Salvia miltiorrhiza

"Red sage" redirects here. Lantana camara (Spanish Flag) is sometimes called this although it is not a sage.

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 3,900 ft) elevation, preferring grassy places in forests, hillsides, and along stream banks. The specific epithet miltiorrhiza means "red juice extracted from a root".^[3]

Description

S. miltiorrhiza is a deciduous perennial with branching stems that are 30 to 60 cm (0.98 to 2.0 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 other European countries for the treatment of cardiovascular and cerebrovascular diseases. In China, the specific clinical use is angina pectoris, 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).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.^[8]

In Traditional Chinese medicine

The outside of the taproot of Danshen, which is the part used in medicine, is red.^{[citation needed]}

Danshen is widely used in traditional Chinese medicine for treating chronic renal failure^[9] and to prevent and treat heart conditions and strokes.^{[citation needed]}

The root (Radix Salvia miltiorrhiza) is used with Kudzu root (Radix Puerariae lobata) for the treatment of coronary heart disease in Chinese medicine.^[10]

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.^[11][12] The other ingredients of TZQ are red peony root, mulberry leaf, lotus leaf^{[citation needed]}, and hawthorn leaf.^[11]

Chemical constituents

An antioxidant called salvianolic acid or salvianolic acid B isolated from Danshen is under study for protection against cerebrovascular disorders.^[9][13]

Dihydrotanshinone, tanshinone I, and tanshinone IIA are also under study for anti-cancer effects.^[14][15]

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,^[16][17] Tanshinone IIA (Tan IIA) has been widely used for various cardiovascular and cerebrovascular disorders^[18] in Asian countries.^[19] Tanshinone IIA might be a novel promising therapeutic agent for oxidative stress injury in neurodegenerative diseases.^[20] Tanshinone IIA may improve renal dysfunction associated with chronic kidney disease.^[21] Tan IIA was effective for attenuating the extent of brain edema formation in response to ischemia injury in rats.^[22]

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. 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. ^[23]

Salvia miltiorrhiza inhibits α-glucosidase activity.^[24]

Danshen may stop the spread of several different cancer cell types by interrupting the cell division process^[25] and also by causing cancer cells to undergo cell death (apoptosis).^[15] In contrast, the cerebrovascular protective effect of Salvianolic acid has been found to be due to prevention of apoptosis.^[9]

For HIV, chemicals in Danshen may block the effectiveness of an enzyme, HIV-1 integrase, that the virus needs to replicate.^[26]

Salvia may stimulate dopamine release and has protective effects against free radical-induced cell toxicity.^[27][28]

S. miltiorrhiza stimulates increased osteogenesis in vivo (bone cell growth).^[29]

Salvianolic acid B could possibly facilitate the repair of tubular epithelial structures and the regression of renal fibrosis in injured kidneys.^[30]

Drug Interactions

Danshen has been shown to potentiate the effects of the common anticoagulation drug warfarin, leading to gross anticoagulation and bleeding complications. Dan shen should be avoided by those using warfarin.^[31] Danshen causes in vitro interference when measuring digoxin levels when measured using Chemiluminescence Immunoassays (CLIA).^{[citation needed]}

References

1. ^ "Salvia miltiorrhiza information from NPGS/GRIN". www.ars-grin.gov. http://www.ars-grin.gov/cgi-bin/npgs/html/taxon.pl?402704. Retrieved 2008-03-31. 
2. ^ Tan, Benny K.-H., Boon-Huat Bay, and Yi-Zhun Zhu. 2004. Novel compounds from natural products in the new millennium: potential and challenges. Singapore: World Scientific. Page 183.
3. ^ ^{a b} Clebsch, Betsy; Carol D. Barner (2003). The New Book of Salvias. Timber Press. pp. 196–198. ISBN 9780881925609. http://books.google.com/books?id=NM0iwB8GrQYC&pg=PA196. 
4. ^ Sutton, John (2004). The Gardener's Guide to Growing Salvias. Workman Publishing Company. p. 123. ISBN 9780881926712. 
5. ^ Zhou, L. Zuo, Z. Chow ,MS. 2005. Danshen: an overview of its chemistry, pharmacology, pharmacokinetics, and clinical use. Journal of Clinical Pharmacology. 45(12):1345-1359
6. ^ Wu, B. Liu, M. Zhang, S. 2007. Dan Shen agents for acute ischaemic stroke. [Update of Cochrane Database Syst Rev. 2004;(4):CD004295; PMID: 15495099] Cochrane Database of Systematic Reviews (2):CD004295
7. ^ Cheng, T.O. 2007. Cardiovascular effects of Danshen. International Journal of Cardiology 121:1 (9-22
8. ^ Chinese Herbal Medicine Clears US FDA Phase II Trials http://cms.herbalgram.org/heg/volume7/10October/TCMproductinFDAIIItrials.html?t=1285951198
9. ^ ^{a b c} Wang, Qing-Lan, Tao, Yan-Yan, Yuan, Ji-Li, Shen, Li, Liu, Cheng-Hai, 2010. Salvianolic acid B prevents epithelial-to-mesenchymal transition through the TGF-beta1 signal transduction pathway in vivo and in vitro. BMC Cell Biology 11(31):1471–2121. doi:10.1186/1471-2121-11-31 abstract
10. ^ Chiu PY, Wong SM, Leung HY, Leong PK, Chen N, Zhou L, Zuo Z, Lam PY, Ko KM 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 Research 9(4)
11. ^ ^{a b} Tao, W.; Deqin, Z.; Yuhong, L.; Hong, L.; Zhanbiao, L.; Chunfeng, Z.; Limin, H.; Xiumei, G. (2010). Regulation effects on abnormal glucose and lipid metabolism of TZQ-F, a new kind of Traditional Chinese Medicine. Journal of Ethnopharmacology. 128(3):575-82 abstract.
12. ^ Wang, W; Miura, T.; Shi, H.; Ma, D.-M.; Zhao, Q.-D.; Zhang, W.-P.; Ishihara, E.;, Masayuki, K.; Zhang, B.L.; Gao, X.M.; Zhang D.Q. Ishida, T. 2008. Effect of tangzhiqing on glucose and lipid metabolism in genetically type 2 diabetes kk-Ay mice, Journal of Health Science 54:203–206 abstract
13. ^ Liu C-L, Xie L-X, Li M, Durairajan SSK, Goto S, et al. 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 abstract
14. ^ Lee, W.Y.W.; Cheung, C.C.M.; Liu, K.W.K.; Fung, K.P.; Wong, J.; Lai, P.B.S.; Yeung, J.H.K. (2010). Cytotoxic effects of Tanshinones from Salvia miltiorrhiza on Doxorubicin-resistant human liver cancer cells. Journal of Natural Products. 73(5): 854–859.
15. ^ ^{a b} Yoosik Yoon, Yeon-Ok Kim, Won-Kyung Jeon, Hee-Juhn Park and Hyun Jea Sung 1999. Tanshinone IIA isolated from Salvia miltiorrhiza BUNGE induced apoptosis in HL60 human premyelocytic leukemia cell line. Journal of Ethnopharmacology 68(1–3):121–127. doi:10.1016/S0378-8741(99)00059-8 abstract
16. ^ Effects of tanshinone IIA on the hepatotoxicity and gene expression involved in alcoholic liver disease Yin H.-Q., Kim Y.-S., Choi Y.-J., Kim Y.-C., Sohn D.-H., Ryu S.-Y., Lee B.-H. Archives of Pharmacal Research 2008 31:5 (659-665)
17. ^ Protective effect of Salvia Miltiorrhizae injection on N(G)-nitro-d-arginine induced nitric oxide deficient and oxidative damage in rat kidney You Z., Xin Y., Liu Y., Han B., Zhang L., Chen Y., Chen Y., Gu L., Gao H., Xuan Y. [Article in Press] Experimental and Toxicologic Pathology 2010
18. ^ Tan X, Li J, Wang X, Chen N, Cai B, Wang G, Shan H, Dong D, Liu Y, Li X, Yang F, Li X, Zhang P, Li X, Yang B, Lu Y. Tanshinone IIA Protects Against Cardiac Hypertrophy via Inhibiting Calcineurin/Nfatc3 Pathway. Int J Biol Sci 2011; 7:383-389. Available from http://www.biolsci.org/v07p0383.htm
19. ^ Wang X, Wang Y, Jiang M, Zhu Y, Hu L, Fan G, Wang Y, Li X, Gao X.,"Differential cardioprotective effects of salvianolic acid and tanshinone on acute myocardial infarction are mediated by unique signaling pathways." J Ethnopharmacol. 2011 Apr 8;
20. ^ Wang W., Zheng L.-L., Wang F., Hu Z.-L., Wu W.-N., Gu J., Chen J.-G. [Article in Press 2010] Tanshinone IIA attenuates neuronal damage and the impairment of long-term potentiation induced by hydrogen peroxide. Journal of Ethnopharmacology
21. ^ Ahn Y.-M., Kim S.K., Lee S.-H., Ahn S.-Y., Kang S.W., Chung J.-H., Kim S.-D., Lee B.-C. 2010. Renoprotective effect of Tanshinone IIA, an active component of Salvia miltiorrhiza, on rats with chronic kidney disease Phytotherapy Research 24(12):1886–1892)
22. ^ Tang C., Xue H., Bai C., Fu R., Wu A. 2010. The effects of Tanshinone IIA on blood-brain barrier and brain edema after transient middle cerebral artery occlusion in rats. Phytomedicine 17(14):1145-1149
23. ^ Xiping Z, Jie Z, Shuyun Y, Qili W, Guanghua F, Yan P"Influence of Salvia miltiorrhizae on the mesenteric lymph node of rats with severe acute pancreatitis or obstructive jaundice." Mediators Inflamm 2009;2009:675195
24. ^ Ma HY, Gao HY, Sun L, Huang J, Xu XM, Wu LJ.,"Constituents with α-glucosidase and advanced glycation end-product formation inhibitory activities from Salvia miltiorrhiza Bge." J Nat Med. 2011 Jan;65(1):37-42
25. ^ Su CC, Chen GW, Kang JC, Chan MH.,"Growth Inhibition and Apoptosis Induction by Tanshinone IIA in Human Colon Adenocarcinoma Cells." Planta Med. 2008 Jul 11;
26. ^ Ibrahim S. Abd-Elazema, Hong S. Chenb, Robert B. Batesc and Ru Chih C. Huang 2002. Isolation of two highly potent and non-toxic inhibitors of human immunodeficiency virus type 1 (HIV-1) integrase from Salvia miltiorrhiza. Antiviral Research 55(1):91–106. doi:10.1016/S0166-3542(02)00011-6 abstract
27. ^ Chung T.-W., Koo B.-S., Kim K.-O., Jeong H.-S., Kim M.-G., Chung K.-H., Lee I.-S., Kim C.-H. 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. Neurochemical Research 31:1 (109-120)
28. ^ Protective effects of Salvia miltiorrhizae on oxidative stress in rats with focal cerebral ischemia Liu C., Min L.-Q., Ji Z.-S., Wang Q., Jia Y.-J., Li S.-Y. Chinese Journal of Clinical Rehabilitation 2006 10:3 (37-39)
29. ^ Chin A., Yang Y., Chai L., Wong R.W.K., Rabie A.-B.M. "Effects of medicinal herb salvia miltiorrhiza on osteoblastic cells in vitro", Journal of Orthopaedic Research 2011 29:7 (1059-1063)
30. ^ Pan RH, Xie FY, Chen HM, Xu LZ, Wu XC, Xu LL, Yao G"Salvianolic acid B reverses the epithelial-to-mesenchymal transition of HK-2 cells that is induced by transforming growth factor-β." Arch Pharm Res. 2011 Mar;34(3):477-83
31. ^ Chan, T.Y. 2001. Interaction between warfarin and danshen (Salvia miltiorrhiza). The Annals of Pharmacotherapy, Vol. 35, No. 4, pp. 501–504. DOI 10.1345/aph.19029 abstract Retrieved on 06.08.2009

External links

• Salvia and the History of Microcirculation Research in China
• Salvia miltiorrhiza List of Chemicals (Dr. Duke's Databases)