New Study Links ER Stress to Coronary Artery Disease—Could Ginkgo Biloba Help?

A 2026 study published in Scientific Reports has uncovered new links between endoplasmic reticulum (ER) stress and coronary artery disease (CAD). Led by researchers Zhao, Fj., Wang, F., Qin, C., and their team, the findings suggest that ER stress worsens plaque instability and vascular inflammation. The work also highlights a potential treatment: Ginkgo biloba extract, which may help restore cellular balance in damaged blood vessels.

CAD remains one of the world's top causes of death, driven by the narrowing or blockage of coronary arteries due to atherosclerosis. While current treatments focus on managing symptoms and risk factors, this research proposes a different approach—targeting ER stress directly with plant-based compounds.

The study used single-cell RNA sequencing to examine cellular responses within atherosclerotic plaques. This method revealed distinct cell types and their varying reactions to ER stress. One key finding was a subgroup of endothelial cells showing heightened stress pathways, which weakened the artery lining and fuelled inflammation. These changes made plaques more likely to rupture, increasing the risk of heart attacks.

Immune cells, such as macrophages and T lymphocytes, also displayed different levels of ER stress activation. This chronic stress contributed to ongoing vascular inflammation, speeding up the progression of atherosclerosis. Meanwhile, vascular smooth muscle cells (VSMCs) responded to ER stress by breaking down the plaque's structural matrix and attracting more inflammatory cells, further destabilising the arteries. The researchers then tested *Ginkgo biloba* extract (GbE), a compound traditionally used to improve blood flow and treat arteriosclerosis. The extract reduced ER stress markers in vascular cells, helping to restore normal function and improve cell survival. Unlike standard CAD treatments, this approach combines cellular stress biology with phytopharmacology, offering a fresh strategy for tackling the disease. Historically, *Ginkgo biloba* has been documented in Western medicine for its antioxidant effects, particularly in enhancing cerebral circulation and addressing conditions like vertigo. This study builds on that foundation, suggesting its potential in cardiovascular care beyond previous applications.

The findings present ER stress as a critical factor in CAD progression, with single-cell analysis exposing how different vascular cells contribute to plaque vulnerability. By demonstrating Ginkgo biloba extract's ability to ease ER stress and support cell function, the study opens a new path for CAD treatment.

Further research could explore how this plant-based intervention might complement existing therapies. For now, the work provides a clearer picture of CAD's cellular mechanisms and a promising direction for future drug development.