Research progress on the pharmacological properties of active ingredients from Salvia miltiorrhiza: A review

Abstract

Background: Salvia miltiorrhiza (Danshen), a well-known botanical drug in traditional Chinese medicine, has been used for over 2000 years to treat cardiovascular and inflammatory disorders. In the context of rapidly expanding global markets for natural medicines, broad-spectrum efficacy of Salvia miltiorrhiza against cardiovascular diseases, fibrosis, diabetes, and viral infection positions it as a critical candidate for modern therapeutic development. Nevertheless, few studies are available reviewing the pharmacological properties and underlying mechanism of active ingredients in Salvia miltiorrhiza.

Purpose: This study aims to systematically review the pharmacological effects, underlying mechanisms, pharmacokinetics, and toxicological profiles of Salvia miltiorrhiza and its active ingredients, and to evaluate its potential applications in modern medicine. Additionally, strategies to optimize its therapeutic efficacy and safety are proposed.

Methods: Data on the pharmacology, pharmacokinetics, and toxicology of Salvia miltiorrhiza were collected through scientific databases including Web of Science, PubMed, Scopus, ScienceDirect, and CNKI. This review conducted relevant searches using the key words "Salvia miltiorrhiza", "Danshen", "biologically active ingredients in Salvia miltiorrhiza" and their combination with "pharmacological properties", "pharmacokinetics", "toxicology" and "clinical", and included studies reported up to April 2025.

Results: The two major bioactive groups: lipophilic diterpenoid tanshinones (e.g., tanshinone IIA and cryptotanshinone) and hydrophilic phenolic acids (e.g., salvianolic acids A and B), endowing Salvia miltiorrhiza with a wide range of biological activities, including antifibrotic, antitumor, antidiabetic, cardiovascular protective, neuroprotective, anti-osteoporotic, and so on. However, its clinical application is limited due to its low oral bioavailability and possible adverse reactions such as liver and kidney damage. Fortunately, methods such as nanotechnology and drug delivery systems may significantly improve bioavailability and reduce adverse reactions.

Conclusion: This review synthesizes critical advances in understanding Salvia miltiorrhiza, affirming its multifaceted therapeutic potential through rigorous pharmacological evidence. In the future, addressing the bioavailability limitations of Salvia miltiorrhiza and elucidating its systemic mechanisms through an interdisciplinary approach will unlock its full potential, which will bridge the gap between traditional Chinese medicine and contemporary biomedical innovation, promoting the global application of Salvia miltiorrhiza.

Keywords: Active ingredients; Clinical; Pharmacological properties; Salvia miltiorrhiza; Toxicology.