Positive influence of gut microbiota on the effects of Korean red ginseng in metabolic syndrome: a randomized, double-blind, placebo-controlled clinical trial

Abstract

Background Ginseng, a traditional herbal medicine, has been used for thousands of years to treat various diseases including metabolic syndrome (MS). However, the underlying mechanism(s) of such beneficial actions of ginseng against MS is poorly understood. Emerging evidence indicates a close association of the host gut microbiota with MS. The present study was conducted to examine, whether the beneficial effects of Korean red ginseng (KRG) against MS could be influenced by gut microbial population and whether gut microbial profile could be considered a valuable biomarker for targeted treatment strategy for MS in compliance with the predictive, preventive, and personalized medicine (PPPM / 3PM). Methods This clinical study was a randomized, double-blind, placebo-controlled trial evaluating the effects of KRG treatment for 8 weeks on patients with MS. The anthropometric parameters, vital signs, metabolic biomarkers, and gut microbial composition through 16S rRNA gene sequencing were assessed at the baseline and endpoint. The impact of KRG was also evaluated after categorizing the subjects into responders and non-responders, as well as enterotypes 1 and 2 based on their gut microbial profile at the baseline. ResultsFifty out of 60 subjects who meet the MS criteria completed the trial without showing adverse reactions. The KRG treatment caused a significant decrease in systolic blood pressure (SBP). Microbial analysis revealed a decrease in Firmicutes, Proteobacteria, and an increase in Bacteroidetes in response to KRG. In patient stratification analysis, the responders showing marked improvement in the serum levels of lipid metabolic biomarkers TC and LDL due to the KRG treatment exhibited higher population of both the family Lachnospiraceae and order Clostridiales compared to the non-responders. The homeostasis model assessment-insulin resistance (HOMA-IR) and insulin level were decreased in enterotype 1 (Bacteroidesabundant group) and increased in enterotype 2 (prevotella-abundant group) following the KRG treatment. Conclusion In this study, the effects of KRG on the glucose metabolism in MS patients were influenced by the relative abundances of gut microbial population and differed according to the individual enterotype. Therefore, the analysis of enterotype categories is considered to be helpful in predicting the effectiveness of KRG on glucose homeostasis of MS patients individually. This will further help to decide on the appropriate treatment strategy for MS, in compliance with the perspective of PPPM.

Gut Metagenome as a Potential Diagnostic and Predictive Biomarker in Slow Transit Constipation

“…The results showed that all the samples clustered into 1 of 3 enterotypes. The Bacteroides and Prevotella enterotypes were identical to those reported earlier in other diseases (27)(28)(29) and the 3rd enterotype was distinguished by high levels of Alistipes and Eubacterium, which have never been reported, may be unique to patients with STC, and were different from other types of diseases. Some strong correlations occur between host properties and particular functions at the gene or module level (a module is a part of a pathway that is functionally tightly interconnected); we also attempted to identify bacterial biomarkers that may help in the diagnosis of STC by generating 10 different metagenomic shotgun markers.…”

“…The results showed that all the samples clustered into 1 of 3 enterotypes. The Bacteroides and Prevotella enterotypes were identical to those reported earlier in other diseases ( 27 – 29 ) and the 3rd enterotype was distinguished by high levels of Alistipes and Eubacterium, which have never been reported, may be unique to patients with STC, and were different from other types of diseases.…”

Metagenomic Analysis of the Microbiome of the Upper Reproductive Tract Focuses on Prediction, Prevention, and Personalized Medicine to Combat Ovarian Cancer

“…Tumor-associated microbes could predict to the occurrence of cancer. On the other hand, microbes enriched in tumor pose unexpected effects on the therapeutic effect of different cancer treatments (including radiotherapy, chemotherapy, and especially immunotherapy) [23,24]. Our previous 16S rRNA sequencing analysis suggested that there were distinct microbial signatures in ovarian cancer tissue as compared to the normal fallopian tube tissue [4].…”

Gut Microbiota: Therapeutic Targets of Ginseng Against Multiple Disorders and Ginsenoside Transformation

“…In obesity animal models, Firmicutes, Bacteroides, Lactobacillus , and Helicobacter may be potential targets for ginseng in the treatment of obesity ( Table 1 ). Meanwhile, relative studies have found ginseng could reduce the body weight, blood lipid, blood glucose, and inflammatory level, as well as can significantly improve the structure of gut microbiota in obese patients ( Table 2 ) ( Song et al., 2014 ; Seong et al., 2021 ).…”

“…Besides these ginsenosides, the combination of red ginseng, Aronia, Shiitake mushroom, and Nattokinase and Buzhong Tongluo decoction including Astragalus membranaceus , Dioscorea hemsleyi , Salvia miltiorrhiza , Scrophularia ningpoensis , Ophiopogon japonicus , Panax ginseng , Fritillariae cirrhosae , and Whitmania pigra Whitman have been proved to be able to up-regulate Bacteroides, Lactobacillus, Akkermansia probiotics, reduce the abundance of bacteria causing hyperglycemia, such as Helicobacter , Flavonifractor , and reduce the ratio of Firmicutes and Bacteroidetes , thus play their hypoglycemic effects ( Yang et al., 2018 ; Zheng et al., 2020 ). In another disorder, metabolic syndrome, the powder from Korean red ginseng (KRG) has a good therapeutic effect, and its mechanism might be related to the improvement of the disorder of lipid metabolism (the reductions of TC and low-density lipoprotein, LDL) by increasing the relative abundance of Bacteroides and reducing the relative abundance of Firmicutes and Proteobacteria ( Seong et al., 2021 ). Most studies show that ginseng can correct the abnormal metabolic level in the body by reversing the ratio of Firmicutes and Bacteroidetes .…”