Antiviral Potential of the Genus Panax: An updated review on their effects and underlying mechanism of action

Abstract

Viral infections are known as one of the major factors causing death. Ginseng is a medicinal plant that demonstrated a wide range of antiviral potential, and saponins are the major bioactive ingredients in the genus Panax with vast therapeutic potential. Studies focusing on the antiviral activity of the genus Panax plant-derived agents (extracts and saponins) and their mechanisms were identified and summarized, including contributions mainly from January 2016 until January 2022. P. ginseng, P. notoginseng, and P. quinquefolius were included in the review as valuable medicinal herbs against infections with 14 types of viruses. Reports from 9 extracts and 12 bioactive saponins were included, with 6 types of protopanaxadiol (PPD) ginsenosides and 6 types of protopanaxatriol (PPT) ginsenosides. The mechanisms mainly involved the inhibition of viral attachment and replication, the modulation of immune response by regulating signaling pathways, including the Janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathway, cystathionine γ-lyase (CSE)/hydrogen sulfide (H₂S) pathway, phosphoinositide-dependent kinase-1 (PDK1)/ protein kinase B (Akt) signaling pathway, c-Jun N-terminal kinase (JNK)/activator protein-1 (AP-1) pathway, and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway. This review includes detailed information about the mentioned antiviral effects of the genus Panax extracts and saponins in vitro and in vivo, and in human clinical trials, which provides a scientific basis for ginseng as an adjunctive therapeutic drug or nutraceutical.

Keywords: ARI, acute respiratory illness; BG, black ginseng; BVDV, bovine viral diarrhea virus; CHB, chronic hepatitis B; CSFV, classical swine fever virus; CVBs, group B coxsackieviruses; DAA, direct-acting antiviral therapies; EBV, the Epstein-Barr virus; EV, enterovirus; EV71, human enterovirus 71; GCRV, grass carp reovirus; GSLS, Ginseng stem-leaf saponins; HAART, highly active antiretroviral drug therapy; HBV, hepatitis B virus; HCV, Hepatitis C virus; HIV-1, human immunodeficiency virus type 1; HP, highly pathogenic; HSV, herpes simplex virus; HVJ, hemagglutinating virus of Japan; IFN-1, type-I interferon; JAK, janus kinase; JNK, c-Jun N-terminal kinase; KRG, Korean Red Ginseng; KSHV, Kaposi's sarcoma-associated herpesvirus; MHV-68, murine gammaherpesvirus 68; NDV, Newcastle disease virus; NK, natural killer; PNAB, PEGylated nanoparticle albumin-bound; PNR, P. notoginseng root water extract; PPD, protopanaxadiol; PPT, protopanaxatriol; PRRSV, porcine reproductive and respiratory syndrome virus; Panax ginseng; RSV, respiratory syncytial virus; RV, rotavirus; STAT, signal transducer and activator of transcription; antiviral activity; ginseng; ginsenosides; mechanism of action.