Ginsenosides are the primary bioactive constituents of Panax ginseng, exhibiting multiple pharmacological activities, including neuroprotection, antitumor effects, anti-aging properties, and metabolic regulation. In this review, the molecular mechanisms of ginsenosides in treating neurodegenerative diseases, cancer, and metabolic disorders are summarized, and the current status of clinical translational research on ginsenosides in advanced gastric cancer, breast cancer, stroke, and diabetes is introduced, incorporating critical evidence regarding safety assessments and potential toxicity risks. In addition, recent advances in biotransformation and modern preparation technologies are reviewed. Innovative solutions, including nanodelivery systems, structural modifications, and AI-driven formulation design, are systematically discussed to address the current issues, such as low oral bioavailability and limited blood–brain barrier permeability. The future development of ginsenosides continues to face several critical challenges, including a scarcity of high-quality clinical evidence, an incomplete understanding of their mechanisms of action, a dearth of long-term safety data, and variations in quality between batches.
Sun et al. (Thu,) studied this question.