Platycodon

Platycodon (Platycodon grandiflorum): A Comprehensive Reference

1. Identity and Botanical Classification

Platycodon grandiflorus (Jacq.) A. DC. is the sole species in the genus Platycodon A. DC. (family Campanulaceae) and has a long history of use as a traditional herbal medicine for the treatment of cough, phlegm, sore throat, lung abscess, chest pain, dysuria, and dysentery. Known in English as the balloon flower, it occupies both medicinal and culinary roles across its range.

It is also known as Kikyou in Japan and is primarily found in northeastern, northern, and central China, as well as in Korea, Japan, the far east area of Russia, and southeastern Siberia.

The plant carries multiple official and common names across the traditions in which it is used:

• Chinese (TCM): Platycodonis Radix, or Jiegeng (桔梗) in Chinese, is a well-known traditional Chinese medicine used for both medicinal and culinary purposes.
• Korean: The root is referred to as doraji in Korean, where it has been prized for centuries for its health-promoting properties.
• Japanese: It is known as Kikyou in Japan.

As a perennial plant, Jiegeng has application in both food and medicine, with a typical growth cycle spanning two to three years. The root is the medicinally utilized part of the plant. As a legal medicine and dietary supplement, it is also frequently used as an ingredient in health foods and vegetable dishes.

Common Preparations and Dosage Forms

In terms of food development, beyond the long history of Jiegeng pickles, people have also developed Jiegeng beverages, sausages, and dried fruits; furthermore, tablets, oral solutions, wines, and other health foods have been developed. Jiegeng Tang, a traditional Chinese medicinal compound, is mainly used to treat lung diseases, especially sore throat and chest stuffiness, with a high rate of use in pediatrics. Jiegeng is also the main drug in many Chinese patent medicines, including Platycodon Donghuanhua Tablets, Codeine Platycodon Tablets, Compound Jiegeng Cough Tablets, and Ke Chuan Ning. It is often used in the development of cold mixed vegetables, canned vegetables, preserved fruit, salted vegetables, and cosmetics in northeast China, South Korea, Japan, and Korea.

2. Traditional and Historical Use

Traditional Chinese Medicine (TCM)

The rhizomes of Platycodon grandiflorus have been widely used in traditional Chinese medicine with remarkable therapeutic effects for the treatment of cough, excessive phlegm, and sore throat, as determined by the Committee for the Pharmacopoeia of PR China (2005). The medical application of this plant was first listed in Shennong Bencao Jing, a famous monograph of traditional Chinese medicine written in China in approximately 300 A.D.

In terms of Chinese medical theories, Traditional Chinese Medicine (TCM) believes that the root of P. grandiflorum has the functions of relieving sore throat, eliminating phlegm, and draining pus, and is widely used in lung diseases and respiratory system disorders. Chinese doctors widely prescribed Platycodon grandiflorus to treat lung carbuncles in ancient China.

During the Ming dynasty, the renowned physician Li Shizhen included P. grandiflorum in his Ben Cao Gang Mu (Compendium of Materia Medica), emphasizing its action on the lung meridian and its ability to "scatter phlegm."

In classical TCM formulas, it was commonly prescribed for productive coughs, chest congestion, and tonsillitis, often paired with licorice root (Gan Cao) or other harmonizing herbs to enhance its soothing and clearing effects. A total of 1,826 Chinese prescriptions and 685 Chinese patent medicines containing Jiegeng have been documented.

Korean Traditional Medicine

In early Korean medical tomes of the Goryeo period (918–1392 CE), it was frequently prescribed as a decoction for chronic bronchitis and hoarseness. In Korean traditional medicine, platycodon root (called doraji) is similarly revered and is still widely used in teas, syrups, and soups to maintain lung and throat health. Korean folk medicine also includes its use in improving voice clarity and treating chronic respiratory weakness. In Korean folk medicine, doraji is often combined with honey or pears to create soothing syrups for cough and throat discomfort.

Japanese Kampo Medicine

Japanese Kampo medicine incorporates Platycodon grandiflorus in several formulas focused on chest tightness, hoarseness, and cough with thick phlegm.

Culinary Use

P. grandiflorum is utilized for both medicinal and culinary purposes in various countries, including Japan, South Korea, and China. Its roots are rich in proteins, iron, calcium, trace elements, vitamins, and essential amino acids, which are used for dietary supplementation.

3. Key Constituents and Active Compounds

Researchers have to date identified 219 chemical constituents in Platycodon grandiflorum (Jacq.) A. DC., encompassing 89 saponins, 11 flavonoids, 21 polysaccharides, 14 phenolic acids, six polyacetylenes, five sterols, 34 fatty acids, 17 amino acids, and 22 trace elements.

Triterpenoid Saponins (Platycosides / Platycodins)

Platycodins, an oleanane-type pentacyclic triterpenoid saponin class, are abundant in the roots of P. grandiflorum and are the major bioactive constituents of this plant. Triterpene saponins are the primary bioactive compounds of P. grandiflorum; to date, 76 triterpene saponin compounds have been isolated and identified.

Platycodin D (PLD) is an oleanane-type triterpenoid saponin and one of the active substances in P. grandiflorum. Platycodin D is an index component for the identification of Platycodon grandiflorum medicinal materials and decoction pieces recorded in the 2020 edition of the Chinese Pharmacopoeia. Additional prominent saponins include platycoside E, platyconic acid A, and deapioplatycoside E.

The saponins present in P. grandiflorum root (PGR), known as platycosides, have been reported to exhibit a spectrum of pharmacological activities, including anti-obesity, anti-inflammatory, anti-allergic, antioxidative, neuroprotective, and anti-cancer properties. Saponins within PGR are primarily glycosylated saponins with more than three sugar moieties, known for their limited absorption in the intestine. Conversely, saponins with fewer than two sugar residues — referred to as deglycosylated saponins — are recognized for enhanced absorption from the gastrointestinal tract into the bloodstream.

Polysaccharides

Polysaccharide is the main immunologically active substance in P. grandiflorum, which has an obvious immunomodulatory effect. Polysaccharides extracted from P. grandiflorum have been shown to activate various cell types of the innate and adaptive immune systems. P. grandiflorum polysaccharides induce dendritic cell (DC) maturation by activating MAPK and NF-κB signaling downstream of TLR4, and MAPK/AP-1 and TLR4/NF-κB signaling pathways are also involved in macrophage activation by P. grandiflorum polysaccharides.

Flavonoids and Phenolic Acids

P. grandiflorum has been shown to exhibit extensive pharmacological effects including anti-tumor, antioxidation, anti-inflammatory, and antibacterial activities. In the past few decades, it has been reported to contain various chemical constituents such as triterpenoid saponins, flavonoids, phenolic acids, polyacetylenes, phytosterols, and polysaccharides. Notable flavonoids found in the plant include luteolin and apigenin, which have been identified among its anti-tumor active components. The identified anti-tumor active components of P. grandiflorum include platycodin D, P. grandiflorum polysaccharides, lobetyolin, luteolin, and apigenin.

Other Constituents

It contains a large number of fatty acids such as linoleic acid (up to 63.24%), a variety of amino acids, vitamins, and multiple essential trace elements.

4. Mechanisms of Action

Expectorant and Antitussive Action

Platycodin D3 and deapi-platycodin, isolated from Platycodon grandiflorum, act as expectorants by stimulating mucin secretion from the airway and inhibiting mucin production in the airway cell line. Studies have shown that P. grandiflorum inhibits the secretion of mucus and regulates the differentiation of immune cells and the expression of inflammatory factors. Modern medical research has confirmed that the saponin platycodin D in P. grandiflorum can inhibit airway mucin secretion in the inflammatory state.

Jiegeng saponin (JGS) was found to enhance antitussive and expectorant effects through gut microbiota metabolism. Metabolomic analysis revealed that both the JGS fraction and its active microbial metabolites regulated linoleic acid, arachidonic acid, and glycerophospholipid metabolism, contributing to antitussive and expectorant activities.

Anti-inflammatory Signaling

Platycodin D (PLD), an effective triterpenoid saponin isolated from the root of Platycodon grandiflorum, has been reported to have anti-inflammatory, antitumor, and antioxidative effects. PLD inhibits LPS-induced NO and TNF-α production in RAW264.7 cells and has been shown to inhibit LPS-induced acute lung injury in mice. The pharmacological effects of PD in regulating Th1/Th2 immune balance, anti-inflammatory and expectorant activity, and antitumor effects have attracted significant research attention. It has been reported that PD had a vital therapeutic effect on allergic asthma model mice, reducing airway resistance and eosinophils and inflammatory factors by inhibiting NF-κB.

P. grandiflorum contains high levels of triterpenoid saponins, which are glycosides made from terpenoids combined with sugars, and these substances can form complexes with membrane sterols and other membrane lipid components.

Anti-cancer Mechanisms

Platycodin D is a triterpenoid saponin and possesses multiple biological and pharmacological properties including anti-nociceptive, anti-atherosclerosis, antiviral, anti-inflammatory, anti-obesity, immunoregulatory, hepatoprotective, and anti-tumour activities. The molecular mechanisms responsible for anticancer activity involve the suppression of Akt, PI3K, MAPK, JNK, ROS, NF-κB, and other pathways, promotion of apoptosis, and inhibition of cell cycle and proliferation.

PD-induced cancer cell death was associated with cytoplasmic pinocytic and autophagic vacuolation. Cellular energy levels were decreased by this compound, leading to the activation of AMP-activated protein kinase (AMPK). Compound C, an inhibitor of AMPK, completely prevented PD-induced vacuolation. These results suggest that PD induces cancer cell death associated with excessive vacuolation through AMPK activation when cellular energy levels are low.

Lipid and Cholesterol Metabolism

Studies in hyperlipidemic rats showed that different doses of PD depressed serum and hepatic cholesterol, triglyceride, and low-density lipoprotein cholesterol concentrations, thereby increasing liver LDL-receptor protein content and decreasing liver HMG-CoA reductase mRNA levels. Cytochrome P450 7A1 (CYP7A1) mRNA expression and fecal bile acid levels were significantly higher in the PD-treated groups compared to hyperlipidemic controls.

A P. grandiflorum extract was found to significantly inhibit pancreatic lipase activity in a dose-dependent manner; a 10 mg/mL dose of PG extract decreased pancreatic lipase activity by approximately 50%. Inhibition of pancreatic lipase activity results in decreased lipolysis and decreased absorption of dietary fat by the small intestine.

Immunomodulatory Action

Significant increases in T lymphocyte proliferation were observed with P. grandiflorum polysaccharide extracts, individually or synergistically with phytohemagglutinin (PHA) at most concentrations. PLD has been recently considered to have the potential to be a solubilizer or an immunologic adjuvant.

Bioavailability Considerations

The bioavailability of PLD could be improved by being prescribed with Glycyrrhiza uralensis Fisch. (licorice root) or by creating a new dosage form. Literature indicates that P. grandiflorum root saponins are poorly absorbed in the gastrointestinal tract, and oral administration effectively suppresses hemolytic activity.

5. Scientific Evidence by Area of Use

5.1 Respiratory Health: Cough, Phlegm, and Airway Inflammation

Overview: The respiratory indications of platycodon are among the best-corroborated by both tradition and pharmacological research, though large-scale randomized controlled trials (RCTs) in humans remain scarce.

Jiegeng has a long history of clinical use in the treatment of respiratory diseases, with its main functions being lung ventilation and phlegm expulsion. Modern clinical experience has demonstrated that P. grandiflorum plays a crucial role in treating chronic pharyngitis, plum pneumonia, pneumoconiosis, and acute and chronic laryngitis.

Preclinical evidence: PLD was found to have protective effects against OVA-induced allergic asthma in mice. A study exploring the effects of platycodin D3 (PD3) in airway remodeling and inflammation in asthma used OVA-induced asthma mice given PD3 at doses of 20 mg/kg, 40 mg/kg, and 80 mg/kg in different groups; the asthma mice administered dexamethasone were enrolled as the positive control group.

Mechanistic research: Natural products derived from Jiegeng regulate the production and secretion of airway mucin, explaining the expectorant and antitussive effects of Jiegeng.

Evidence strength: The evidence for respiratory effects is primarily derived from preclinical (animal and in vitro) studies and traditional clinical use. The mechanistic rationale (mucin regulation, NF-κB suppression, airway resistance reduction) is well-documented preclinically, but rigorous large-scale human RCTs are lacking. Most pharmacokinetic data derive from rodent models.

5.2 Obesity and Body Weight Management

Overview: This is one of the areas with the most directly relevant human clinical trial data, though the trials are preliminary.

Human clinical trial (RCT): Platycodon grandiflorus root extract (PGE) had shown various properties, including anti-hyperlipidemia, anti-diabetic, and anti-obesity effects, but mostly in animal studies. A preliminary study on the anti-obesity effect of PGE was conducted in 108 Korean adults (aged 20–60 years, BMI between 23 kg/m² and 30 kg/m²). Participants were randomly assigned to four groups and administered the placebo, PGE571 (571 mg as PGE), PGE1142 (1142 mg as PGE), and PGE2855 (2855 mg as PGE), independently, for 12 weeks. Body composition, nutrient intake, computed tomography scan, and plasma adipokines, as well as hepatic/renal function markers, were assessed. The PGE571 group revealed a significant decrease in body fat mass and body fat percentage when compared with the placebo group.

Animal evidence: One study selected 80% ethanol extract as the PGE based on HPLC results. Inclusion of PGE in a high-fat diet markedly attenuated food intake, body weight, epididymal fat weight, adipocyte size, and blood glucose levels by the oral glucose tolerance test in mice, and maintained serum levels of adiponectin, resistin, leptin, fructosamine, and triglycerides.

P. grandiflorum plays an anti-obesity role in fat production and metabolic processes. Platycodin D (PD), the main active compound extracted from P. grandiflorus, can inhibit lipase activity.

Evidence strength: The single small RCT (n=108, 12 weeks, single center) provides preliminary positive human evidence at the 571 mg dose. This is corroborated by several animal studies. However, the evidence is insufficient to establish efficacy in humans; replication in larger, multicenter RCTs is needed.

5.3 Lipid Metabolism and Cardiovascular Effects

Overview: Evidence is predominantly animal-based, with one registered clinical trial identified.

Animal studies: Studies in which diet-induced hyperlipidemic rats were fed diets containing 5% and 10% P. grandiflorum powder for 3 weeks showed that the feeding markedly decreased both serum and liver lipid concentrations. Especially, the 5% P. grandiflorum diet significantly decreased the concentrations of total cholesterol and triglycerides in serum and liver compared with those of the hyperlipidemic control group. Dietary P. grandiflorum also induced a reduction in LDL-cholesterol as well as an increase in the concentration of HDL-cholesterol in serum, and the atherogenic index was also low in rats fed the P. grandiflorum diet.

Dietary Platycodon grandiflorum feeding for 4 weeks resulted in a significant decrease in the concentration of plasma triglyceride in both lean and obese Zucker rats. Furthermore, dietary Platycodon grandiflorum markedly decreased both plasma cholesterol and fasting plasma insulin levels, and significantly decreased the postprandial glucose level at 30 min during an oral glucose tolerance test in obese Zucker rats.

Registered human trial: A registered clinical trial (NCT04023864) investigated whether P. grandiflorum extract (GCWB107) can reduce blood lipids in patients with obesity.

Evidence strength: Evidence for lipid-lowering effects is largely preclinical (rodent studies). The mechanistic basis (pancreatic lipase inhibition, HMG-CoA reductase suppression, bile acid excretion) is reasonably well characterized in animal models, but human evidence is very limited.

5.4 Anti-cancer Activity

Overview: This area has generated extensive preclinical research but has essentially no human clinical trial evidence. All evidence to date is in vitro or animal-based.

PD exerts potent anti-cancer activity against many types of cancers. Most studies report potent growth inhibition, strong cytotoxicity against various cancer cell lines, and robust antiangiogenic activity on endothelial cells.

Research has shown that P. grandiflorum reduces the expression of PD-1 on the surface of CD8+ T cells to exert antitumor effects in non-small cell lung cancer (NSCLC) models. The identified anti-tumor active components of P. grandiflorum include platycodin D, P. grandiflorum polysaccharides, lobetyolin, luteolin, and apigenin, which act by inhibiting cancer cell proliferation through inducing apoptosis, blocking the cell cycle, and inhibiting tumor metastasis.

Evidence strength: Research on the anti-tumor effects of P. grandiflorum extract and its active components still lacks large-scale clinical trials. All anticancer findings are preclinical. The clinical translation of PLD still has a long way to go.

5.5 Immunomodulation

Overview: Both polysaccharides and saponins from P. grandiflorum have demonstrated immune-modulating activity in cell and animal studies, with one registered human trial.

PGPStc could facilitate lymphocyte cell cycle progression from the G0/G1 phase to the S and G2/M phases and increase the levels of CD4+ T cells. Pharmacological studies showed that P. grandiflorum has immunomodulatory and immune-enhancing properties in in vitro and in vivo models.

Registered human trial: A study (trial registration number: KCT0005945) discovered that P. grandiflorum extract can enhance human immune function.

Evidence strength: Immunomodulatory effects are supported by mechanistically detailed cell and animal studies. One registered human trial has been identified, but full results are not yet widely published. Evidence remains preliminary for humans.

5.6 Antidiabetic and Metabolic Effects

Total saponins of P. grandiflorus at 200 mg/kg administered for 18 weeks were able to reduce blood sugar, serum cholesterol, triglyceride, and low-density lipoprotein levels, and increase serum high-density lipoprotein levels, and improve liver function, thereby reducing type 2 diabetic liver damage in rats. PGE may improve obesity in mice fed a high-fat diet and glucose uptake in L6 muscle cells by modifying adipokines, suggesting potential clinical benefits as a supplement to treat obesity and diabetes.

Evidence strength: Evidence is preclinical. Human diabetic outcomes data from RCTs are absent.

5.7 Hepatoprotective Effects

PLD protected against alcohol-induced liver injury in mice. A Platycodon grandiflorum root ethyl acetate extract (PGEA) exhibited antioxidant activity. In CPAE cells, PGEA inhibited both oxLDL-induced cell death and lactate dehydrogenase release. In high-fat diet-induced obese mice that received PGEA, significantly reduced plasma and hepatic lipid levels were observed.

Evidence strength: Hepatoprotective effects are supported by animal model data only. No human clinical trials have been identified for this specific indication.

5.8 Anti-inflammatory and Atopic/Allergic Conditions

PLD was found to protect alloxan-induced diabetic mice via regulation of Treg/Th17 balance. Fermented P. grandiflorus extract is a well-known traditional herbal medicine administered for bronchitis and inflammatory diseases, and its anti-inflammatory effect is higher than that of non-fermented extract.

Evidence strength: Anti-inflammatory effects are well-characterized mechanistically across multiple preclinical models but have not been validated in large human clinical trials.

6. Body Systems and Health Areas Associated with Platycodon

• Respiratory system: Platycodonis Radix is a well-known traditional Chinese medicine, and its historical use as an antitussive and expectorant has been extensively documented.
• Immune system: Jiegeng exhibits diverse pharmacological effects including immune regulation.
• Metabolic/endocrine system: In the past decade, researchers have discovered the new pharmacological potential of platycodin in the treatment of chronic conditions, including hyperlipidemia, hypertension, diabetes, and obesity.
• Cardiovascular system: P. grandiflorus has several biological applications, including in hypotension, lipid reduction, and atherosclerosis.
• Hepatic system: Jiegeng shows potential in protecting the heart and liver.
• Oncology (preclinical): Anti-cancer activity is among the diverse pharmacological effects documented for Jiegeng.
• Gastrointestinal system: Research has shown that platycodin at doses of 5, 10, and 40 mg/kg orally to rats exerted a stimulatory effect on the gastrointestinal tract and NF-κB expression, with a dose-dependent relationship.

7. Dosage Forms and Dosages Reported in Studies

Dosages cited below are those reported in the primary literature and are not treatment recommendations.

• Human RCT (anti-obesity): A study in 108 Korean adults (aged 20–60 years, BMI 23–30 kg/m²) administered the placebo, PGE571 (571 mg as PGE), PGE1142 (1142 mg as PGE), and PGE2855 (2855 mg as PGE), independently, for 12 weeks. The PGE571 group revealed a significant decrease in body fat mass and body fat percentage when compared with the placebo group.
• Animal studies — total saponins (diabetic and lipid parameters): Total saponins of P. grandiflorus at 200 mg/kg for 18 weeks reduced blood sugar, cholesterol, triglyceride, and LDL levels in type 2 diabetic rats.
• Animal studies — PD3 for asthma: OVA-induced asthma mice were given PD3 at 20 mg/kg, 40 mg/kg, and 80 mg/kg in different groups.
• Animal studies — PD for 14-day safety: Administration of Platycodin D to mice at doses of 2000, 1000, 500, 250, and 125 mg/kg over a 14-day period did not result in observed mortality, changes in body weight, or alterations in clinical signs.
• Animal studies — cardiovascular protection (in vivo): C57BL/6 mice were fed a high-fat diet for 9 weeks; the HF diet was supplemented with 0, 25, or 75 mg/kg PGEA during the last 4 weeks of the experimental period.
• Gastrointestinal/NF-κB stimulation (animal): Researchers administered platycodin at doses of 5, 10, and 40 mg/kg orally to rats, and after 7 days observed that platycodin exerted a stimulatory effect on the gastrointestinal tract and NF-κB expression, with a dose-dependent relationship.
• Traditional decoction / food form: P. grandiflorum is mostly used in the form of a "decoction" or "aqueous leaching" in traditional practice.

8. Safety Considerations

General Toxicological Profile

P. grandiflorum contains a wide range of chemical components, among which triterpene saponins, especially platycoside D (PD), play a strong role in pharmacological activity, representing a natural phytomedicine with low toxicity that has applications in food, animal feed, and cosmetics.

Subchronic Toxicity Studies

The results of genotoxic assays indicated that fermented P. grandiflorus extract (FPGE) induced neither mutagenicity nor clastogenicity. The acute toxicity test showed that FPGE did not affect animal mortality, clinical signs, body weight changes, or microscopic findings at doses ≤3000 mg/kg. The approximate lethal dose (ALD) of FPGE in SD rats was >3000 mg/kg. For the 13-week subchronic toxicity assay, no FPGE dose induced any significant change in mortality, clinical signs, body or organ weight, food consumption, ophthalmology, urinalysis, hematology, serum chemistry, gross findings, or histopathologic examination in either rat sex. The NOAEL for FPGE was set at 3000 mg/kg.

Studies on chronic toxicity of aqueous extracts at various doses revealed no changes in body weight, food and water consumption, urinalysis, serum biochemistry, or necropsy findings at a dose of 3000 mg/kg/day.

Hemolytic Activity

PLD has been discovered to have hemolytic activity. However, literature indicates that P. grandiflorum root saponins are poorly absorbed in the gastrointestinal tract, and oral administration effectively suppresses their hemolytic activity. This is an important distinction: hemolytic effects reported in vitro may not translate to clinically significant risk with standard oral use.

Gastrointestinal Effects at High Doses

Platycodon grandiflorus root is a widely used herb in East Asia for treating respiratory diseases, and research on its oral safety — particularly its potential adverse gastrointestinal effects — is a topic of ongoing investigation. Researchers found that platycodin at doses of 5, 10, and 40 mg/kg orally to rats exerted a stimulatory effect on the gastrointestinal tract in a dose-dependent relationship.

Bioavailability and Drug Interactions

The bioavailability of PLD could be improved by being prescribed with Glycyrrhiza uralensis Fisch. (licorice root). This interaction is relevant both therapeutically (as it is a traditional co-prescription) and as a potential pharmacokinetic consideration when multiple herbal medicines are used together.

Human Clinical Safety Data

In the context of the clinical trial conducted in overweight and moderately obese Korean adults, PGE was assessed for hepatic and renal function markers alongside its efficacy endpoints, indicating that the authors considered and monitored for potential organ-level toxicity. No significant adverse safety signals were reported in that 12-week trial at the doses tested.

Summary of Limitations in the Evidence Base

Research on the anti-tumor effects of P. grandiflorum extract and its active components still lacks large-scale clinical trials. Human pharmacokinetic studies are limited — most data derive from rodent models. The clinical translation of PLD still has a long way to go. The same caveat applies broadly: while preclinical data are rich, definitive human efficacy and safety evidence across most indications remains limited or preliminary. The respiratory indications supported by centuries of traditional use and converging preclinical data represent the most historically grounded area of use, and the single-center obesity RCT provides the only direct randomized human evidence currently available in the published literature.

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