Ginseng occupies a prominent position in the list of best-selling natural products in the world. Compared to the long history of use and widespread research on Asian ginseng, the study of American ginseng is relatively limited. In the past decade, some promising advances have been achieved in understanding the chemistry, pharmacology and structure-function relationship of American ginseng. To date, there is no systematic review of American ginseng. In this review, we present the different structures of the ginsenosides in American ginseng, including naturally occurring compounds and those resulting from steaming or biotransformation.

Most studied pharmacological activities

Like Asian ginseng, American ginseng has multiple pharmacological actions. In general, antioxidant, anti-inflammatory, and immunostimulatory activities seem to be related to the possible mechanisms of ginseng. In this section, we report the recent preclinical and clinical advancements in the study of American ginseng and the effects of its ginsenosides on the central nervous system, cardiovascular system, and antidiabetic and anticancer activities (Fig. 3). American ginseng’s immunomodulatory effects and prophylactic effect on acute respiratory illness are not discussed here (McElhaney et al., 2004; Predy et al., 2006; Vohra et al., 2008).