The red ginseng has a direct inhibitory effect on platelet aggregation in in vivo antithrombotic and ex vivo antiplatelet models, and this could correlate with its ability to increase NO production. It has been reported that the saponin fraction of Korean red ginseng enhances the formation of citrulline from exogenously added arginine, which activates NOS, and purified ginsenosides from ginseng enhanced the release of NO from endothelial cells of the rat aorta. Korean red ginseng also shows a significant protective effect on arterial thrombosis in
vivo, which may be due to antiplatelet activity rather than anticoagulation activity, and this result suggests that red ginseng intake may be beneficial for individuals with high risks of thrombosis and CVDs [70], [71] and [72]. Dihydroginsenoside Rg3 potently inhibited platelet aggregation through the modulation of downstream signaling components such as cyclic adenosine monophosphate and extracellular signal-regulated find more kinase 2 [73]. Protopanaxadiol or protopanaxatriol-type ginsenosides have a complicated effect on hemin-induced hemolysis, which depends on the interaction between the sugar moieties at different positions [74]. Post-treatment with P. notoginseng significantly reduced the lipopolysaccharide-mediated microcirculatory disturbance by inhibiting
adherence of leukocytes to the venular wall, degranulation of mast cells, and the release of cytokines [75]. A total of seven ginsenosides, namely Rg6, F4, Rk3, Rh4, Rs3, Rs4, and Rs5, isolated from processed ginseng were evaluated for their effects on platelet aggregation Proteases inhibitor induced by adenosine diphosphate (ADP), collagen, arachidonic acid, and U46619 (thromboxane A2 mimetic drug). The acetylated ginsenosides such as Rs3, Rs4, and Rs5 only had mild effects on aggregation induced by four stimulators. Some of the ginsenosides including Rg6, F4, Rh4, Rs3, and Rs5 showed negligible effects
on ADP and collagen-induced platelet aggregation [76]. There are some synergistic interactions Methocarbamol between Korean red ginseng and warfarin in patients with cardiac valve replacement. Korean red ginseng could be used with close monitoring and under appropriate instruction in patients who take warfarin during cardiac valve replacement. Because such patients could take higher amounts of Korean red ginseng along with warfarin, this combination can also be applied in cardiac valve treatment [77]. Coronary perfusion flow of isolated heart can be increased by total ginsenosides, which also protected heart tissues from ischemia/reperfusion injury. This effect of total ginsenosides is mediated by activation of PI3K/Akt-eNOS signaling and NO production [78]. These results suggest that ginseng has a potent antithrombotic effect in vivo, which may be due to the antiplatelet activity rather than the anticoagulation activity, and that ginseng intake may be beneficial for individuals with high risks of thrombosis and CVDs.
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