Journal of Ethnopharmacology 134 (2011) 584–607 Contents lists available at ScienceDirect Journal of Ethnopharmacology journal homepage: www.elsevier.com/locate/jethpharm Review Kudzu root: Traditional uses and potential medicinal benefits in diabetes and cardiovascular diseases Ka H. Wong a , George Q. Li a , Kong M. Li b , Valentina Razmovski-Naumovski a,c , Kelvin Chan a,c,∗ a Herbal Medicines Research and Education Centre, Faculty of Pharmacy, The University of Sydney, NSW 2006, Australia b Discipline of Pharmacology, Bosch Institute, University of Sydney, NSW 2006, Australia c Centre for Complementary Medicine Research, College of Health & Science, University of Western Sydney, NSW 2560, Australia article info Article history: Received 28 October 2010 Received in revised form 25 January 2011 Accepted 5 February 2011 Available online 18 February 2011 Keywords: Gegen Kudzu root Pueraria lobata Pueraria thomsonii Traditional Chinese medicine Cardiovascular diseases Diabetes Metabolic syndrome abstract Kudzu root (Gegen in Chinese) is the dried root of Pueraria lobata (Willd.) Ohwi, a semi-woody, perennial and leguminous vine native to South East Asia. It is often used interchangeably in traditional Chinese medicine with thomson kudzu root (Fengen in Chinese), the dried root of P. thomsonii, although the Chi- nese Pharmacopoeia has separated them into two monographs since the 2005 edition. For more than 2000 years, kudzu root has been used as a herbal medicine for the treatment of fever, acute dysentery, diarrhoea, diabetes and cardiovascular diseases. Both English and Chinese literatures on the traditional applications, phytochemistry, pharmacological activities, toxicology, quality control and potential interactions with conventional drugs of both species have been included in the present review. Over seventy phytochem- icals have been identified in kudzu root, with isoflavonoids and triterpenoids as the major constituents. Isoflavonoids, in particular puerarin, have been used in most of the pharmacological studies. Animal and cellular studies have provided support for the traditional uses of kudzu root on cardiovascular, cere- brovascular and endocrine systems, including diabetes and its complications. Further studies to define the active phytochemical compositions, quality standards and clinical efficacy are warranted. Strong interdis- ciplinary collaboration to bridge the gap between traditional medicine and modern biomedical medicine is therefore needed for the development of kudzu root as an effective medicine for the management of diabetes and cardiovascular diseases. © 2011 Elsevier Ireland Ltd. All rights reserved. Abbreviations: ACE2, angiotensin-converting enzyme 2; ADP, adenosine diphosphate; AGE, advanced glycation end-products; APV, DL-2-amino-5-phosphonovaleric acid; AT1, angiotensin II type I receptor; A25-35, -amyloid; Bcl-2, B-cell leukemia/lymphoma-2; BKCa, large-conductance calcium-activated potassium channel; CAM, comple- mentary and alternative medicine; CMM, Chinese materia medica; CVD, cardiovascular diseases; CYP, cytochrome P450; CYP51, lanosterol 14 -demethylase; CYP7A1, 7-hydroxylase; DNQX, 6,7-dinitroquinoxaline-2,3 (1H4H)-diane; eNOS, endothelial NO synthase; EPO, erythropoietin; GABA, -aminobutyric acid; GLUT, glucose trans- porter; G-V, conductance-voltage; HEK293, human embryonic kidney 293; HIF-1, hypoxia-inducible factor 1 ; HMG-CoA, 3-hydroxy-3-methylglutaryl coenzyme A; HO-1, heme oxygenase-1; HSP70, heat shock protein70; HSPG, heparin sulphate proteoglycan; 5-HT, 5-hydrotryptamine; HUVECs, human umbilical vein endothelial cells; ICAM-1, intercellular adhesion molecules-1; iNOS, inducible NOS; IUCN, International Union for Conservation of Nature; JAK2, Janus kinase 2; KA, kainic acid; K ATP , ATP-sensitive K channel; LAD, left anterior descending; LDH, lactate dehydrogenase; L-NAME, N-nitro-arginine methyl ester; L-NNA, N-nitro-L-arginine; MCAO, middle cerebral artery occlu- sion; mK ATP , mitochondrial ATP-sensitive potassium channel; MMP-2, matrix metalloproteinases-2; MPP + , 1-methyl-4-phenylpyridinium; mPTP, mitochondrial permeability transition pore; NADPH, nicotinamide adenine dinucleotide phosphate; NF-B, nuclear factor kappa-light-chain-enhancer of activated B cells; NMDA, N-nethyl-D-aspartic acid; NO, nitric oxide; Nrf-2, NF-E2 related factor-2; ODQ, 1H-[1,2, 4]oxadiazolo[43-]quinoxaline-1-one; OGD, oxygen/glucose deprivation; PC12, pheochromocytoma cells; PKC, protein kinase C; PLR, Puerariae Lobatae Radix; PPAR, peroxisome proliferator-activated receptor gamma; PTR, Puerariae Thomsonii Radix; RAGE, receptor for advanced glycation end-products; RCT, randomised double blind placebo-controlled trial; ROS, reactive oxidative stress; SD, Spargue-Dawley; SGLT, sodium-coupled glucose transporter; SHR, spontaneous hypertensive rats; STAT3, signal transducers and activators of transcription 3; STZ, streptozotocin; T2DM, type 2 diabetes mellitus; TCM, Traditional Chinese medicine; TIMP-2, tissue inhibitors of matrix metalloproteinases-2; TNF-, tumour necrosis factors-; USDA, United States Department of Agri- culture; VCAM-1, vascular cell adhesion molecule-1; VEGF, vascular endothelial growth factor; VLDL, very low density lipoprotein; WHO, World Health Organisation; XIAP, X-chromosome linked inhibitor of apoptosis protein. ∗ Corresponding author at: Herbal Medicines Research & Education Centre, Fac- ulty of Pharmacy, The University of Sydney, NSW 2006 and CompleMED, College of Health & Science, University of Western Sydney, NSW 2560, Australia. Tel.: +61 (2) 91141485; fax: +61 (2) 4620 3291. E-mail address: kelvin.chan@sydney.edu.au (K. Chan). 0378-8741/$ – see front matter © 2011 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.jep.2011.02.001