A close up of the Angelica sinensis plant, also known as female ginsengShare on Pinterest
Female ginseng could have potential as an osteoporosis treatment. Image Source/Getty Images
  • In the female ginseng (dong quai) plant, researchers have discovered a unique compound that may lead to new treatments for osteoporosis.
  • Osteoporosis is a bone condition that causes bones to become more porous, weakening them.
  • It affects women more frequently than men, but both sexes are at risk.
  • The authors of the new study have synthesized the ginseng compound in the lab and found that, in cells, it inhibits the action of osteoclasts that cause osteoporosis to develop and progress.

A new study announces the discovery of a new compound that shows promise for treating osteoporosis. The authors of the study found the compound in female ginseng — the plant is referred to as “dong quai” or “dang-gui” in China.

The compound, which the researchers have since synthesized in their lab, inhibited the in vitro generation of osteoclasts that promote bone loss, suggesting a new pathway toward treatment of the condition.

The researchers discovered two phthalide compounds in dong quai, Falcarinphthalide A–B, with carbon skeleton structures unlike any that have been seen before in the plant Angelica sinensis. Falcarinphthalide A is the compound with anti-osteoporosis promise.

Osteoporosis is a condition that weakens bones, causing them to become less solid and more porous, increasing the risk of fractures and breaks. It is a condition that becomes more likely with age, and strikes women in far greater numbers than men.

According to the U.S. Centers For Disease Control (CDC), the prevalence of its precursor low bone mass has held steady over the last few decades. However, with the aging of the U.S. population, the incidence of osteoporosis in women is on the rise.

In data from 2017-2018, the prevalence of osteoporosis at either the femur neck — the hip — or lumbar spine, or both, among adults 50 and older was 12.6% on average. Its occurrence was higher, 19.6%, for women than it was for men, 4.4%.

The study is published in ACS Central Science.

Study co-author Dr. Xin-Luan Wang explained the current treatment landscape for the condition. She cited bisphosphonates as the first line of treatment for osteoporosis. They have been used for preventing and treating the condition for over two decades by reducing osteoclast function, and typical adverse effects are not serious: stomach upset or heartburn.

Another widely used medication for osteoporosis is denosumab. However, there can be complications from both drugs.

“Reported complications of bisphosphonates and denosumab include a break or crack in the middle of the thigh bone, known as atypical femoral fracture, and osteonecrosis of the jaw,” Dr. Wang told Medical News Today.

Estrogen, sometimes paired with progestin, was also frequently used for osteoporosis. However, Dr. Wang said that “This treatment can increase the risk of blood clots, endometrial cancer, breast cancer, and possibly heart disease.”

Osteoporosis medications typically inhibit the activity of osteoclasts.

Dr. Wang said this is a desirable effect, explaining, “Osteoclasts promote bone loss through a process called ‘bone resorption.’”

Specifically, she said, “They attach to the surface of bone and release hydrochloric acid and proteases — such as cathepsin K —to dissolve the mineral and matrix components of bone tissue simultaneously. This activity can mediate bone loss and contribute to conditions such as osteoporosis.”

Phthalides “are a widely studied class of natural products with a history of over 100 years in chemical research. They have gained increasing importance due to their diverse pharmacological activities and complex chemical structures, exemplified by drugs like mycophenolic acid and n-butylphthalide,” said Dr. Wang.

She noted that roughly 180 natural phthalides have been identified.

However, “The Falcarinphthalide A-B compounds represent an entirely new class of phthalides, distinct from any previously reported types,” said Dr. Wang.

A remarkable aspect of Falcarinphthalide A-B is that they are the first examples of phthalide heteropolymers, a novel phthalide category in natural substances.

What appears to be special about phthalide heteropolymers is their unique structure and mechanism of action.

“This novel structure opens up possibilities for identifying new target sites and mechanisms, offering potential solutions for addressing the significant challenge of osteoporosis,” said Dr. Wang.

The U.S. National Institutes of Health (NIH), while noting the condition can strike anyone, listed a few groups at exceptional risk.

For women, non-Hispanic white women and Asian women are most frequently affected by osteoporosis.

The NIH adds that African American and Hispanic women are at a lower risk of developing osteoporosis, but their risk remains significant.

Among men, osteoporosis is most likely to occur in non-Hispanic whites.

Dr. Amber Robins, board certified family physician and author, who was not involved in the study, suggested the following to avoid osteoporosis:

“Weight-bearing exercises like walking and dancing can be helpful in reducing the likelihood of osteoporosis. Also, eating foods that are rich in calcium can be helpful, too. If you have a vitamin D deficiency, it can be helpful to take vitamin D supplements to keep your bones strong.”

The NIH also recommends drinking alcohol only in moderation, not smoking, and faithfully taking prescribed osteoporosis medications.

Dr. Robins described how one might know they have or are developing osteoporosis.

“There are some who first learn they have osteoporosis if they have a fracture in their spine or hip after having a minor accident,” said Dr. Robins.

There are externally visible indicators of osteoporosis as well.

“Other signs of osteoporosis that are considered telltale symptoms are having a hump-shaped curvature of your back. The medical term for this is ‘kyphosis,’” said Dr. Robins.

For people diagnosed with osteoporosis, Dr. Robins also endorsed caution and medication.

“Taking the time to do exercises to improve your balance and flexibility can help prevent falls that could cause bone injury,” she said.

It is also a good idea to ask one’s physician about drugs that can help the worsening of osteoporosis, such as Fosamax and Prolia, which Dr. Robins noted can help strengthen bones.