Effectiveness of activated charcoal and equilibrium dialysis in removing Asian, American, Siberian and Indian ginseng from human serum

Background: Ginsengs are used by the general population worldwide and toxicity of various ginsengs has been reported. We studied the effectiveness of activated charcoal and in vitro equilibrium dialysis for removal of Asian, American, Siberian and Indian ginseng from human serum by measuring digoxin-like immunoreactivity using the fluorescence polarization immunoassay. Methods: 1× PBS (phosphate buffered saline) or drug free serum pool was supplemented with Asian, American, Siberian or Indian ginseng extract in amount expected in overdose. The aliquots of supplemented buffer or serum pool were treated with activated charcoal (15 or 50 mg of activated charcoal/ml of buffer/serum) for 5, 10, 20 and 30 min and digoxin-like immunoreactivities were compared with the original specimens. Other drug free serum pools were also supplemented with various ginsengs and then passed through a small column packed with activated charcoal or subjected to in vitro equilibrium dialysis against phosphate buffer at pH 7.4. Results: Complete removal of digoxin-like immunoreactivity from buffer solution or serum pool supplemented with various ginsengs can be achieved by treatment with activated charcoal. Moreover, when serum pools supplemented with various ginsengs were passed through columns packed with activated charcoal, we observed complete removal of digoxin-like immunoreactivity. In addition, significant removal of digoxin-like immunoreactivity was observed when serum pools supplemented with ginsengs were subjected to equilibrium dialysis for 24 h. Conclusions: Removal of digoxin-like immunoreactivity from buffer solution or serum due to the presence of ginsengs can be achieved by treatment with activated charcoal in vitro but complete removal of digoxin-like activity from serum is not possible even after 24 h of equilibrium dialysis.