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Danshen

Scientific Name(s): Salvia miltiorrhiza Bunge
Common Name(s): Dan shen, Danshen, Radix, Tan-shen, Tanshen

Clinical Overview

Use

Danshen has been used extensively in traditional Chinese medicine as a single herb and in multiherb formulations. Limited clinical studies have shown efficacy in coronary artery disease and acute ischemic stroke, but the quality of methodology limits the validity and extrapolation of these findings.

Dosing

Active components in commercially available preparations of danshen vary greatly. Doses include danshen 20 mg/kg capsules. Dosages of danshen root extract 5 g twice daily for 60 days have been used in diabetic patients with coronary heart disease.

Contraindications

Contraindications have not been identified.

Pregnancy/Lactation

Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

Danshen may interfere with laboratory digoxin plasma levels and increase the anticoagulant effect of warfarin. It may reduce the plasma concentration and therefore pharmacologic effects of midazolam. Danshen inhibits numerous cytochrome P450 (CYP-450) enzymes in vitro.

Adverse Reactions

Adverse reactions include allergy, dizziness, headache, mild GI symptoms, and reversible thrombocytopenia.

Toxicology

No data.

Botany

Danshen is a perennial herb found mainly on sunny hillsides and stream edges in China. It has violet-blue flowers that bloom in the summer, with oval, finely serrated leaves. The fruit is an oval brown nut. Danshen's vivid scarlet red roots, from which many of the common names derive, are the primary medicinal part of the plant. Danshen is related to common sage, the culinary herb.Wu 2007, Zhou 2005 A study of samples sold in Chinese markets identified 18 related Salvia species collected, used, and sold as danshen, and evaluated their folk uses, traditional functions, and chemistry.Li 2008 Although only S. miltiorrhiza is recorded as the official species of danshen in the Pharmacopoeia of the People's Republic of China, Salvia przewalskii Maxim is widely used in southern China. Genetic diversity and population structure of S. miltiorrhiza have been studied.Song 2010 Danshen is related to other Salvia species such as Salvia hispanica L. (chia) and Salvia officinalis (sage).

History

Danshen is considered one of the most important traditional Chinese medicines and has widespread use in Asian countries.Fang 2010 The "dripping pill" is made by thermally blending the extract with excipients and then dripping the mixture into an insoluble cooling liquid until solidified droplets are formed.Zhou 2005 As a single herbal supplement, S. miltiorrhiza has been investigated in clinical trials for its effect on cardiovascular risk factors in patients with hyperlipidemia, hypertension, and diabetes.Qian 2012, Qian 2012, van Poppel 2015

Traditionally, danshen has been used to improve body function (eg, promote circulation, blood flow), as well as to treat hemorrhage, dysmenorrhea, miscarriage, swelling, insomnia, and hepatitis. More recent primary uses include treatment of cardiovascular and cerebrovascular conditions.Wang 2007, Zhou 2005

Chemistry

More than 50 compounds have been identified in danshen, the majority being lipophilic diterpenes, known as tanshinones, and polar phenolic compounds.Wang 2007 Antibacterial, antioxidant, and antineoplastic effects are attributed to the lipophilic compounds, of which more than 30 have been described; tanshinone I, tanshinone IIA, and cryptotanshinone are the major constituents. Hydrophilic compounds from danshen consist of phenolic acids, including caffeic acid and its derivatives, such as danshensu, salvianolic acids A and B, rosmarinic acid, and prolithospermic acid.Jiang 2005, Wang 2007 Antioxidant and anticoagulant effects may derive from these hydrophilic compounds. Other compounds include baicalin, beta-sitosterol, daucosterol, flavanones, vitamin E, and tannins.Jiang 2005, Wang 2007, Zhou 2005

A study of chemical variations of 13 constituents in 74 samples of danshen collected in China has been conducted using high-performance liquid chromatography (HPLC) analysis.Zhong 2009 Seasonal and cultivar variation in danshen grown in Australia has also been analyzed.Li 2009, Li 2009, Sheng 2009 A metabonomic nuclear magnetic resonance study examined primary metabolites of 3 phenotypically distinct cultivars of danshen.Dai 2010 Analytical procedures for determination of important constituents in crude danshen have proliferated, with HPLC/diode array/mass spectral techniques the most prominent.Chen 2011, Park 2008 Measurements of danshen compounds in body fluids have been achievedLu 2008 and several pharmacokinetic and distribution studies have been conducted on isolated constituents and their interactions with each other.Bi 2008, Chang 2010, Pan 2008, Xiaohui 2007

Uses and Pharmacology

Alcoholism

Animal data

Cryptotanshinone and danshen extract were protective against ethanol injury to rat hepatocytes.Yin 2009 Studies suggest tanshinone IIA may inhibit voluntary intake of alcohol in rats with induced alcoholism.Cheng 2007, Xu 2005 Danshen limited the effects of experimental pancreatitis or obstructive jaundice in rats.Xiping 2009, Xiping 2009 It also protected against ischemia reperfusion injury in experimental liver transplantation in rats.Liang 2009 In a mouse model, danshen was protective against damage associated with alcoholic liver disease.Ding 2017

Antithrombotic effects

Animal data

Antithrombotic actions of danshen have been reported in animal experiments.Chang 1985, Dong 1996, Yu 1994, Zou 1993

Antiosteoclastogenic activity

In vitro data

In a study to examine the effects of S. miltiorrhiza on osteoclastogenesis and osteoblast differentiation, the S. miltiorrhiza fraction (methanol and ethanol isolated) with a low concentration of tanshinone IIA inhibited osteoclastogenesis.Kim 2008

Antioxidant effects

Clinical data

The effect of S. miltiorrhiza root extract on biomarkers of oxidative stress in diabetic patients with coronary heart disease was investigated in a randomized, placebo-controlled trial (N=62). Only serum malonaldehyde levels were significantly decreased after 30 days of treatment (5 g twice daily) compared with baseline (P<0.05), with further reductions after 60 days (P<0.005). No other oxidative stress biomarkers changed significantly. Similarly, no lipid parameters were affected by S. miltiorrhiza root extract supplementation.Qian 2012

Cancer

In vitro data

Danshen and its constituents inhibit the growth of several types of cancer cell lines, including breast,Yang 2010 prostate,Gong 2011, Won 2010 liver,Lee 2010 and colon.Lin 2017 The effects appear to be primarily due to tanshinones. The effect in hepatocellular cancer may be mediated through TGF-beta/SMAD signaling,Liu 2010 while the effect in prostate cancer cells has been attributed to the PI3-kinase/AKT pathway.Won 2010 Experiments show that danshen inhibits angiogenesis, possibly due to cryptotanshinone and tanoshinone IIa.Fan 2006

Animal data

Tanshinone I has been observed to inhibit prostate cancer xenografts in mice.Gong 2011

Clinical data

A retrospective cohort analysis found that survival time was slightly increased in colon cancer patients using danshen at greater dosages and for longer durations.Lin 2017

Cognitive impairment

Animal data

In a study of mice, crytotanshinone attenuated beta-amyloid deposition in the brain,Mei 2009 and another study showed cholinesterase inhibition, suggesting potential for use in Alzheimer disease.Wong 2010

Coronary artery disease

In vitro data

In one study, a standardized extract of danshen protected rat cardiac myocytes from tumor necrosis factor–induced apoptosis. In cultured cardiac fibroblasts, the extract reduced collagen synthesis.Ling 2009 The isolated constituent 15,16-dihydrotansinone I inhibited collagen-induced platelet aggregation, blocking intracellular calcium mobilization and liberation of arachidonic acid.Park 2008 Several tanshinones inhibited prostaglandin and nitric oxide production in lipopolysaccharide-stimulated RAW 264.7 cells, further supporting anti-inflammatory mechanisms for danshen.Jeon 2008 Tanshinone IIA inhibited migration of human aortic smooth muscle cells through an AKT and matrix metalloprotease-9 pathway.Jin 2008

Animal data

In a study in rats, danshen was cardioprotective for infarct size and mortality, and in another experiment, danshen demonstrated comparable effects to captopril.Cheng 2007 A similar rat coronary artery ligation experiment found that tanshinone IIA reduced monocyte chemoattractant protein 1 expression, thereby blocking inflammation. Macrophage infiltration and transforming growth factor (TGF)–beta secretion were also blocked.Ren 2010 The effect of the phenolic danshen constituent danshensu on the homocysteine pathway was studied in a rat model, with the compound lowering elevated plasma total homocysteine levels after 3 weeks of treatment, which may result in activation of the transsulfuration pathway.Cao 2009

Clinical data

A review of trials using danshen to treat angina reported that it may be better than isosorbide dinitrate for long-term management of angina. Danshen also appears to be effective in relieving angina caused by coronary artery spasm, possibly because of its calcium antagonistic properties.Cheng 2007, Zhou 2005 A trial of danshen/Pueraria lobata found modest improvements in cardiovascular parameters over 1 year of treatment.Tam 2009 The effect of S. miltiorrhiza root extract on biomarkers of coronary heart disease (CHD) (von Willebrand factor [vWF] and serum vascular cell adhesion molecule-1 [sVCAM-1]) was studied in a randomized, placebo-controlled trial (N=62). Diabetic patients with CHD who received S. miltiorrhiza root extract (5 g twice daily for 60 days) experienced significant decreases in sVCAM-1, vWF, and oxidized low-density lipoprotein (LDL) cholesterol (P<0.05, P<0.05, and P<0.01, respectively). Treatment was well tolerated with no adverse events reported.Qian 2012

Apparent efficacy in treatment of myocardial infarction (MI) may be due to sedative, antioxidant, and antiplatelet effects, as well as by improved coronary microcirculation. Danshen also decreases myocardial reperfusion injury in patients with acute MI following percutaneous intervention.Cheng 2007

Diabetes

In vitro data

Tanshinones enhanced insulin activity in Chinese hamster ovary cells and in adipocytes.Jung 2009 Pathways through which dihydrotanshinone might affect blood glucose were examined in cellular experiments.Liu 2010 Inhibition of advanced glycation end products through alpha-glucosidase blockade by danshen was reported.Ma 2011

Clinical data

In a double-blind, randomized, placebo-controlled crossover trial in patients with hyperlipidemia and hypertension (N=20), a dose of S. miltiorrhiza root extract 1 g 3 times daily administered for 28 days did not affect metabolic parameters. Changes in fasting plasma glucose, glycosylated hemoglobin (HbA1c), fasting insulin, HOMA-IR, and HOMA-B were not observed.van Poppel 2015

Hepatitis

Clinical data

Earlier studies suggest danshen may be useful in relieving nausea, malaise, liver pain, and abdominal distention in patients with chronic hepatitis.Bai 1984, Chang 1985

Hyperlipidemia

In vitro data

A mixture of danshen and P. lobata decreased total cholesterol while increasing intracellular adhesion molecule (ICAM-1) expression and cellular adhesion in human monocyte–derived macrophages.Sieveking 2005 Two constituents of danshen, salvianolic acid A and magnesium tanshinoate B, inhibited LDL oxidation. A functional proteomics study of danshen extract in rat smooth muscle cells found effects on oxidative stress pathways.Hung 2010

Animal data

ICAM-1 was validated as a hyperlipidemic target of danshen in an apolipoprotein E(-/-) mouse model. While lipid levels were not altered, increased expression of ICAM-1 in circulating leukocytes driven by an atherogenic diet was abolished by danshen treatment. Atherosclerotic plaque was also attenuated in this experiment.Ling 2008 In a rabbit model, serum triglycerides were lower in the danshen-fed group compared with the control group. A rat model of hyperlipidemia treated with danshen extract showed decreases in total cholesterol, LDL, and triglycerides, with elevation of high-density lipoprotein (HDL).Ji 2008 Molecular analysis implicated a mechanism operating through farnesoid X receptor/liver X receptor coagonism.Ji 2008

Clinical data

A study among elderly patients with hyperlipidemia (N=96) showed decreased total cholesterol and LDL with danshen.Cheng 2007 A double-blind, randomized, controlled crossover study (N=20) investigated S. miltiorrhiza root extract administered as 1 g 3 times daily for 28 days in patients with risk factors for cardiovascular disease (ie, hyperlipidemia, hypertension). After correcting for baseline values and changes observed with placebo, danshen root extract caused a significant increase in LDL cholesterol compared with baseline and placebo (P<0.01 each). No other lipid parameters or blood pressure, vascular response, metabolic, antioxidant, inflammatory, or coagulation measurements changed significantly. Peripheral facial nerve paralysis was the one serious adverse event that occurred during danshen treatment.van Poppel 2015

Hypertension

In vitro data

Dihydrotanshinone relaxed isolated rat coronary arteries stimulated with 5-hydroxytryptamine (5-HT). The effect was blocked by the guanylate cyclase inhibitor ODQ, indicating a mechanism involving inhibition of calcium influx in smooth muscle cells of the vasculature.Lam 2008 A novel phenolic compound from danshen, isopropyl 3-(3,4-dihydroxyphenyl)-2-hydroxylpropanoate (IDHP), also had a vasorelaxant effect on rat mesenteric artery contracted with 5-HT or epinephrine. The authors posited a direct effect on vascular smooth muscle cells through intracellular calcium release and inhibition of calcium influx. Potassium channels may also be involved.Wang 2008 In contrast, the phenolic danshen constituent danshensu had a biphasic effect on isolated rat aortic rings, with high doses producing vasodilation.Zhang 2010 In vitro experiments with isolated arteries implicated ATP-sensitive calcium channels in the mechanism.Chan 2011

Animal data

In a study investigating the effects of danshen on blood pressure and its possible mechanisms, danshen constituent tanshinone IIA given intraperitoneally at 10 mg/kg lowered systolic blood pressure in spontaneously hypertensive rats but had no effect on blood pressure in normotensive rats. Oral administration had the same effects.Chan 2011 In another study, rats treated with phenylephrine followed by either danshen extract or magnesium tanshinoate B displayed lower blood pressure values.Leung 2010

Clinical data

Danshen is used for the management of hypertension in China, Korea, and Japan, and is thought to act via inhibition of angiotensin-converting enzymes.Cheng 2007 However, in a double-blind, randomized, placebo-controlled crossover study (N=20), blood pressure and vascular response did not change in patients with hypertension and hyperlipidemia following treatment with S. miltiorrhiza root extract 1 g 3 times daily for 28 days.van Poppel 2015

Immunomodulation

Animal data

Tanshinones inhibited cutaneous anaphylaxis in a study in mice.Trinh 2010

Ototoxicity

Animal data

In a study in guinea pigs, S. miltiorrhiza demonstrated protection against cisplatin-induced ototoxicity.Xu 2011

Renal

Animal data

Animal experiments suggest that danshen affects glomerular filtration rate and renal blood flow.Cheng 2007, Wojcikowski 2004 Tanshinone IIA given to rats with experimental renal insufficiency improved many end points.Ahn 2010 Pretreatment with danshen before experimental kidney transplantation in rats reduced ischemia reperfusion injury.Guan 2009

Stroke

Many studies reflect danshen's extensive use in China as a standard treatment in acute ischemic stroke. The injury to the vasculature following ischemia and reperfusion may be ameliorated by danshen treatment.Han 2008, Lin 2010

In vitro data

In one study, rat basilar artery rings precontracted with the prostaglandin analog U46619 were relaxed by a formulation containing danshen and Pueraria lobata. This effect was not dependent on voltage-sensitive or inwardly rectifying potassium channels, but could be blocked by glibenclamide, an inhibitor of adenosine triphosphate (ATP)–sensitive potassium channels. The authors concluded that danshen's vasorelaxant effect is independent of the arterial endothelium.Lam 2010 In another study, tanshinone IIA inhibited vascular smooth muscle cell proliferation and reduced intimal hyperplasia through a mitogen-activated protein kinase and c-fos mechanism.Li 2010

Animal data

Animal experiments with extracts of danshen have demonstrated increased cerebral microcirculation. A study of balloon-induced vascular injury in rats showed that oxidative damage was limited by treatment with magnesium lithospermate, a danshen constituent.Hur 2008 Two reviews summarize the pharmacologic effects of polar and lipophilic danshen constituents in models of cerebral infarction, with emphasis on antioxidant pathways.Han 2008, Lin 2010

Clinical data

Three meta-analyses of clinical trials evaluating use of danshen for ischemic stroke have been conducted. One meta-analysis included 11 trials in which danshen was compared with other medicinesSze 2005 and another included 6 trials in which danshen was compared with placebo.Wu 2007 A third meta-analysis included trials that examined use of many traditional Chinese medicines, including danshen.Wu 2007 Although improvement in neurological deficit was reported with danshen use,Wu 2007, Wu 2007 quality of life was not assessed and deaths (from any cause) were not reported. Long-term follow-up was not reported, and few trials reported adverse reactions. The authors of all 3 meta-analyses question the quality of trials, and ultimately were not able to make definitive statements about the role of danshen in therapy.Sze 2005, Wu 2007, Wu 2007, Zhou 2005

Dosing

Active components in commercially available preparations of danshen vary greatly.Zhou 2005 The Pharmacopoeia of the People's Republic of China recommends an S. miltiorrhiza dosage of 9 to 15 g/day of the root.van Poppel 2015 Commonly cited dosages include danshen 20 mg/kg capsules.Fang 2010, Jiang 2005

A dosage of S. miltiorrhiza hydrophilic root extract 5 g (as a tablet) twice daily for 60 days has been used in diabetic patients with coronary heart disease.Qian 2012, Qian 2012

Pregnancy / Lactation

Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

Digoxin

Danshen may interfere with laboratory values for digoxin plasma levels. Monitoring free digoxin concentrations can circumvent the positive and negative interference caused by danshen.Cheng 2007, Wahed 2001

Warfarin

Danshen interacts with warfarin; avoid use in patients with heart failure.Page 2016 Three case reports of overcoagulation with coadministration of warfarin and danshen exist. Pharmacokinetic and dynamic factors have been suggested for this effect. In rats, danshen appears to increase warfarin absorption rate and area under the curve (AUC) and decrease clearance and volume of distribution.Holbrook 2005, Hu 2005, Izzo 2005, Zhou 2005

Other

Danshen and salicylate may compete for protein-binding sites.Hu 2005, Zhou 2005 Danshen induces CYP-450 in rats but not in mice.Zhou 2005 Danshen aqueous extract has been shown to competitively inhibit CYP1A2 metabolism of caffeine in human and rat liver microsomes, and decrease caffeine clearance in rats. Tanshinones were responsible for the inhibition.Wang 2009, Wang 2010 Different modes of inhibition (competitive, uncompetitive, and noncompetitive) were posited for tanshinones on 4 human CYP isoforms.Wang 2010 Danshen decreased CYP3A in rats, increasing the effect of midazolam.Wang 2010 In a study of 12 healthy men, pretreatment with danshen extract 4 g 3 times daily increased midazolam oral clearance by approximately 35% and reduced the maximum plasma concentration and AUC by approximately 31% and 27%, respectively.Qiu 2010 However, in healthy volunteers, no effect was seen on theophylline metabolism.Qiu 2008 In rats, no effect on the metabolism of metoprolol by salvianolic acid B was detected.Wan 2010

Experiments suggest that danshen may protect against the nephrotoxic and ototoxic effects of gentamicin.Cheng 2007

Adverse Reactions

Few trials report adverse reactions related to danshen use; therefore, any statements regarding safety are difficult to qualify. Allergy, dizziness, headache, mild GI symptoms, and reversible thrombocytopenia have been reported.Cheng 2007, Wu 2007, Zhou 2005

In a 2016 scientific statement by the American Heart Association regarding drugs that may cause or exacerbate heart failure, danshen was recognized as a product with antiplatelet activity that may increase bleeding risk when used with anticoagulants. The guidance noted that natural medicines are not recommended for the management of heart failure symptoms, nor for secondary prevention of cardiovascular events, and that nutritional supplements are not recommended for the treatment of heart failure.Page 2016

Toxicology

Research reveals limited information regarding toxicity with the use of danshen. Oral danshen (2,500 mg/kg body weight) given to rats for 90 days at a dosage 400 times that of the recommended human dosage was reported to be nontoxic. The median lethal dose of the water-soluble extract of danshen is reported to be 25 g/kg body weight in mice.Zhou 2005

References

Ahn YM, Kim SK, Lee SH, et al. Renoprotective effect of Tanshinone IIA, an active component of Salvia miltiorrhiza, on rats with chronic kidney disease. Phytother Res. 2010;24(12):1886-1892.21043035
Bai Y. Therapeutic effect of danshen injection on chronic active hepatitis [in Chinese]. Zhong Xi Yi Jie He Za Zhi. 1984;4(2):86-87.6235048
Bi HC, Zuo Z, Chen X, et al. Preclinical factors affecting the pharmacokinetic behaviour of tanshinone IIA, an investigational new drug isolated from Salvia miltiorrhiza for the treatment of ischaemic heart diseases. Xenobiotica. 2008;38(2):185-222.18197559
Cao Y, Chai JG, Chen YC, et al. Beneficial effects of danshensu, an active component of Salvia miltiorrhiza, on homocysteine metabolism via the trans-sulphuration pathway in rats. Br J Pharmacol. 2009;157(3):482-490.19422396
Chan P, Liu IM, Li YX, Yu WJ, Cheng JT. Antihypertension induced by tanshinone IIA isolated from the roots of Salvia miltiorrhiza. Evid Based Complement Alternat Med. 2011;2011:392627.19542183
Chang HM,HWC Yeung, WW Tso. Advances in Chinese Medicinal Materials Research. Singapore: World Scientific;1985:559-580.
Chang BB, Zhang L, Cao WW, et al. Pharmacokinetic interactions induced by content variation of major water-soluble components of danshen preparation in rats. Acta Pharmacol Sin. 2010;31(5):638-646.20364158
Cheng TO. Cardiovascular effects of danshen. Int J Cardiol. 2007;121(1):9-22.17363091
Chen H, Zhang Q, Wang X, Yang J, Wang Q. Qualitative analysis and simultaneous quantification of phenolic compounds in the aerial parts of Salvia miltiorrhiza by HPLC-DAD and ESI/MS(n). Phytochem Anal. 2011;22(3):247-257.21046689
Dai H, Xiao C, Liu H, Hao F, Tang H. Combined NMR and LC-DAD-MS analysis reveals comprehensive metabonomic variations for three phenotypic cultivars of Salvia Miltiorrhiza Bunge. J Proteome Res. 2010;9(3):1565-1578.20067324
Ding L, Wo L, Du Z, Tang L, Song Z, Dou X. Danshen protects against early-stage alcoholic liver disease in mice via inducing PPARα activation and subsequent 4-HNE degradation. PLoS One. 2017;12(10):e0186357.29020055
Dong JC, Xu LN. Beneficial effects of acetylsalvianolic acid A on focal cerebral ischemic rats subjected to middle cerebral artery thrombosis [in Chinese]. Yao Xue Xue Bao. 1996;31(1):6-9.8762456
Fan TP, Yeh JC, Leung KW, Yue PY, Wong RN. Angiogenesis: from plants to blood vessels. Trends Pharmacol Sci. 2006;27(6):297-309.16697473
Fang Y. Chinese patent traditional medicine first time passes U.S. FDA crucial clinical trials. XINHUANET.com website. http://news.xinhuanet.com/english2010/china/2010-08/07/c_13434173.htm. Published August 7, 2010. Accessed July 8, 2011.
Gong Y, Li Y, Lu Y, et al. Bioactive tanshinones in Salvia miltiorrhiza inhibit the growth of prostate cancer cells in vitro and in mice. Int J Cancer. 2011;129(5):1042-1052.20848589
Guan X, Dei-Anane G, Bruns H, et al. Danshen protects kidney grafts from ischemia/reperfusion injury after experimental transplantation. Transpl Int. 2009;22(2):232-241.18954374
Han JY, Fan JY, Horie Y, et al. Ameliorating effects of compounds derived from Salvia miltiorrhiza root extract on microcirculatory disturbance and target organ injury by ischemia and reperfusion. Pharmacol Ther. 2008;117(2):280-295.18048101
Holbrook AM, Pereira JA, Labiris R, et al. Systematic overview of warfarin and its drug and food interactions. Arch Intern Med. 2005;165(10):1095-1106.15911722
Hu Z, Yang X, Ho PC, et al. Herb-drug interactions: a literature review. Drugs. 2005;65(9):1239-1282.15916450
Hung YC, Wang PW, Pan TL. Functional proteomics reveal the effect of Salvia miltiorrhiza aqueous extract against vascular atherosclerotic lesions [published correction appears in Biochim Biophys Acta. 2011;1814(12):2010]. Biochim Biophys Acta. 2010;1804(6):1310-1321.20170756
Hur KY, Seo HJ, Kang ES, et al. Therapeutic effect of magnesium lithospermate B on neointimal formation after balloon-induced vascular injury. Eur J Pharmacol. 2008;586(1-3):226-233.18387604
Izzo AA, Di Carlo G, Borrelli F, Ernst E. Cardiovascular pharmacotherapy and herbal medicines: the risk of drug interaction. Int J Cardiol. 2005;98(1):1-14.15676159
Jeon SJ, Son KH, Kim YS, Choi YH, Kim HP. Inhibition of prostaglandin and nitric oxide production in lipopolysaccharide-treated RAW 264.7 cells by tanshinones from the roots of Salvia miltiorrhiza bunge. Arch Pharm Res. 2008;31(6):758-763.18563358
Ji W, Gong BQ. Hypolipidemic activity and mechanism of purified herbal extract of Salvia miltiorrhiza in hyperlipidemic rats. J Ethnopharmacol. 2008;119(2):291-298.18691646
Jiang RW, Lau KM, Hon PM, Mak TC, Woo KS, Fung KP. Chemistry and biological activities of caffeic acid derivatives from Salvia miltiorrhiza. Curr Med Chem. 2005;12(2):237-246.15638738
Jin UH, Suh SJ, Chang HW, et al. Tanshinone IIA from Salvia miltiorrhiza BUNGE inhibits human aortic smooth muscle cell migration and MMP-9 activity through AKT signaling pathway. J Cell Biochem. 2008;104(1):15-26.17979138
Jung SH, Seol HJ, Jeon SJ, Son KH, Lee JR. Insulin-sensitizing activities of tanshinones, diterpene compounds of the root of Salvia miltiorrhiza Bunge. Phytomedicine. 2009;16(4):327-335.19200697
Kim HK, Woo ER, Lee HW, et al. The correlation of Salvia miltiorrhiza extract-induced regulation of osteoclastogenesis with the amount of components tanshinone I, tanshinone IIA, cryptotanshinone, and dihydrotanshinone. Immunopharmacol Immunotoxicol. 2008;30(2):347-364.18569089
Lam FF, Yeung JH, Chan KM, Or PM. Dihydrotanshinone, a lipophilic component of Salvia miltiorrhiza (danshen), relaxes rat coronary artery by inhibition of calcium channels. J Ethnopharmacol. 2008;119(2):318-321.18682284
Lam FF, Deng SY, Ng ES, et al. Mechanisms of the relaxant effect of a danshen and gegen formulation on rat isolated cerebral basilar artery. J Ethnopharmacol. 2010;132(1):186-192.20723594
Lee WY, Cheung CC, Liu KW, et al. Cytotoxic effects of tanshinones from Salvia miltiorrhiza on doxorubicin-resistant human liver cancer cells. J Nat Prod. 2010;73(5):854-859.20455578
Leung SW, Zhu DY, Man RY. Effects of the aqueous extract of Salvia miltiorrhiza (danshen) and its magnesium tanshinoate B-enriched form on blood pressure. Phytother Res. 2010;24(5):769-774.19943333
Li MH, Chen JM, Peng Y, Wu Q, Xiao PG. Investigation of danshen and related medicinal plants in China. J Ethnopharmacol. 2008;120(3):419-426.18930799
Li CG, Sheng SJ, Pang EC, et al. Cultivar variations of Australian-grown danshen (Salvia miltiorrhiza): bioactive markers and root yields. Chem Biodivers. 2009;6(2):170-181.19235159
Li CG, Sheng SJ, Pang EC, May B, Xue CC. HPLC profiles and biomarker contents of Australian-grown Salvia miltiorrhiza f. alba roots. Chem Biodivers. 2009;6(7):1077-1086.19623553
Li X, Du JR, Yu Y, Bai B, Zheng XY. Tanshinone IIA inhibits smooth muscle proliferation and intimal hyperplasia in the rat carotid balloon-injured model through inhibition of MAPK signaling pathway. J Ethnopharmacol. 2010;129(2):273-279.20363310
Liang R, Bruns H, Kincius M, et al. Danshen protects liver grafts from ischemia/reperfusion injury in experimental liver transplantation in rats. Transpl Int. 2009;22(11):1100-1109.19663939
Lin TH, Hsieh CL. Pharmacological effects of Salvia miltiorrhiza (danshen) on cerebral infarction. Chin Med. 2010;5:22.20565944
Lin YY, Lee IY, Huang WS, et al. Danshen improves survival of patients with colon cancer and dihydroisotanshinone I inhibit the proliferation of colon cancer cells via apoptosis and skp2 signaling pathway [published correction appears in J Ethnopharmacol. 2017]. J Ethnopharmacol. 2017;209:305-316.28807849
Ling S, Dai A, Guo Z, Komesaroff PA. A preparation of herbal medicine Salvia miltiorrhiza reduces expression of intercellular adhesion molecule-1 and development of atherosclerosis in apolipoprotein E-deficient mice. J Cardiovasc Pharmacol. 2008;51(1):38-44.18209567
Ling S, Luo R, Dai A, Guo Z, Guo R, Komesaroff PA. A pharmaceutical preparation of Salvia miltiorrhiza protects cardiac myocytes from tumor necrosis factor-induced apoptosis and reduces angiotensin II-stimulated collagen synthesis in fibroblasts. Phytomedicine. 2009;16(1):56-64.19010649
Liu X, Yang Y, Zhang X, et al. Compound Astragalus and Salvia miltiorrhiza extract inhibits cell invasion by modulating transforming growth factor-beta/Smad in HepG2 cell. J Gastroenterol Hepatol. 2010;25(2):420-426.19793165
Liu Q, Zhang Y, Lin Z, et al. Danshen extract 15,16-dihydrotanshinone I functions as a potential modulator against metabolic syndrome through multi-target pathways. J Steroid Biochem Mol Biol. 2010;120(4-5):155-163.20380878
Lu T, Yang J, Gao X, et al. Plasma and urinary tanshinol from Salvia miltiorrhiza (danshen) can be used as pharmacokinetic markers for cardiotonic pills, a cardiovascular herbal medicine. Drug Metab Dispos. 2008;36(8):1578-1586.18474682
Ma HY, Gao HY, Sun L, Huang J, Xu XM, Wu LJ. Constituents with α-glucosidase and advanced glycation end-product formation inhibitory activities from Salvia miltiorrhiza Bge. J Nat Med. 2011;65(1):37-42.20835851
Mei Z, Zhang F, Tao L, et al. Cryptotanshinone, a compound from Salvia miltiorrhiza modulates amyloid precursor protein metabolism and attenuates beta-amyloid deposition through upregulating alpha-secretase in vivo and in vitro. Neurosci Lett. 2009;452(2):90-95.19154776
Page RL 2nd, O'Bryant CL, Cheng D, et al; American Heart Association Clinical Pharmacology and Heart Failure and Transplantation Committees of the Council on Clinical Cardiology; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular and Stroke Nursing; Council on Quality of Care and Outcomes Research. Drugs that may cause or exacerbate heart failure: a scientific statement from the American Heart Association [published correction appears in Circulation. 134(12):e261]. Circulation. 2016;134(6):e32-e69.27400984
Pan Y, Bi HC, Zhong GP, et al. Pharmacokinetic characterization of hydroxylpropyl-beta-cyclodextrin-included complex of cryptotanshinone, an investigational cardiovascular drug purified from danshen (Salvia miltiorrhiza). Xenobiotica. 2008;38(4):382-398.18340563
Park EJ, Ji HY, Kim NJ, et al. Simultaneous determination of tanshinone I, dihydrotanshinone I, tanshinone IIA and cryptotanshinone in rat plasma by liquid chromatography-tandem mass spectrometry: application to a pharmacokinetic study of a standardized fraction of Salvia miltiorrhiza, PF2401-SF. Biomed Chromatogr. 2008;22(5):548-555.18205136
Park JW, Lee SH, Yang MK, et al. 15,16-dihydrotanshinone I, a major component from Salvia miltiorrhiza Bunge (dansham), inhibits rabbit platelet aggregation by suppressing intracellular calcium mobilization. Arch Pharm Res. 2008;31(1):47-53.18277607
Qian Q, Qian S, Fan P, Huo D, Wang S. Effect of Salvia miltiorrhiza hydrophilic extract on antioxidant enzymes in diabetic patients with chronic heart disease: a randomized controlled trial. Phytother Res. 2012;26(1):60-66.21544882
Qian S, Wang S, Fan P, Huo D, Dai L, Qian Q. Effect of Salvia miltiorrhiza hydrophilic extract on the endothelial biomarkers in diabetic patients with chronic artery disease. Phytother Res. 2012;26(10):1575-1578.22318996
Qiu F, Wang G, Zhao Y, et al. Effect of danshen extract on pharmacokinetics of theophylline in healthy volunteers. Br J Clin Pharmacol. 2008;65(2):270-274.17961194
Qiu F, Wang G, Zhang R, Sun J, Jiang J, Ma Y. Effect of danshen extract on the activity of CYP3A4 in healthy volunteers. Br J Clin Pharmacol. 2010;69(6):656-662.20565457
Ren ZH, Tong YH, Xu W, Ma J, Chen Y. Tanshinone II A attenuates inflammatory responses of rats with myocardial infarction by reducing MCP-1 expression. Phytomedicine. 2010;17(3-4):212-218.19800776
Sheng SJ, Pang EC, Xue CC, Li CG. Seasonal variations in bioactive marker contents in Australian-grown Salvia miltiorrhiza roots. Chem Biodivers. 2009;6(4):551-560.19353536
Sieveking DP, Woo KS, Fung KP, Lundman P, Nakhla S, Celermajer DS. Chinese herbs danshen and gegen modulate key early atherogenic events in vitro. Int J Cardiol. 2005;105(1):40-45.16207543
Song Z, Li X, Wang H, Wang J. Genetic diversity and population structure of Salvia miltiorrhiza Bge in China revealed by ISSR and SRAP. Genetica. 2010;138(2):241-249.19844793
Sze FK, Yeung FF, Wong E, Lau J. Does danshen improve disability after acute ischaemic stroke? Acta Neurol Scand. 2005;111(2):118-125.15644072
Tam WY, Chook P, Qiao M, et al. The efficacy and tolerability of adjunctive alternative herbal medicine (Salvia miltiorrhiza and Pueraria lobata) on vascular function and structure in coronary patients. J Altern Complement Med. 2009;15(4):415-421.19388864
Trinh HT, Chae SJ, Joh EH, Son KH, Jeon SJ, Kim DH. Tanshinones isolated from the rhizome of Salvia miltiorrhiza inhibit passive cutaneous anaphylaxis reaction in mice. J Ethnopharmacol. 2010;132(1):344-348.20732401
van Poppel PC, Breedveld P, Abbink EJ, et al. Salvia miltiorrhiza root water-extract (danshen) has no beneficial effect on cardiovascular risk factors. A randomized double-blind cross-over trial. PLoS One. 2015;10(7):e0128695.26192328
Wahed A, Dasgupta A. Positive and negative in vitro interference of Chinese medicine dan shen in serum digoxin measurement. Elimination of interference by monitoring free digoxin concentration. Am J Clin Pathol. 2001;116(3):403-408.11554169
Wan RZ, Zhou MJ, Liu CX. The effects of salvianolic acid B from radix Salvia miltiorrhizae on the oral pharmacokinetics of metoprolol and metoprolol acid in rats. Phytother Res. 2010;24(6):846-851.19957247
Wang X, Morris-Natschke SL, Lee KH. New developments in the chemistry and biology of the bioactive constituents of Tanshen. Med Res Rev. 2007;27(1):133-148.16888751
Wang SP, Zang WJ, Kong SS, et al. Vasorelaxant effect of isopropyl 3-(3, 4-dihydroxyphenyl)-2-hydroxypropanoate, a novel metabolite from Salvia miltiorrhiza, on isolated rat mesenteric artery. Eur J Pharmacol. 2008;579(1-3):283-288.17976578
Wang X, Lee WY, Or PM, Yeung JH. Effects of major tanshinones isolated from danshen (Salvia miltiorrhiza) on rat CYP1A2 expression and metabolism of model CYP1A2 probe substrates. Phytomedicine. 2009;16(8):712-725.19403289
Wang X, Yeung JH. Effects of the aqueous extract from Salvia miltiorrhiza Bunge on caffeine pharmacokinetics and liver microsomal CYP1A2 activity in humans and rats. J Pharm Pharmacol. 2010;62(8):1077-1083.20663043
Wang X, Cheung CM, Lee WY, Or PM, Yeung JH. Major tanshinones of danshen (Salvia miltiorrhiza) exhibit different modes of inhibition on human CYP1A2, CYP2C9, CYP2E1 and CYP3A4 activities in vitro. Phytomedicine. 2010;17(11):868-875.20638257
Wang X, Lee WY, Zhou X, Or PM, Yeung JH. A pharmacodynamic-pharmacokinetic (PD-PK) study on the effects of danshen (Salvia miltiorrhiza) on midazolam, a model CYP3A probe substrate, in the rat. Phytomedicine. 2010;17(11):876-883.20637580
Wojcikowski K, Johnson DW, Gobé G. Medicinal herbal extracts—renal friend or foe? Part two: herbal extracts with potential renal benefits. Nephrology (Carlton). 2004;9(6):400-405.15663644
Won SH, Lee HJ, Jeong SJ, et al. Tanshinone IIA induces mitochondria dependent apoptosis in prostate cancer cells in association with an inhibition of phosphoinositide 3-kinase/AKT pathway. Biol Pharm Bull. 2010;33(11):1828-1834.21048307
Wong KK, Ho MT, Lin HQ, et al. Cryptotanshinone, an acetylcholinesterase inhibitor from Salvia miltiorrhiza, ameliorates scopolamine-induced amnesia in Morris water maze task. Planta Med. 2010;76(3):228-234.19774505
Wu B, Liu M, Liu H, et al. Meta-analysis of traditional Chinese patent medicine for ischemic stroke. Stroke. 2007;38(6):1973-1979.17463317
Wu B, Liu M, Zhang S. Dan Shen agents for acute ischaemic stroke. Cochrane Database Syst Rev. 2007;(2):CD004295.17443544
Xia Z, Gu J, Ansley DM, Xia F, Yu J. Antioxidant therapy with Salvia miltiorrhiza decreases plasma endothelin-1 and thromboxane B2 after cardiopulmonary bypass in patients with congenital heart disease. J Thorac Cardiovasc Surg. 2003;126(5):1404-1410.14666012
Xiaohui Z, Xinfeng Z, Xin Z, Shixiang W, Yinmao W, Jianbin Z. Determination of the main bioactive metabolites of Radix Salvia miltiorrhizae in compound danshen dripping pills and the tissue distribution of danshensu in rabbit by SPE-HPLC-MSn. J Sep Sci. 2007;30(6):851-857.17536730
Xiping Z, Yang C, Dijiong W, et al. Effects of Salvia miltiorrhiza on intercellular adhesion molecule 1 protein expression in the lungs of rats with severe acute pancreatitis or obstructive jaundice. Pancreas. 2009;38(3):309-317.19034056
Xiping Z, Jun F, Chengjun W, et al. Effect of Salvia miltiorrhizae on pulmonary apoptosis of rats with severe acute pancreatitis or obstructive jaundice. Inflammation. 2009;32(5):287-295.19543819
Xu BJ, Zheng YN, Sung CK. Natural medicines for alcoholism treatment: a review. Drug Alcohol Rev. 2005;24(6):525-536.16361209
Xu O, Liu Y, Li X, et al. Protective effects of Salvia miltiorrhiza against cisplatin-induced ototoxicity in guinea pigs. Am J Otolaryngol. 2011;32(3):228-234.20447728
Yang W, Ju JH, Jeon MJ, Han X, Shin I. Danshen (Salvia miltiorrhiza) extract inhibits proliferation of breast cancer cells via modulation of Akt activity and p27 level. Phytother Res. 2010;24(2):198-204.19610045
Yin HQ, Choi YJ, Kim YC, Sohn DH, Ryu SY, Lee BH. Salvia miltiorrhiza Bunge and its active component cryptotanshinone protects primary cultured rat hepatocytes from acute ethanol-induced cytotoxicity and fatty infiltration. Food Chem Toxicol. 2009;47(1):98-103.19013495
Yu WG, Xu LN. Effect of acetylsalvianolic acid A on platelet function [in Chinese]. Yao Xue Xue Bao. 1994;29(6):412-416.7992621
Zhang N, Zou H, Jin L, et al. Biphasic effects of sodium danshensu on vessel function in isolated rat aorta. Acta Pharmacol Sin. 2010;31(4):421-428.20228827
Zhong GX, Li P, Zeng LJ, Guan J, Li DQ, Li SP. Chemical characteristics of Salvia miltiorrhiza (danshen) collected from different locations in China. J Agric Food Chem. 2009;57(15):6879-6887.19601629
Zhou L, Zuo Z, Chow MS. Danshen: an overview of its chemistry, pharmacology, pharmacokinetics, and clinical use. J Clin Pharmacol. 2005;45(12):1345-1359.16291709
Zou ZW, Xu LN, Tian JY. Antithrombotic and antiplatelet effects of rosmarinic acid, a water-soluble component isolated from radix Salviae miltiorrhizae (danshen) [in Chinese]. Yao Xue Xue Bao. 1993;28(4):241-245.8213164

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