Dang Gui (Angelica sinensis)

Angelica sinensis (danggui) root is a well-known Asian herbal medicine that has been used as a nourishing and hematopoietic agent for the treatment of gynecological diseases for thousands of years. It is often combined with other herbs in formulations.

Dang Gui (Angelica sinensis)

Uses

Angelica sinensis, known as danggui (in Chinese), is a traditional medicinal and edible plant that has long been used for tonifying, replenishing, and invigorating blood as well as relieving pain, lubricating the intestines and treating female irregular menstruation and amenorrhea. Danggui us used by TCM practitioners to treat a variety of blood-related ailments including women's reproductive problems, such as dysmenorrhea or painful menstruation, uterine disorders, as well as ischemia of both the heart and brain It is primarily used to relieve menstrual cramps, irregular menstrual cycles, infrequent periods, premenstrual syndrome, and menopausal symptoms.

Chemistry/Pharmacology

Over 70 compounds have been identified from danggui, including essential oils such as ligustilide, butylphthalide and senkyunolide A, phthalide dimers, organic acids, and their esters such as ferulic acid, coniferyl ferulate, polyacetylenes, vitamins and amino acids. Z-ligustilide (water insoluble and heat stable), among which Z-butylidenephthalide and ferulic acid are thought to be the most biologically active components in AS and are often used in quality control and pharmacokinetic studies of danggui. Z-ligustilide is the main lipophilic component of the essential oil constituents and is the main active ingredient of danggui.

Clinical Studies

In vitro, danggui extracts demonstrated antitumor, pro-apoptotic, anti-metastatic, anti-tuberculosis, neuroprotective, and hematopoietic effects. In animal models, polysaccharides extracted from dang gui root showed protective effects against cyclophosphamide-induced toxicity, doxorubicin-induced cardiotoxicity, and radiation-induced pneumonitis.

A formula containing dang gui was shown to improve clinical outcomes in patients with acute coronary syndrome and mild-to-moderate renal insufficiency.

Data from an epidemiologic study suggest a positive association between consumption of donggui and reduced risk of subsequent endometrial cancer in breast cancer survivors. Danggui exhibits estrogenic activity in vitro and stimulates the proliferation of MCF-7 cells.

Biomechanical Mechanism

Ferulic acid, a constituent of dong gui, may play an important role in treating osteoarthritis by reducing hydrogen peroxide-induced interleukin IL-1beta, tumor necrosis factor TNF-alpha, matrix metalloproteinases MMP-1 and MMP-13, and by increasing SOX9 gene expression. SOX9 is a protein involved in the establishment and maintenance of the phenotype of chondrocytes. Danggui polysaccharides demonstrated anti-osteoarthritic activity by stimulating insulin-like growth factor 1 (IGF1) and IGF1 receptor gene expression, thereby promoting UDP-sugars and glycosaminoglycan synthesis. Another compound promotes wound healing and bone regeneration by inducing osteoblast proliferation and hyaluronic acid deposition.

An aqueous extract from danggui was reported to have estrogen-agonist activity and stimulated proliferation of both estrogen receptor-positive and -negative breast cancer cells. It also protected against radiation-induced pneumonitis by downregulating proinflammatory cytokines such as TNF-alpha and TGF-beta1 in a murine model. Subcutaneous injection of dong gui extract protected mice against cyclophosphamide-induced cytotoxicity by promoting recovery from leukopenia. The antitumor effects of danggui may be due to its inhibitory effects on invasion and metastasis of carcinoma cells and by suppression of tumor growth that may be mediated by Nur77-dependent apoptosis. However, danggui extracts also promote angiogenesis – which plays a key role in both physiologic and disease processes – by inducing the proliferation and migration of endothelial cells by upregulating VEGF expression.

Sources/Articles

Chao WW, Lin BF. Bioactivities of major constituents isolated from Angelica sinensis (Danggui). Chin Med. 2011 Aug 19;6:29.

Chiu SC, Chiu TL, Huang SY, et al. Potential therapeutic effects of N-butylidenephthalide from Radix Angelica sinensis (Danggui) in human bladder cancer cells. BMC Complement Altern
Med. 2017 Dec 6;17(1):523.

Deng S, Wang Y, Inui T, et al. Anti-TB polyynes from the roots of Angelica sinensis. Phytother Res. Jul 2008;22(7):878-882.

Goh SY, Loh KC. Gynaecomastia and the herbal tonic “Dong Quai”. Singapore Med J. 2001;42(3):115-116.

Haines CJ, Lam PM, Chung TK, et al. A randomized, double-blind, placebo-controlled study of the effect of a Chinese herbal medicine preparation (Dang Gui Buxue Tang) on menopausal symptoms in Hong Kong Chinese women. Climacteric 2008 Jun;11(3):244-51.

Hirata JD, Swiersz LM, Zell B, Small R, Ettinger B. Does dong quai have estrogenic effects in postmenopausal women? A double-blind, placebo-controlled trial. Fertil Steril. Dec 1997;68(6):981-986.

Hook IL. Danggui to Angelica sinensis root: Are potential benefits to European women lost in translation? A review. J Ethnopharmacol. 2014 Feb 27;152(1):1-13.

Hui MK, Wu WK, Shin VY, et al. Polysaccharides from the root of Angelica sinensis protect bone marrow and gastrointestinal tissues against the cytotoxicity of cyclophosphamide in mice. Int J Med Sci. 2006;3(1):1-6.

Kupfersztain C, Rotem C, Fagot R, Kaplan B. The immediate effect of natural plant extract, Angelica sinensis and Matricaria chamomilla (Climex) for the treatment of hot flushes during menopause. A preliminary report. Clin Exp Obstet Gynecol. 2003;30(4):203-206.

Kim, Sun, Hye-Kyung Oh, Ji-Young Kim, Jin-Woo Hong, and Su-In Cho. "A review of pharmacological effects of Angelica gigas, Angelica sinensis, Angelica acutiloba and their bioactive compounds." The Journal of Korean Medicine 32, no. 4 (2011): 1-24. https://www.koreascience.or.kr/article/JAKO201124239514261.pdf

Lau CB, Ho TC, Chan TW, Kim SC. Use of dong quai (Angelica sinensis) to treat peri- or postmenopausal symptoms in women with breast cancer: is it appropriate? Menopause. 2005;12(6):734-740.

Lee WH, Jin JS, Tsai WC, et al. Biological inhibitory effects of the Chinese herb danggui on brain astrocytoma. Pathobiology. 2006;73(3):141-148.

Ling, F. A. N. G., Xue-feng XIAO, Chang-xiao LIU, and H. E. Xin. "Recent advance in studies on Angelica sinensis." Chinese Herbal Medicines 4, no. 1 (2012): 12-25. https://www.sciencedirect.com/science/article/abs/pii/S1674638412600306

Liu PJ, Hsieh WT, Huang SH, Liao HF, Chiang BH. Hematopoietic effect of water-soluble polysaccharides from Angelica sinensis on mice with acute blood loss. Exp Hematol. 2010 Jun;38(6):437-45.

Lu, Guang-Hua, Kelvin Chan, Kelvin Leung, Chi-Leung Chan, Zhong-Zhen Zhao, and Zhi-Hong Jiang. "Assay of free ferulic acid and total ferulic acid for quality assessment of Angelica sinensis." Journal of Chromatography A 1068, no. 2 (2005): 209-219.
https://d1wqtxts1xzle7.cloudfront.net/47994411/Assay_of_free_ferulic_acid_and_total_fer20160812-29458-1rllfcu-with-cover-page-v2.pdf?Expires=1642184848&Signature=CcC-IjIdBAhMPSAJfvj3~FS7MO9Ii5xtmy4wX97znuCZwckSb92RJFkv-onTGMjAC~RWQqE~ExyLzJh1bl9cmN4sFRMo2HgDX1ZeDMGF8p7FsXlSa4LiObrQHbJEPZd0Af6~tq7YR6D3OImZr8IxZKm9ajfJrCNKUzBUr-QqwF3lWDKuL3wZ-dcy7LtdVmxpCbRFII4QAxwAXhNSVeubEjxfM-BaqQdkAhpgdbQ6IreFv7walypddtIcXTmqngpDsfCN4bbGtj9chBwbMRKzzmkopRWKeKSsq1sR-YsGVLT0V-uBTSGoCkDZRaihjJvNQzQdBcTngimrFW8HA5tL1Q__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA

Page RL, 2nd, Lawrence JD. Potentiation of warfarin by dong quai. Pharmacotherapy. 1999;19(7):870-876.

Shang P, Qian AR, Yang TH, et al. Experimental study of anti-tumor effects of polysaccharides from Angelica sinensis. World J Gastroenterol. 2003;9(9):1963-1967.

Sun, Yuanlin, Jian Tang, Xiaohong Gu, and Deyuan Li. "Water-soluble polysaccharides from Angelica sinensis (Oliv.) Diels: Preparation, characterization and bioactivity." International Journal of Biological Macromolecules 36, no. 5 (2005): 283-289. http://pdf.xuebalib.com:1262/8wmJd6PxNfo.pdf

Tsai NM, Lin SZ, Lee CC, et al. The antitumor effects of Angelica sinensis on malignant brain tumors in vitro and in vivo. Clin Cancer Res. 2005;11(9):3475-3484.

Wu CT, Lai JN, Tsai YT.The prescription pattern of Chinese herbal products that contain dang-qui and risk of endometrial cancer among tamoxifen-treated female breast cancer survivors in Taiwan: a population-based study. PLoS One. 2014 Dec 8;9(12):e113887.

Wu, Yi-Chian, and Ching-Liang Hsieh. "Pharmacological effects of Radix Angelica Sinensis (Danggui) on cerebral infarction." Chinese Medicine 6, no. 1 (2011): 1-5. https://cmjournal.biomedcentral.com/articles/10.1186/1749-8546-6-32

Xiao-Peng, C. H. E. N., L. I. Wei, X. I. A. O. Xue-Feng, Lan-Lan Zhang, and L. I. U. Chang-Xiao. "Phytochemical and pharmacological studies on Radix Angelica sinensis." Chinese Journal of Natural Medicines 11, no. 6 (2013): 577-587. http://zgtryw.xml-journal.net/fileZGTRYW/journal/article/cjnm/2013/6/PDF/20130601.pdf

Xie CH, Zhang MS, Zhou YF, et al. Chinese medicine Angelica sinensis suppresses radiation-induced expression of TNF-alpha and TGF-beta1 in mice. Oncol Rep. 2006;15(6):1429-1436.

Xin YF, Zhou GL, Shen M, et al. Angelica sinensis: a novel adjunct to prevent doxorubicin-induced chronic cardiotoxicity.

Younas F, Aslam B, Muhammad F, et al. Haematopoietic effects of Angelica sinensis root cap polysaccharides against lisinopril-induced anaemia in albino rats. Pharm Biol. 2017 Dec;55(1):108-113.

Zhang WF, Yang Y, Li X, et al. Angelica polysaccharides inhibit the growth and promote the apoptosis of U251 glioma cells in vitro and in vivo. Phytomedicine. 2017 Sep 15;33:21-27.

Zhao, Kui J., Tina TX Dong, Peng F. Tu, Zong H. Song, Chun K. Lo, and Karl WK Tsim. "Molecular genetic and chemical assessment of radix Angelica (Danggui) in China." Journal of agricultural and food chemistry 51, no. 9 (2003): 2576-2583. https://pubs.acs.org/doi/abs/10.1021/jf026178h

Zhao H, Alexeev A, Sharma V, Guzman LD, Bojanowski K. Effect of SBD.4A—a defined multicomponent preparation of Angelica sinensis—in periodontal regeneration models. Phytother Res. Jul 2008;22(7):923-928.