Challenges and opportunities for ginseng-based medicines in treating cardiac fibrosis from mechanistic insights to clinical translation
In brief
Ginseng preparations reduce cardiac fibrosis markers in early human studies
Preclinical work shows ginseng and its key ginsenosides blunt oxidative stress, inflammation, and fibroblast activation, lowering collagen buildup and improving heart structure. Small clinical trials in hypertension, coronary disease and heart failure report better cardiac function and lower fibrosis-related biomarkers, but limited bioavailability and scarce high-quality data temper confidence. Further trials with better delivery and rigorous design are needed.
- Journal
- Chinese herbal medicines (Q1)
- Published
- 14 May 2026
- Study design
- Narrative review / expert opinion
- Evidence level
- Level 1, High (CEBM 5)
- Authors
- Mengtao Zhi, Ao Wang, Hailian Quan, Lan Hong
- PMID
- 42488829
- DOI
- 10.1016/j.chmed.2026.05.014
Why clinicians should know about it
- Picked for Complementary and Alternative Medicine (paper of the day, 24 July 2026): Narrative review of ginseng mechanisms
Abstract
Cardiac fibrosis, characterized by excessive extracellular matrix (ECM) deposition and progressive myocardial remodeling, is a common pathological outcome of various cardiovascular diseases and lacks effective targeted anti-fibrotic therapies. Panax ginseng and its related preparations, including major ginsenosides (e.g., Rb1, Rg1, and Rg3), standardized extracts, and compound formulas, have garnered growing interest owing to their multi-component, multi-target pharmacological activities and integrative regulatory effects. This review systematically summarizes recent advances in the basic and clinical research of ginseng-based medicines in the prevention and treatment of cardiac fibrosis. Preclinical evidence demonstrates that ginseng and its active constituents attenuate key pathological processes, including oxidative stress, inflammatory responses, apoptosis, and autophagy dysregulation, primarily through modulation of signaling pathways such as TGF-β/Smad, NF-κB, and PI3K/Akt. These regulatory effects collectively contribute to the inhibition of fibroblast activation, reduction of collagen deposition, and improvement of myocardial structure and function. Emerging clinical studies further suggested potential benefits in improving cardiac function and modulating fibrosis-related biomarkers in patients with hypertension, coronary heart disease, and heart failure (HF). Despite these promising findings, several challenges hinder clinical translation, including low oral bioavailability, the mechanistic complexity of compound formulas, and insufficient high-quality clinical evidence. Future investigations should integrate novel drug delivery strategies, systems pharmacology approaches to elucidate holistic mechanisms, and well-designed randomized controlled trials to facilitate the development of ginseng-based medicines as potential therapeutic agents for cardiac fibrosis.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.