Therapeutic potential of pharmacological components of Salvia miltiorrhiza against atherosclerosis: A preclinical systematic review and meta-analysis
Clinical Snapshot
PICO Framework
| P — Population | Animal models of atherosclerosis |
| I — Intervention | Pharmacological components of Salvia miltiorrhiza (Danshen) |
| C — Comparator | Control groups (placebo, vehicle, or standard care) |
| O — Outcomes | Atherosclerotic plaque formation and stability, lipid profiles, inflammatory cytokines, oxidative stress indicators, endothelial function markers, matrix metalloproteinases |
Bottom Line
This systematic review of 64 animal studies suggests Salvia miltiorrhiza components may benefit atherosclerosis through multiple mechanisms including lipid modulation, anti-inflammatory effects, and endothelial protection. However, this represents preclinical evidence only with significant limitations. The lack of quantified effect sizes, heterogeneity assessment, and confidence intervals limits interpretation. Most critically, animal model findings often fail to translate to human clinical benefit. While the comprehensive search strategy and appropriate bias assessment tool strengthen the methodology, clinicians should not alter practice based on these findings. Human clinical trials with appropriate endpoints, safety profiles, and regulatory oversight are essential before considering therapeutic applications. The machine learning dosing predictions, while novel, remain theoretical without human validation.
Key Findings
P Value: Not reported
Effect Size: Not quantified in abstract
Primary Outcome: Amelioration of atherosclerotic plaque formation and stability
Nnt Or Sensitivity: Optimal Tanshinone IIA regimen: 33.18 mg/kg daily for 84 days (animal model)
Confidence Interval: Not reported
Clinical Application
Low immediate feasibility - requires human clinical trials, regulatory approval, standardisation of active components Not directly applicable to Australian practice; would require TGA evaluation for therapeutic goods, RACGP guideline consideration only after human efficacy data, potential PBS listing contingent on clinical trial outcomes Limited applicability - animal studies only, significant species translation gap
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE: Atherosclerosis (AS) severely threatens global health, while current therapies exhibit limitations. Recognized as a 'superior-grade' herb in the Shennong Ben Cao Jing, Salvia miltiorrhiza Bunge (Danshen) has been shown in modern studies to protect against cardiovascular diseases. AIM OF THE STUDY: The aim of this study was to investigate the therapeutic potential and protective mechanism of pharmacological components of Salvia miltiorrhiza against AS. MATERIALS AND METHODS: Relevant animal studies were collected from 8 databases, namely, PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang Data, VIP, and SinoMed. Risk of bias of the included studies was evaluated using the SYRCLE's tool. Statistical analysis was performed using R 4.2.0 and Python 3.14.2 software. Machine learning model was trained to predict optimal intervention parameters and was subsequently validated. RESULTS: A total of 64 studies were included. The pharmacological components of Salvia miltiorrhiza ameliorated atherosclerotic plaque formation and stability, and modulated various biomarkers, including lipid profiles, inflammatory cytokines, oxidative stress indicators, endothelial function markers, as well as matrix metalloproteinases. Machine learning identified an optimal Tanshinone IIA regimen against AS, which was defined as a single dose of 33.18 mg/kg dose over 84 days and demonstrated predictive robustness in validation. CONCLUSIONS: The pharmacological components of Salvia miltiorrhiza attenuate AS by regulating lipid metabolism, anti-inflammatory and antioxidant actions, improving endothelial function, modulating of vascular smooth muscle cells, remodeling extracellular matrix, and regulating programmed cell death. These findings provide translational insights that pave the way for subsequent preclinical and early-clinical studies, pending systematic validation through more rigorous research.
References
- 1.Zhang, J., Sun, X., Wang, Q., Sun, Z., Liu, W., Huang, M., Jiang, L., & Yao, K. (2026). Therapeutic potential of pharmacological components of Salvia miltiorrhiza against atherosclerosis: A preclinical systematic review and meta-analysis. Journal of Ethnopharmacology, 121294. https://doi.org/10.1016/j.jep.2026.121294
Related Research
Bioelectrochemistry (Amsterdam, Netherlands)
From data to diagnosis: A comprehensive review of machine learning-driven wearable sensors in healthcare.
2 Aug 2026
Ultrasound in medicine & biology
A Systematic Review: The Application of Attention Mechanisms in Medical Ultrasound Image Processing
2 Aug 2026
Journal of the American Medical Informatics Association : JAMIA
Explainable machine learning in healthcare: methods, interpretation, and applications for clinical research
2 Aug 2026
This content is for educational purposes for healthcare professionals only and does not constitute clinical advice. Clinical decisions should be based on individual patient assessment, current guidelines, and appropriate specialist consultation. Editorial Standards · Privacy Policy · Terms of Service