Efficacy and mechanism of escin in improving the tissue microenvironment of blood vessel walls via anti-inflammatory and anticoagulant effects: Implications for clinical practice

Escin, a natural medicinal saponin, has garnered significant attention in recent years for its pharmacological effects in various diseases. Though the structure and pharmacodynamic targets of escin are documented, reviews on its efficacy and mechanisms were still mainly from the clinical application perspective at the organ level or animal models. Deeper discussion at the tissue microenvironment level remains sparse, as the sophisticated cell and molecular technique is required. Contradictory conclusion might occur if such experiment setups are not carefully distinguished. This article reviews and analyzes literature to discuss escin's ability to improve the tissue microenvironment of blood vessel walls and elucidates the underlying mechanisms. Escin demonstrates significant anti-inflammatory properties and neutralizes free radicals, thereby protecting vascular endothelial cells from oxidative stress. Additionally, escin's anticoagulant properties reduce blood viscosity, preventing clot formation and maintaining vessel patency. These mechanisms collectively enhance the tissue microenvironment of blood vessel walls and promote cardiovascular health, which provides a multi-target therapeutic strategy for cardiovascular diseases (CVD), integrating anti-inflammatory, antioxidant, endothelial repair, and microcirulation-enhancing mechanisms, consistent with current pathophysiological insights. The article also addresses the current research status, challenges, and future potential of escin in vascular protection, offering new perspectives and strategies for CVD treatment and prevention.