How It Works
Bottom Line: There is not enough data which shows that huanglian can treat cancer, high blood pressure, infections, or any other medical condition.
Huanglian is a root extract that is used in traditional Chinese medicine. Recently several laboratory experiments have been performed with huanglian to study its possible anticancer activity. A substance called berberine in huanglian has been found to slow the replication of liver cancer cells in the laboratory by interfering with the mechanisms of cell division. Berberine also halts the growth of bacteria by interfering with their metabolism. Scientists think that berberine may have antidiarrheal activity due to its ability to slow down intestinal peristalsis (motion), but they are unsure exactly how this effect happens. The ability of berberine to lower blood pressure is attributed to its effects in the body that resemble parasympathetic nervous system stimulation (e.g., impulses to "rest and digest" rather than "fight or flight"). Such an effect has been shown in studies using dogs. In laboratory experiments, berberine also inhibits the process of blood clotting.
Purported Uses
To treat bacterial and viral infections
Laboratory studies show that berberine, a compound in huanglian, stops the growth of bacteria on contact. However, there is no proof from clinical trials that huanglian can treat infections.
To treat diarrhea and other gastrointestinal symptoms
Laboratory studies support this use, but it has not been studied in clinical trials.
To lower high blood pressure
Laboratory and animal studies support this use, but there is no proof from clinical trials that this effect occurs in humans.
To treat respiratory and ear infections
Laboratory studies show that berberine, a compound in huanglian, stops the growth of bacteria on contact. However, there is no proof from clinical trials that huanglian can treat infections.
Research Evidence
No clinical trials have been performed to study the anticancer effects of huanglian. However, a phase I trial evaluating the correct dosage of huanglian is being conducted at Memorial Sloan-Kettering Cancer Center.
Warnings
This product is regulated by the FDA as a dietary supplement. Unlike approved drugs, supplements are not required to be manufactured under specific standardized conditions. This product may not contain the labeled amount or may be contaminated. In addition, it may not have been tested for safety or effectiveness.
Do Not Take If
You are taking antihypertensive medications (for high blood pressure) (In theory, huanglian may lower your blood pressure even further. Use with caution).
You have severe underlying heart disease (Botanicals that contain berberine, such as huanglian, may cause QTc prolongation).
Huanglian displaces bilirubin and should not be administered to jaundiced neonates.
Side Effects
Nausea
Vomiting
Shortness of breath
Toxicity from high doses of huanglian can cause seizures, liver toxicity, and cardiac toxicity.
Scientific Name
Common Name
Goldthread, Coptis chinese, Coptis deltoidea, Coptis teetoides
Clinical Summary
Derived from the root of the plant. This supplement is used in traditional Chinese medicine primarily for gastrointestinal complaints, diarrhea, hypertension, bacterial and viral infections. Berberine and berberine-like alkaloids are thought responsible for its activity
(1). Laboratory studies indicate that berberine induces morphological changes and internucleosomal DNA fragmentation in hepatoma cancer cells
(3). Preliminary data support the hypothesis that huanglian suppresses cyclin B1 protein and causes cell cycle arrest at G2
(5). Huanglian has potent antiangiogenesis activity
(6). It also interacts with acetylcholine and muscarinic receptors and inhibits cholinesterase. Possible adverse effects include nausea and vomiting
(1). Theoretically huanglian may have additive hypotensive effects with antihypertensive agents. A phase I dose escalation study of huanglian in solid tumors is currently underway at Memorial Sloan-Kettering Cancer Center based on promising in vitro results.
Purported uses
Diarrhea
Ear infections
Hypertension
Microbial infection
Respiratory infections
Constituents
Alkaloids: Berberine (7-9%), coptisine, urbenine, worenine, palmaline, jatrorrhizine, columbamine
(1)
Mechanism of Action
The berberine and berberine-like compounds in huanglian are thought responsible for its activity. Berberine inhibits human hep-62 hepatoma cell growth due to morphological changes and internucleosomal DNA fragmentation (3). Huanglian inhibits topoisomerase I and is thought to suppress cyclin B1 protein and cause cancer cell arrest at G2 phase (2). It also has potent antiangiogenesis activity (6). Berberine interferes with the gastric peristalsis resulting in antidiarrheal activity, interferes with bacterial metabolism of carbohydrates, protein synthesis, and complex with nucleic acids resulting in growth inhibition. Hypotensive effects are thought mediated by muscarinic stimulation and inhibition of cholinesterase. In dogs berberine shows positive inotropic effects and lowers peripheral vascular resistance. Berberine also inhibits platelet aggregation and can antagonize thromboxane B2. Berberine can cause potassium channel blockade resulting in prolongation of the action potential in cat ventricular monocytes (1). Huanglian extract has been shown to induce apoptosis and to arrest cell growth by upregulating Interferon beta and tumor necrosis factor-alpha genes in breast cancer cells (7).
Contraindications
Huanglian displaces bilirubin and should not be administered to jaundiced neonates.
Berberine-containing botanicals may cause QTc prolongation in patients with severe underlying heart disease.
(4)
Adverse Reactions
Common (oral): Nausea, vomiting, and dyspnea
Toxicity (oral): Seizures, hepatic toxicity, cardiac toxicity
(1)
Herb-Drug Interactions
Antihypertensives: Theoretically, huanglian may cause additive hypotension.
Literature Summary and Critique
There are no published trials evaluating the efficacy of huanglian for any of its traditional applications. However, a phase I trial evaluating huanglian capsules on solid tumors is being conducted at MSKCC as in vitro studies conducted here suggest potential activity.
References
- Huang KC. The Pharmacology of Chinese Herbs, 2nd ed. New York: CRC Press; 1999.
- Kobayashi Y, et al. Inhibitors of DNA topoisomerase I and II isolated from the Coptis rhizomes. Planta Med 1995;61:414-8.
- Lin HL, et al. Up-regulation of multidrug resistance transporter expression by berberine in human and murine hepatoma cells. Cancer 1999;85:1937-42.
- Brinker F. Herb Contraindications and Drug Interactions, 3rd ed. Sandy (OR): Eclectic Medical Publications; 2001.
- Li XK, et al. Huanglian, A Chinese herbal extract, inhibits cell growth by suppressing the expression of cyclin B1 and inhibiting CDC2 kinase activity in human cancer cells. Mol Pharmacol 2000;58:1287-93.
- Wang S, et al. Angiogenesis and anti-angiogenesis activity of Chinese medicinal herbal extracts. Life Sci. 2004 Apr 2;74(20):2467-78.
- Kang JX, Liu J, Wang J, et al. The extract of huanglian, a medicinal herb, induces cell growth arrest and apoptosis by upregulation of interferon-beta and TNF-alpha in human breast cancer cells. Carcinogenesis 2005;26(11):1934-9
