Multidirectional pharmacological effects of saponins in light of clinical trials: a systematic review of literature
DOI:
https://doi.org/10.12775/JEHS.2023.39.01.007Keywords
saponins, sports injuries and trauma, abnormal fasting glycemic state, ischemic heart disease, pancytopenia, aplastic anemia, cukrzyca typu IIAbstract
Introduction: Saponins are secondary metabolites widely distributed in higher plants with multidirectional pharmacological effects. We distinguish between steroidal and triterpenoidal saponins, which are composed of glycone and aglycone. The varied medicinal properties of saponins are influenced by the presence of different substituents in the polycyclic aglycone, e.g. hydroxyls, hydroxymethyls, carboxyls and acyl groups, as well as the difference in bonding, composition and number of sugar chains. It is noteworthy that foods rich in these compounds can reduce the risk of developing various diseases, and the isolation of these compounds from the plant matrix provides new opportunities to create potential and effective drugs.
Purpose of the work: Conduct a literature review on the basis of available clinical studies on the pharmacological effects of saponins extracted from medicinal plants and their potential application in medicine.
Materials and methods: The work was based on a literature review of available medical publications from clinical trials conducted for the multidirectional therapeutic effects of saponins. Reports available in publications and scientific studies posted in medical information databases such as Pubmed and Google Scholar were summarised.
Results: Clinical studies confirm the pharmacological effect of saponins in the treatment of sports injuries and trauma, type II diabetes, abnormal glycemic state fasting glucose, ischemic heart disease, pancytopenia and aplastic anemia.
Conclusions: With the advancement of scientific research on saponins, it is possible to use them to produce potential drugs and dietary supplements with pharmacological effects. However, before saponins can be used for medical treatment, further research on their efficacy and safety is needed.
References
Arunkumar, S.; Muthuselvam, M. Analysis of Phytochemical Constituents and Antimicrobial Activities of Aloe Vera L. against Clinical Pathogens. World journal of agricultural sciences 2009, 5, 572–576.
Sparg, S.G.; Light, M.E.; van Staden, J. Biological Activities and Distribution of Plant Saponins. Journal of Ethnopharmacology 2004, 94, 219–243.
Aziz, M.A.E.A.; Ashour, A.S.; Melad, A.S.G. A Review on Saponins from Medicinal Plants: Chemistry, Isolation, and Determination. Journal of Nanomedicine Research 2019, 8, 6‒12.
Güçlü-Üstündağ, Ö.; Mazza, G. Saponins: Properties, Applications and Processing. Critical Reviews in Food Science and Nutrition 2007, 47, 231–258.
Faizal, A.; Geelen, D. Saponins and Their Role in Biological Processes in Plants. Phytochemistry Reviews 2013, 12, 877–893.
Zaynab, M.; Sharif, Y.; Abbas, S.; Afzal, M.Z.; Qasim, M.; Khalofah, A.; Ansari, M.J.; Khan, K.A.; Tao, L.; Li, S. Saponin Toxicity as Key Player in Plant Defense against Pathogens. Toxicon 2021, 193, 21–27.
Wetzel, D.; Menke, W.; Dieter, R.; Smasal, V.; Giannetti, B.; Bulitta, M. Escin/Diethylammonium Salicylate/Heparin Combination Gels for the Topical Treatment of Acute Impact Injuries: A Randomised, Double Blind, Placebo Controlled, Multicentre Study. British Journal of Sports Medicine 2002, 36, 183–188.
Park, S.-H.; Oh, M.-R.; Choi, E.-K.; Kim, M.-G.; Ha, K.-C.; Lee, S.-K.; Kim, Y.-G.; Park, B.-H.; Kim, D.-S.; Chae, S.-W. An 8-Wk, Randomized, Double-Blind, Placebo-Controlled Clinical Trial for the Antidiabetic Effects of Hydrolyzed Ginseng Extract. Journal of Ginseng Research 2014, 38, 239–243.
Oh, M.-R.; Park, S.-H.; Kim, S.-Y.; Back, H.-I.; Kim, M.-G.; Jeon, J.-Y.; Ha, K.-C.; Na, W.-T.; Cha, Y.-S.; Park, B.-H. Postprandial Glucose-Lowering Effects of Fermented Red Ginseng in Subjects with Impaired Fasting Glucose or Type 2 Diabetes: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. BMC complementary and alternative medicine 2014, 14, 1–7.
Vuksan, V.; Xu, Z.Z.; Jovanovski, E.; Jenkins, A.L.; Beljan-Zdravkovic, U.; Sievenpiper, J.L.; Mark Stavro, P.; Zurbau, A.; Duvnjak, L.; Li, M.Z. Efficacy and Safety of American Ginseng (Panax Quinquefolius L.) Extract on Glycemic Control and Cardiovascular Risk Factors in Individuals with Type 2 Diabetes: A Double-Blind, Randomized, Cross-over Clinical Trial. European journal of nutrition 2019, 58, 1237–1245.
Song, H.; Wang, P.; Liu, J.; Wang, C. Panax Notoginseng Preparations for Unstable Angina Pectoris: A Systematic Review and Meta-Analysis. Phytotherapy Research 2017, 31, 1162–1172.
Yang, X.; Xiong, X.; Wang, H.; Yang, G.; Wang, J. Xuesaitong Soft Capsule (Chinese Patent Medicine) for the Treatment of Unstable Angina Pectoris: A Meta-Analysis and Systematic Review. Evidence-Based Complementary and Alternative Medicine 2013, 2013, 1–8.
Shang, Q.; Xu, H.; Liu, Z.; Chen, K.; Liu, J. Oral Panax Notoginseng Preparation for Coronary Heart Disease: A Systematic Review of Randomized Controlled Trials. Evidence-Based Complementary and Alternative Medicine 2013, 2013, e940125.
Gao, R.; Chong, B.H. Research and Development of the Effective Components of Panaxdiol Saponin as New Chinese Patent Medicine for Treating Hemocytopenia. Chinese Journal of Integrative Medicine 2012, 18, 897–902.
Kuang, Y.; Zhu, Y.; Gao, R.; Hu, J.; Jiang, Z.; Huang, L.; Tong, Y.; Luo, X.; Gao, X.; Zheng, Z. Clinical Study of Pai-Neng-Da Capsule in the Treatment of Chronic Aplastic Anemia. Chinese Journal of Integrative Medicine2016, 22, 124–129.
Jiang, Z.; Yu, F.; Gao, R.; Kuang, Y.; Zhu, Y.; Chen, Y.; Li, L.; Ouyang, G.; Hu, J.; Wu, X. Treatment of Chronic Aplastic Anemia with Chinese Patent Medicine Pai-Neng-Da Capsule for Replacing Androgen Partially: A Clinical Multi-Center Study. Chinese Journal of Integrative Medicine 2022, 28, 20–27.
Podolak, I.; Galanty, A.; Sobolewska, D. Saponins as Cytotoxic Agents: A Review. Phytochemistry Reviews 2010, 9, 425–474.
Fang, Z.; Li, J.; Yang, R.; Fang, L.; Zhang, Y. A Review: The Triterpenoid Saponins and Biological Activities of Lonicera Linn. Molecules 2020, 25, 3773.
Xin, W.; Zhang, L.; Fan, H.; Jiang, N.; Wang, T.; Fu, F. Escin Attenuates Acute Lung Injury Induced by Endotoxin in Mice. European Journal of Pharmaceutical Sciences 2011, 42, 73–80.
Duan, L.; Xiong, X.; Hu, J.; Liu, Y.; Wang, J. Efficacy and Safety of Oral Panax Notoginseng Saponins for Unstable Angina Patients: A Meta-Analysis and Systematic Review. Phytomedicine 2018, 47, 23–33.
Khincha, P.P.; Wentzensen, I.M.; Giri, N.; Alter, B.P.; Savage, S.A. Response to Androgen Therapy in Patients with Dyskeratosis Congenita. British Journal of Haematology 2014, 165, 349–357.
Maffulli, N.; Longo, U.G.; Gougoulias, N.; Caine, D.; Denaro, V. Sport Injuries: A Review of Outcomes. British medical bulletin 2011, 97, 47–80.
Soundy, A.; Roskell, C.; Stubbs, B.; Probst, M.; Vancampfort, D. Investigating the Benefits of Sport Participation for Individuals with Schizophrenia: A Systematic Review. Psychiatria Danubina 2015, 27, 0–13.
Rui, P.; Ashman, J.J.; Akinseye, A. Emergency Department Visits for Injuries Sustained during Sports and Recreational Activities by Patients Aged 5–24 Years, 2010–2016. CDC Stacks Public Health Publications 2019, 1–15.
Weaver, N.L.; Marshall, S.W.; Miller, M.D. Preventing Sports Injuries: Opportunities for Intervention in Youth Athletics. Patient Education and Counseling 2002, 46, 199–204.
Sarlis, V.; Chatziilias, V.; Tjortjis, C.; Mandalidis, D. A Data Science Approach Analysing the Impact of Injuries on Basketball Player and Team Performance. Information Systems 2021, 99, 101750.
Egan, A.M.; Dinneen, S.F. What Is Diabetes? Medicine 2019, 47, 1–4.
Skorupska, S.; Chomiuk, T.; Mamcarz, A. Czy Sport to Zdrowie Dla Chorego Na Cukrzycę. Przegląd Kardiodiabetologiczny 2008, 3, 232–236.
Danaei, G.; Fahimi, S.; Lu, Y.; Zhou, B.; Hajifathalian, K.; Di Cesare, M.; Lo, W.-C.; Reis-Santos, B.; Cowan, M.J.; Shaw, J.E. Effects of Diabetes Definition on Global Surveillance of Diabetes Prevalence and Diagnosis: A Pooled Analysis of 96 Population-Based Studies with 331 288 Participants. The Lancet Diabetes & Endocrinology 2015, 3, 624–637.
Gawrecki, A.; Naskręt, D.; Zozulińska-Ziółkiewicz, D. Sport a Cukrzyca Typu 1. Diabetologia Praktyczna 2011, 12, 52–55.
Mirska, I.; Kreft, P.; Skalski, D.W.; Rybak, O.; Kowalski, D.; Dyachuk, V. Aktywność Fizyczna jako Istotny Element Profilaktyki i Leczenia Zespołu Metabolicznego. Rehabilitation and Recreation 2023, 164–169.
Association, A.D. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2021. Diabetes care 2021, 44, S15–S33.
Punthakee, Z.; Goldenberg, R.; Katz, P. Definition, Classification and Diagnosis of Diabetes, Prediabetes and Metabolic Syndrome. Canadian journal of diabetes 2018, 42, S10–S15.
Bedekar, A.; Shah, K.; Koffas, M. Natural Products for Type II Diabetes Treatment. Advances in applied microbiology 2010, 71, 21–73.
Mols, R.E.; Borregaard, B.; Løgstrup, B.B.; Rasmussen, T.B.; Thrysoee, L.; Thorup, C.B.; Christensen, A.V.; Ekholm, O.; Rasmussen, A.A.; Eiskjær, H. Patient-Reported Outcome Is Associated with Health Care Costs in Patients with Ischaemic Heart Disease and Arrhythmia. European journal of cardiovascular nursing 2023, 22, 23–32.
Wrzosek, K.; Krysztofiak, H.; Mamcarz, A. Aktywność Fizyczna-Czy Alternatywa Dla Farmakoterapii w Chorobie Niedokrwiennej Serca? Choroby Serca i Naczyń 2006, 3, 61–67.
Allesøe, K.; Aadahl, M.; Jacobsen, R.K.; Kårhus, L.L.; Mortensen, O.S.; Korshøj, M. Prospective Relationship between Occupational Physical Activity and Risk of Ischemic Heart Disease-Are Men and Women Differently Affected? European Journal of Preventive Cardiology 2023, zwad067.
Barbara Więckowska Proces Leczenia w Polsce – Analizy i Modele; Ministerstwo Zdrowia: Warszawa, 2015; Vol. Tom II: Kardiologia; ISBN 978-83-941589-1-0.
Knuuti, J.; Wijns, W.; Saraste, A.; Capodanno, D.; Barbato, E.; Funck-Brentano, C.; Prescott, E.; Storey, R.F.; Deaton, C.; Cuisset, T. ESC Guidelines for the Diagnosis and Management of Chronic Coronary Syndromes: The Task Force for the Diagnosis and Management of Chronic Coronary Syndromes of the European Society of Cardiology (ESC). European heart journal 2020, 41, 407–477.
Chen, H.; Dong, Q.; Zheng, X. Efficacy of Shexiang Baoxin Pills for the Treatment of Unstable Angina Pectoris: Protocol of Systemic Review and Meta-Analysis. Medicine 2019, 98.
Vargas-Carretero, C.J.; Fernandez-Vargas, O.E.; Ron-Magaña, A.L.; Padilla-Ortega, J.A.; Ron-Guerrero, C.S.; Barrera-Chairez, E. Etiology and Clinico-Hematological Profile of Pancytopenia: Experience of a Mexican Tertiary Care Center and Review of the Literature. Hematology 2019, 24, 399–404.
Hałaburda, K.; Tomaszewska, A. Leczenie chorych na niedokrwistość aplastyczną. Hematologia 2013, 4, 257–270.
Damian, M.-T.; Vulturar, R.; Login, C.C.; Damian, L.; Chis, A.; Bojan, A. Anemia in Sports: A Narrative Review. Life 2021, 11, 987.
Nicotra, D.; Arieli, R.; Redlich, N.; Navot-Mintzer, D.; Constantini, N.W. Iron Deficiency and Anemia in Male and Female Adolescent Athletes Who Engage in Ball Games. Journal of Clinical Medicine 2023, 12, 970.
Young, N.S. Aplastic Anemia. New England Journal of Medicine 2018, 379, 1643–1656.
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