Table 1.

Possible Anti-Atherosclerotic Mechanisms of Action of Medicinal Plants.

Effect	Plants/complex of plants	Mechanism
Anti-inflammatory (suppression of inflammatory mediators expression and signal pathway)	1) Inflaminat (Calendula (Calendula officinalis L.) + Black Elder (Sambucus nigra L.) + Violet (Viola tricolor L.))	Inhibiting expression of IL-1β and TNF (Kirichenko et al., 2016)
	Licorice (Glycyrrhiza glabra L.)	- JNK and NF-κB signaling blocking (Kwon et al., 2007; Cook-Mills et al., 2011) - TNF-α, IL-1β production suppression (Park et al., 2010) - Adhesion molecules suppression (Jong et al., 2006; Chang et al., 2010)
	Garlic (Allium sativum L.)	- Inflammation signaling inhibiting (like TNF-α, IL-1β, ICAM-1 and HLA-DR) (Karagodin et al., 2016a)
	Turmeric (Curcuma longa L.)	- Inhibiting expression of JAK/STAT signaling pathway (Kocaadam and Şanlier, 2017) - Suppressing activity of iNOS, COX-2, lipoxygenase, and xanthine oxidase (Kocaadam and Şanlier, 2017) - Activation of NF-kB (Kocaadam and Şanlier, 2017)
	Chinese sage (Salvia miltiorrhiza)	- Inhibition of NF-kB pathway (Yang et al., 2016; Zhao D. et al., 2016)
	Chinese sage (Salvia miltiorrhiza) and gegen (Pueraria lobate Willd.)	- Inhibition of adhesion molecules expression (Koon et al., 2011) - Suppression of MCP-1secretion (Koon et al., 2011)
	Huang Liang (Coptis chinensis Franch.)	- JNK phosphorylation (Guo et al., 2016) - Activation of p38 pathway (Huang et al., 2011) - NF-kB activation (Huang et al., 2012)
	Mulberry (Morus alba L.)	- Modulation of AP-1, NF-κB, PPARs, and STAT3 signaling (Kim et al., 2014)
	Pomegranate (Punica granatum L.)	- Reduction plasma levels of IL-6 and TNFa and increase IL-10 (Harzallah et al., 2016)
Antioxidant (Inhibition of LDL oxidation)	Licorice extract (Glycyrrhiza glabra L.)	- Inhibiting of LDL oxidation by suppression of AAPH-induced formation of cholesteryl linoleate hydroperoxide in LDL particle (Rosenblat et al., 1999; Kang et al., 2015)
	Chinese sage (Salvia miltiorrhiza Bge.)	- Inhibiting ROS production (Lin et al., 2006; Huang et al., 2010; Yang et al., 2011; Joe et al., 2012)
	Mulberry (Morus alba L.)	- Down-regulating intracellular redox-dependent signaling pathways (Chao et al., 2013)
	Pomegranate (Punica granatum L.)	- Reducing ROS level production by mitochondria (Harzallah et al., 2016; Mandal et al., 2017)
Antithrombotic activity (prevention of platelet aggregation)	Garlic (Allium sativum L.)	- Suppression of cyclooxygenase-2 (Ali et al., 2000) - Reducing synthesis of vasoconstrictors such as prostaglandin E2 and leukotriene C4 (Vilahur and Badimon, 2013) - Regulation of serotonin and coagulation factor IV production (Rahman, 2007) - Supression of platelet aggregation by increasing of cyclic nucleotides (Allison et al., 2012; Rahman et al., 2016) - Inhibiting the GPIIb/IIIa receptor and fibrinogen binding (Morihara and Hino, 2017) - Suppressing the phosphorylation of collagen-induced ERK, JNK and p38 (Morihara and Hino, 2017)
	Hop flowers (Hunulus lupulus L.)	- Increasing of intracellular cAMP and cGMP lexpression, promotion of VASP phosphorylation (Di Vito et al., 2012)
	Chinese sage (Salvia miltiorrhiza Bge.)	- Inhibition of phosphoinositide 3-kinase (Huang et al., 2010)
	Mulberry (Morus alba L.)	- Blocking of platelet activation and aggregation, thromboxane B2 formation (Kim et al., 2014)
Anti-atherogenic (suppression of Intracellular cholesterol accumulation in cultured cells)	Garlic (Allium sativum L.)	- Down-regulation of HMGR, FAS, SREBP-1c, G6PDH, acetyl-CoA carboxylase, and ACAT (Rai et al., 2009) - Inhibiting HMGR activity (Venkataiah et al., 2016)
	Turmeric (Curcuma longa L.)	- Inhibiting of SR-A-mediated oxidized LDL uptake (Zhao et al., 2012; Lin et al., 2015) - Promoting ABCA1-dependent cholesterol efflux through activation of AMPK-SIRT1-LXRα signaling (Zhao et al., 2012; Lin et al., 2015)
	Chinese sage (Salvia miltiorrhiza Bge.)	- Down-regulating of CD36 expression (Bao et al., 2012; Yang et al., 2018) - Up-regulating of Prdx1/ABCA1 signaling (Bao et al., 2012; Yang et al., 2018)
	Huang Liang (Coptis chinensis Franch.)	- Up-regulating of LDLR (Kong et al., 2004; Chang et al., 2012) - Up-regulating apoE expression (Kong et al., 2004; Chang et al., 2012) - Down-regulating HMGR expression (Kong et al., 2004; Chang et al., 2012) - Enhancing LXRα-ABCA1-dependent cholesterol efflux (Lee et al., 2010) - Activating the AMPK-SIRT1-PPAR-γ pathway (Chi et al., 2014)
	Pomegranate (Punica granatum L.)	- Regulating LXR/PPAR-ABCA1 pathway (Zhao S. et al., 2016) - Up-regulation of LXRα and ABCA1 expression (Zhao et al., 2014)
Hypotensive effects	Garlic (Allium sativum L.)	- Inhibition of angiotensin-converting enzyme (Asdaq and Inamdar, 2010) - Activation of the growth suppressor p27 (Castro et al., 2010) - Down-regulation of angiotensin II receptor (Mansour et al., 2013) - Reduction of vasoconstrictor prostanoids synthesis (Al-Qattan et al., 2001) - Stimulation of H2S production (Al-Qattan et al., 2006) - Regulation of endothelial NO synthesis (Ried and Fakler, 2014; Karagodin et al., 2016b)