so the length of time that potentially damaging substances stay in the liver may be reduced, also reducing the possible injury they may cause. Results from a few animal studies showed it may also protect kidney tissues from damage caused by diabetes. In China, danshen has also been studied for treating acute pancreatitis, a painful and possibly dangerous inflammation of the pancreas.[26]

Salvia miltiorrhiza inhibits α-glucosidase activity.[27]

Danshen may stop the spread of several different cancer cell types by interrupting the cell division process[28] and also by causing cancer cells to undergo cell death (apoptosis).[16] In contrast, the cerebrovascular protective effect of Salvianolic acid has been found to be due to prevention of apoptosis.[10]

For HIV, chemicals in Danshen may block the effectiveness of an enzyme, HIV-1 integrase, that the virus needs to replicate.[29]

Salvia may stimulate dopamine release and has protective effects against free radical-induced cell toxicity.[30][31]

S. miltiorrhiza stimulates increased osteogenesis (bone cell growth) in vitro .[32]

Salvianolic acid B could possibly facilitate the repair of tubular epithelial structures and the regression of renal fibrosis in injured kidneys.[33]

Drug Interactions

Danshen has been shown to potentiate the effects of the common anticoagulation drug warfarin, leading to gross anticoagulation and bleeding complications.Therefore, danshen should be avoided by those using warfarin.[9][34] Danshen causes in vitro interference when measuring digoxin levels when measured using Chemiluminescence Immunoassays (CLIA).

[35]

References

  1. ↑ "Salvia miltiorrhiza information from NPGS/GRIN". www.ars-grin.gov. Retrieved 2008-03-31.
  2. ↑ Ji X-Y; Tan BK-H; Huang S-H; et al. (2004). "Effects of Salvia miltiorrhiza After Accute Myocardial Infarction in Rats". In Tan, BK-H; Bay B-H; Zhu Y-Z. Novel compounds from natural products in the new millennium: potential and challenges. Singapore: World Scientific. pp. 183–95. ISBN 978-981-256-221-0.
  3. ↑ Clebsch, Betsy; Barner, Carol D. (2003). The New Book of Salvias. Timber Press. pp. 196–198. ISBN 978-0-88192-560-9.
  4. ↑ Sutton, John (2004). The Gardener's Guide to Growing Salvias. Workman Publishing Company. p. 123. ISBN 978-0-88192-671-2.
  5. ↑ Zhou L; Zuo Z; Chow MS (December 2005). "Danshen: an overview of its chemistry, pharmacology, pharmacokinetics, and clinical use". J Clin Pharmacol. 45 (12): 1345–59. doi:10.1177/0091270005282630. PMID 16291709.
  6. ↑ Wu B, Liu M, Zhang S (2004). Liu, Ming, ed. "Dan Shen agents for acute ischaemic stroke". Cochrane Database Syst Rev (4): CD004295. doi:10.1002/14651858.CD004295.pub2. PMID 15495099.
  7. ↑ Cheng TO (September 2007). "Cardiovascular effects of Danshen". Int. J. Cardiol. 121 (1): 9–22. doi:10.1016/j.ijcard.2007.01.004. PMID 17363091.
  8. ↑ Lindsay Stafford (2010). "Chinese Herbal Medicine Clears US FDA Phase II Trials". HerbalEGram. 7 (10).
  9. 1 2 Dhamananda, Ph.D, Subhuti. "Salvia". Institute for Traditional Medicine. Retrieved 31 August 2015.
  10. 1 2 3 Wang QL; Tao YY; Yuan JL; Shen L; Liu CH (2010). "Salvianolic acid B prevents epithelial-to-mesenchymal transition through the TGF-beta1 signal transduction pathway in vivo and in vitro". BMC Cell Biol. 11: 31. doi:10.1186/1471-2121-11-31. PMC 2874764Freely accessible. PMID 20441599.
  11. ↑ Chiu PY, Wong SM, Leung HY, et al. (April 2011). "Long-term treatment with danshen-gegen decoction protects the myocardium against ischemia/reperfusion injury via the redox-sensitive protein kinase C-ε/mK(ATP) pathway in rats". Rejuvenation Res. 14 (2): 173–84. doi:10.1089/rej.2010.1094. PMID 21204655.
  12. 1 2 Tao W, Deqin Z, Yuhong L, et al. (April 2010). "Regulation effects on abnormal glucose and lipid metabolism of TZQ-F, a new kind of Traditional Chinese Medicine". J Ethnopharmacol. 128 (3): 575–82. doi:10.1016/j.jep.2010.01.044. PMID 20123010.
  13. ↑ Wang, Wei; Miura, Toshihiro; Shi, Hong; Ma, Dong-Ming; Zhao, Qi-Duo; Zhang, Wen-Ping; Ishihara, Eriko; Masayuki, Kanehara; et al. (2008). "Effect of Tangzhiqing on Glucose and Lipid Metabolism in Genetically Type 2 Diabetes KK-Ay Mice". Journal of Health Science. 54 (2): 203–6. doi:10.1248/jhs.54.203.
  14. ↑ Liu CL; Xie LX; Li M; Durairajan SS; Goto S; Huang JD (2007). "Salvianolic acid B inhibits hydrogen peroxide-induced endothelial cell apoptosis through regulating PI3K/Akt signaling". PLoS ONE. 2 (12): e1321. doi:10.1371/journal.pone.0001321. PMC 2117346Freely accessible. PMID 18091994.
  15. ↑ Lee WY, Cheung CC, Liu KW, et al. (May 2010). "Cytotoxic effects of tanshinones from Salvia miltiorrhiza on doxorubicin-resistant human liver cancer cells". J. Nat. Prod. 73 (5): 854–9. doi:10.1021/np900792p. PMID 20455578.
  16. 1 2 Yoon Y; Kim YO; Jeon WK; Park HJ; Sung HJ (December 1999). "Tanshinone IIA isolated from Salvia miltiorrhiza BUNGE induced apoptosis in HL60 human premyelocytic leukemia cell line". J Ethnopharmacol. 68 (1–3): 121–7. doi:10.1016/S0378-8741(99)00059-8. PMID 10624871.
  17. ↑ Yin HQ, Kim YS, Choi YJ, et al. (May 2008). "Effects of tanshinone IIA on the hepatotoxicity and gene expression involved in alcoholic liver disease". Arch. Pharm. Res. 31 (5): 659–65. doi:10.1007/s12272-001-1209-2. PMID 18481025.
  18. ↑ You Z, Xin Y, Liu Y, et al. (July 2012). "Protective effect of Salvia miltiorrhizae injection on N(G)-nitro-D-arginine induced nitric oxide deficient and oxidative damage in rat kidney". Exp. Toxicol. Pathol. 64 (5): 453–8. doi:10.1016/j.etp.2010.10.013. PMID 21112748.
  19. ↑ Tan X, Li J, Wang X, et al. (2011). "Tanshinone IIA protects against cardiac hypertrophy via inhibiting calcineurin/NFATc3 pathway". Int. J. Biol. Sci. 7 (3): 383–9. doi:10.7150/ijbs.7.383. PMC 3076506Freely accessible. PMID 21494433.
  20. ↑ Wang X, Wang Y, Jiang M, et al. (June 2011). "Differential cardioprotective effects of salvianolic acid and tanshinone on acute myocardial infarction are mediated by unique signaling pathways". J Ethnopharmacol. 135 (3): 662–71. doi:10.1016/j.jep.2011.03.070. PMID 21497648.
  21. ↑ Wang W, Zheng LL, Wang F, et al. (March 2011). "Tanshinone IIA attenuates neuronal damage and the impairment of long-term potentiation induced by hydrogen peroxide". J Ethnopharmacol. 134 (1): 147–55. doi:10.1016/j.jep.2010.11.069. PMID 21134432.
  22. ↑ Ahn YM, Kim SK, Lee SH, et al. (December 2010). "Renoprotective effect of Tanshinone IIA, an active component of Salvia miltiorrhiza, on rats with chronic kidney disease". Phytother Res. 24 (12): 1886–92. doi:10.1002/ptr.3347. PMID 21043035.
  23. ↑ Tang C; Xue H; Bai C; Fu R; Wu A (December 2010). "The effects of Tanshinone IIA on blood-brain barrier and brain edema after transient middle cerebral artery occlusion in rats". Phytomedicine. 17 (14): 1145–9. doi:10.1016/j.phymed.2010.03.017. PMID 20570121.
  24. ↑ Jianhua Liu; Ruolin Yang; Yang Lu (2014). "Identification of Tanshinone IIA as a Natural Monoacylglycerol Lipase Inhibitor by Combined in silico and in vitro Approach". MedChemComm. 5: 1528–1532. doi:10.1039/c4md00186a.
  25. ↑ Yan, Xijun (Oct 27, 2014). Dan Shen (Salvia miltiorrhiza) in Medicine: Volume 2. Pharmacology and Quality Control, Volume 2. Springer.
  26. ↑ Xiping Z; Jie Z; Shuyun Y; Qili W; Guanghua F; Yan P (2009). "Influence of Salvia miltiorrhizae on the mesenteric lymph node of rats with severe acute pancreatitis or obstructive jaundice". Mediators Inflamm. 2009: 675195. doi:10.1155/2009/675195. PMC 2822241Freely accessible. PMID 20169004.
  27. ↑ Ma HY; Gao HY; Sun L; Huang J; Xu XM; Wu LJ (January 2011). "Constituents with α-glucosidase and advanced glycation end-product formation inhibitory activities from Salvia miltiorrhiza Bge". J Nat Med. 65 (1): 37–42. doi:10.1007/s11418-010-0453-2. PMID 20835851.
  28. ↑ Su CC; Chen GW; Kang JC; Chan MH (September 2008). "Growth inhibition and apoptosis induction by tanshinone IIA in human colon adenocarcinoma cells". Planta Med. 74 (11): 1357–62. doi:10.1055/s-2008-1081299. PMID 18622903.
  29. ↑ Abd-Elazem IS; Chen HS; Bates RB; Huang RC (July 2002). "Isolation of two highly potent and non-toxic inhibitors of human immunodeficiency virus type 1 (HIV-1) integrase from Salvia miltiorrhiza". Antiviral Res. 55 (1): 91–106. doi:10.1016/S0166-3542(02)00011-6. PMID 12076754.
  30. ↑ Chung TW, Koo BS, Kim KO, et al. (January 2006). "Salviae Miltiorrhizae BGE Radix increases rat striatal K(+)-stimulated dopamine release and activates the dopamine release with protection against hydrogen peroxide-induced injury in rat pheochromocytoma PC12 cells". Neurochem. Res. 31 (1): 109–20. doi:10.1007/s11064-005-9264-3. PMID 16475004.
  31. ↑ Liu C; Min L-Q; Ji Z-S; et al. (January 2006). 丹参对局灶性脑缺血大鼠氧化应激反应的保护效应水 [Protective effects of salvia miltiorrhizae on oxidative stress in rats with focal cerebral ischemia] (PDF). Chin J Clin Rehabil (in Chinese). 10 (3): 37–9.
  32. ↑ Chin A; Yang Y; Chai L; Wong RW; Rabie AB (July 2011). "Effects of medicinal herb salvia miltiorrhiza on osteoblastic cells in vitro". J. Orthop. Res. 29 (7): 1059–63. doi:10.1002/jor.21376. PMID 21319217.
  33. ↑ Pan RH, Xie FY, Chen HM, et al. (March 2011). "Salvianolic acid B reverses the epithelial-to-mesenchymal transition of HK-2 cells that is induced by transforming growth factor-β". Arch. Pharm. Res. 34 (3): 477–83. doi:10.1007/s12272-011-0317-7. PMID 21547681.
  34. ↑ Chan TY (April 2001). "Interaction between warfarin and danshen (Salvia miltiorrhiza)". Annals of Pharmacotherapy. 35 (4): 501–4. doi:10.1345/aph.19029. PMID 11302416.
  35. ↑ Yang, TY; Wei, JC; Lee, MY; Chen, CM; Ueng, KC (2012). "A randomized, double-blind, placebo-controlled study to evaluate the efficacy and tolerability of Fufang Danshen (Salvia miltiorrhiza) as add-on antihypertensive therapy in Taiwanese patients with uncontrolled hypertension.". Phytother Res. 26 (2): 291–298. doi:10.1002/ptr.3548.

34. Geng, QX; Zhu, XL; Zhang, XH (2004). ". Effect of combined therapy of shenmai and compound Danshen injection on myocardial reperfusion injury after percutaneous coronary interventions in patients with acute myocardial infarction". Chinese Journal of Integrated Traditional and Western Medicine (24): 496–499. 

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