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Clinical use of ginkgo biloba

Author
Robert B Saper, MD, MPH
Section Editor
Joann G Elmore, MD, MPH
Deputy Editor
H Nancy Sokol, MD

INTRODUCTION

Ginkgo biloba, more commonly known as ginkgo, has been used medicinally for over 1000 years [1]. The ginkgo tree is the world's oldest living tree species (picture 1).

Ginkgo was originally utilized by traditional Chinese clinicians for a variety of problems including asthma and digestive disorders [1]. More recently, ginkgo leaf extract has been utilized for its antioxidant properties, for a number of vascular problems, and for the treatment of memory loss, dementia, and macular degeneration [2]. Ginkgo represents one of the most studied and commonly used herbal remedies in the world. The National Health Interview Survey found that ginkgo was the ninth most popular natural product in the United States in 2012 [3]. Over 400 clinical trials have been performed looking at a variety of medicinal properties and clinical uses.

MECHANISM OF ACTION

It is thought that there are two main groups of active constituents responsible for ginkgo biloba's medicinal effects: terpene lactones and ginkgo flavone glycosides, which are present in varying concentrations in the leaf of the ginkgo tree [4,5]. Approximately 40 different flavonoids have been isolated, including ginkgetin, bilobetin, and sciadopitysin [6]. Terpenes isolated include a number of ginkgolides and diterpenes, most importantly the ginkgolides A, B, and C along with bilobalide [4].

The bioactive properties of ginkgo biloba extracts are varied. Ginkgo biloba extract appears to alter neurotransmission and provide neuroprotection via a number of mechanisms demonstrated in animal models, including decreased glucose utilization in brain areas mediating somatosensory processing and vigilance [7]. Furthermore, ginkgo reduces the number of peripheral adrenal benzodiazepine receptors, altering corticosteroid secretion [8]. Ginkgo biloba extract also has been shown to protect against age-related changes in the mouse hippocampus [9]. Other studies indicate that ginkgo biloba extract reversibly inhibits monoamine oxidase A and B [10].

Other studies examining the mechanism of action include:

                    

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Literature review current through: Nov 2016. | This topic last updated: Mon Oct 17 00:00:00 GMT+00:00 2016.
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