Preclinical and clinical examinations of Salvia miltiorrhiza and its tanshinones in ischemic conditions

Abstract

Salvia miltiorrhiza (Labiatae, Laminaceae), danshen, is an annual sage mainly found in China and neighboring countries. The crude drug (dried root) and its preparations are currently used in China to treat patients suffering from heart attack, angina pectoris, stroke and some other conditions. The use of S. miltiorrhiza has been increasing in the management of stroke. Pharmacological examinations showed that the plant and its active ingredients, tanshinones and salvianolic acids, have anticoagulant, vasodilatory, increased blood flow, anti-inflammatory, free radical scavenging, mitochondrial protective and other activities. This review discusses the pharmacology, medicinal chemistry and clinical studies published, especially in China, for danshen and tanshinone preparations. Clinical examinations are evaluated in terms of S. miltiorrhiza preparation, dose, double blinding, control, clinical assessments of outcomes and other parameters. Meta-analyses of S. miltiorrhiza are also discussed.

Figure 1

Tanshinones found in S. miltiorrhiza. All of these compounds contain benzoquinone functionalities.

Figure 2

Isotanshinones found in S. miltiorrhiza. All of these compounds contain naphthoquinone groups.

Figure 3

Miltirone and salviol from S. miltiorrhiza. These compounds contain phenol or benzoquinone groups.

Figure 4

Danshensu and monoterpenoids from S. miltiorrhiza. All of these compounds contain catechol functionalities.

Figure 5

Salvianolic acids from S. miltiorrhiza. All of these compounds contain catechol moieties.

Figure 6

Lithospermic acids from S. miltiorrhiza. Each of these compounds contains two or more catechols.