# Research progress on the mechanism of panax notoginseng saponin in the treatment of atherosclerosis

**Authors:** Long Xiong, Dongli Liu, Jiao Cheng, Tingfu Yin

PMC · DOI: 10.3389/fcvm.2026.1659763 · Frontiers in Cardiovascular Medicine · 2026-02-05

## TL;DR

This paper reviews how panax notoginseng saponin may help treat atherosclerosis by targeting multiple biological processes with fewer side effects.

## Contribution

The study systematically reviews the pharmacological mechanisms and biological properties of panax notoginseng saponin in treating atherosclerosis.

## Key findings

- Panax notoginseng saponin targets six key aspects in atherosclerosis treatment.
- It exhibits anti-inflammatory, anti-oxidative, and lipid-regulating effects.
- The compound inhibits vascular smooth muscle cell proliferation and angiogenesis.

## Abstract

With the increasing incidence and prevalence of atherosclerosis (AS), it has become a major global public health concern. While interventional surgery and Western medicines are effective in treating AS, their adverse effects are noteworthy. Traditional Chinese medicine offers the advantage of low side effects and significant therapeutic effects, making its active ingredients potential candidates for new medicine development. Panax notoginseng saponin (PNS), a compound derived from the natural drug panax notoginseng, has shown significant efficacy in AS treatment by targeting six main aspects: anti-inflammation, regulation of lipid metabolism, anti-oxidative stress, inhibition of vascular smooth muscle cell proliferation and migration, inhibition of angiogenesis, and regulation of autophagy. This study reviews the pharmacological mechanisms of PNS in AS treatment, as well as its biological properties, in vivo metabolism, synthesis, and regulation, providing insights for future research.

## Linked entities

- **Diseases:** atherosclerosis (MONDO:0005311)

## Full-text entities

- **Genes:** Abcg1 (ATP binding cassette subfamily G member 1) [NCBI Gene 11307] {aka Abc8, White}, SOD1 (superoxide dismutase 1) [NCBI Gene 6647] {aka ALS, ALS1, HEL-S-44, IPOA, SOD, STAHP}, Bcl2 (B cell leukemia/lymphoma 2) [NCBI Gene 12043] {aka Bcl-2, C430015F12Rik, D630044D05Rik, D830018M01Rik}, Hif1a (hypoxia inducible factor 1, alpha subunit) [NCBI Gene 15251] {aka HIF-1-alpha, HIF1-alpha, HIF1alpha, MOP1, bHLHe78}, Atg5 (autophagy related 5) [NCBI Gene 365601], NFE2L2 (NFE2 like bZIP transcription factor 2) [NCBI Gene 4780] {aka IMDDHH, NRF2, Nrf-2}, Nr1h3 (nuclear receptor subfamily 1, group H, member 3) [NCBI Gene 22259] {aka LXR, RLD1, Unr1}, VCAM1 (vascular cell adhesion molecule 1) [NCBI Gene 7412] {aka CD106, INCAM-100}, BCL2 (BCL2 apoptosis regulator) [NCBI Gene 596] {aka Bcl-2, PPP1R50}, Nup62 (nucleoporin 62) [NCBI Gene 18226] {aka D7Ertd649e, Nupc1, p62}, Camk2b (calcium/calmodulin-dependent protein kinase II, beta) [NCBI Gene 12323] {aka CaMKII}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, Hif1a (hypoxia inducible factor 1 subunit alpha) [NCBI Gene 29560] {aka HIF1-alpha, MOP1}, PIK3R1 (phosphoinositide-3-kinase regulatory subunit 1) [NCBI Gene 5295] {aka AGM7, GRB1, IMD36, p85, p85-ALPHA, p85alpha}, IL4 (interleukin 4) [NCBI Gene 3565] {aka BCGF-1, BCGF1, BSF-1, BSF1, IL-4}, MAPK14 (mitogen-activated protein kinase 14) [NCBI Gene 1432] {aka CSBP, CSBP1, CSBP2, CSPB1, EXIP, Mxi2}, Ldlr (low density lipoprotein receptor) [NCBI Gene 16835] {aka Hlb301}, PCSK9 (proprotein convertase subtilisin/kexin type 9) [NCBI Gene 255738] {aka FH3, FHCL3, HCHOLA3, LDLCQ1, NARC-1, NARC1}, CCND1 (cyclin D1) [NCBI Gene 595] {aka BCL1, D11S287E, PRAD1, U21B31}, HIF1A (hypoxia inducible factor 1 subunit alpha) [NCBI Gene 3091] {aka HIF-1-alpha, HIF-1A, HIF-1alpha, HIF1, HIF1-ALPHA, MOP1}, CDK4 (cyclin dependent kinase 4) [NCBI Gene 1019] {aka CMM3, MCPH31, PSK-J3}, Anxa3 (annexin A3) [NCBI Gene 25291] {aka Anx3, LC3, LRRGT00047}, Pink1 (PTEN induced putative kinase 1) [NCBI Gene 68943] {aka 1190006F07Rik, BRPK, mFLJ00387}, HMOX1 (heme oxygenase 1) [NCBI Gene 3162] {aka HMOX1D, HO-1, HSP32, bK286B10}, PIK3CB (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit beta) [NCBI Gene 5291] {aka P110BETA, PI3K, PI3KBETA, PIK3C1}, IL13 (interleukin 13) [NCBI Gene 3596] {aka IL-13, P600}, PPARG (peroxisome proliferator activated receptor gamma) [NCBI Gene 5468] {aka CIMT1, FPLD3, GLM1, NR1C3, PPARG1, PPARG2}, Cd34 (CD34 antigen) [NCBI Gene 12490], Becn1 (beclin 1, autophagy related) [NCBI Gene 56208] {aka Atg6}, STAT6 (signal transducer and activator of transcription 6) [NCBI Gene 6778] {aka D12S1644, HIES6, IL-4-STAT, STAT6B, STAT6C}, Mtor (mechanistic target of rapamycin kinase) [NCBI Gene 56717] {aka 2610315D21Rik, FRAP, FRAP2, Frap1, RAFT1, RAPT1}, Vegfa (vascular endothelial growth factor A) [NCBI Gene 22339] {aka L-VEGF, Vegf, Vpf}, IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, Serpinf1 (serine (or cysteine) peptidase inhibitor, clade F, member 1) [NCBI Gene 20317] {aka EPC-1, Pedf, Pedfl, Sdf3}, CCL2 (C-C motif chemokine ligand 2) [NCBI Gene 6347] {aka GDCF-2, HC11, HSMCR30, MCAF, MCP-1, MCP1}, Bnip3 (BCL2 interacting protein 3) [NCBI Gene 84480], AGER (advanced glycosylation end-product specific receptor) [NCBI Gene 177] {aka RAGE, SCARJ1, sRAGE}, Bax (BCL2-associated X protein) [NCBI Gene 12028], TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, RB1 (RB transcriptional corepressor 1) [NCBI Gene 5925] {aka OSRC, PPP1R130, RB, p105-Rb, p110-RB1, pRb}, Nox4 (NADPH oxidase 4) [NCBI Gene 50490], BAX (BCL2 associated X, apoptosis regulator) [NCBI Gene 581] {aka BCL2L4}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, Abca1 (ATP-binding cassette, sub-family A member 1) [NCBI Gene 11303] {aka ABC-1, Abc1}, TLR4 (toll like receptor 4) [NCBI Gene 7099] {aka ARMD10, CD284, TLR-4, TOLL}, RETN (resistin) [NCBI Gene 56729] {aka ADSF, FIZZ3, RENT, RETN1, RSTN, XCP1}, Atg5 (autophagy related 5) [NCBI Gene 11793] {aka 2010107M05Rik, 3110067M24Rik, Apg5l, Atg5l, Paddy}, Pcsk9 (proprotein convertase subtilisin/kexin type 9) [NCBI Gene 100102] {aka FH3, HCHOLA3, Narc1, PC9}, Rb1 (RB transcriptional corepressor 1) [NCBI Gene 19645] {aka Rb, Rb-1, p110-RB1, pRb, pp105}, Becn1 (beclin 1) [NCBI Gene 114558] {aka Beclin1}, SIRT1 (sirtuin 1) [NCBI Gene 23411] {aka SIR2, SIR2L1, SIR2alpha}, TP53 (tumor protein p53) [NCBI Gene 7157] {aka BCC7, BMFS5, LFS1, P53, TRP53}, Map1lc3a (microtubule-associated protein 1 light chain 3 alpha) [NCBI Gene 66734] {aka 1010001H21Rik, 4922501H04Rik, LC3, LC3a}, CDKN1A (cyclin dependent kinase inhibitor 1A) [NCBI Gene 1026] {aka CAP20, CDKN1, CIP1, MDA-6, P21, SDI1}, ICAM1 (intercellular adhesion molecule 1) [NCBI Gene 3383] {aka BB2, CD54, P3.58}, PRKAB1 (protein kinase AMP-activated non-catalytic subunit beta 1) [NCBI Gene 5564] {aka AMPK, HAMPKb}, CASP3 (caspase 3) [NCBI Gene 836] {aka CPP32, CPP32B, SCA-1}, BNIP3 (BCL2 interacting protein 3) [NCBI Gene 664] {aka HABON, NIP3}, APOE (apolipoprotein E) [NCBI Gene 348] {aka AD2, APO-E, ApoE4, LDLCQ5, LPG}, Traf6 (TNF receptor-associated factor 6) [NCBI Gene 22034] {aka 2310003F17Rik, C630032O20Rik}
- **Diseases:** cytotoxicity (MESH:D064420), vascular endothelial cell injury (MESH:D057772), cerebral infarction (MESH:D002544), myocardial ischemia (MESH:D017202), CVD (MESH:D002318), acute myocardial infarction (MESH:D009203), AS (MESH:D050197), death (MESH:D003643), Disorders of lipid metabolism (MESH:D052439), ischemic brain injury (MESH:D001930), reperfusion injury (MESH:D015427), thrombosis (MESH:D013927), homocysteinemia (MESH:C566403), necrosis (MESH:D009336), hyperuricemia (MESH:D033461), diabetic nephropathy (MESH:D003928), atherosclerotic plaque (MESH:D058226), calcium homeostasis (MESH:D002128), angina pectoris (MESH:D000787), cancer (MESH:D009369), cerebral ischemia (MESH:D002545), diabetes (MESH:D003920), plaque rupture (MESH:D012421), coronary heart disease (MESH:D003327), arterial vascular occlusion (MESH:D008641), mitochondrial (MESH:D028361), pain (MESH:D010146), hyperlipidemia (MESH:D006949), platelet aggregation (MESH:D001791), inflammation (MESH:D007249), occlusive vasculitis (MESH:D014657), Hypoxia (MESH:D000860), ischemia (MESH:D007511), hypoxic (MESH:D002534), bleeding (MESH:D006470), obesity (MESH:D009765)
- **Chemicals:** MDA (MESH:D008315), geranyl pyrophosphate (MESH:C015234), cholesterol ester (MESH:D002788), ginsenosides Re (MESH:C049864), amino acids (MESH:D000596), NGR1 (MESH:C072936), ginsenoside Rc (MESH:C044462), xuesaitong (MESH:C509799), NO (MESH:D009614), curcumin (MESH:D003474), H2O2 (MESH:D006861), 20 (S)-protobirdiol (-), ROS (MESH:D017382), saponins (MESH:D012503), glycosides (MESH:D006027), flavonoids (MESH:D005419), IPP (MESH:C004809), sphingolipid (MESH:D013107), sterols (MESH:D013261), 2,3-epoxysqualene (MESH:C520393), Lipid (MESH:D008055), FPP (MESH:C004808), GSH (MESH:D005978), PPT (MESH:C081552), ginsenosides Rd (MESH:C049863), Re (MESH:D012211), TG (MESH:D014280), 20(S)-protopanaxadiol (MESH:C062916), ginsenosides Rg1 (MESH:C035054), cyclic peptides (MESH:D010456), MVA (MESH:D008798), ginsenoside (MESH:D036145), DMAPP (MESH:C043060), -cholesterol (MESH:D002784), terpenoid (MESH:D013729), Squalene (MESH:D013185), ginsenoside F2 (MESH:C407883), GCK (MESH:C112772), aspirin (MESH:D001241)
- **Species:** Homo sapiens (human, species) [taxon 9606], Rattus norvegicus (brown rat, species) [taxon 10116], Panax notoginseng (notoginseng, species) [taxon 44586], Oryctolagus cuniculus (domestic rabbit, species) [taxon 9986], Mus musculus (house mouse, species) [taxon 10090]
- **Cell lines:** VSMC — Homo sapiens (Human), Finite cell line (CVCL_4009), hy926 — Homo sapiens (Human), Hybrid cell line (CVCL_3901)

## Full text

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## Figures

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## References

106 references — full list in the complete paper: https://tomesphere.com/paper/PMC12916700/full.md

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Source: https://tomesphere.com/paper/PMC12916700