Hepatic fibrosis is overly exuberant wound healing in which excessive connective tissue builds up in the liver. The extracellular matrix is overproduced, degraded deficiently, or both.

The trigger is chronic injury, especially if there is an inflammatory component. Various types of chronic liver injury can cause fibrosis. Sometimes more than one cause is present in the same person. Globally, 57% of liver fibrosis is attributable to either hepatitis B (30%) or hepatitis C (27%). Alcohol consumption is another important cause, accounting for about 20% of the cases.

Fibrosis itself causes no symptoms but can lead to portal hypertension (the scarring distorts blood flow through the liver) or cirrhosis (the scarring results in disruption of normal hepatic architecture and liver dysfunction). Portal hypertension leads to splenomegaly (increase in size of the spleen), esophageal varices, caput medusa (dilated periumbilical collateral veins), and Cruveilhier-Baumgarten murmur (a venous hum heard in the epigastric region).

In the initial stages, hepatic fibrosis can regress if the cause is reversible (eg, with viral clearance), after months or years of chronic or repeated injury, fibrosis becomes permanent. Therefore, the drug intervention at its early stage is critical for arresting or retarding the progression of liver fibrosis.

Dammrane saponins can be found in Araliaceae species, including ginseng and Panax notoginseng (San Qi). Rg1 isolated from P. notoginseng is able to prevent the development of liver fibrosis, a results disclosed by a team of researchers from China.

The researchers used carbon tetrachloride (CCl4) to cause liver injury in rats, and the persistant inflammatory response will lead to connective tissue production and accumulation in the liver. When carbon tetrachloride was adminstered, Rg1 and total ginsenosides from P. notoginseng were given at the same time to examine their effects on fibrosis development.

Strinkingly, both Rg1 and total ginsenosides from P. notoginseng alleviate liver fibrosis, all fibrosis indicators were improved to various degrees, especially in Rg1 treated rats. Another ginsenoside Rb1 is also found in P. notoginseng, however, Rb1 does not show any ability in prevention of the develpment of fibrosis.

The study results suggest that, when administered at early stage, Rg1 could alleviate the develpment of liver fibrosis, making Rg1 a proming drug in populations at high risk for liver fibrosis / cirrhosis.