Salvia miltiorrhiza
Encyclopedia
Salvia miltiorrhiza 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
. Native to China
and Japan
, it grows at 90 to 1200 m (295.3 to 3,937 ft) elevation, preferring grassy places in forests, hillsides, and along stream banks. The specific epithet miltiorrhiza means "red juice extracted from a root".
, and acute ischemic stroke.
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).1 The product, Compound Danshen Dripping Pill (also referred to as Cardiotonic Pill), is produced by Tianjin Tasly 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.
Danshen is widely used in traditional Chinese medicine for treating chronic renal failure and to prevent and treat heart conditions and strokes.
The root (Radix Salvia miltiorrhiza) is used with Kudzu
root (Radix Puerariae lobata) for the treatment of coronary heart disease in Chinese medicine.
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 been shown to be effective for type 2 diabetes
and prediabetes
. The other ingredients of TZQ are red peony root, mulberry leaf, lotus leaf, and hawthorn
leaf.
Dihydrotanshinone, tanshinone I, and tanshinone IIA are also under study for anti-cancer effects.
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,
Tanshinone IIA (Tan IIA) has been widely used for various cardiovascular and cerebrovascular disorders in Asian countries. Tanshinone IIA might be a novel promising therapeutic agent for oxidative stress injury in neurodegenerative diseases.
Tanshinone IIA may improve renal dysfunction associated with chronic kidney disease. Tan IIA was effective for attenuating the extent of brain edema formation in response to ischemia injury in rats.
s. It also decreases the production of fibrin, the threads of protein
that trap blood cells to form clot
s. 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. 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.
Salvia miltiorrhiza inhibits α-glucosidase activity.
Danshen may stop the spread of several different cancer cell types by interrupting the cell division process and also by causing cancer cells to undergo cell death (apoptosis
). In contrast, the cerebrovascular protective effect of Salvianolic acid has been found to be due to prevention of apoptosis.
For HIV, chemicals in Danshen may block the effectiveness of an enzyme
, HIV-1
integrase, that the virus needs to replicate.
Salvia may stimulate dopamine
release and has protective effects against free radical-induced cell toxicity.
S. miltiorrhiza stimulates increased osteogenesis in vivo (bone cell growth).
Salvianolic acid B could possibly facilitate the repair of tubular epithelial structures and the regression of renal fibrosis
in injured kidneys.
, leading to gross anticoagulation and bleeding complications. Dan shen should be avoided by those using warfarin.
Danshen causes in vitro interference when measuring digoxin levels when measured using Chemiluminescence Immunoassays (CLIA).
Perennial plant
A perennial plant or simply perennial is a plant that lives for more than two years. The term is often used to differentiate a plant from shorter lived annuals and biennials. The term is sometimes misused by commercial gardeners or horticulturalists to describe only herbaceous perennials...
in the genus Salvia
Salvia
Salvia is the largest genus of plants in the mint family, Lamiaceae, with approximately 700-900 species of shrubs, herbaceous perennials, and annuals. It is one of several genera commonly referred to as sage. When used without modifiers, sage generally refers to Salvia officinalis ; however, it is...
, highly valued for its roots in traditional Chinese medicine
Traditional Chinese medicine
Traditional Chinese Medicine refers to a broad range of medicine practices sharing common theoretical concepts which have been developed in China and are based on a tradition of more than 2,000 years, including various forms of herbal medicine, acupuncture, massage , exercise , and dietary therapy...
. Native to China
China
Chinese civilization may refer to:* China for more general discussion of the country.* Chinese culture* Greater China, the transnational community of ethnic Chinese.* History of China* Sinosphere, the area historically affected by Chinese culture...
and Japan
Japan
Japan is an island nation in East Asia. Located in the Pacific Ocean, it lies to the east of the Sea of Japan, China, North Korea, South Korea and Russia, stretching from the Sea of Okhotsk in the north to the East China Sea and Taiwan in the south...
, it grows at 90 to 1200 m (295.3 to 3,937 ft) elevation, preferring grassy places in forests, hillsides, and along stream banks. The specific epithet miltiorrhiza means "red juice extracted from a root".
Description
S. miltiorrhiza is a deciduous perennial with branching stems that are 30 to 60 cm (0.984251968503937 to 2 ft) tall, with widely spaced leaves that are both simple and divided. The 0.3 m (0.984251968503937 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 (0.0820209973753281 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. Most Salvia seeds have a higher germination rate when exposed to light, though it is not required.Uses
Salvia miltiorrhiza has been widely used in China and, to a lesser extent, in Japan, the United States, and other European countries for the treatment of cardiovascular and cerebrovascular diseases. In China, the specific clinical use is angina pectoris, hyperlipidemiaHyperlipidemia
Hyperlipidemia, hyperlipoproteinemia, or hyperlipidaemia is the condition of abnormally elevated levels of any or all lipids and/or lipoproteins in the blood...
, and acute ischemic stroke.
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
Traditional Chinese medicine
Traditional Chinese Medicine refers to a broad range of medicine practices sharing common theoretical concepts which have been developed in China and are based on a tradition of more than 2,000 years, including various forms of herbal medicine, acupuncture, massage , exercise , and dietary therapy...
(TCM) product to obtain drug approval from the US Food and Drug Administration (FDA).1 The product, Compound Danshen Dripping Pill (also referred to as Cardiotonic Pill), is produced by Tianjin Tasly Pharmaceutical Co. Ltd. in Tianjin
Tianjin
' is a metropolis in northern China and one of the five national central cities of the People's Republic of China. It is governed as a direct-controlled municipality, one of four such designations, and is, thus, under direct administration of the central government...
, 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
Borneol
Borneol is a bicyclic organic compound and a terpene. The hydroxyl group in this compound is placed in an endo position.Borneol is easily oxidized to the ketone yielding camphor. One historical name for borneol is Borneo camphor which explains the name. Borneol can be synthesized by reduction of...
, an active ingredient that replaces the more expensive natural borneol found in cardamom
Cardamom
Cardamom refers to several plants of the genera Elettaria and Amomum in the ginger family Zingiberaceae. Both genera are native to India and Bhutan; they are recognised by their small seed pod, triangular in cross-section and spindle-shaped, with a thin papery outer shell and small black seeds...
, ginger
Ginger
Ginger is the rhizome of the plant Zingiber officinale, consumed as a delicacy, medicine, or spice. It lends its name to its genus and family . Other notable members of this plant family are turmeric, cardamom, and galangal....
, and other spices.
In Traditional Chinese medicine
The outside of the taproot of Danshen, which is the part used in medicine, is red.Danshen is widely used in traditional Chinese medicine for treating chronic renal failure and to prevent and treat heart conditions and strokes.
The root (Radix Salvia miltiorrhiza) is used with Kudzu
Kudzu
Kudzu is a plant in the genus Pueraria in the pea family Fabaceae, subfamily Faboideae. It is a climbing, coiling, and trailing vine native to southern Japan and southeast China. Its name comes from the Japanese name for the plant, . It is a weed that climbs over trees or shrubs and grows so...
root (Radix Puerariae lobata) for the treatment of coronary heart disease in Chinese medicine.
Danshen is one of five ingredients in tangzhiqing (TZQ) used In traditional Chinese medicine for treating diabetes. In studies with mice and in vitro
In vitro
In vitro refers to studies in experimental biology that are conducted using components of an organism that have been isolated from their usual biological context in order to permit a more detailed or more convenient analysis than can be done with whole organisms. Colloquially, these experiments...
studies, TZQ and a modified formula known as TZQ-F have been shown to be effective for type 2 diabetes
Diabetes mellitus type 2
Diabetes mellitus type 2formerly non-insulin-dependent diabetes mellitus or adult-onset diabetesis a metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency. Diabetes is often initially managed by increasing exercise and...
and prediabetes
Prediabetes
Prediabetes is the state in which some but not all of the diagnostic criteria for diabetes are met. It is often described as the “gray area” between normal blood sugar and diabetic levels. While in this range, patients are at risk for not only developing type 2 diabetes, but also for cardiovascular...
. The other ingredients of TZQ are red peony root, mulberry leaf, lotus leaf, and hawthorn
Crataegus
Crataegus , commonly called hawthorn or thornapple, is a large genus of shrubs and trees in the rose family, Rosaceae, native to temperate regions of the Northern Hemisphere in Europe, Asia and North America. The name hawthorn was originally applied to the species native to northern Europe,...
leaf.
Chemical constituents
An antioxidant called salvianolic acid or salvianolic acid B isolated from Danshen is under study for protection against cerebrovascular disorders.Dihydrotanshinone, tanshinone I, and tanshinone IIA are also under study for anti-cancer effects.
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,
Tanshinone IIA (Tan IIA) has been widely used for various cardiovascular and cerebrovascular disorders in Asian countries. Tanshinone IIA might be a novel promising therapeutic agent for oxidative stress injury in neurodegenerative diseases.
Tanshinone IIA may improve renal dysfunction associated with chronic kidney disease. Tan IIA was effective for attenuating the extent of brain edema formation in response to ischemia injury in rats.
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 plateletPlatelet
Platelets, or thrombocytes , are small,irregularly shaped clear cell fragments , 2–3 µm in diameter, which are derived from fragmentation of precursor megakaryocytes. The average lifespan of a platelet is normally just 5 to 9 days...
s. It also decreases the production of fibrin, the threads of protein
Protein
Proteins are biochemical compounds consisting of one or more polypeptides typically folded into a globular or fibrous form, facilitating a biological function. A polypeptide is a single linear polymer chain of amino acids bonded together by peptide bonds between the carboxyl and amino groups of...
that trap blood cells to form clot
Thrombus
A thrombus , or blood clot, is the final product of the blood coagulation step in hemostasis. It is achieved via the aggregation of platelets that form a platelet plug, and the activation of the humoral coagulation system...
s. 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. 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
Cirrhosis
Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrosis, scar tissue and regenerative nodules , leading to loss of liver function...
, 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.
Salvia miltiorrhiza inhibits α-glucosidase activity.
Danshen may stop the spread of several different cancer cell types by interrupting the cell division process and also by causing cancer cells to undergo cell death (apoptosis
Apoptosis
Apoptosis is the process of programmed cell death that may occur in multicellular organisms. Biochemical events lead to characteristic cell changes and death. These changes include blebbing, cell shrinkage, nuclear fragmentation, chromatin condensation, and chromosomal DNA fragmentation...
). In contrast, the cerebrovascular protective effect of Salvianolic acid has been found to be due to prevention of apoptosis.
For HIV, chemicals in Danshen may block the effectiveness of an enzyme
Enzyme
Enzymes are proteins that catalyze chemical reactions. In enzymatic reactions, the molecules at the beginning of the process, called substrates, are converted into different molecules, called products. Almost all chemical reactions in a biological cell need enzymes in order to occur at rates...
, HIV-1
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
integrase, that the virus needs to replicate.
Salvia may stimulate dopamine
Dopamine
Dopamine is a catecholamine neurotransmitter present in a wide variety of animals, including both vertebrates and invertebrates. In the brain, this substituted phenethylamine functions as a neurotransmitter, activating the five known types of dopamine receptors—D1, D2, D3, D4, and D5—and their...
release and has protective effects against free radical-induced cell toxicity.
S. miltiorrhiza stimulates increased osteogenesis in vivo (bone cell growth).
Salvianolic acid B could possibly facilitate the repair of tubular epithelial structures and the regression of renal fibrosis
Fibrosis
Fibrosis is the formation of excess fibrous connective tissue in an organ or tissue in a reparative or reactive process. This is as opposed to formation of fibrous tissue as a normal constituent of an organ or tissue...
in injured kidneys.
Drug Interactions
Danshen has been shown to potentiate the effects of the common anticoagulation drug warfarinWarfarin
Warfarin is an anticoagulant. It is most likely to be the drug popularly referred to as a "blood thinner," yet this is a misnomer, since it does not affect the thickness or viscosity of blood...
, leading to gross anticoagulation and bleeding complications. Dan shen should be avoided by those using warfarin.
Danshen causes in vitro interference when measuring digoxin levels when measured using Chemiluminescence Immunoassays (CLIA).