New dawn of ginsenosides: regulating gut microbiota to treat metabolic syndrome

Metabolic Syndrome (MS) is an amalgamation of symptoms encompassing insulin resistance, obesity, dyslipidemia, elevated fasting blood glucose levels, and hepatic steatosis. Emerging evidence suggests that the hallmark of MS lies in alterations in the composition of the gut microbiota and its metabolites. These alterations traverse a compromised intestinal barrier, exerting an impact on various metabolic organs, thereby precipitating the onset of MS. In recent years, the rapid advancement of sequencing methodologies, bioinformatics, and metagenomic technologies has rendered the exploration of the composition and functionality of the gut microbiota feasible. The manipulation of the gut microbiota is now considered a highly promising novel strategy for the treatment of MS. Ginsenosides, serving as the principal bioactive constituents of the esteemed herb ginseng, have been unequivocally validated to possess a diverse array of pharmacological activities, encompassing anti-inflammatory, antidiabetic, and cardiovascular protective properties. Nevertheless, the intricacies of the therapeutic mechanisms underlying ginsenosides in the treatment of MS remain unclear, owing to the challenge posed by their inherently low absorption rates. Recent studies indicate that when ginsenosides enters the gastrointestinal tract, ginsenosides can interact with the gut microbiota. The gut microbiota may represent a potential mechanism for the therapeutic effects of ginsenosides in treating MS. Based on this, this review aims to summarize the latest research progress of ginsenosides targeting the gut microbiota and its metabolites for the treatment of MS, and provide evidence to confirm that ginsenosides have the potential to become modulators of gut microbiota for the treatment of MS.