Traditional indications

Coptis root is a traditional Chinese herbal medicine. Coptis root is alternative, anaesthetic, analgesic, antibacterial, antidote, antipyretic, antispasmodic, bitter, blood tonic, carminative, cholagogue, digestive, dysentery, sedative, stomachic, tonic and vasodilator. The root is a pungent, very bitter, cooling herb that controls bacterial and viral infections, relaxes spasms, lowers fevers and stimulates the circulation. It is one of the most frequently used herbs in prescriptions for the treatment of diabetes mellitus. It is particularly helpful in the treatment of diarrhoea, acute enteritis and dysentery, whilst it is also used in the treatment of insomnia, fidget, delirium due to high fever, leukaemia and otitis media (1).

In TCM Coptis Root is called Huang Lian 黄芩. Huang Lian enters the spleen, stomach, heart, liver and large intestine to clears heat, dry damp, eliminates toxicity, drains stomach and liver fire, and arrest bleeding due to heat. Huang Lian is considered one of the 50 fundamental herbs in Traditional Chinese Medicine (TCM). Huang Lian clears damp heat in the middle jiao. Damp heat impedes digestive function and is associated with cystitis, diarrhoea and alternating bowel symptoms. Coptis contains the phytochemical berberine, well known for its antimicrobial and anti-inflammatory properties. The herb is commonly used as a digestive aid (2).

Pharmacognosy

The alkaloid berberine has neuroprotective, anti-inflammatory and hypolipidemic activities (3). Ongoing experimental and clinical studies have illuminated great potential of berberine in regulation of glucose and lipid homeostasis, cancer growth and inflammation (4). Berberine has been shown to prolong the duration of ventricular action potential which suggests its possible clinical usefulness in the treatment of arrhythmias and/or heart failure (5). Preliminary studies showed that the Coptis root and ginseng formula could relieve insulin resistance and prevent the progression of diabetes in mice (6).

Coptis Root has been shown to inhibit coronavirus replication and is being explored as a potential COVID-19 treatment (7). Oxyberberine is an alkaloid and a metabolite of the alkaloid berberine. Berberine, the main compound of berberis, is an isoquinoline alkaloid and produced by many plants, such as Coptis japonica Makino, Coptis, Berberis petiolaris and B. vulgaris (2). The World Health Organisation (WHO) website states that berberine reduces circulating inflammatory mediators in patients with severe COVID-19 (8).Berberine and obatoclax inhibit SARS-CoV-2 replication in primary human nasal epithelial cells in vitro (9). Oxybereberine one of several phytochemicals found to act as Potential inhibitors of SARS-CoV-2 (COVID 19) spike protein of the delta and delta plus variant: In silico studies of medicinal plants of North-East India (10).

 

1. PFAF. Coptis chinensis - Franch. Devon, UK: Plants For A Future; 2022 [Available from: https://pfaf.org/user/Plant.aspx?LatinName=Coptis+chinensis.
2. Healing WRIo. Coptis (Huang Lian) Kelseyville, California, US: White Rabbit Institute of Healing; 2011 [Available from: https://www.whiterabbitinstituteofhealing.com/herbs/coptis/.
3. Baska A, Leis K, Gałązka P. Berberine in the Treatment of Diabetes Mellitus: A Review. Endocr Metab Immune Disord Drug Targets. 2021;21(8):1379-86.
4. Wang H, Zhu C, Ying Y, Luo L, Huang D, Luo Z. Metformin and berberine, two versatile drugs in treatment of common metabolic diseases. Oncotarget. 2018;9(11):10135-46.
5. Lau CW, Yao XQ, Chen ZY, Ko WH, Huang Y. Cardiovascular actions of berberine. Cardiovasc Drug Rev. 2001;19(3):234-44.
6. Jiang L, Fu Q, Wang S, Chen Y, Li J, Xiao Y, et al. Effect of RG (Coptis root and ginseng) formula in patients with type 2 diabetes mellitus: a study protocol for a randomized controlled and double-blinding trial. Trials. 2022;23(1):305.
7. Li L, Wu Y, Wang J, Yan H, Lu J, Wang Y, et al. Potential Treatment of COVID-19 with Traditional Chinese Medicine: What Herbs Can Help Win the Battle with SARS-CoV-2? Engineering. 2021.
8. WHO. Berberine reduces circulating inflammatory mediators in patients with severe COVID-19. Geneva, Switzerland: WHO; 2022 [Available from: https://search.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/en/covidwho-955791.
9. Varghese FS, van Woudenbergh E, Overheul GJ, Eleveld MJ, Kurver L, van Heerbeek N, et al. Berberine and obatoclax inhibit SARS-CoV-2 replication in primary human nasal epithelial cells in vitro. bioRxiv. 2020:2020.12.23.424189.
10. Solo P, doss MA. Potential inhibitors of SARS-CoV-2 (COVID 19) spike protein of the delta and delta plus variant: In silico studies of medicinal plants of North-East India. Current Research in Pharmacology and Drug Discovery. 2021;2:100065.