7. Korean Panax Red Ginseng Improves Endothelial Dysfunction and Arterial Stiffness in Patients with Coronary Artery Disease Probably by Decreasing Rho-Associated Kinase Activity of Peripheral Blood Mononuclear Cells

Abstract

Background

Korean Panax Red Ginseng (KPRG) is known to enhance endothelium-dependent vasorelaxation by activating eNOS. Activation of Rho-associated kinase (ROCK) is implicated in endothelial dysfunction in part through destabilization of eNOS mRNA. This study, a randomized, double-blind, placebo-controlled, crossover trial, is aimed to analyze the effect of KPRG on endothelial function, arterial stiffness, and ROCK activity of peripheral blood mononuclear cells (PBMC) in patients with coronary artery disease (CAD).

Methods

Patients (n=20, 12 males, 62.5 yrs) with stable angina (multi-vessel disease: n=10) were treated alternatively with either KPRG (3g/d) or placebo (starch, 3g/d) for 10 weeks (washout period for 4 wks). Measurements of flow mediated dilation (FMD) and nitroglycerine mediated dilation (NMD) on the brachial artery and collection of peripheral venous blood for the biochemical study were performed at day 0 (baseline) and after completion (endpoint) of each treatment. Activity of ROCK of PBMC was assessed by analyzing phospho-Thr853 in the myosin binding subunit (MBS) of myosine light chain phosphatase with use of Western blot, and was expressed as the % ratio of phospho-Thr853-MBS/total MBS at endpoint versus baseline. Patients were classified into low (<5%) FMD group (n=11) and high (>5%) FMD group (n=9).

Results

Treatment with KPRG significantly increased FMD in low FMD group (3.49±0.35% vs 5.50±0.72%, p=0.013), but not in high FMD group. Brachial ankle pulse wave velocity (ba-PWV), measured by VP2000, tends to be decreased by KPRG (1770±185 vs. 1499±95, p=0.05. There was no significant changes in nitroglycerine mediated dilation after each drug treatment in both patient groups. Treatment with KPRG significantly decreased ROCK activity in PBMC of CAD patients (n=6) by 23.9±3.01 as compared with the baseline (p<0.05). Placebo treatment did not change any of these indices significantly.

Conclusion

In conclusions, KPRG improves endothelial dysfunction and peripheral arterial stiffness in patients with CAD probably by decreasing ROCK activity of PBMC.