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. 2024 Oct 3;15:1483431. doi: 10.3389/fphar.2024.1483431

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Copyright © 2024 Wang, Wang, Dai, Yue, Yin, Xu, Shi, Liu, Jia, Brömme, Zhang and Zhang.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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The actions and mechanisms of Salvia Miltiorrhiza on osteoporosis. Ethanol-soluble tanshinones inhibit RANKL (receptor activator of nuclear factor kappa-Β ligand) and M-CSF (macrophage colony-stimulating factor) induced osteoclasts differentiation and bone resorption via blocking the ERK (extracellular signal regulated kinase)/AKT (protein kinase B)/NF-κB (nuclear factor-kappa B) pathway. Both ethanol-soluble tanshinone IIA (Tan IIA) and water-soluble tanshinol and Sal B (salvianolic acid B) promote osteogenesis by limiting ROS (reactive oxygen species) over-production via regulating the Nox4 (NADPH oxidase 4)/Nrf2 (nuclear factor erythroid 2-related factor 2)/HO-1 (heme oxygenase 1) pathway, promoting osteogenesis and inhibiting adipogenesis via inhibiting the PPARγ (peroxisome proliferator-activated receptor γ) pathway and activating the Wnt (wingless-related integration site)/β-catenin and BMP (bone morphogenic protein)-2 pathways, as well as facilitating osteogenesis-angiogenesis coupling via the Wnt/β-catenin/VEGF (vascular endothelial growth factor) pathway.