This article review recent basic and clinical studies of ginseng, particularly the anti-cancer effects and the potential chemopreventive actions by activating the transcriptional factor, Nuclear factor (erythroid-derived 2)-like 2 factor 2 (Nrf2) anti-oxidative stress / anti-inflammatory pathways. Nrf2 is a novel target for cancer prevention as it regulates the antioxidant responsive element (ARE), a critical regulatory element in the promoter region of genes encoding cellular phase II detoxifying and anti-oxidative stress enzymes. The studies on the chemopreventive effects of ginseng or its components/products showed that Nrf2 could also be a target for ginseng’s actions. A number of papers also demonstrated the anti-inflammatory effects of ginseng, which could be related to the Nrf2 signaling pathway. Targeting Nrf2 pathway is a novel approach to the investigation of ginseng’s cancer chemopreventive actions, including some oxidative stress / inflammatory conditions responsible for the initiation, promotion and progression of carcinogenesis.
Ginseng protects the cardiovascular system, stimulates the central nervous system  and possesses anti-cancer activities [2, 3] inhibiting human gastric adenocarcinoma  and human breast carcinoma . Therefore, ginseng is a potential cancer preventive agent . Nuclear factor (erythroid-derived 2)-like 2 factor 2 (Nrf2) is a key regulator of the antioxidant responsive element (ARE)-mediated gene expression and therefore a potential anti-cancer target for chemopreventive compounds , including ginseng . However, concerns have been raised for possible inappropriate claims of ginseng products [11, 12]. This article reviews the potential chemopreventive actions of ginseng via the Nrf2 signaling pathway and the potential molecular mechanism of ginseng’s anti-cancer effects.
A full literature search (up to 2010) was conducted during November 2009 till April 2010 with ‘ginseng’ as the search keyword was performed in PubMed and the Chinese National Knowledge Infrastructure (CNKI). Other keywords used in the search included ‘ginseng’, ‘Nrf2’, ‘chemoprevention’, ‘cancer prevention’, ‘clinical studies’ and ‘anti-cancer’. A total of 3917 and 147 papers from PubMed and CNKI respectively were retrieved and screened for anti-cancer clinical studies with ginseng. Seven published articles were found in PubMed with the keywords ‘ginseng’ and ‘Nrf2’ including a paper on Angelica sinensis (Danggui) .
Ginseng in Chinese medicine
In Chinese medicine, a disorder is often a manifestation of an imbalance between yin and yang and/or changes in the pathogenic and antipathogenic qi. Ginseng is the drug of choice for replenishing qi, especially in the case of qi collapse. Major Chinese medicinal uses of ginseng and its commercial products and their indications are provided in Table 1.
Clinical studies on ginseng as adjuvant therapy for cancer
Anti-oxidative and anti-inflammatory effects of ginseng
This article is an Open Access article published in Chinese Medicine.
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