Ginseng & Healthy Aging

Healthy Aging is becoming one of the biggest challenges in modern health; life expectancy is at an all-time high and people aspire to live longer and healthier lives.

At the same time, the approach to health is shifting from the alleviation and treatment of established health conditions to the prevention and delaying of their onset; and while the key-role of diet and lifestyle is no longer debated, that of supplementation is becoming increasingly important in this context.

Nutraceutical brands have embarked on a race to offer an ever-expanding range of preventive solutions, targeting consumers as young as 40 to support them in the inevitable process of aging. And despite dynamic innovation in the industry, many products continue to draw inspiration from foods and plants known for their anti-aging potential since the dawn of time.

This is particularly the case for Ginseng – undoubtedly the most famous medicinal plant in traditional Asian medicine, and for good reason: its virtues as an elixir of longevity have earned it more than 3000 use and a place of honour in the Chinese, Korean and Japanese pharmacopoeias.

But to what extent does modern science support the effects of the millennial panacea on human health and its potential for preventing age-related discomforts and pathologies ? Could research earn ginseng a new-found glory in modern medicine through the backing of its legendary properties with solid science ? Could an ingredient like ginseng fit the current market’s trends and needs ?

In this article, we offer an overview of the Healthy Aging segment of the Nutraceutical sector and we review the existing bibliography on the anti-aging properties of Panax ginseng roots to find out.


Healthy aging is one of the leading trends on the Nutraceutical market today – and one that will inevitably keep going strong and shaping the Nutraceutical landscape in the current demographic context.

The current demographic transition is a major factor in the development of the Healthy Ageing offer on the Nutraceutical market. According to the World Health Organization (WHO), the population over 60 is expected to double in the first half of the 21st century and reach 2,1 billion by 2050.

Given the decreasing birth rates, the population over 60 years old will increase from 14% of the current global population to 21,4% in 2050. In Western countries like France, population over 65 is expected to go from 17% to 26% in the same period (EU Commission data). The population over 80 years old on the other hand, is expected to triple by the middle of the century and represent 4,4% of the world population.

This unprecedented increase in life expectancy has been leading to an explosion in the incidence of age-related non-communicable diseases (NCDs), also strongly favoured / supported by unhealthy modern lifestyles. The WHO estimates that NCDs currently account for as much as 71% of global deaths and has been emphasizing the crucial role of prevention in controlling their incidence for more than a decade.

Furthermore, numerous medico-economic studies agree that prevention – particularly through nutritional supplementation – would allow a significantly reduce the economic burden that the health care of our aging populations will represent in the forthcoming future.

Not only are adults and seniors a growing portion of our societies, but they are also target of choice for Nutraceutical brands. More and more consumers over the age of 40 are taking a proactive, preventive approach to preserving their health and living longer, healthier lives – and are turning to nutritional and natural supplements to do the job. Adults in the earliest phases of aging are increasingly aware of the importance of investing in their future well-being and they also have more financial means to do so.

Indeed, in the UK only, the proportion of dietary supplements users over the age of 65 reached 40% in 2019 and no less than 27% in Italy. In North America, CRN Consumer Survey on Dietary Supplements reported that the proportion of supplement users goes up to 81% for +55 year/olds.

In 2020 (pre-covid), Euromonitor International’s Health and Nutrition Survey also reported that 32% of global respondents aged 60+ took vitamins and dietary supplements on a daily basis – twice as much as 15- to 29-year-olds (16%).

Market needs are also changing; consumers are looking for comprehensive tailored-made solutions to address their health and well-being in a broader sense; they no longer seek targeted functional product promises such as fatigue, joint health or cholesterol – which they still largely rely on their doctors to prescribe – but rather “Vitality”, “Antioxidant” and “Metabolic balance”. They are willing to start early if it means they will maintain their quality of life in the future without having to swallow a pillbox of meds every morning.

In addition, natural plant-based, clinically proven and sustainably sourced remain very attractive purchase factors for this category as well.

The major health concern of seniors echoes the most widespread life-threatening health issue in our populations: cardiovascular health (cholesterol, blood pressure and related risks of heart attack or stroke). Second comes a major factor of well-being: mobility. Finally, energy and brain function – which includes the preservation of cognitive faculties, focus and memory – also remain among the priorities for + 50 consumers. On the contrary, applications like weight management are relegated to the background in favor of the treatment solutions for the consequences of sustained overweight on health.

In terms of applications, Healthy Aging is a very fragmented market with many areas of focus; from general categories like cognitive health and mobility (which includes joint health, bone health and vitality), to holistic wellness (menopause) and functional positionings (vision, diabetes, memory) and even cosmetic applications (anti-aging of the skin, hair loss).

A striking example of this transition is the transition from vitality and mobility segments into the more comprehensive concept of “Active living”. This category not only addresses mental alertness, physical energy, and joint / bone health but also, and increasingly so, the support of sports performance. Indeed, the segment is seeing the emergence of a great number of products borrowing their codes and promises from sports nutrition, to address a growing portion of mature consumers highly invested in sports practice and wishing to support and boost their performance.

Another emerging trend to which the development of the healthy aging market is contributing significantly is that of Nutricosmetics. Indeed, maintaining a youthful appearance remains an important drive for the consumption of nutritional supplements in the context of aging. In addition, the in&out and preventive approaches are taking a growing space in the cosmetic market and present significant applicative potential for nutraceutical ingredients with benefits for skin, nails or hair health. The fascinating segment of nutricosmetics will be the subject of a separate article in the future.

Contrary to millennials, a large portion of over 50 consumers rely on the advice of a prescriber or pharmacist to choose their products. This contributes to keeping the offer on Healthy Aging relatively medicalized, since Nutraceutical brands must first and foremost convince health professionals.

However, this tendency is destined to shrink as digital-era generations of seniors get older and as the market transitions from treating age-related discomforts to preventing and slowing their appearance. And new innovative brands are addressing the younger portions of aging adults with more lifestyle formulations and positionings. The market seems to be evolving with its future consumers and is seeing tremendous innovation at all levels.

In terms of ingredients, formulations are extremely diverse and address such a diversity of applications that it is difficult to establish an exhaustive classification. However, several important categories stand out in the market:

  • Vitamins & Minerals, used as a treatment base to prevent age-related deficiencies and protect the normal functioning of vital functions.


  • Antioxidants like glutathione, resveratrol, hydroxytyrosol, green tea catechins, or anthocyanins from berries. They help slow down the oxidation process and protect cells from ROS damage throughout the body. Lutein and zeaxanthin are particularly known for their potential to prevent macular degeneration and therefore protect vision.


  • Anti-inflammatory compounds like curcurmin from turmeric, boswellin from Boswellia or gingerol from ginger to help fight local (joints, intestines) and low-grade generalized inflammation.
  • Coenzymes like NAD+ (and its precursors) and CoQ10. They naturally decline with age and are involved in mitochondrial metabolism and essential to cellular energy production.


  • Hormone-regulating plants like phytoestrogens for menopause (hops, soy, flax seeds) or plants with androgenic benefits for prostate or hair loss (saw palmetto), to help attenuate the important hormonal changes consumer go through as they age – or phytosterols to lower cholesterol.

Traditional anti-aging plants from ancient pharmacopeias are also regaining great interest of the public. Inspired by Asian Traditional Medicine, Ayurveda or traditional phytotherapy, they fit right in the current trend for natural safe plant-based solutions. Amongst the most well-know are turmeric for inflammation and joint health, berries like aronia for their antioxidant properties, gingko for memory, and ginseng for energy – to name a few.

The Healthy Aging segment also draws the inspiration for its key active ingredients from the diets of the world’s longest-lived populations. This is particularly the case for the Mediterranean diet, which is rich in antioxidant foods and fatty acids from fish (omega-3) and associated with a lower risk of diabetes and cholesterol, cardiovascular disease and even neurodegenerative diseases. Countless nutraceutical products capitalize on the natural antioxidant properties of olive oil (hydroxytyrosol), grapes (resveratrol) or even pomegranate (punicalagins) for the maintenance of good health and longevity.

Finally, the ubiquitous trend of microbiome is also expanding into the Healthy Aging market. There is a growing interest in bacterial strains that promote longevity, and many studies show that the microbiotic balance plays a key role in the prevention of inflammatory and oxidative syndromes at the origin of aging.


From a biological perspective, aging represents the accumulation of cellular damage in the body over time, slowly leading to a less efficient function of organs and metabolic processes. In turn, physiological dysfunctions lead to a decline in mental, physical and even vital functions that are expressed by a variety of so-called geriatric syndromes.

In addition to genetic and socio-economic predispositions, the onset of symptoms and diseases related to aging is strongly impacted by lifestyle risk factors such as diet, stress, physical fitness and unhealthy habits (tobacco and alcohol, living in polluted areas); all of which can be aggravating factors.

Research on rejuvenating and longevity solutions is still at its first steps but existing offer generally capitalizes on fighting two of the main mechanisms of aging: exposure to oxidative stress and low-grade inflammation.

The known antioxidant and anti-inflammatory effects of ginseng and its bioactive molecules may therefore have far more ramifications and health benefits than will appear in the tradition of Asian medicine.

2.1. Neurological benefits

According to the WHO, dementia – or the progressive deterioration of cognitive function with age – affects more than 55 million people worldwide. Among the 10 million new cases of dementia each year, between 60 and 70% are cases of Alzheimer’s; it is also one of the main causes of disability adjusted life years (DALYs).

To this day, no effective pharmacological treatment has been found, most scientific literature rather pointing at the importance of prevention in the delaying on its first symptoms and the slowing of its development.

  • Neuroprotection & Cognitive performance

A significant number of studies support the positive neurological potential of ginseng and its bioactive compounds. Rg3 in particular shows neuroprotective properties [1-8]. This rare ginsenoside has also been identified as a “shield” against cognitive deterioration in multiple experimental models [9-10]. The benefits of Rg3 on Alzheimer related mechanisms also look very promising [11-14].

In addition, Rg5 & Rk1 have recently been identified as beneficial in the neurological area, including depression [15] and sleeping issues [16]. However, most of the literature on the neurological impact of these ginsenosides, is referring to neuroprotective properties [17] including preservation of cognitive capacities [18-19] and positive impact in neurodegenerative models [20]. In addition, it has been shown that Rg3, Rg5 & Rk1 may have memory enhancing effects, as they were shown to significantly reversed scopolamine – induced memory dysfunction on top of neuroprotective effects [21].


  • Fatigue

Ginseng is traditionally considered a natural tonic and has largely been investigated in that sphere. In fact, ginseng preparations and a variety of its bioactive components – among which saponins [22] polysaccharides [23-24] or oligopeptides [25] – have revealed promising potential for the treatment of age or chronic illness-related fatigue.

More specifically, rare ginsenoside Rg3 seems to play an important role in ginsengs ergogenic properties. Rg3 has been reported to have positive impact on fatigue, both from a metabolic [26] and a neurological [27] standpoint. In addition, it has been shown to “mimic exercise training” on cardiac mitochondrial system [28], suggesting new application potential for sport nutrition.


2.2. Metabolic benefits

Metabolic disorders are one of the major health concerns deriving from unhealthy diets and lifestyles, although genetic predispositions also play a role in their onset. Closely correlated with the boom of obesity, chronic metabolic dysfunctions like diabetes can cause serious damage to the cardiovascular, uro-digestive, and neurological systems and constitute a great and increasing economic burden to society.

According to the WHO, diabetes affects more than 400 million people worldwide and was the direct cause of 1,5 million deaths in 2019. In addition, 48% of deaths from diabetes occur before the age of 70 and would therefore be preventable.

Ginseng, and in particular noble ginsenoside-rich black ginseng, has also demonstrated significant efficacy in the context of both glycaemic and lipidemic regulation [29].

Experimental data points at the efficacy of the ginsenoside tandem Rg3, Rg5 and Rk1 in multiple models [30-33]. Indeed, an increasing number of scientific data shows the positive impact of these three bioactive ginsenosides on sugar and fats metabolism, which clearly suggests considering them an option for early stages of “metabolic imbalance”. 

Even separately, Rg5 [34-35] and Rg3 [36-38] have been identified as a promising adjuvant treatment for diabetic patients. Rg3, shows significant balancing effect on blood sugar [39-42] and potential benefits on complications related to the diabetic condition [43-46].

2.3. Cardiovascular benefits

According to WHO estimates, cardiovascular diseases (CVDs) are the leading cause of death worldwide. Mainly represented by heart attacks and strokes, CVDs account for no less than 38% of all premature deaths (under 70) due to NCDs each year, making in one of the top health topics for both patients and health authorities.

Although current prevention strategies mainly address behavioural risk factors such as unhealthy and sedentary lifestyles, obesity and alcohol and tobacco use, dietary supplements brands are also addressing the issue with cholesterol and heart health natural solutions.

Numerous research supports the cardioprotective potential of ginseng. Studies show oral administration of ginseng extracts can have positive effects on both vascular tone and function [47-49] and cardiac function [50], as well as anti-thrombotic potential through anti-platelet aggregation effects [50-51].

In terms of bioactive molecules, Rg3 has revealed beneficial against hypertension [52-53] and has shown potential as a cardioprotective [54] and vasculoprotective [55] solution. Rg3 has also demonstrated efficacy in experimental models of atherosclerosis [56-58]. In addition, Rg3 seems to have beneficial effect on osteoporosis-related mechanisms [59-61].

On the other hand, scientific data on the cardiovascular benefits of Rg5 & Rk1 is still relatively limited. Current research does however seem to confirm the cardioprotective [62], vasculoprotective [63] and anti-aggregation activity [64] of these saponins. In addition, Rg5 promotes angiogenesis and shows strong vasorelaxant properties [65]. These preliminary results thus seem to point to the efficiency of those rare ginsenosides in a comparable manner than that of Rg3, which should encourage additional research for Rg5 & Rk1 applications in this field.

2.4. Joint & bone health

Joint & bone health are two major factors in preserving mobility at an old age. Chronic joint inflammation – in particular arthritis – can be very painful and disabling and bone tissue fragilization (osteoporosis) significantly increases the risk of fracture.

Rare bioactive forms of ginsenosides were identified as beneficial for bone health in different models.

Several studies showed improved growth, differentiation, and proliferation of murine preosteoblastic cell lines upon application of bioactive ginsenoside tandem Rg5:Rk1 [66] and Rg3-enriched fermented red ginseng [67].

Rg3 was also proven to inhibit osteoclastogenesis, and thus reduce bone resorption, which suggests potential applications for osteoporosis [68-69]. Other potential mechanisms of Rg3 efficacy in alleviating aluminium-induced osteoporosis were also uncovered in another study, pointing at an increased resistance to oxidative stress, growth factor regulation and facilitation of bone formation [70].

Finally, ginseng noble ginsenosides have shown potential for prevention and treatment of cartilage degradation in osteoarthritis models. Rg3 has demonstrated higher proliferative and telomerase activity, leading to protective properties against chondrocyte senescence [71]. Rg5 on the other hand inhibits cartilage apoptosis and thus prevents cartilage degradation [72].

2.5. Other benefits

  • Regulation of autophagy

 The loss of autophagic capacity in human cells is one of the key processes of aging. Maintaining and restoring the physiological mechanisms of autophagy is thus a key strategy in developing treatment solutions targeting longevity. In this context, investigating the underlying autophagic mechanisms that may have earned ginseng its millennial reputation as an elixir of longevity could be of real interest for applications in healthy aging.

First, a 2016 study unveiled the protective effect and autophagy upregulation role of ginsenoside Rg3 in the context of prion-induced neuron cytotoxicity and mitochondrial damage [73], suggesting the saponin’s potential for the treatment of neurodegenerative diseases.

Rg3(S) also showed potential to reverse the effects of replicative senescence in Human Dermal Fibroblasts (HDFs) by restoration of ATP levels and the NAD+/NADH ratio [74] and induction of antioxidant enzymes like PRDX3 [78]. The mechanism behind it could be Rg3’s modulation of Akt-mTOR-sirtuin signaling to promote the biogenesis of mitochondria [75].

Another study later established the link between Rg3’s role on senescence regulation and autophagy in HDFs. Rg3’s was shown to induce autophagy and NRF2 antioxidant signalling (through promotion of AMPK activation), resulting in the abolishment of replicative and ROS‐induced senescence in HDFs [76]. Ultimately, Rg3 was shown to promote rejuvenation in skin aging, thus opening new research perspectives for its use in autophagy‐dependent antisenescence treatment strategies. The same AMPK activation mechanism was observed for Rg3-induced autophagy in the context of myocardial injury [77].

  • Skin anti-photoaging properties

The antioxidant properties of ginsenosides have also led them to be investigated for the prevention of skin aging, with potential for nutricosmetic applications.

Indeed, oral administration of red ginseng showed a significant inhibition of UVB-radiation related wrinkles on hairless rats’ skin, probably through inhibition of collagen degradation [78]. In human studies, red and enzyme-modified ginseng not only showed reduced various skin roughness indexes (i.e. wrinkles) but also improved the skin’s moisture and elasticity [79-80].

At a cellular level, Rg3-enriched ginseng extract has shown antiphotoaging effects on human dermal fibroblasts after exposure to both UV and IR [81]. Rg3 treatment also restored ATP mitochondrial dysfunction in skin cells damaged by UV irradiation, as well as to enhance the expression of antioxidant proteins [82]. Another study had also previously shown the stereoselective anti-photoaging properties of 20(S)-Rg3 on HaCaT human skin cells [83], through ROS-scavenging and MMP-2 inhibitory mechanisms.

  • Sexual function enhancement

Although clinical evidence is still largely suggestive on this matter [84], sexual function enhancement is one of the most widespread traditional applications of ginseng.

A recent study on a steamed ginseng extract suggested the interest of rare ginsenosides, in particular Rk1 and Rg5, in the recovery of erectile function [85]. In another paper, oral supplementation of Rg3 also showed protective effects against erectile dysfunction through antioxidant and anti-apoptotic effects in corpus cavernosum cells, in a murine model of streptozotocin (STZ)-induced diabetes [86].

  • Microbiotic benefits

Microbiotic health also appears to have a role in maintaining health at an old age, and ginseng may again provide benefits in this sphere. Indeed, diets rich in fermented foods have repeatedly been correlated with the extraordinary longevity of certain populations such as the Mediterranean or the Japanese diets – the latter even holds the record of the greatest number of centenarians within it.

We now know that microbiotic balance is an important health modulator intimately linked to physiological functions, from immunity to neurology and metabolism. On the contrary, states of dysbiosis and the chronic low-grade inflammation they cause are an increased risk factor for the development of age-related non-communicable (or lifestyle) diseases such as diabetes.

Recent research shows that several active compounds of Panax ginseng [87-88] – including specific polysaccharides [89-91] and bioactive ginsenosides like Rh4 & Rk3 [92-94] – have been identified as beneficial for the gut microbiota. While it is too soon to affirm that specific ginseng compounds could support seniors’ health through this microbiotic dimension, an increasing number of data points in this direction.

  • Hormonal deregulation

Ginseng also shows benefits for the alleviation of hormone-dependent conditions in both men and women. However, ginsenosides do not demonstrate estrogenic or androgenic activity despite having a very similar structure to that of steroid hormones.

In the case of androgenic alopecia – a hormone-related condition and predominant cause of hair loss in men – ginseng and several of its bioactive saponins have demonstrated significant clinical potential in both preventing / attenuating hair loss and stimulating hair growth at the follicular level. Rare ginsenosides inhibitory action of on 5α-reductase, a testosterone converting enzyme whose activity is correlated to the onset of androgenic alopecia, was found to be one of the mechanisms involved. This same inhibition mechanism was also identified as the main mode of action of saw palmetto in the treatment of prostatic hypertrophy, suggesting that ginseng may also have benefits in this area.

    On the other hand, ginseng also demonstrates a multi-target action on various menopausal discomforts – among which hot flashes, mood stability, sleeping issues and osteoporosis, and could thus help women through their peri-menopausal transition through significant symptomatic alleviation.


    Ginseng is one of the most studied medicinal plants in the world, and therefore benefits from a wide range of scientifically proven properties of particular interest in the context of aging.

    The anti-inflammatory and antioxidant properties of ginseng and its active constituents give it a wide spectrum of action, ranging from regulation of autophagy to protection of cognitive (neuroprotection), cardiovascular (cardioprotection) and metabolic functions.

    Ginseng is also involved in alleviating age-related hormonal imbalances, with significant potential for menopause, osteoporosis and even hair loss.

    Finally, ginsenosides have an interesting potential to prevent the appearance of visible signs of aging on the skin and perhaps to address in a safe and natural way other problems at increased risk in the elderly such erectile dysfunction and intestinal dysbiosis.

    In conclusion, harnessing the full potential of this age-old panacea could open-up the path to new development opportunities in the market of Healthy Aging. Generally known for energy, ginseng’s use could very be well fit the needs of the sector and be used both as a stand-alone general well-being ingredient or in combination with other potent plants or nutrients active on more specifically targeted age-related health issues.

    Today more than ever, ginseng continues to live up to its age-old reputation as an elixir of youth, offering a wide variety of scientifically proven benefits for the prevention of age-related pathologies and the mitigation of geriatric symptoms.


    [1] Hou J, Xue J, Wang Z, Li W (2018) – “Ginsenoside Rg3 and Rh2 protect trimethyltin-induced neurotoxicity via prevention on neuronal apoptosis and neuroinflammation.” Phytother Res. 2018 Dec;32(12):2531-2540. doi: 10.1002/ptr.6193. Epub 2018 Oct 2.

    [2] Park SM, Choi MS, Sohn NW, Shin JW (2012) – “Ginsenoside Rg3 attenuates microglia activation following systemic lipopolysaccharide treatment in mice.” Biol Pharm Bull. 2012;35(9):1546-52.

    [3] He B, Chen P, Yang J, Yun Y, Zhang X, Yang R, Shen Z (2012) – “Neuroprotective effect of 20(R)-ginsenoside Rg(3) against transient focal cerebral ischemia in rats.” Neurosci Lett. 2012 Sep 27;526(2):106-11. doi: 10.1016/j.neulet.2012.08.022. Epub 2012 Aug 19.

    [4] Kim SO, You JM, Yun SJ, Son MS, Nam KN, Hong JW, Kim SY, Choi SY, Lee EH (2010) – “Ginsenoside rb1 and rg3 attenuate glucocorticoid-induced neurotoxicity.” Cell Mol Neurobiol. 2010 Aug;30(6):857-62. doi: 10.1007/s10571-010-9513-0. Epub 2010 Mar 25.

    [5] Tian J, Zhang S, Li G, Liu Z, Xu B (2009) – “20(S)-ginsenoside Rg3, a neuroprotective agent, inhibits mitochondrial permeability transition pores in rat brain.” Phytother Res. 2009 Apr;23(4):486-91. doi: 10.1002/ptr.2653.

    [6] Joo SS, Yoo YM, Ahn BW, Nam SY, Kim YB, Hwang KW, Lee DI (2008) – “Prevention of inflammation-mediated neurotoxicity by Rg3 and its role in microglial activation.” Biol Pharm Bull. 2008 Jul;31(7):1392-6.

    [7] Kim JH, Cho SY, Lee JH, Jeong SM, Yoon IS, Lee BH, Lee JH, Pyo MK, Lee SM, Chung JM, Kim S, Rhim H, Oh JW, Nah SY (2007) – “Neuroprotective effects of ginsenoside Rg3 against homocysteine-induced excitotoxicity in rat hippocampus.” Brain Res. 2007 Mar 9;1136(1):190-9. Epub 2006 Dec 22.

    [8] Tian J, Fu F, Geng M, Jiang Y, Yang J, Jiang W, Wang C, Liu K (2005) – “Neuroprotective effect of 20(S)-ginsenoside Rg3 on cerebral ischemia in rats.” Neurosci Lett. 2005 Feb 10;374(2):92-7.

    [9] Kim J, Shim J, Lee S, Cho WH, Hong E, Lee JH, Han JS, Lee HJ, Lee KW (2016) – “Rg3-enriched ginseng extract ameliorates scopolamine-induced learning deficits in mice.” BMC Complement Altern Med. 2016 Feb 18;16:66. doi: 10.1186/s12906-016-1050-z.

    [10] Lee B, Sur B, Park J, Kim SH, Kwon S, Yeom M, Shim I, Lee H, Hahm DH (2013) – “Effects of Ginsenoside Rg3 on fatigue resistance and SIRT1 in aged rats -induced learning and memory impairments by anti-inflammatory activity in rats.” Biomol Ther (Seoul). 2013 Sep 30;21(5):381-90. doi: 10.4062/biomolther.2013.053.

    [11] Zhang Y, Yang X, Wang S, Song S (2019) – “Ginsenoside Rg3 Prevents Cognitive Impairment by Improving Mitochondrial Dysfunction in the Rat Model of Alzheimer’s Disease.” J Agric Food Chem. 2019 Sep 11;67(36):10048-10058. doi: 10.1021/acs.jafc.9b03793. Epub 2019 Aug 27.

    [12] Jang SK, Yu JM, Kim ST, Kim GH, Park DW, Lee DI, Joo SS (2015) – “An Aβ42 uptake and degradation via Rg3 requires an activation of caveolin, clathrin and Aβ-degrading enzymes in microglia.” Eur J Pharmacol. 2015 Jul 5;758:1-10. doi: 10.1016/j.ejphar.2015.03.071. Epub 2015 Apr 4.

    [13] Kang MS, Baek SH, Chun YS, Moore AZ, Landman N, Berman D, Yang HO, Morishima-Kawashima M, Osawa S, Funamoto S, Ihara Y, Di Paolo G, Park JH, Chung S, Kim TW (2013) – “Modulation of lipid kinase PI4KIIα activity and lipid raft association of presenilin 1 underlies γ-secretase inhibition by ginsenoside (20S)-Rg3.” J Biol Chem. 2013 Jul 19;288(29):20868-82. doi: 10.1074/jbc.M112.445734. Epub 2013 May 30.

    [14] Yang L, Hao J, Zhang J, Xia W, Dong X, Hu X, Kong F, Cui X (2009) – “Ginsenoside Rg3 promotes beta-amyloid peptide degradation by enhancing gene expression of neprilysin.” J Pharm Pharmacol. 2009 Mar;61(3):375-80. doi: 10.1211/jpp/61.03.0013.

    [15] Xu D, Wang C, Zhao W, Gao S, Cui Z (2017) – “Antidepressant-like effects of ginsenoside Rg5 in mice: Involving of hippocampus BDNF signaling pathway.” Neurosci Lett. 2017 Apr 3;645:97-105. doi: 10.1016/j.neulet.2017.02.071. Epub 2017 Mar 1.

    [16] Shao J , Zheng X , Qu L , Zhang H , Yuan H , Hui J , Mi Y , Ma P , Fan D (2020) – “Ginsenoside Rg5/Rk1 ameliorated sleep via regulating the GABAergic/serotoninergic signaling pathway in a rodent model.” Food Funct. 2020 Feb 26;11(2):1245-1257. doi: 10.1039/c9fo02248a.

    [17] Lee YY, Park JS, Jung JS, Kim DH, Kim HS (2013) – “Anti-inflammatory effect of ginsenoside Rg5 in lipopolysaccharide-stimulated BV2 microglial cells.” Int J Mol Sci. 2013 May 8;14(5):9820-33. doi: 10.3390/ijms14059820.

    [18] An KS, Choi YO, Lee SM, Ryu HY, Kang SJ, Yeon Y, Kim YR, Lee JG, Kim CJ, Lee YJ, Kang BJ, Choi JE, Song KS (2019) – “Ginsenosides Rg5 and Rk1 Enriched Cultured Wild Ginseng Root Extract Bioconversion of Pediococcus pentosaceus HLJG0702: Effect on Scopolamine-Induced Memory Dysfunction in Mice.” Nutrients. 2019 May 20;11(5). pii: E1120. doi: 10.3390/nu11051120.

    [19] Kim EJ, Jung IH, Van Le TK, Jeong JJ, Kim NJ, Kim DH (2013) –Ginsenosides Rg5 and Rh3 protect scopolamine-induced memory deficits in mice.” J Ethnopharmacol. 2013 Mar 7;146(1):294-9. doi: 10.1016/j.jep.2012.12.047. Epub 2013 Jan 9.

    [20] Chu S, Gu J, Feng L, Liu J, Zhang M, Jia X, Liu M, Yao D (2014) – “Ginsenoside Rg5 improves cognitive dysfunction and beta-amyloid deposition in STZ-induced memory impaired rats via attenuating neuroinflammatory responses.” Int Immunopharmacol. 2014 Apr;19(2):317-26. doi: 10.1016/j.intimp.2014.01.018. Epub 2014 Feb 4.

    [21] Bao, H. Y., Zhang, J., Yeo, S. J., Myung, C. S., Kim, H. M., Kim, J. M., … & Kang, J. S. (2005) –Memory enhancing and neuroprotective effects of selected ginsenosides”. Archives of Pharmacal Research, 28(3), 335-342.

    [22] Lee, N., Lee, S. H., Yoo, H. R., & Yoo, H. S. (2016)“Anti-fatigue effects of enzyme-modified ginseng extract: a randomized, double-blind, placebo-controlled trial”. The Journal of Alternative and Complementary Medicine, 22(11), 859-864.

    [23] Wang, J., Li, S., Fan, Y., Chen, Y., Liu, D., Cheng, H., … & Zhou, Y. (2010) – “Anti-fatigue activity of the water-soluble polysaccharides isolated from Panax ginseng CA Meyer”. Journal of ethnopharmacology, 130(2), 421-423.

    [24] Wang, J., Sun, C., Zheng, Y., Pan, H., Zhou, Y., & Fan, Y. (2014) – “The effective mechanism of the polysaccharides from Panax ginseng on chronic fatigue syndrome”. Archives of pharmacal research, 37(4), 530-538.

    [25] Bao, L., Cai, X., Wang, J., Zhang, Y., Sun, B., & Li, Y. (2016)“Anti-fatigue effects of small molecule oligopeptides isolated from Panax ginseng CA Meyer in mice”. Nutrients, 8(12), 807.

    [26] Yang QY, Lai XD, Ouyang J, Yang JD (2018) – “Effects of Ginsenoside Rg3 on fatigue resistance and SIRT1 in aged rats.” Toxicology. 2018 Nov 1;409:144-151. doi: 10.1016/j.tox.2018.08.010. Epub 2018 Aug 23.

    [27] Xu Y, Zhang P, Wang C, Shan Y, Wang D, Qian F, Sun M, Zhu C (2013) – “Effect of ginsenoside Rg3 on tyrosine hydroxylase and related mechanisms in the forced swimming-induced fatigue rats.” J Ethnopharmacol. 2013 Oct 28;150(1):138-47. doi: 10.1016/j.jep.2013.08.016. Epub 2013 Aug 28.

    [28] M, Huang C, Wang C, Zheng J, Zhang P, Xu Y, Chen H, Shen W (2013) – “Ginsenoside Rg3 improves cardiac mitochondrial population quality: mimetic exercise training.” Biochem Biophys Res Commun. 2013 Nov 8;441(1):169-74. doi: 10.1016/j.bbrc.2013.10.039. Epub 2013 Oct 15.

    [29] Metwaly AM, Lianlian Z, Luqi H, Deqiang D (2019) – “Black Ginseng and Its Saponins: Preparation, Phytochemistry and Pharmacological Effects.” Molecules. 2019 May 14;24(10):1856. doi: 10.3390/molecules24101856.

    [30] Jeong YJ, Hwang MJ, Hong CO, Yoo DS, Kim JS, Kim DY, Lee KW (2020) – “Anti-hyperglycemic and hypolipidemic effects of black ginseng extract containing increased Rh4, Rg5, and Rk1 content in muscle and liver of type 2 diabetic db/db mice.” Food Sci Biotechnol. 2020 Jul 1;29(8):1101-1112. doi: 10.1007/s10068-020-00753-3. eCollection 2020

    [31] Ponnuraj SP, Siraj F, Kang S, Noh HY, Min JW, Kim YJ, Yang DC (2014) – “Amelioration of insulin resistance by Rk1 + Rg5 complex under endoplasmic reticulum stress conditions.” Pharmacognosy Res. 2014 Oct;6(4):292-6. doi: 10.4103/0974-8490.138257.

    [32] Bai L, Gao J, Wei F, Zhao J, Wang D, Wei J (2018) – “Therapeutic Potential of Ginsenosides as an Adjuvant Treatment for Diabetes.” Front Pharmacol. 2018 May 1;9:423. doi: 10.3389/fphar.2018.00423. eCollection 2018. Review.

    [33] Yesmin Simu S, Ahn S, Castro-Aceituno V, Yang DC (2017) – “Ginsenoside Rg5: Rk1 Exerts an Anti-obesity Effect on 3T3-L1 Cell Line by the Downregulation of PPARγ and CEBPα.” Iran J Biotechnol. 2017 Dec 29;15(4):252-259. doi: 10.15171/ijb.1517. eCollection 2017.

    [34] Zhu Y, Yang H, Deng J, Fan D (2021) – “Ginsenoside Rg5 Improves Insulin Resistance and Mitochondrial Biogenesis of Liver via Regulation of the Sirt1/PGC-1alpha Signaling Pathway in db/db Mice.” J Agric Food Chem. 2021 Aug 4;69(30):8428-8439. doi: 10.1021/acs.jafc.1c02476. Epub 2021 Jul 26.

    [35] Xiao N, Yang LL, Yang YL, Liu LW, Li J, Liu B, Liu K, Qi LW, Li P (2017) – “Ginsenoside Rg5 Inhibits Succinate-Associated Lipolysis in Adipose Tissue and Prevents Muscle Insulin Resistance.” Front Pharmacol. 2017 Feb 14;8:43. doi: 10.3389/fphar.2017.00043. eCollection 2017.

    [36] Kim K, Nam KH, Yi SA, Park JW, Han JW, Lee J (2020) – “Ginsenoside Rg3 Induces Browning of 3T3-L1 Adipocytes by Activating AMPK Signaling.” Nutrients. 2020 Feb 7;12(2):427. doi: 10.3390/nu12020427.

    [37] Lee JB, Yoon SJ, Lee SH, Lee MS, Jung H, Kim TD, Yoon SR, Choi I, Kim IS, Chung SW, Lee HG, Min JK, Park YJ (2017) – “Ginsenoside Rg3 ameliorated HFD-induced hepatic steatosis through downregulation of STAT5-PPARgamma.” J Endocrinol. 2017 Dec;235(3):223-235. doi: 10.1530/JOE-17-0233.

    [38] Lee S, Lee MS, Kim CT, Kim IH, Kim Y (2012) – “Ginsenoside Rg3 reduces lipid accumulation with AMP-Activated Protein Kinase (AMPK) activation in HepG2 cells.” Int J Mol Sci. 2012;13(5):5729-39. doi: 10.3390/ijms13055729. Epub 2012 May 11.

    [39] Park MW, Ha J, Chung SH (2008) – “20(S)-ginsenoside Rg3 enhances glucose-stimulated insulin secretion and activates AMPK.” Biol Pharm Bull. 2008 Apr;31(4):748-51. doi: 10.1248/bpb.31.748.

    [40] Kim KS, Jung Yang H, Lee IS, Kim KH, Park J, Jeong HS, Kim Y, Seok Ahn K, Na YC, Jang HJ (2015) – “The aglycone of ginsenoside Rg3 enables glucagon-like peptide-1 secretion in enteroendocrine cells and alleviates hyperglycemia in type 2 diabetic mice.” Sci Rep. 2015 Dec 17;5:18325. doi: 10.1038/srep18325.

    [41] Niu J, Pi ZF, Yue H, Yang H, Wang Y, Yu Q, Liu SY (2012) – “Effect of 20(S)-ginsenoside Rg3 on streptozotocin-induced experimental type 2 diabetic rats: a urinary metabonomics study by rapid-resolution liquid chromatography/mass spectrometry.” Rapid Commun Mass Spectrom. 2012 Dec 15;26(23):2683-9. doi: 10.1002/rcm.6392.

    [42] Kim M, Ahn BY, Lee JS, Chung SS, Lim S, Park SG, Jung HS, Lee HK, Park KS (2009) – “The ginsenoside Rg3 has a stimulatory effect on insulin signaling in L6 myotubes.” Biochem Biophys Res Commun. 2009 Nov 6;389(1):70-3. doi: 10.1016/j.bbrc.2009.08.088. Epub 2009 Aug

    [43] Saba E, Kim SH, Kim SD, Park SJ, Kwak D, Oh JH, Park CK, Rhee MH (2018) – “Alleviation of diabetic complications by ginsenoside Rg3-enriched red ginseng extract in western diet-fed LDL-/- mice.” J Ginseng Res. 2018 Jul;42(3):352-355. doi: 10.1016/j.jgr.2017.04.004. Epub 2017 Apr 24.

    [44] Kim YJ, Park SM, Jung HS, Lee EJ, Kim TK, Kim TN, Kwon MJ, Lee SH, Rhee BD, Kim MK, Park JH (2016) – “Ginsenoside Rg3 prevents INS-1 cell death from intermittent high glucose stress.” Islets. 2016 Apr 18;8(3):57-64. doi: 10.1080/19382014.2016.1161874.

    [45] Sun HQ, Zhou ZY (2010)“Effect of ginsenoside-Rg3 on the expression of VEGF and TNF-α in retina with diabetic rats.” Int J Ophthalmol. 2010;3(3):220-3. doi: 10.3980/j.issn.2222-3959.2010.03.09. Epub 2010 Sep 18.

    [46] Kang KS, Yamabe N, Kim HY, Park JH, Yokozawa T (2008)“Therapeutic potential of 20(S)-ginsenoside Rg(3) against streptozotocin-induced diabetic renal damage in rats.” Eur J Pharmacol. 2008 Sep 4;591(1-3):266-72. doi: 10.1016/j.ejphar.2008.06.077. Epub 2008 Jun 27.

    [47] Irfan, M., Kwak, Y. S., Han, C. K., Hyun, S. H., & Rhee, M. H. (2020) –  “Adaptogenic effects of Panax ginseng on modulation of cardiovascular functions”. Journal of Ginseng Research44(4), 538-543.

    [48] Kim, J. H. (2018) – “Pharmacological and medical applications of Panax ginseng and ginsenosides: a review for use in cardiovascular diseases”. Journal of ginseng research42(3), 264-269.

    [49] Park, J. B., Kwon, S. K., Nagar, H., Jung, S. B., Jeon, B. H., Kim, C. S., … & Kim, C. S. (2014) –Rg3-enriched Korean Red Ginseng improves vascular function in spontaneously hypertensive rats”. Journal of ginseng research38(4), 244-250.

    [50] Kwon, H. W. (2018) – “Inhibitory Effect of 20 (S)-Ginsenoside Rg3 on Human Platelet Aggregation and Intracellular Ca2+ Levels via Cyclic Adenosine Monophosphate Dependent Manner”. Preventive nutrition and food science23(4), 317.

    [51] Jeong, D., Irfan, M., Kim, S. D., Kim, S., Oh, J. H., Park, C. K., … & Rhee, M. H. (2017) – “Ginsenoside Rg3-enriched red ginseng extract inhibits platelet activation and in vivo thrombus formation”. Journal of Ginseng Research, 41(4), 548-555.

    [52] Nagar H, Choi S, Jung SB, Jeon BH, Kim CS (2016) – “Rg3-enriched Korean Red Ginseng enhances blood pressure stability in spontaneously hypertensive rats.” Integr Med Res. 2016 Sep;5(3):223-229. doi: 10.1016/j.imr.2016.05.006. Epub 2016 Jun 3.

    [53] Jovanovski, E., Bateman, E. A., Bhardwaj, J., Fairgrieve, C., Mucalo, I., Jenkins, A. L., & Vuksan, V. (2014)“Effect of Rg3-enriched Korean red ginseng (Panax ginseng) on arterial stiffness and blood pressure in healthy individuals: a randomized controlled trial”. Journal of the American Society of Hypertension, 8(8), 537-541.

    [54] Jiang Y, Li M, Lu Z, Wang Y, Yu X, Sui D, Fu L (2017) – “Ginsenoside Rg3 induces ginsenoside Rb1-comparable cardioprotective effects independent of reducing blood pressure in spontaneously hypertensive rats.” Exp Ther Med. 2017 Nov;14(5):4977-4985. doi: 10.3892/etm.2017.5198. Epub 2017 Sep 22.

    [55] Min JK, Kim JH, Cho YL, Maeng YS, Lee SJ, Pyun BJ, Kim YM, Park JH, Kwon YG (2006) – “20(S)-Ginsenoside Rg3 prevents endothelial cell apoptosis via inhibition of a mitochondrial caspase pathway.” Biochem Biophys Res Commun. 2006 Oct 27;349(3):987-94. Epub 2006 Aug 30.

    [56] Xue, Q., He, N., Wang, Z., Fu, X., Aung, L. H. H., Liu, Y., … & Yu, T. (2021) – “Functional roles and mechanisms of ginsenosides from Panax ginseng in atherosclerosis”. Journal of ginseng research, 45(1), 22-31.

    [57] Guo M, Xiao J, Sheng X, Zhang X, Tie Y, Wang L, Zhao L, Ji X (2018) – “Ginsenoside Rg3 Mitigates Atherosclerosis Progression in Diabetic apoE-/- Mice by Skewing Macrophages to the M2 Phenotype.” Front Pharmacol. 2018 May 9;9:464. doi: 10.3389/fphar.2018.00464. eCollection 2018.

    [58] Guo M, Guo G, Xiao J, Sheng X, Zhang X, Tie Y, Cheng YK, Ji X (2018) – “Ginsenoside Rg3 stereoisomers differentially inhibit vascular smooth muscle cell proliferation and migration in diabetic atherosclerosis.” J Cell Mol Med. 2018 Jun;22(6):3202-3214. doi: 10.1111/jcmm.13601. Epub 2018 Mar 22.

    [59] Zhang X, Chen K, Wei B, Liu X, Lei Z, Bai X (2016) – “Ginsenosides Rg3 attenuates glucocorticoid-induced osteoporosis through regulating BMP-2/BMPR1A/Runx2 signaling pathway.” Chem Biol Interact. 2016 Aug 25;256:188-97. doi: 10.1016/j.cbi.2016.07.003. Epub 2016 Jul 5.

    [60] Siddiqi MH, Siddiqi MZ, Kang S, Noh HY, Ahn S, Simu SY, Aziz MA, Sathishkumar N, Jiménez Pérez ZE, Yang DC (2015) – “Inhibition of Osteoclast Differentiation by Ginsenoside Rg3 in RAW264.7 Cells via RANKL, JNK and p38 MAPK Pathways Through a Modulation of Cathepsin K: An In Silico and In Vitro Study.” Phytother Res. 2015 Sep;29(9):1286-1294. doi: 10.1002/ptr.5374. Epub 2015 Jun 8.

    [61] Siddiqi MZ, Siddiqi MH, Kim YJ, Jin Y, Huq MA, Yang DC (2015) – “Effect of Fermented Red Ginseng Extract Enriched in Ginsenoside Rg3 on the Differentiation and Mineralization of Preosteoblastic MC3T3-E1 Cells”. J Med Food. 2015 May;18(5):542-8. doi: 10.1089/jmf.2014.3251. Epub 2015 Mar 12.

    [62] Yang YL, Li J, Liu K, Zhang L, Liu Q, Liu B, Qi LW (2017) – “Ginsenoside Rg5 increases cardiomyocyte resistance to ischemic injury through regulation of mitochondrial hexokinase-II and dynamin-related protein 1.” Cell Death Dis. 2017 Feb 23;8(2):e2625. doi: 10.1038/cddis.2017.43.

    [63] Maeng YS, Maharjan S, Kim JH, Park JH, Suk Yu Y, Kim YM, Kwon YG (2013)“Rk1, a ginsenoside, is a new blocker of vascular leakage acting through actin structure remodeling.” PLoS One. 2013 Jul 22;8(7):e68659. doi: 10.1371/journal.pone.0068659. Print 2013.

    [64] Lee JG, Lee YY, Kim SY, Pyo JS, Yun-Choi HS, Park JH (2009) – “Platelet antiaggregating activity of ginsenosides isolated from processed ginseng.” Pharmazie. 2009 Sep;64(9):602-4.

    [65] Cho YL, Hur SM, Kim JY, Kim JH, Lee DK, Choe J, Won MH, Ha KS, Jeoung D, Han S, Ryoo S, Lee H, Min JK, Kwon YG, Kim DH, Kim YM (2015) – “Specific activation of insulin-like growth factor-1 receptor by ginsenoside Rg5 promotes angiogenesis and vasorelaxation.” J Biol Chem. 2015 Jan 2;290(1):467-77. doi: 10.1074/jbc.M114.603142. Epub 2014 Nov 12.

    [66] Muhammad Hanif Siddiqi, Muhammad Zubair Siddiqi, Sungeun Ahn, Sera Kang, Yeon-Ju Kim, Karpagam Veerappan, Dong-Uk Yang, Deok-Chun Yang (2014) – “Stimulative effect of ginsenosides Rg5:Rk1 on murine osteoblastic MC3T3-E1 cells” Phytother Res. 2014 Oct;28(10):1447-55. doi: 10.1002/ptr.5146. Epub 2014 Mar 19.

    [67] Siddiqi MZ, Siddiqi MH, Kim YJ, Jin Y, Huq MA, Yang DC. (2015) – “Effect of Fermented Red Ginseng Extract Enriched in Ginsenoside Rg3 on the Differentiation and Mineralization of Preosteoblastic MC3T3-E1 Cells.” J Med Food. 2015 May;18(5):542-8. doi: 10.1089/jmf.2014.3251. Epub 2015 Mar 12.

    [68] Siddiqi MH, Siddiqi MZ, Kang S, Noh HY, Ahn S, Simu SY, Aziz MA, Sathishkumar N, Jiménez Pérez ZE, Yang DC (2015) – “Inhibition of Osteoclast Differentiation by Ginsenoside Rg3 in RAW264.7 Cells via RANKL, JNK and p38 MAPK Pathways Through a Modulation of Cathepsin K: An In Silico and In Vitro Study.” Phytother Res. 2015 Sep;29(9):1286-1294. doi: 10.1002/ptr.5374. Epub 2015 Jun 8.

    [69] Zhang X, Chen K, Wei B, Liu X, Lei Z, Bai X. (2016) – “Ginsenosides Rg3 attenuates glucocorticoid-induced osteoporosis through regulating BMP-2/BMPR1A/Runx2 signaling pathway.” Chem Biol Interact. 2016 Aug 25;256:188-97. doi: 10.1016/j.cbi.2016.07.003. Epub 2016 Jul 5.

    [70] Song M, Jia F, Cao Z, Zhang H, Liu M, Gao L (2020) – “Ginsenoside Rg3 Attenuates Aluminum-Induced Osteoporosis Through Regulation of Oxidative Stress and Bone Metabolism in Rats.” Biol Trace Elem Res. 2020 Dec;198(2):557-566. doi: 10.1007/s12011-020-02089-9.

    [71] So, M. W., Lee, E. J., Lee, H. S., Koo, B. S., Kim, Y. G., Lee, C. K., & Yoo, B. (2013) – “Protective effects of ginsenoside Rg3 on human osteoarthritic chondrocytes”. Modern rheumatology23(1), 104-111.

    [72] Zhang, P. (2017) – Ginsenoside-Rg5 treatment inhibits apoptosis of chondrocytes and degradation of cartilage matrix in a rat model of osteoarthritis”. Oncology reports37(3), 1497-1502.

    [73] Moon, J. H., Lee, J. H., Lee, Y. J., & Park, S. Y. (2016) – “Autophagy flux induced by ginsenoside-Rg3 attenuates human prion protein-mediated neurotoxicity and mitochondrial dysfunction”. Oncotarget7(52), 85697.

    [74] Yang, K. E., Jang, H. J., Hwang, I. H., Hong, E. M., Lee, M. G., Lee, S., … & Choi, J. S. (2020) – Stereoisomer-specific ginsenoside 20 (S)-Rg3 reverses replicative senescence of human diploid fibroblasts via Akt-mTOR-Sirtuin signalling”. Journal of ginseng research44(2), 341-349.

    [75] Jang, I. S., Jo, E., Park, S. J., Baek, S. J., Hwang, I. H., Kang, H. M., … & Choi, J. S. (2020) – “Proteomic analyses reveal that ginsenoside Rg3 (S) partially reverses cellular senescence in human dermal fibroblasts by inducing peroxiredoxin”. Journal of ginseng research44(1), 50-57.

    [76] Kim, D., Yang, K. E., Kim, D. W., Hwang, H. Y., Kim, J., Choi, J. S., & Kwon, H. J. (2021) – “Activation of Ca2+‐AMPK‐mediated autophagy by ginsenoside Rg3 attenuates cellular senescence in human dermal fibroblasts”. Clinical and Translational Medicine11(8).

    [77] Sun, G. Z., Meng, F. J., Cai, H. Q., Diao, X. B., Zhang, B., & Bai, X. P. (2020) – “Ginsenoside Rg3 protects heart against isoproterenol-induced myocardial infarction by activating AMPK mediated autophagy”. Cardiovascular diagnosis and therapy10(2), 153.

    [78] Kang, T. H., Park, H. M., Kim, Y. B., Kim, H., Kim, N., Do, J. H., … & Kim, S. Y. (2009)“Effects of red ginseng extract on UVB irradiation-induced skin aging in hairless mice”. Journal of ethnopharmacology123(3), 446-451.

    [79] Hwang, E., Park, S. Y., Jo, H., Lee, D. G., Kim, H. T., Kim, Y. M., … & Yi, T. H. (2015)“Efficacy and safety of enzyme-modified Panax ginseng for anti-wrinkle therapy in healthy skin: a single-center, randomized, double-blind, placebo-controlled study”. Rejuvenation research18(5), 449-457.

    [80] Park, S. Y., Shin, Y. K., Kim, H. T., Kim, Y. M., Lee, D. G., Hwang, E., … & Yi, T. H. (2016) – “A single-center, randomized, double-blind, placebo-controlled study on the efficacy and safety of “enzyme-treated red ginseng powder complex (BG11001)” for antiwrinkle and proelasticity in individuals with healthy skin”. Journal of ginseng research40(3), 260-268.+

    [81] Nam, J. J., Min, J. E., Son, M. H., Oh, J. H., & Kang, S. (2017)Ultraviolet‐and infrared‐induced 11 beta‐hydroxysteroid dehydrogenase type 1 activating skin photoaging is inhibited by red ginseng extract containing high concentration of ginsenoside Rg3 (S)Photodermatology, photoimmunology & photomedicine33(6), 311-320.

    [82] Lee, H., Hong, Y., Tran, Q., Cho, H., Kim, M., Kim, C., … & Park, J. (2019)“A new role for the ginsenoside RG3 in antiaging via mitochondria function in ultraviolet-irradiated human dermal fibroblasts”. Journal of ginseng research43(3), 431-441.

    [83] Lim, C. J., Choi, W. Y., & Jung, H. J. (2014)“Stereoselective Skin Anti-Photoaging Properties of Ginsenoside Rg3 in UV-B–Irradiated Keratinocytes”Biological and Pharmaceutical Bulletin, b14-00167.

    [84] Jang, D. J., Lee, M. S., Shin, B. C., Lee, Y. C., & Ernst, E. (2008) – “Red ginseng for treating erectile dysfunction: a systematic review”. British journal of clinical pharmacology66(4), 444-450.

    [85] Ying A, Yu QT, Guo L, Zhang WS, Liu JF, Li Y, Song H, Li P, Qi LW, Ge YZ, Liu EH, Liu Q (2018) – “Structural-Activity Relationship of Ginsenosides from Steamed Ginseng in the Treatment of Erectile Dysfunction.” Am J Chin Med. 2018;46(1):137-155. doi: 10.1142/S0192415X18500088. Epub 2018 Jan 3.

    [86] Liu, T., Peng, Y. F., Jia, C., Yang, B. H., Tao, X., Li, J., & Fang, X. (2015) – “Ginsenoside Rg3 improves erectile function in streptozotocin‐induced diabetic rats”. The journal of sexual medicine12(3), 611-620.

    [87] Song MY, Kim BS, Kim H (2014) – “Influence of Panax ginseng on obesity and gut microbiota in obese middle-aged Korean women.” J Ginseng Res. 2014 Apr;38(2):106-15. doi: 10.1016/j.jgr.2013.12.004. Epub 2014 Jan 9.

    [88] Zhou SS, Zhou J, Xu JD, Shen H, Kong M, Yip KM, Han QB, Zhao ZZ, Xu J, Chen HB, Li SL (2021) – “Ginseng ameliorates exercise-induced fatigue potentially by regulating the gut microbiota.” Food Funct. 2021 May 11;12(9):3954-3964. doi: 10.1039/d0fo03384g.

    [89] Wang D, Shao S, Zhang Y, Zhao D, Wang M (2021) – “Insight Into Polysaccharides From Panax ginseng C. A. Meyer in Improving Intestinal Inflammation: Modulating Intestinal Microbiota and Autophagy.” Front Immunol. 2021 Jul 20;12:683911. doi: 10.3389/fimmu.2021.683911. eCollection 2021.

    [90] Huang J, Liu D, Wang Y, Liu L, Li J, Yuan J, Jiang Z, Jiang Z, Hsiao WW, Liu H, Khan I, Xie Y, Wu J, Xie Y, Zhang Y, Fu Y, Liao J, Wang W, Lai H, Shi A, Cai J, Luo L, Li R, Yao X, Fan X, Wu Q, Liu Z, Yan P, Lu J, Yang M, Wang L, Cao Y, Wei H, Leung EL (2021) – “Ginseng polysaccharides alter the gut microbiota and kynurenine/tryptophan ratio, potentiating the antitumour effect of antiprogrammed cell death 1/programmed cell death ligand 1 (anti-PD-1/PD-L1) immunotherapy.” Gut. 2021 May 18:gutjnl-2020-321031. doi: 10.1136/gutjnl-2020-321031. Online ahead of print.

    [91] Li S, Qi Y, Chen L, Qu D, Li Z, Gao K, Chen J, Sun Y (2019) – « Effects of Panax ginseng polysaccharides on the gut microbiota in mice with antibiotic-associated diarrhea.” Int J Biol Macromol. 2019 Mar 1;124:931-937. doi: 10.1016/j.ijbiomac.2018.11.271. Epub 2018 Nov 30.

    [92] Liang W, Zhou K, Jian P, Chang Z, Zhang Q, Liu Y, Xiao S, Zhang L (2021) – “Ginsenosides Improve Nonalcoholic Fatty Liver Disease via Integrated Regulation of Gut Microbiota, Inflammation and Energy Homeostasis.” Front Pharmacol. 2021 Feb 12;12:622841. doi: 10.3389/fphar.2021.622841. eCollection 2021.

    [93] Qu L, Ma X, Fan D (2021) – « Ginsenoside Rk3 Suppresses Hepatocellular Carcinoma Development through Targeting the Gut-Liver Axis.” J Agric Food Chem. 2021 Sep 8;69(35):10121-10137. doi: 10.1021/acs.jafc.1c03279. Epub 2021 Aug 20.

    [94] Bai X , Fu R , Duan Z , Liu Y , Zhu C , Fan D (2021) – « Ginsenoside Rh4 alleviates antibiotic-induced intestinal inflammation by regulating the TLR4-MyD88-MAPK pathway and gut microbiota composition.” Food Funct. 2021 Apr 7;12(7):2874-2885. doi: 10.1039/d1fo00242b. Epub 2021 Mar 19.