The role of rare ginsenosides in the prevention and treatment of liver diseases.

[ETHNOPHARMACOLOGICAL RELEVANCE] Ginseng (Panax ginseng C. A. Mey.) is a traditional herb that occupies a very important position in traditional Chinese medicine (TCM). Many references have recorded the traditional application methods of ginseng, which improve the effects of liver-blood insufficiency and chronic liver injury. Modern studies have found that rare ginsenosides are the key to their role and have therapeutic effects on a variety of liver diseases, further verifying their traditional applications.

[AIM OF THIS REVIEW] This article reviews recent research advances on the structure, origin and pharmacological effects of rare ginsenosides to evaluate the preventive and therapeutic effects of rare ginsenosides on different types of liver diseases.

[MATERIALS AND METHODS] This article utilized keywords like "Rare ginsenosides", "Source", "Drug-induced liver injury", "Metabolic dysfunction-associated fatty liver disease", "Liver fibrosis", "Hepatocellular carcinoma", and "Therapeutic interventions" to gather research on rare ginsenosides related to liver diseases from databases such as PubMed, Web of Science, and CNKI, up to September 2025. The collected information was then summarized and analyzed.

[RESULTS] The structural characterization and preparation process of rare ginsenosides were clarified. In terms of pharmacological activities, rare ginsenosides possess a variety of activities, including anti-inflammatory, antioxidant, anti-tumor and immunomodulatory. In addition, rare ginsenosides showed protective effects against liver diseases through various mechanisms. However, their clinical application remains limited due to low content, poor water solubility, low oral bioavailability, and unclear mechanisms. Future efforts will accelerate translation through fermentation optimization, nanocarriers, structural modification, and microbiome research.

[CONCLUSION] The multiple pharmacological activities of rare ginsenosides make them candidates for the treatment of various liver diseases and provide a broader direction for exploring the Chinese medicine treatment of liver diseases.