Coptis chinensis

Coptis Chinensis (Huanglian / Chinese Goldthread)

1. Identity, Botanical Description, and Common Preparations

Botanical and Pharmacopeial Identity

Coptidis Rhizoma (CR), also known as Huanglian in Chinese, is the rhizome of Coptis chinensis Franch., C. deltoidea C.Y. Cheng et Hsiao, or C. teeta Wall., all members of the family Ranunculaceae. Coptis chinensis, the Chinese goldthread, is a species of goldthread flowering plant native to China. Coptis chinensis is a perennial herb with yellow, branched rhizomes. It is mainly distributed in southeastern China, and its rhizome has been used as a traditional medicine for more than 2,000 years in China and many other Asian countries.

According to the China Pharmacopoeia, Coptidis Rhizoma is the dried root of three Coptis species: C. chinensis Franch. (Weilian in Chinese), C. deltoidea C.Y. Cheng et Hsiao (Yalian in Chinese), and C. teeta Wall. The rhizomes contain the isoquinoline alkaloids berberine, palmatine, and coptisine among others, and Coptis chinensis is one of the 50 fundamental herbs used in traditional Chinese medicine, where it is called duǎn è huánglián.

Coptis is a low, creeping perennial evergreen that grows in damp, boggy spots in woods, producing a mass of thread-like golden rhizomes that are used in healing. C. chinensis is native to the cooler parts of Asia and is extensively cultivated in Szechwan province in China.

Nomenclature and Common Names

• Scientific name: Coptis chinensis Franch.
• Pharmacopeial drug name: Coptidis Rhizoma (CR)
• Chinese names: Huanglian (黄连), Weilian
• Other names applied in various traditions include goldthread, Chinese goldthread, mouth root, cankerroot, yellowroot, coptidis, mishmi bitter, and chonlin.

Common Forms and Preparations

Clinical treatment with traditional Chinese medicine usually occurs via oral administration of a water decoction solution. The dried rhizome is the standard medicinal part used. In traditional Chinese medicine, Huang Lian is typically prepared as a decoction (boiled tea), where 3–9 grams of the dried rhizome are simmered in water. Modern preparations also include standardized dry extracts, dispensing granules, and isolated alkaloid fractions. Quantitative methods including UPLC allow simultaneous measurement of ten main compounds in preparations, including coptisine, epiberberine, jatrorrhizine, berberine, and palmatine. The United States Pharmacopeia (USP) lists a reference standard for Coptis Chinensis Rhizome Dry Extract, reflecting the herb's incorporation into regulatory quality frameworks.

2. Traditional and Historical Use

China: Classical Texts and Long-Term Application

C. chinensis was first recorded in the Eastern Han Dynasty text Shen Nong's Herbal Classic and was classified as a top-grade herb. Relevant statistics show that in 13 prescriptions before the Song Dynasty, more than 32,000 Chinese medical formulae mentioned Coptidis Rhizoma.

According to the records of traditional Chinese medicine, this herb is effective in clearing heat, drying dampness, and detoxifying. In TCM theory, it has the effect of clearing heat and drying dampness, purging fire, and detoxification. It is used for conditions such as hot and humid fullness, vomiting and acid swallowing, diarrhea, jaundice, high fever and dizziness, heart-fire hyperactivity, upset insomnia, and palpitations. Additionally, it can be used externally for eczema and wet sores.

In traditional Chinese medicine, coptis is used to treat conditions associated with excess dampness and excess heat, such as insomnia and irritability. Heat in TCM means excessive activity, not high temperature, although the affected part of the body could be red or inflamed. Coptis is said to have a cold nature and a bitter taste. In TCM, it is considered one of the 50 fundamental herbs, and is associated with the heart, liver, stomach, and large intestine.

It has been widely used to treat bacillary dysentery, diabetes, pertussis, sore throat, aphtha, and eczema in China. Classical TCM books, including the Explanation of Materia Medica and the Tang Materia Medica, clarified that prescriptions containing Coptis chinensis can effectively alleviate the symptoms of polydipsia, polyphagia, and polyuria — symptoms corresponding to what would now be recognized as diabetes mellitus.

In the Qing Dynasty, the heat-clearing effect of C. chinensis combined with other traditional Chinese medicines was used to treat abdominal pain, and classical prescriptions containing C. chinensis were frequently found in various Chinese medical texts.

Key Classical Formulas

For centuries, C. chinensis has been one of the principal components in multiple traditional Chinese medicine prescriptions; typical ones are Sanhuang-Xiexin-Tang decoction and Gegen-Qinlian-Tang decoction.

Use in Other Asian Traditions

As a treatment for diabetes mellitus and related complications, Coptis chinensis also has a long history of use in Japan, Korea, Malaysia, Singapore, and India. In Japan, Coptis anemonaefolia is sometimes used; Coptis trifolia is used in North America; and Coptis teeta grows in India and is used in Ayurvedic medicine.

Traditional Use as a Dye

Because of the strong coloring quality of berberine, the plant has been traditionally used as a dye, especially for wool and other fibers.

3. Key Constituents and Chemical Profile

Currently, 128 chemical constituents have been isolated and identified from Coptidis Rhizoma. Alkaloids are the characteristic components, together with organic acids, coumarins, phenylpropanoids, and quinones.

Primary Isoquinoline Alkaloids

The major active constituents of Coptis chinensis are isoquinoline alkaloids, including berberine, coptisine, palmatine, and jatrorrhizine. These isoquinoline alkaloids are responsible for various pharmacological effects, including antibacterial, blood glucose-lowering, and lipid-lowering effects.

The specific alkaloids identified through quality-marker predictive analysis include berberine, coptisine, palmatine, epiberberine, jatrorrhizine, columbamine, and berberrubine.

There are several active ingredients of Coptis chinensis, such as berberine (BBR), palmatine, coptisine, jatrorrhizine, worenine, columbamine, cedarone, obakunone, obakulactone, magnoflorine, and ferulic acid; berberine is the main bioactive component of Coptis chinensis and is present at a content of 5.20–7.69%.

Various biological and pharmacological activities of extracts from Coptis chinensis result from the presence of alkaloids — the derivatives of phenylalanine that contain an isoquinoline moiety in their structure, namely coptisine, berberine, jatrorrhizine, magnoflorine, and other protoberberines and aporphines.

Structure-activity research concludes that the isoquinoline alkaloids in C. chinensis — namely berberine, coptisine, palmatine, epiberberine, and jatrorrhizine — are the main constituents responsible for its bioactive properties.

Secondary Compound Classes

• Alkaloids and organic acids are the two main component categories designated as quality markers.
• Additional isolated compounds include worenine, methyl-5-O-feruloylquinate, ethyl-5-O-feruloylquinate, and apocynol, among others.
• Polysaccharides are another important component present in Coptis chinensis that have been reported to have biological activity.

Intra-Plant Metabolic Interactions

Coptisine, a co-occurring constituent in Coptis chinensis, inhibits the metabolism of berberine in the liver and may increase its bioavailability. There are different degrees of metabolic interaction between the four main components of the plant, with coptisine showing the strongest inhibition toward berberine metabolism. The alkaloids in Coptis chinensis are poorly absorbed when taken orally, resulting in low oral bioavailability.

4. Mechanisms of Action

Berberine: Central Mechanisms

Berberine directly binds KCNH6 potassium channels, significantly accelerates channel closure, and subsequently reduces KCNH6 currents. This is one documented pathway by which berberine stimulates insulin secretion. The mechanism by which berberine lowers glucose levels also involves modulating insulin signaling, acting as an insulin sensitizer and insulinotropic agent, inhibiting α-glucosidase, inducing glycolysis, and inhibiting gluconeogenesis.

Berberine, derived from Coptis species, shows significant promise for managing obesity and associated metabolic disorders through modulation of AMP-activated protein kinase (AMPK) signaling, gut microbiota composition, lipid metabolism, and adipokine networks, with these actions converging to suppress adipogenesis and improve insulin sensitivity.

Berberine regulates cholesterol metabolism through multiple mechanisms involving intestinal dietary cholesterol absorption and biliary cholesterol reabsorption, cholesterol biosynthesis, LDL-receptor-mediated LDL cholesterol clearance, bile acid synthesis, cholesterol catabolism, excretion, cholesterol secretion into bile, and final elimination via the feces. These multiple mechanisms govern cholesterol metabolism and many of them are interregulated and involve complex positive and negative feedback loops.

In the regulation of blood lipids, berberine can decrease triglyceride expression in hepatocyte cell lines and modulate bile acids. Modulation of the gut microbiome may be another novel mechanism of action by which berberine ameliorates metabolic disorders.

Berberine inhibits proliferation by modulating RXR-α/β-catenin signaling and miR-214-3P/SCT pathways. It induces cell cycle arrest through the inhibition of Cyclin D1, CDK-1, and CDK-4, while activating P21, P27, and P38. Berberine suppresses metastasis by downregulating Ras/Raf/ERK signaling and inhibiting epithelial-mesenchymal transition (EMT). It promotes apoptosis via the STAT3/Bcl-2/Bcl-xL axis and enhances autophagy through AMPK, Beclin-1, and LC3II pathways.

Coptisine: Mechanisms

Coptisine exerts potential as an anti-cancer, anti-inflammatory, coronary artery disease-ameliorating, or antibacterial agent through regulating the signalling transduction of pathways such as NF-κB, MAPK, PI3K/Akt, NLRP3 inflammasome, RANKL/RANK, and Beclin 1/Sirt1. However, the plasma concentration of coptisine demonstrates an obvious non-linear relationship with dosage, and even the highest dosage used in animal studies cannot reach the minimum concentration level used in cell experiments, owing to the poor absorption and low availability of coptisine.

Gut Microbiota Modulation

Metagenomics has identified Akkermansia as key to berberine's metabolic benefits, validated by microbiota transplantation. Berberine enhances Akkermansia growth, preserving intestinal mucus and tight junctions. Additionally, berberine positively influences gut microbiota, increasing beneficial bacteria such as Clostridiales, Bacteroidales, and Lactobacillaceae, which contribute to overall metabolic and immune homeostasis.

5. Scientific Evidence by Area of Use

5.1 Glycemic Regulation and Type 2 Diabetes

Evidence strength: Moderate — supported by multiple randomized controlled trials (RCTs) and meta-analyses, primarily conducted in China.

A pilot RCT was conducted to determine the efficacy and safety of berberine in the treatment of type 2 diabetic patients. In study A, 36 adults with newly diagnosed type 2 diabetes were randomly assigned to treatment with berberine or metformin (0.5 g three times daily) in a 3-month trial. The hypoglycemic effect of berberine was similar to that of metformin. Significant decreases in HbA1c (from 9.5% ± 0.5% to 7.5% ± 0.4%), fasting blood glucose (from 10.6 ± 0.9 mmol/L to 6.9 ± 0.5 mmol/L), postprandial blood glucose (from 19.8 ± 1.7 to 11.1 ± 0.9 mmol/L), and plasma triglycerides were observed in the berberine group. In Study B, 48 adults with poorly controlled type 2 diabetes were treated with berberine supplementation in a 3-month trial.

Berberine, a key active component from Coptis chinensis, was contained in numerous classical Chinese herbal formulas for improving insulin resistance and regulating blood glucose levels. Clinical trials confirm that berberine monotherapy reduces glycated hemoglobin (HbA1c) by 1.5% in type 2 diabetes patients, comparably to metformin.

In a systematic review of RCTs of berberine in type 2 diabetes, intervention duration ranged from 4 weeks to 6 months. Eleven trials compared berberine with placebo or none, while four trials compared berberine with metformin. Primary outcomes included HbA1c, fasting plasma glucose, 2-hour postprandial blood glucose, and HOMA-IR.

Modern pharmacological investigations have indicated that ingredients in Coptis chinensis — such as berberine, jatrorrhizine, coptisine, palmatine, epiberberine, and polysaccharides — exert significant therapeutic effects on multiple targets to improve islet function and regulate glucose metabolism.

Limitation: Although Coptis chinensis has been used as an ancient Chinese herb for treating diabetes in China for thousands of years, its underlying mechanisms remain incompletely understood. The majority of trials have been conducted in China, trial sizes are relatively small, and independent replication by research groups outside China remains limited.

5.2 Lipid Metabolism and Hyperlipidemia

Evidence strength: Moderate for berberine-specific effects; preliminary for whole-plant preparations.

The antidiabetic and lipid-lowering effects of berberine have been demonstrated in numerous clinical studies and experimental models. Studies with diabetic patients have shown that berberine has a hypoglycemic effect comparable to that of rosiglitazone and metformin. Preclinical and clinical studies demonstrate berberine's multimodal anti-obesity mechanisms, including AMPK activation enhancing lipolysis and β-oxidation, PPAR-γ suppression inhibiting adipogenesis, gut microbiota modulation improving metabolic endotoxemia, and UCP1 upregulation promoting adipose browning.

In a preclinical study, berberine reduced triglycerides and cholesterol, showing metabolic protective effects. These findings are corroborated by mechanistic data: once AMPK is activated by berberine, it phosphorylates its downstream substrates, leading to reduced ATP-consuming anabolic pathways that include cholesterol synthesis.

5.3 Gastrointestinal Infections and Inflammatory Bowel Disease

Evidence strength for antimicrobial (preclinical/in vitro): Substantial. Evidence for IBD in humans: Preliminary.

Through antiproliferative and anti-adhesive actions, berberine inhibits a wide range of microbial pathogens including Staphylococci, Streptococci, Salmonella, Clostridium, H. pylori, Shigella, Vibrio, and Cryptococci.

A study of C. chinensis extract at 100 μg/ml completely inhibited the colonization of H. pylori. The novel constituent with anti-H. pylori activity was found to be palmatine. The anti-H. pylori activity of palmatine and berberine (16 μg/ml) was similar to that of ampicillin (positive control), indicating that both palmatine and berberine derived from C. chinensis play major roles in its antimicrobial activity against H. pylori.

In modern clinical applications, C. chinensis is mainly used for the treatment of reflux esophagitis, gastric and duodenal ulcer, chronic cholecystitis, acute and chronic enteritis, gastrointestinal ulcer, and IBD. To date, C. chinensis together with other herbs is involved in many Chinese herbal prescriptions for the treatment of IBD, but only limited research has focused on the single therapeutic effects of C. chinensis or its extracts alone for the treatment of this disease. Berberine was reported to treat IBD effectively, and interest in this area has been growing rapidly in recent years.

5.4 Colorectal Adenoma Recurrence Prevention

Evidence strength: Promising, with published RCT and follow-up data.

Berberine, isolated from Coptis chinensis, has been used to treat diarrhea and enteritis for centuries in China, and recent animal studies have reported that berberine can inhibit colorectal tumor growth. A multicentre, double-blind, randomised controlled study published in Lancet Gastroenterology & Hepatology (2020) evaluated berberine versus placebo for the prevention of recurrence of colorectal adenoma, with findings cited across multiple reviews. The isoquinoline alkaloid berberine from Coptis chinensis has been documented to have specific antibacterial activity. It has been shown that berberine significantly ameliorates colorectal cancer progression in Apc^min/+ mice fed with a high-fat diet, with reduced numbers of tumors and decreased inflammation in colon tissues. Treatment with berberine reversed the imbalance in intestinal microbiota caused by Fusobacterium nucleatum colonization.

5.5 Cardiovascular Effects

Evidence strength: Largely preclinical/mechanistic; some clinical data on lipid-lowering.

Accumulating studies report a broad spectrum of pharmacologic benefits of Coptidis Rhizoma including antiviral, antibacterial, antifungal, efficacy in hepatic steatosis, antiatherosclerotic, antiarrhythmic, antihypertensive, cardioprotective, antidiabetic, anti-inflammatory, antioxidative, neuroprotective, and anticancer activity.

Berberine exerts cardioprotective effects through multifaceted mechanisms, leveraging its antioxidant, anti-inflammatory, and lipid-lowering properties to mitigate the risk of cardiovascular events. The increased lipid in serum and liver was reduced with the administration of berberine, which improved intima-media thickening, restored aortic endothelium-dependent vasodilatation, and alleviated atherosclerotic lesions in APOE(−/−) mice fed a western-type diet for 12 weeks. These findings are based on preclinical models; large independent human RCTs specifically targeting cardiovascular endpoints with C. chinensis preparations are not yet available.

5.6 Anti-Inflammatory Activity

Evidence strength: Substantial in vitro and in vivo (animal); human data limited.

Research demonstrated that Coptis chinensis and myrobalan possess synergistic anti-inflammatory activities in vitro and in vivo, indicating therapeutic potential for the prevention and treatment of inflammation-mediated diseases. Shengyang Sanhuo Decoction containing Coptidis Rhizoma is prescribed in traditional Chinese medicine for the treatment of neuropathic pain, and its effectiveness is attributed to the inhibition of TNFα, IL-6, and CRP production. Various contemporary studies confirm the anti-inflammatory and analgesic activity of C. chinensis.

5.7 Anticancer Activity

Evidence strength: Preclinical and in vitro. Clinical evidence is preliminary.

Based on its pharmacological properties, Coptis chinensis exerts multiple pharmacological actions, including antibacterial, antiviral, anti-inflammatory, anti-arrhythmic, antihypertensive, and anti-tumor effects.

The phytochemical constituents of Coptis chinensis — such as berberine, jatrorrhizine, palmatine, and coptisine — significantly inhibited the viability and growth of gastric cancer cell lines ACC-201 and NCI-N87 in cell culture experiments.

Ethanolic extracts of Coptis chinensis were shown to have potent anti-Gram-positive bacterial activity, antiviral activity, and anticancer activity in laboratory assays. These results are derived from cell-based and animal models, and direct evidence of anticancer efficacy from human trials specifically with C. chinensis preparations remains limited.

5.8 Neuroprotection

Evidence strength: Preclinical (in vitro and animal models); no established human clinical trial data.

The protective effects of C. chinensis rhizome extract and its active constituents — berberine, coptisine, and palmatine — against Parkinson's disease were assessed using GBA reporter cells, LC3 reporter cells, and cells expressing mutated (A53T) α-synuclein. C. chinensis rhizome extract is a major herb widely used to treat human diseases.

6. Body Systems Associated with Coptis Chinensis

• Gastrointestinal system: Coptis chinensis is widely used either alone or in combination with other herbs for patients with gastroenteritis, diabetes, and hyperlipidemia.
• Metabolic/endocrine system: Huanglian is traditionally applied for treating metabolic diseases based on its activities of clearing heat, drying dampness, purging fire, and detoxifying.
• Cardiovascular system: Anti-arrhythmic, antihypertensive, antiatherosclerotic, and cardioprotective effects are documented in preclinical studies.
• Immune/inflammatory system: Modulation of NF-κB, NLRP3, and cytokine pathways.
• Nervous system: Preliminary neuroprotective data in Parkinson's disease models.
• TCM organ associations: Coptis chinensis is classified in TCM as bitter and cold, affecting the heart, spleen, stomach, liver, gallbladder, and large intestine channels, possessing heat-clearing, dampness-drying, and detoxifying properties.

7. Dosage Forms and Dosages Reported in Studies

The standard dosage of Coptis Rhizome in classical TCM practice is 1.5–9 g, and the dosage depends on the individual patient, the condition being treated, and the overall formula. Huang Lian is typically prepared as a decoction (boiled tea), where 3–9 grams of the dried rhizome are simmered in water.

Specific dosages reported in clinical trials of the principal alkaloid berberine:

• In one RCT, 36 adults with newly diagnosed type 2 diabetes were randomly assigned to treatment with berberine or metformin at 0.5 g three times daily (1.5 g/day total) in a 3-month trial.
• In systematic review analyses, intervention duration ranged from 4 weeks to 6 months.

Regarding alkaloid content in standardized preparations: The total content of five alkaloids in Coptidis Rhizoma traditional decoction (TD) ranged from 71.00 to 78.62 mg, whereas in dispensing granule preparations it ranged from 38.77 to 53.68 mg per 1 g of decoction pieces.

8. Safety Considerations and Interactions

General Tolerability

Mild adverse effects associated with berberine include anorexia, upset stomach, diarrhea, constipation, and rash; the compound is otherwise generally well tolerated in clinical use.

Acute Toxicity Data

In preclinical single-dose studies, Coptis chinensis Franch (methanolic extract of fibrous root) did not induce toxicity in mice after a single oral ingestion of a high dose. The LD50 values were greater than 7,000 mg/kg body weight.

Neonates, Pregnancy, and Breastfeeding

This is the most extensively documented safety concern specific to Coptis chinensis and berberine. A study investigated the effect of berberine, the major ingredient of Chinese herb huanglian (Coptis chinensis), reported to pose some risk for kernicterus among jaundiced newborn Chinese infants, on the protein binding of bilirubin. Berberine was found in vitro to be about tenfold superior to phenylbutazone (a known potent displacer of bilirubin) in displacing bilirubin from albumin, on a molar basis. Chronic administration of berberine to adult rats resulted in a significant decrease in mean bilirubin serum protein binding and a persistent elevation in steady-state serum concentrations of unbound and total bilirubin, possibly due to inhibition of metabolism.

Two commonly used berberine-containing Chinese herbs, Rhizoma coptidis and Cortex phellodendri, have been banned in Singapore for more than three decades due to the implication of berberine in aggravating jaundice and kernicterus in neonates with glucose-6-phosphate dehydrogenase deficiency. However, the picture is not entirely uniform: one observational study in Guigang, Guangxi province, found that its results did not support the view that C. chinensis could aggravate jaundice of G6PD-deficient neonates.

Berberine should be avoided by those who are pregnant or breastfeeding, as it may worsen jaundice in infants or result in kernicterus, a condition in which prolonged high bilirubin levels can cause irreversible effects. Berberine-containing plants are not recommended for use during pregnancy due to their potential for causing uterine contractions. The use of berberine-containing herbs in late pregnancy and during lactation is generally not advised.

It is proposed that berberine usage should be avoided in pregnancy, breastfeeding period, and in G6PD-deficient neonates.

Cytochrome P450 Drug Interactions

Many studies have reported interactions between berberine-containing products and cytochrome P450 (CYP) enzymes. A two-phase randomized-crossover clinical study in healthy male subjects confirmed that berberine alters CYP activities in humans after repeated doses. Berberine was metabolized mainly by CYP2D6 in human liver microsomes.

Berberine, an isoquinoline alkaloid extracted from Coptis chinensis, has been traditionally used in Chinese herbal medicine. Berberrubine is the primary metabolite of berberine generated via hepatic cytochrome P450 enzymes. Both berberine and berberrubine can induce CYP3A4 mRNA expression in a concentration-dependent manner.

Specific drug interactions documented in clinical reports include:

• In a pediatric patient with idiopathic nephrotic syndrome, clinically relevant increases in tacrolimus concentrations and renal toxicity occurred when berberine was added to control diarrhea.
• When clinically relevant doses of berberine supplements were co-administered with bosutinib, simulations predict a moderate 1.3-fold increase in systemic exposure to bosutinib.

Clinical Cautions in TCM Practice

Coptis Rhizome is described as extremely bitter and cold, to be used cautiously and briefly. It is contraindicated in deficiency cold patterns in classical TCM practice.

Bioavailability Limitations

Despite berberine's promise, challenges in oral bioavailability and drug interactions necessitate the development of advanced delivery strategies. The low oral bioavailability of the alkaloid fraction of C. chinensis is a recognized limitation of translating in vitro and in vivo results to clinical applications; the interaction between coptisine and berberine metabolism described above may represent one endogenous mechanism that partially compensates for this.

9. Research Gaps and Evidence Limitations

As an important herbal medicine in Chinese medicine, Coptidis Rhizoma has the potential to treat various diseases. However, further research should be undertaken to investigate the clinical effects, toxic constituents, target organs, and pharmacokinetics, and to establish criteria for quality control, for CR and its related medications. The active constituents other than alkaloids, in both raw and processed products of CR, should be further investigated.

The number of components identified in extracts of Coptis chinensis is large. However, due to the marked structural similarity of all constituents, their purification from plant material for bioactivity studies is difficult and challenging.

There are few reports on safety evaluation of C. chinensis that address long-term use, chronic toxicity, and the safety of non-alkaloid fractions such as polysaccharides and coumarins under clinical conditions. Most clinical trials of berberine — the main alkaloid — have been conducted in single countries, predominantly China, with limited external replication.

References

• Coptidis Rhizoma: a comprehensive review of its traditional uses, botany, phytochemistry, pharmacology and toxicology — PMC / Journal of Ethnopharmacology (Tan et al., 2019)
• Coptisine from Coptis chinensis exerts diverse beneficial properties: A concise review — PMC (Wang et al., 2019)
• Isoquinoline Alkaloids from Coptis chinensis Franch: Focus on Coptisine as a Potential Therapeutic Candidate against Gastric Cancer Cells — PMC (2022)
• Metabolic Interaction of the Active Constituents of Coptis chinensis in Human Liver Microsomes — PMC (Liu et al., 2015)
• Efficacy of Berberine in Patients with Type 2 Diabetes — PMC (Yin et al., 2008)
• The Effect of Berberine on Metabolic Profiles in Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials — PMC
• Berberine is an insulin secretagogue targeting the KCNH6 potassium channel — Nature Communications (2021)
• Beneficial effects of berberine in the treatment of diabetes and its complications — PMC (2025)
• Systematic review and meta-analysis of Coptis chinensis Franch.-containing TCM as an adjunct therapy to metformin in type 2 diabetes — Frontiers in Pharmacology (2022)
• A Natural Isoquinoline Alkaloid With Antitumor Activity: Studies of the Biological Activities of Berberine — PMC (2019)
• Inhibitory Activities of Palmatine from Coptis chinensis Against Helicobacter pylori and Gastric Damage — PMC (2014)
• Coptis chinensis and Myrobalan Can Synergistically Inhibit Inflammatory Response In Vitro and In Vivo — PMC (2014)
• Repeated administration of berberine inhibits cytochromes P450 in humans — PMC (2016)
• Displacement of bilirubin from albumin by berberine — PubMed / Biol Neonate (Chan, 1993)
• Berberine-induced Haemolysis Revisited: Safety of Rhizoma coptidis and Cortex phellodendri in Chronic Haematological Diseases — Phytotherapy Research (2011)
• Berberine — Memorial Sloan Kettering Cancer Center Integrative Medicine
• Berberine — MotherToBaby Fact Sheet, NIH/NCBI Bookshelf
• Tracking evidences of Coptis chinensis for the treatment of inflammatory bowel disease — PubMed / Journal of Ethnopharmacology (2020)
• Exploring the Mechanism of Berberine Intervention in Ulcerative Colitis — PMC (2021)
• Update on the Benefits and Mechanisms of Berberine on Lipid Metabolism and Homeostasis — PMC (2018)
• The mechanism of berberine alleviating metabolic disorder based on gut microbiome — Frontiers in Cellular and Infection Microbiology (2022)
• Berberine as a Bioactive Alkaloid: Multi-Omics Perspectives on Its Role in Obesity Management — PMC (2025)
• Berberine: A Review of its Pharmacokinetics Properties and Therapeutic Potentials in Diverse Vascular Diseases — PMC (2022)
• The chromosome-level reference genome of Coptis chinensis provides insights into genomic evolution and berberine biosynthesis — PMC (2021)
• Topoisomerase inhibitory activity of ethanolic extracts from Coptis chinensis and Salvia officinalis — PMC (2025)
• Toxicology effects of Berberis vulgaris and its active constituent, berberine: a review — PMC (2017)
• Unveiling the Therapeutic Potential of Traditional Chinese Medicine Rhizome Coptidis: A Comprehensive Review — ScienceDirect (2024)
• Coptis Chinensis Franch: Substance Basis, Mechanism of Action and Quality Control Standard — PubMed (2024)
• Coptidis alkaloids extracted from Coptis chinensis Franch attenuate IFN-γ-induced destruction of bone marrow cells — PMC (2020)
• Comparative study on main compounds and hypoglycemic effects of dispensing granules of Coptidis Rhizoma and traditional decoction — PMC (2023)
• Sanguinarine–Chelerythrine from Coptis chinensis Offers Analgesic and Anti-Inflammatory Effects Without Gastrotoxicity — PMC (2025)
• Frontiers | Beneficial effects of berberine in the treatment of diabetes and its complications (2025)
• Berberine in cardiovascular therapy: bridging modern pharmacology with traditional Chinese botanicals — ScienceDirect (2025)
• Total alkaloids from Coptis chinensis Franch ameliorate hyperlipidemia and hepatic steatosis via dual pathway modulation — Frontiers in Pharmacology (2025)
• Berberine as a multi-target therapeutic agent for obesity: from pharmacological mechanisms to clinical evidence — PMC (2025)
• Berberine ameliorates high-fat diet-induced metabolic disorders through promoting gut Akkermansia and modulating bile acid metabolism — PMC (2025)
• Exploration of key pathogenic mechanisms and potential intervention targets of Coptis chinensis in treatment of cervical cancer — PMC (2025)
• Investigation of Coptis chinensis on jaundice of G6PD-deficient neonates from Guigang, Guangxi — PubMed (2008)