Ginsenosides and their biomaterials in arthritis treatment: Challenges and strategies for advancing therapeutic potential of Chinese herbal medicines

Arthritis is an inflammatory and immune response in joint involving bone and cartilage that causes bone damage and degeneration, eventually leading to irreversible bone destruction, such as joint deformity. Current clinical treatments primarily focus on anti-inflammatory strategies and regulation of immune tolerance. However, these treatments are often associated with side effects, including infections and immunosuppression, while no existing therapy can fully address these issues. Ginsenosides, as bioactive components in traditional Chinese herbal medicines, can effectively treat arthritis through their anti-inflammatory effects, regulation of metabolism and immunity, and promotion of bone protection and repair. Moreover, the development of interdisciplinary medicine and engineering has facilitated the creation of biomaterials loaded with ginsenosides, which is conducive to improving the bioavailability of ginsenosides and promoting bone formation for the repair of bone damage. This review explores the pharmacological mechanisms of ginsenosides in arthritis treatment and evaluates the current status and limitations of their clinical application. It further discusses combination pathway, mechanism of action, therapeutic advantages and limitations of biomaterials loaded with ginsenosides for arthritis treatment in current stage of basic research. The review aims to summarize the theoretical foundations of ginsenosides in treating various types of arthritis and provide strategies and perspectives for achieving and optimizing their clinical transformation.