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Steamed Panax notoginseng saponins ameliorate cyclophosphamide-induced anemia by promoting erythroid progenitor proliferation via the cAMP/PI3K/AKT/cGMP pathway.

Source: PubMed, NCBI / U.S. National Library of Medicine

Journal of ethnopharmacologyXu Cuiping, Cui Hao, Fang Qionglian, et al.Published 6/5/2026Last synced 6/8/2026Status: syncedPMID: 42250832DOI: 10.1016/j.jep.2026.121971

Steamed Panax notoginseng has long been used in traditional medicine to enrich the blood, and its principal constituents are saponins. This traditional blood-enriching property suggests its potential value in treating chemotherapy-induced anemia. To elucidate the underlying mechanism and identify the key active components through which steamed Panax notoginseng saponins (SPNS) ameliorate cyclophosphamide-induced anemia. A model of anemia was established by intraperitoneal injection of cyclophosphamide combined with acetylphenylhydrazine. Cell proliferation was evaluated by examining peripheral blood and HE-stained bone marrow sections. Our multiomics analysis revealed hematopoiesis-related pathways, and surface plasmon resonance (SPR) confirmed saponin binding to target proteins. The proliferative effect of individual saponins on erythrocytes was validated in zebrafish with fluorescently-labeled red blood cells. Cellular damage was assessed by flow cytometry and electron microscopy. The expression of hemoglobin-related genes and signaling pathway proteins was detected by real-time PCR and Western blotting, respectively. The cAMP and PI3K/AKT signaling pathways were significantly enriched in the SPNS group. The ginsenosides Rkand Rhwere bound strongly to G protein-coupled receptors (GPCRs) and guanylate cyclase (GC), while Fwas bound to integrin α5 (ITGA5). All three ginsenosides enhanced erythrocyte proliferation in zebrafish. SPNS also repaired cyclophosphamide (CTX)-i

Abstract

Steamed Panax notoginseng has long been used in traditional medicine to enrich the blood, and its principal constituents are saponins. This traditional blood-enriching property suggests its potential value in treating chemotherapy-induced anemia. To elucidate the underlying mechanism and identify the key active components through which steamed Panax notoginseng saponins (SPNS) ameliorate cyclophosphamide-induced anemia. A model of anemia was established by intraperitoneal injection of cyclophosphamide combined with acetylphenylhydrazine. Cell proliferation was evaluated by examining peripheral blood and HE-stained bone marrow sections. Our multiomics analysis revealed hematopoiesis-related pathways, and surface plasmon resonance (SPR) confirmed saponin binding to target proteins. The proliferative effect of individual saponins on erythrocytes was validated in zebrafish with fluorescently-labeled red blood cells. Cellular damage was assessed by flow cytometry and electron microscopy. The expression of hemoglobin-related genes and signaling pathway proteins was detected by real-time PCR and Western blotting, respectively. The cAMP and PI3K/AKT signaling pathways were significantly enriched in the SPNS group. The ginsenosides Rkand Rhwere bound strongly to G protein-coupled receptors (GPCRs) and guanylate cyclase (GC), while Fwas bound to integrin α5 (ITGA5). All three ginsenosides enhanced erythrocyte proliferation in zebrafish. SPNS also repaired cyclophosphamide (CTX)-induced damage in K-562 cells, promoted the expression of hemoglobin-related genes, and increased the phosphorylation of key proliferative pathway proteins. SPNS mitigates cyclophosphamide-induced anemia by activating the cAMP/PI3K/AKT/cGMP pathway, an effect that is likely mediated by its active components Rk, Rh, and F, thereby promoting erythropoiesis, inhibiting apoptosis, and restoring hematopoietic function. This study provides valuable insights into clinical applications of the active ingredients of SPNS.

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