Danshen: A Very Promising Species of Sage

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A very important species of Salvia is known as Salvia miltiorrhiza. Salvia miltiorrhiza (simplified Chinese: 丹参; traditional Chinese: 丹參; pinyin: dānshēn ), is also known as red sage, Chinese red sage, tan shen, or danshen. 

Danshen has been used by Traditional Chinese Medicine for centuries, especially for cardiovascular disorders.   Within the past 20 years, many research studies have been published on the wide variety of health benefits of Danshen.  As of the date of this article (October 2015), there are 2217 published studies on Salvia miltiorrhiza or Danshen on PubMed.

There are a number of chemical constituents of Chinese Red Sage:

  • cryptotanshinone
  • danshensu
  • danshenspiroketallactone
  • dehydromiltirone
  • feruginol
  • hydroxytanshinone
  • isocryptotanshinone
  • isotanshinone-i
  • isotanshinone-ii
  • Isotanshinone-iii
  • magnesium
  • manganese
  • methyl-tanshinonate
  • methyl-tanshinone
  • miltirone
  • nortanshinone
  • oleanolic acid
  • protocatechuic aldehyde
  • protocatechuic acid
  • rosmarinic acid
  • salvianolic-acid
  • salviol
  • sodium
  • tanshinolactone
  • tanshinone-i
  • tanshinone-ii
  • tanshinone-ii
  • tanshinone-iii
  • tanshinonic-acid

The chemical compounds that have been and are being researched for their health benefits include:

Salvianolic acid

Salvianolic acid is an antioxidant that has been researched for it ability to protect against cerebrovascular disorders.  1  2

Dihydrotanshinone, tanshinone I, and tanshinone IIA

Dihydrotanshinone I (DI) has been reported to have cytotoxicity to a variety of tumor cells.  3

Both Tanshinone I and Tanshinone IIA have been researched extensively for its  for anti-cancer effects.  4  5

Tanshinone IIA is the chemical compound researched the most and shows promise in the following areas:

  • antioxidant  6
  • anti-inflammatory  7
  • cardiovascular disorders  8
  • cerebrovascular disorders  9
  • neurodegenerative diseases  10
  • renal dysfunction associated with chronic kidney disease  11
  • brain edema formation in response to ischemia  12

The Table below is a more comprehensive list of the health benefits of Danshen (but by no means a complete list):

Health Benefits of Danshen (Salvia miltiorrhiza)

SystemCondition/SubstanceBenefitReference
Cardiovascular
Stroke
The roots of Salvia miltiorrhiza (Danshen), is widely used in the treatment of coronary heart disease, stroke 1
Ischemic stroke
In clinical use for ischemic stroke 2
Atherosclerosis
May assist in the prevention of atherosclerosis 3 4 
Ischemia/reperfusion injury
Effectiveness of Danshen-Gegen (DG) decoction extract given prophylactically in affording protection against myocardial I/R injury5
Cardiac hypertrophy
Tanshinone IIA Protects Against Cardiac Hypertrophy via Inhibiting Calcineurin/Nfatc3 Pathway6
Acute myocardial infarction
Salvianolic acid (SAL) and tanshinone (TAN) are major hydrophilic and lipophilic compounds. TAN acts at an early stage after ischemic injury mainly by inhibition of intracellular calcium and cell adhesion pathways whereas SAL acts mainly by down-regulating apoptosis.7
Digestive System
Pancreatitis
Salvia miltiorrhizae can exert protective effects on the lymph nodes of severe acute pancreatitis (SAP) or obstructive jaundice (OJ) rats via a mechanism that is associated with reducing the contents of inflammatory mediators in blood.8
α-glucosidase inhibitor
Compounds from Danshen have been reported to have inhibitory activity against α-glucosidase.9
Immunity
Anti-microbial
tanshinone ΙΙA (1), tanshinone Ι (2), cryptotanshinone (3), dihydrotanshinone Ι (4), rosmarinic acid (5), caffeic acid (6), and danshensu (7 — were evaluated to show a broad antimicrobial spectrum of activity on test microorganisms including eight bacterial and one fungal species.10
Anti-inflammatory
Tanshinone IIA is one of the most abundant constituents of the root of Salvia miltiorrhiza which exerts antioxidant and anti-inflammatory actions 11 12
Anti-angiogenic
The present study confirmed the anti-angiogenic effects of Tan IIA both in vivo and in vitro. Our results also demonstrated that Tan IIA could modulate the secretion of MMP-2 and TIMP-2 in an opposite way and resulted in the decreased MMP-2 activity of vascular endothelial cells.13
Apoptosis
Cryptotanshinone, the major active constituent isolated from the root of Salvia miltiorrhiza Bunge, has been recently evaluated for its anti-cancer activity. Cryptotanshinone is a potent stimulator of ER stress, leading to apoptosis in many cancer cell lines, including HepG2 hepatoma and MCF7 breast carcinoma, and also demonstrate that mitogen-activated protein kinases function as mediators in this process.14
Breast cancer
May be helpful in the treatment of breast cancer15
Lung cancer
Anticancer effects of tanshinones on the highly invasive human lung adenocarcinoma cell line, CL1-5. Tanshinone I significantly inhibited migration, invasion, and gelatinase activity in macrophage-conditioned medium-stimulated CL1-5 cells in vitro and also reduced the tumorigenesis and metastasis in CL1-5-bearing severe combined immunodeficient mice16
Glioma
Results suggest that Tan IIA may serve as an effective adjunctive reagent in the treatment of glioma for its targeting of constitutive STAT3 signaling.17
Colon cancer
Tanshinone II-A inhibited in vitro and in vivo invasion and metastasis of colon carcinoma (CRC) cells. The effect resulted from changes in the levels of uPA, MMP-2, MMP-9, TIMP-1 and TIMP-2, and apparent inhibition of the NF-kappaB signal transduction pathway.18
Liver cancer
May initiate the apoptosis of liver cancer cells19 20
Gastric cancer
Tanshinone IIA can not only cause cell cycle arrest in the G2/M phase, but also trigger the intrinsic apoptotic signaling pathway. The results suggest that Tanshinone IIA may serve as an effective adjunctive reagent in the treatment of gastric cancer.21
Osteosarcoma
Tanshinone IIA (Tan IIA) may be an efficacious anti-osteosarcoma (OS) drug as it could induce cell apoptosis and inhibit proliferation, migration, and invasion in vitro.22
Leukemia
Salvia miltiorrhiza BUNGE, a traditional oriental medical herb, was observed to induce apoptosis in HL60 human premyelocytic leukemia cell line23
Hepatoma
Tanshinone IIA activates calcium-dependent apoptosis signaling pathway in human hepatoma cells24
Prostate cancer
Tanshinone IIA significantly decreased the viable cell number of LNCaP (phosphate and tensin homolog (PTEN) mutant, high AKT, wild type p53) prostate cancer cells more sensitively than against the PC-3 (PTEN null, high AKT, p53 null) prostate cancer cells. Tan IIA significantly increased TdT-mediated dUTP nick-end labeling (TUNEL) positive index and sub-G1 DNA contents of treated cells, consistent with apoptosis.25 26 27
HIV
For HIV, chemicals in Danshen may block the effectiveness of an enzyme, HIV-1 integrase, that the virus needs to replicate.[28
Cytoprotective
Danshen induced HO-1 expression through PI3K/Akt-MEK1-Nrf2 pathway and reduced intracellular production of reactive oxygen species via induction of HO-1 expression. The results support a role of HO-1 in the cytoprotective effect of Danshen.29
Metabolism
Antidiabetic
Results showed that Danshen induced a significant decrease in fasting blood glucose (FBG), fasting blood insulin (FINS), total cholesterol (TC), triglyceride (TG) and blood urea nitrogen (BUN), and an obvious increase in insulin sensitivity index (ISI) in diabetic rats induced by a high fat diet and a low dose of streptozocin (STZ). These results suggested that Danshen has antidiabetic potential in vivo.30
Advanced Glycation End Products
Salvia miltiorrhiza Bge. (Dan shen) afforded two new compounds, 3-hydroxy-2-(2'-formyloxy-1'-methylethyl)-8-methyl-1,4-phenanthrenedione (1), (8'R)-isosalvianolic acid C methyl ester (2), and 14 known compounds. Compounds 2, 6, 11, 14, and 16 exhibited much more potent inhibition against AGEs than the positive control (aminoguanidine, AG, IC(50) 0.11 μM). 31
Antioxidant
Salvia miltiorrhiza has protective effects against free radical-induced cell toxicity. 32
Lipoprotein oxidation
Tanshinone II-A (TSII-A) is an effective antioxidant against LDL oxidation in vitro. The underlying mechanism appears to be related to its peroxyl radical scavenging and LDL binding activity.33
Liver
May protect the Liver from toxins, especially Carbon Tetrachloride34
Liver fibrosis
Tanshinone IIA can possibly help prevent liver fibrosis35
Cirrhosis
May prevent cirrhosis36 
Musculoskeletal System
Osteoporosis
May be useful in the prevention of osteoporosis37
Osteoblastic cells
Salvia Miltiorrhiza (SM), a commonly used Chinese herb increased osteogenesis in vivo38
Neurological
Neuroprotective
Tanshinone IIA (Tan IIA) might serve as a novel promising therapeutic agent for oxidative stress injury in neurodegenerative diseases.39
Alzheimer’s
Tanshinone IIA has been identified as a natural monoacylglycerol lipase (MAGL) inhibitor and may be a good candidate for the treatment of Alzheimer's disease 40
Cerebral blood flow
Danshen may reduce or prolong the development of atherosclerosis and may have anti-hypertensive and anti-platelet aggregation effects, which prevent cerebral infarction.  41
Cerebrovascular
Cerebrovascular protective effect of Salvianolic acid has been found to be due to prevention of apoptosis. 42
Dopamine
Salvia miltiorrhiza may stimulate dopamine release 43 
Brain edema in cerebral ischemia
Tanshinone IIA (Tan IIA) was effective for attenuating the extent of brain edema formation in response to ischemia injury in rats, partly by Tan IIA's protective effect on the BBB. Our results may have implications in the treatment of brain edema in cerebral ischemia.44
Urinary System
Chronic renal diseases
Salvianolic Acid B (Sal B) is a water-soluble component from Danshen (a traditional Chinese herb widely used for chronic renal diseases) with anti-oxidative and cell protective properties. Sal B also has potential protective effects on renal diseases.45


Resources:

BioFoundations.net – Dan shen (EFong)

BioFoundations.net – Dan shen tablets


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