Ginseng Bioactive Components as Gut-Brain Axis-Targeted Modulators: Therapeutic Potential and Mechanisms in Multifactorial Diseases

Ginseng (Panax ginseng C. A. Mey.) is a classic traditional Chinese herbal medicine with a history of clinical use that spans millennia. Its utilisation has long been established in the regulation of physical and mental equilibrium, in addition to the amelioration of conditions pertaining to the heart, spleen, and brain. Recent studies have indicated that the core biological activity of the substance under investigation is mediated by key active components such as ginsenosides, polysaccharides, and polyphenols. These components are closely associated with the regulation of the gut-brain axis (GBA). However, extant reviews have predominantly concentrated on individual diseases or specific mechanisms, thereby lacking a thorough investigation into the comprehensive analysis of how ginseng components exert systemic effects via the GBA. This review systematically searched and analyzed published studies in major databases regarding the regulation of the GBA by ginseng bioactive components, summarizing the latest advances in its role as a multifactorial disease intervention regulator targeting the GBA. It has been demonstrated that ginseng components exert a multifaceted GBA regulatory effect through interconnected mechanisms, including modulation of the gut microbiota, protection of the intestinal barrier, anti-inflammatory actions, and regulation of neurotransmitters, showing promising preclinical therapeutic potential in neurodegenerative diseases, mood disorders, metabolic diseases, and gastrointestinal disorders. Contrary to previous reviews, which focused on the description of individual ginseng components or specific diseases, this study provides a comprehensive analysis of how various bioactive components of ginseng modulate the gut-brain axis in relation to multiple disease categories through a systematic review. However, the preponderance of extant evidence derives from preclinical studies and necessitates further validation through clinical trials. This review provides pivotal directions and theoretical underpinnings for the clinical translation of ginseng’s bioactive components and the development of disease intervention strategies targeting the gut-brain axis.