Ginkgo biloba (EGb 761): An anti-dementia drug with inflammation inhibiting and cardiovascular effects

Background: The metabolic syndrome is associated with an increased risk of developing diabetes and cardio-cerebro-vascular diseases such as coronary artery disease, acute coronary syndrome, acute myocardial infarction, carotid artery disease, transitory ischemic attack, stroke, vascular and Alzheimer dementia. Since an increased frequency of echolucent carotid plaques is correlated with increasing levels of oxidized LDL (oxLDL), the latter being mainly responsible for atherosclerotic plaque development in general, we examined in a pilot study of 11 patients with metabolic syndrome whether atherosclerosis prophylaxis can be successfully practised through an antioxidant phytochemical approach with Ginkgo biloba EGb 761 (2×120mg/d, Rökan® novo, Spitzner Arzneimittel, Ettlingen, Germany).

Materials and Methods: As a biomarker for the earliest stages of plaque development, atherosclerotic nanoplaque formation and size were monitored by ellipsometric techniques (patent EP 0 946 876). A great variety of biomarkers was measured by established photometric methods or commercial ELISAs/EIAs.

Results: After a 2-month medication, the decrease in nanoplaque formation amounted to 14.3±2.9% (p<0.0077) and in nanoplaque size to 23.4±3.7% (p<0.0004). The concentration of cAMP and cGMP in the patients' blood was augmented by 43.5±12.0% (p<0.001) (before: 40.3±3.8 nmol/L; after: 54.5±3.4 nmol/L) and 32.9±10.4% (p<0.001) (before: 8.5±0.5 nmol/L; after: 10.9±0.5 nmol/L), respectively. Further results are summarized in the table. On the background of the clinical trials of Ridker [e.g., J Am Coll Cardiol 2007; 49: 2129–2138; J Periodontol 2008; 79: 1544–1551], our reduction of hs-CRP by about 40% is specially promising with regard to cardiovascular outcome, halving of the risk for myocardial infarction, stroke, and dying from a cardiovascular disease.

Conclusion: Since Ginkgo had beneficial effects on the biomarkers of oxidative stress, inflammation and lipid composition, plaque stability and progression, this phytochemical can be estimated as complementary drug with potentially preventive character.

	2-month Ginkgo biloba (EGb 761) medication
	before	after	change [%]	p (for change)
hs-CRP [mg/L]	8.9±4.1	4.9±2.5	-39.3	<0.0049
WBC [1/nL]	7.8±0.7	7.2±0.5	-6.3	<0.0226
MPO [ng/mL]	60.4±7.8	41.1±7.7	-29.6	<0.0137
MMP-9 [ng/mL]	353.0±60.5	228.4±61.2	-32.9	<0.0420
IL-6 [pg/mL]	3.0±0.5	2.6±0.5	-12.9	<0.0407
oxLDL/LDL [U/L]	65.1±3.0	50.7±2.4	-21.0	<0.0020
Lp(a) [mg/dL]	50.8±7.3	39.5±6.3	-26.3	<0.0010
cGMP [nmol/L]	8.5±0.5	10.9±0.5	+32.9	<0.0010