Coptis chinensis – a more sustainable alternative to Hydrastis canadensis

Due to its declining habitat in the wild, Golden Seal is listed under the CITES (Convention on International Trade in Endangered Species of Wild Fauna and Flora) Appendix II as a plant that may become threatened with extinction unless trade is closely controlled.  Cultivated sources of this herb are also hard to come by, as this is a difficult herb to grow, which further impacts the available yield.  Therefore, in order to help reduce our dependence on Golden Seal, and thus lessen the pressure on its supply and support its sustainability, Phytomed has been looking into alternative medicinal plants which have a similar phytochemistry and tradition of use, to use as a replacement. 

Although the three major alkaloid constituents found in Golden Seal include berberine, hydrastine and canadine, the majority of research into the therapeutic uses of this herb is focussed on berberine.  Other berberine-containing herbs include Oregon Grape (Mahonia aquifolium) and Barberry (Berberis vulgaris), but a very interesting one from China, is Coptis (Coptis chinensis).  Cultivated sources of Coptis rhizome are available from sustainable sources and it generally contains significantly higher levels of berberine than Golden Seal. 

The following table compares the levels of berberine in the current batches of Phytomed hydroethanolic extracts Golden Seal root and Coptis rhizome:

¹ Berberine levels are based on the last batch of product made (Golden Seal root 1:3 STD ORG from batch 21940, Coptis rhizome 1:2 TR from batch 19760).

While the technical sheet on Coptis is available on the Phytomed website, a number of its key actions and medicinal applications is summarised below.

Gastrointestinal system

• Irritable and inflammatory bowel conditions – berberine acts to reduce inflammation, reduce cramping and delay intestinal transit time¹.
• Gastroenteritis, antimicrobial and antiparasitic activity – berberine has been found to be a safe and effective treatment for common gastrointestinal infections, including Escherichia coli (the common cause of ‘traveller’s diarrhoea’), Salmonella typhimurium (food poisoning), and Shigella dysenteriae ^{2, 3}.

Coptis extracts also strongly inhibit Candida spp. growth and biofilm⁴, Blastocystis spp.⁵, Entamoeba histolytica and Giardia lamblia ⁶.  Antibiofilm and P-glycoprotein inhibitory effects by berberine and other alkaloids, may contribute to the synergistic effects shown with several antibiotics against resistant bacteria^{7, 8}.

Endocrine system

• Metabolic syndrome - Systemic reviews show that Coptis aids in weight reduction, lowers elevated plasma lipids, reduces lipid synthesis and inhibits adipogenesis, while regulating gut microflora to promote weight reduction ^9,10. A meta-analysis found that Coptis alkaloids significantly lowered total and LDL cholesterol and triglycerides, while raising HDL cholesterol ¹¹.

Coptis also demonstrates beneficial effects for blood glucose control in the treatment of type 2 diabetic patients, potential protection against diabetic kidney disease, and co-administration with conventional oral hypoglycaemic drugs improved glycaemic control ^{11, 12, 13}.

• Polycystic Ovarian Syndrome (PCOS) - Berberine has shown promise due to its ability to regulate insulin and glucose, inhibit excessive testosterone production, benefit the gut microbiota, and reduce acne ^{14, 15}.
• In a clinical trial, researchers compared berberine to metformin for women with PCOS. After three months, both berberine and metformin groups exhibited improvements in insulin, body weight, and testosterone levels ¹⁶. In another clinical study, both berberine and metformin increased the pregnancy rate and reduced the incidence of severe ovarian hyperstimulation syndrome for women with PCOS undergoing fertility treatment. Berberine treatment was associated with greater decreases in BMI, lipid parameters, total FSH requirement, and an increase in live birth rate with fewer GI adverse events than metformin ¹⁷.

For more information and detail on further uses, please log onto the Phytomed website and refer to the “More information” section of the Coptis herb profile page.

References

1. Habtemariam, S. (2016). Berberine and inflammatory bowel disease: A concise review. Pharmacological Research, 113,592-599. doi: https://doi.org/10.1016/j.phrs.2016.09.041
2. Wu, L. T., Tsou, M. F., Chuang, J. Y., Kuo, H. M., & Chung, J. G. (2005). Berberine inhibits arylamine n-acetyltransferase activity and gene expression in salmonella typhi.  Current Microbiology, 51(4), 255-261. doi: 10.1007/s00284-005-4569-7
3. Shi, C., Li, M., Muhammad, I., Ma, X., Chang, Y., Li, R.,…& Liu, F. (2018). Combination of berberine and ciprofloxacin reduces multi-resistant salmonella strain biofilm formation by depressing mRNA expressions of luxS, rpoE, and ompR. Journal of veterinary science, 19(6), 808–816. doi:10.4142/jvs.2018.19.6.808
4. da Silva, A. R., de Andrade Neto, J. B., da Silva, C. R., Campos, R., Costa Silva, R. A., Freitas, D. D.,…& Nobre Júnior, H. V. (2016). Berberine antifungal activity in fluconazole-resistant pathogenic yeasts: action mechanism evaluated by flow cytometry and biofilm growth inhibition in candida spp. Antimicrobial agents and chemotherapy, 60(6), 3551–3557. doi:10.1128/AAC.01846-15
5. Su, S., Chen, G., Zhang, R., Xie, Q., & Liao, H. (2007). The trichomnacidal effect of nine chinese herbs on the blastocystis hominis. Lishizhen Medicine and Materia Medica Research. Retrieved from http://en.cnki.com.cn/Article_en/CJFDTOTAL-SZGY200703056.htm
6. Kaneda, Y., Tanaka, T. & Saw, T. (1990). Effects of berberine, a plant alkaloid, on the growth of anaerobic protozoa in axenic culture. Tokai Journal of Experimental and Clinical Medicine, 15(6), 417-423
7. Zhou, X. Y., Ye, X. G., He, L. T., Zhang, S. R., Wang, R. L., Zhou, J., & He, Z. S. (2016). In vitro characterization and inhibition of the interaction between ciprofloxacin and berberine against multidrug-resistant Klebsiella pneumoniae. The Journal of Antibiotics, 69(10), 741–746. doi:10.1038/ja.2016.15
8. Morita, Y., Nakashima, K., Nishino, K., Kotani, K., Tomida, J., Inoue, M., & Kawamura, Y. (2016). Berberine is a novel type efflux inhibitor which attenuates the mexxy-mediated aminoglycoside resistance in pseudomonas aeruginosa. Frontiers in Microbiology, 7, 1223. doi:10.3389/fmicb.2016.01223
9. Morita, Y., Nakashima, K., Nishino, K., Kotani, K., Tomida, J., Inoue, M., & Kawamura, Y. (2016). Berberine is a novel type efflux inhibitor which attenuates the mexxy-mediated aminoglycoside resistance in pseudomonas aeruginosa. Frontiers in Microbiology, 7, 1223. doi:10.3389/fmicb.2016.01223
10. Wu, H., He, K., Wang, Y., Xue, D., Ning, N, Zou, Z.,…& Pang, J. (2014). The antihypercholesterolemic effect of jatrorrhizine isolated from rhizoma coptidis. Phytomedicine, 21(11), 1373-81. doi: 10.1016/j.phymed.2014.05.002
11. Dong, H., Zhao, Y., Zhao, L., & Lu, F. (2013). The effects of berberine on blood lipids: a systemic review and meta-analysis of randomized controlled trials. Planta Medica, 79(6), 437-446. doi: 10.1055/s-0032-1328321
12. Prabhakar, P. K., & Doble, M. (2011). Mechanism of action of natural products used in the treatment of diabetes mellitus. Chinese Journal of Integrative Medicine, 17(8), 563-74. doi: 10.1007/s11655-011-0810-3
13. Zhang X, Guan T, Yang B, Chi Z, Wan Q, Gu HF. (2019). Protective effect of berberine on high glucose and hypoxia-induced apoptosis via the modulation of HIF-1α in renal tubular epithelial cells. Am J Trans Res; 11(2):669-682.
14. Yarnell, E., & Abascal, K. (2006). Herbal medicine for acne vulgaris. Alternative and Complementary Therapies, 12(6), 303-309. doi:10.1089/act.2006.12.303
15. Wang, H., Mu, W., Shang, H., Lin, J., & Lei, X. (2014). The antihyperglycemic effects of rhizoma coptidis and mechanism of actions: a review of systematic reviews and pharmacological research. BioMed Research International, 798093. doi:10.1155/2014/798093
16. Wei, W., Zhao, H., Wang, A., Sui, M., Liang, K., Deng, H.,…& Guan, Y. (2012). A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome. European Journal of Endocrinology, 166(1), 99-105. Retrieved Apr 11, 2019, from https://eje.bioscientifica.com/view/journals/eje/166/1/99.xml
17. An, Y., Sun, Z., Zhang, Y., Liu, B., Guan, Y., & Lu, M. (2014). The use of berberine for women with polycystic ovary syndrome undergoing IVF treatment. Clinical Endocrinology, 80, 425-431. doi:10.1111/cen.12294