Botaceuticals

Is Red Sage a natural alternative to corticoids ?

1. SALVIA MILTIORRHIZA & INFLAMMATION

As discussed in previous articles, Red sage (Salvia miltiorrhiza) and its active constituents have been identified as anti-inflammatory agents in numerous contexts like cardiovascular conditions (see the article here) and neurological health (see the article here). Among the therapeutic areas where such an anti-inflammatory effect could be useful, Articular inflammation [1-4] and Respiratory inflammation [5-10] are particularly well documented. These properties could be explained by intricate molecular effects [11-16] involving inhibition of multiple pathways like PI3K/Akt/mTOR, MAPKs/p38 and NF-kappaB. These pathway modulations are partially reminiscent of corticosteroids. 

These similarities beg the question of a possible use of Salvia miltiorrhiza as a natural anti-inflammatory active and maybe even as an alternative to corticoids in some cases. More specifically, since tanshinones are lipophilic active consistuents of Red sage root, the opportunity of a topical use could be considered both in rhumatology and dermatology.

2. SALVIA MILTIORRHIZA & ARTHRITIS

For instance, the positive impact of red sage on arthritis has been identified on in vitro and in vivo models [1-4]. This virtue could be explain by the activity of tanshinone IIA [17-21] and Cryptotanshinone [22-27] which have both been highlighted as effective in diverse models of arthritis (including osteoarthritis and rheumatoid arthritis) too. Considering the previously mentioned effects on molecular cascades like PI3K/Akt/mTOR, NK-kappaB, and STAT-3, these results are not surprising but suggest that red sage is an innovative lead for the natural health in a joints inflammation context.

This health potential also invites to consider combinations with other natural molecules that are beneficial for joints health, like topical application β-caryophyllene [28] (from Copaifera officinalis or Piper nigrum), oral administration of Curcumin [29] (from Curcuma longa) or other polyphenols [30].

3. SALVIA MILTIORRHIZA & SKIN

Tanshinones are lipophilic anti-inflammatory molecules with dermal absorption, which makes them of peculiar interest for potential dermatologic applications. It should be noted that Cryptotanshinone inhibits STAT-3, a key element in skin conditions like atopic dermatitis and psoriasis. In fact, Cryptotanshinone has been identified as effective in a psoriatic skin model (IMQ-induced) [31] and seems also of great interest in atopic dermatitis context [32]. For psoriasis, a combination with Ar-turmerone [32] (from Curcuma longa essential oil) or Baicalin [33] (from Scutellaria baicalensis root) could be an interesting lead for innovative natural solutions.

The inhibition of STAT-3 can also have a positive impact on fibrosis risks during wound healing [34-35]. A combination with other natural molecules with benefits for wound healing like Centella asiatica extract [36] could also generates effective results.
3. CONCLUSION

Due to the anti-inflammatory properties and STAT-3 inhibition activity, topical application of red sage root extract with high concentration of cryptotanshinone, could be a very innovative tool in specific conditions such as Joints inflammation or Psoriasis. The health potential for other skin conditions like eczema or atopic dermatitis is also particularly promising. In the same time, the oral administration could also be of interest for these health problematics since, originally, this medicinal plant is widely used through oral administration (mainly for cardiovascular health). Anyway, the ever growing scientific knowledge on red sage and its active constituents, is clearly a signal asking for more research and interest of natural health industry.
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