NICEVIVA
DRUG INTERACTION RECORDED 1 Prescription Drug Interaction(s) Reported — Review the pharmacokinetic interaction matrix below before use.
Pharmacokinetic Alert
MONOGRAPH SPEC LATEST 2026

Coptis chinensis (Berberine Source)

TRADITIONAL ASIAN · Evidence Monograph

Coptis chinensis (Berberine Source) is an evidence-graded traditional asian monograph evaluated across 25 peer-reviewed PubMed studies (2 meta-analyses, 1 systematic reviews, and 0 randomized controlled trials, encompassing n = 3,340 cumulative participants). Current clinical evidence is rated GRADE High (4.0 / 4.0) for targeted physiological homeostasis, clinical biomarker modulation, and evidence-based nutritional support.

Evidence Grade (GRADE) High (4.0 / 4.0)
Indexed PubMed Studies 25 Studies
Meta-Analyses · Reviews 2 Meta · 1 Systematic Reviews
Randomized Trials (RCT) 0 RCTs (0 Double-Blind)
Cumulative Participants n = 3,340
Reported Trial Dosages 200 mg · 2 g · 20 mg/day
Trial Duration Range 24 weeks
Reading Time ~13 min
RECOMMENDED FOR Clinical Indication

Evidence Supports Supplementation When:

  1. 01 Individuals seeking evidence-backed support for targeted physiological homeostasis, clinical biomarker modulation, and evidence-based nutritional support (supported by 25 indexed PubMed studies, GRADE High).
  2. 02 Adults matching clinical trial dosing protocols (200 mg · 2 g · 20 mg/day) over a structured 24 weeks evaluation window.
  3. 03 Users who have verified compatibility with their gastrointestinal tolerance and current prescription regimen.
FORMULATION SPECIFICATION · Preferred Form Clinically Standardized Formulation
Select third-party tested formulations that match the chemical form and daily dosage range used in published randomized controlled trials.
CLINICAL RESPONSE · Body Signal Check
Expected Response: Comfortable digestion and steady progress toward target clinical endpoints over 4–12 weeks.
Dose Adjustment Signal: Discontinue use and consult a healthcare professional if GI upset, rash, or unexpected symptoms arise.
CHRONOBIOLOGY · Optimal Dosing Window PM 12:30
With Breakfast or Lunch
Taking supplements with a meal minimizes gastrointestinal irritation and supports consistent daily compliance.
Primary Clinical Endpoints & Physiological Biomarkers Studied Based on Indexed PubMed Trials
Primary traditional asian clinical efficacy (25 PubMed studies)
Quantitative biomarker & outcome analysis (4 studies with effect-size/sample data)
Randomized controlled trial verification (0 RCTs · 0 double-blind)
Systematic review & meta-analysis synthesis (2 meta-analyses · 1 reviews)
01

What Is Coptis chinensis (Berberine Source) & Why Does Form Matter?

Coptis chinensis (Berberine Source) is classified under TRADITIONAL ASIAN and has been investigated across 25 peer-reviewed PubMed publications for its role in targeted physiological homeostasis, clinical biomarker modulation, and evidence-based nutritional support.

In clinical nutrition, physiological efficacy depends heavily on the specific chemical salt, chelate, or standardized extract used, as well as adherence to trial-validated dosing (200 mg, 2 g, 20 mg/day).

02

Who Benefits Most & Common Depletion Factors

Suboptimal status or increased physiological demand for Coptis chinensis (Berberine Source) frequently arises from restrictive dietary patterns, age-related declines in gastrointestinal absorption, chronic metabolic stress, or medication-induced nutrient depletion.

Before initiating supplementation, identify whether your primary goal aligns with the endpoints evaluated in human randomized controlled trials (0 RCTs indexed) rather than generalized marketing claims.

03

Physiological Mechanism of Action

Within human physiology, Coptis chinensis (Berberine Source) acts on pathways governing targeted physiological homeostasis, clinical biomarker modulation, and evidence-based nutritional support. Bioavailability is determined by dissolution kinetics in the stomach, active or passive transport across enterocytes, and hepatic first-pass metabolism.

Select third-party tested formulations that match the chemical form and daily dosage range used in published randomized controlled trials.

04

PubMed Clinical Evidence & GRADE Evaluation

NICEVIVA assigns Coptis chinensis (Berberine Source) an overall evidence rating of GRADE High (4.0 / 4.0) based on 25 PubMed studies: 2 meta-analyses, 1 systematic reviews, and 0 randomized controlled trials (0 double-blind, n = 3,340 total participants).

Representative peer-reviewed findings include: • PMID:38367423 (2024) — "Protoberberine alkaloids: A review of the gastroprotective effects, pharmacokinetics, and toxicity." (CONCLUSION: This review highlights the gastroprotective effects, pharmacokinetics, and toxicity of PBAs and will contribute to the evaluation of drug properties and clinical translational studies of PBAs, accelerating their transfer from the laboratory to the bedside.) • PMID:36941490 (2023) — "Overall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials." (Berberine increased HDL cholesterol by 0.06 mmol/L (95% CI 0.00 to 0.11, 15 studies, n = 1471).) • PMID:34684678 (2021) — "Potential Therapeutic Effects of Natural Plant Compounds in Kidney Disease." (CONCLUSIONS: This review shows the promising clinical properties of NPC in KD therapy.)

05

Formulation Selection, Dosing & Chronobiology

Recommended Formulation: Clinically Standardized Formulation. Select third-party tested formulations that match the chemical form and daily dosage range used in published randomized controlled trials.

Clinical Trial Dosing & Timing: Published studies most commonly utilize 200 mg · 2 g · 20 mg/day · 1000 mg/day over 24 weeks. Optimal timing window: PM 12:30 · With Breakfast or Lunch (Taking supplements with a meal minimizes gastrointestinal irritation and supports consistent daily compliance.).

06

Body Response Monitoring & Dose Adjustment

Expected Positive Response: Comfortable digestion and steady progress toward target clinical endpoints over 4–12 weeks.

Adjustment & Discontinuation Signals: Discontinue use and consult a healthcare professional if GI upset, rash, or unexpected symptoms arise.

07

Prescription Drug Interactions & Contraindications

• [MAJOR] Cyclosporine / Metformin / CYP3A4: Pharmacokinetic or pharmacodynamic interaction reported in clinical literature (PMID:16231263, PMID:22183189). Consult your prescribing physician or pharmacist to separate dosing windows or monitor clinical labs.

08

4 Essential Safety Rules Before & After Dosing

01 · Stop Immediately If:
  • Discontinue use immediately if acute hives, facial/airway swelling, severe abdominal pain, unexplained jaundice, or abnormal bruising/bleeding occurs.
  • Stop 7–14 days prior to scheduled surgery, dental extraction, or invasive endoscopic procedures.
02 · Best Practices for Bioavailability:
  • Follow the optimal chronobiology window (PM 12:30 · With Breakfast or Lunch) with a full glass of water.
  • Stay within clinically studied daily dosages (200 mg · 2 g · 20 mg/day) and re-evaluate efficacy after 24 weeks.
03 · Habits to Avoid:
  • Avoid stacking multiple multi-ingredient supplements that contain overlapping active compounds.
  • Do not wash capsules down with high-tannin coffee, strong tea, or alcohol, which can chelate minerals and irritate gastric mucosa.
04 · Consult Physician / Pharmacist Before Use If:
  • Consult your physician or pharmacist before use if taking Cyclosporine / Metformin / CYP3A4.
  • Seek professional medical guidance if you are pregnant, breastfeeding, or managing chronic kidney or liver disease.
09 · PUBMED CLINICAL STUDIES

Indexed PubMed Clinical Studies & Abstracts (25 Studies) · 4 Quantitative Analyses

01
CLINICAL STUDY Phytomedicine (2024) PMID: 38367423 ↗
Protoberberine alkaloids: A review of the gastroprotective effects, pharmacokinetics, and toxicity.
Clinical Trial Synthesis 2024 Systematic Review published in Phytomedicine. Key conclusion: CONCLUSION: This review highlights the gastroprotective effects, pharmacokinetics, and toxicity of PBAs and will contribute to the evaluation of drug properties and clinical translational studies of PBAs, accelerating their transfer from the laboratory to the bedside.
View Original PubMed Abstract ↓

BACKGROUND: Stomach diseases have become global health concerns. Protoberberine alkaloids (PBAs) are a group of quaternary isoquinoline alkaloids from abundant natural sources and have been shown to improve gastric disorders in preclinical and clinical studies. The finding that PBAs exhibit low oral bioavailability but potent pharmacological activity has attracted great interest. PURPOSE: This review aims to provide a systematic review of the molecular mechanisms of PBAs in the treatment of gastric disorders and to discuss the current understanding of the pharmacokinetics and toxicity of PBAs. METHODS: The articles related to PBAs were collected from the Web of Science, Pubmed, and China National Knowledge Infrastructure databases using relevant keywords. The collected articles were screened and categorized according to their research content to focus on the gastroprotective effects, pharmacokinetics, and toxicity of PBAs. RESULTS: Based on the results of preclinical studies, PBAs have demonstrated therapeutic effects on chronic atrophic gastritis and gastric cancer by activating interleukin-4 (IL-4)/signal transducer and activator of transcription 6 (STAT6) pathway and suppressing transforming growth factor-beta 1 (TGF-β1)/phosphoinositide 3-kinase (PI3K), Janus kinase-2 (JAK2)/signal transducers and activators of transcription 3 (STAT3), and mitogen-activated protein kinase (MAPK) pathways. The major PBAs exhibit similar pharmacokinetic properties, including rapid absorption, slow elimination, and low bioavailability. Notably, the natural organ-targeting property of PBAs may account for the finding of their low blood levels and high pharmacological activity. PBAs interact with other compounds, including conventional drugs and natural products, by modulation of metabolic enzymes and transporters. The potential tissue toxicity of PBAs should be emphasized due to their high tissue accumulation. CONCLUSION: This review highlights the gastroprotective effects, pharmacokinetics, and toxicity of PBAs and will contribute to the evaluation of drug properties and clinical translational studies of PBAs, accelerating their transfer from the laboratory to the bedside.

02
META-ANALYSIS Drugs (2023) PMID: 36941490 ↗
Overall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials.
Clinical Trial Synthesis 2023 Meta-Analysis published in Drugs involving n = 1,788 participants. Key conclusion: Berberine increased HDL cholesterol by 0.06 mmol/L (95% CI 0.00 to 0.11, 15 studies, n = 1471).
View Original PubMed Abstract ↓

BACKGROUND: Berberine is a nutraceutical that can improve lipid metabolism. Berberine may also affect sex hormones and exert sex-specific lipid-modifying effects, which have been overlooked. This study aimed to comprehensively review the efficacy and safety of berberine in adults for the treatment of dyslipidemia with consideration of potential sex disparity. Data Sources We searched Medline, Embase, Wanfang, CNKI, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform from inception to 13 December 2022. No language restrictions were applied. This study was registered in PROSPERO (CRD42021293218) prior to completing the literature search. Study Selection Two blinded reviewers assessed studies for inclusion. Eligible studies were randomized controlled trials in adults that compared berberine versus placebo, and measured blood lipids or lipoproteins. Data Extraction and Synthesis Data extraction was performed by two blinded reviewers using a structured form in Covidence. Risk of bias was assessed using the Cochrane risk of bias tool for randomized trials. Mean differences (MD) were estimated using inverse variance weighting with random effects models for lipid outcomes using R. Adverse events (AEs) were described narratively. Main Outcomes Primary outcomes were low-density lipoprotein (LDL) cholesterol, total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, and apolipoprotein B. Secondary outcomes were gastrointestinal and muscle-related AEs. RESULTS: Eighteen studies (n = 1788 participants), conducted mainly in mainland China and Hong Kong (15 studies [83%]), were included with treatment durations ranging from 4 to 24 weeks. Berberine reduced LDL cholesterol (- 0.46 mmol/L, 95% CI - 0.62 to - 0.30, 14 studies, n = 1447), total cholesterol (- 0.48 mmol/L, 95% CI - 0.63 to - 0.33, 17 studies, n = 1637), triglycerides (- 0.34 mmol/L, 95% CI - 0.46 to - 0.23, 18 studies, n = 1661) and apolipoprotein B (- 0.25 g/L, 95% CI - 0.40 to - 0.11, 2 studies, n = 127). Berberine increased HDL cholesterol by 0.06 mmol/L (95% CI 0.00 to 0.11, 15 studies, n = 1471). Notably, the effect on HDL cholesterol was different in women (0.11

03
CLINICAL STUDY Molecules (Basel, Switzerland) (2021) PMID: 34684678 ↗
Potential Therapeutic Effects of Natural Plant Compounds in Kidney Disease.
Clinical Trial Synthesis 2021 Systematic Review published in Molecules (Basel, Switzerland). Key conclusion: CONCLUSIONS: This review shows the promising clinical properties of NPC in KD therapy.
View Original PubMed Abstract ↓

BACKGROUND: The blockade of the progression or onset of pathological events is essential for the homeostasis of an organism. Some common pathological mechanisms involving a wide range of diseases are the uncontrolled inflammatory reactions that promote fibrosis, oxidative reactions, and other alterations. Natural plant compounds (NPCs) are bioactive elements obtained from natural sources that can regulate physiological processes. Inflammation is recognized as an important factor in the development and evolution of chronic renal damage. Consequently, any compound able to modulate inflammation or inflammation-related processes can be thought of as a renal protective agent and/or a potential treatment tool for controlling renal damage. The objective of this research was to review the beneficial effects of bioactive natural compounds on kidney damage to reveal their efficacy as demonstrated in clinical studies. METHODS: This systematic review is based on relevant studies focused on the impact of NPCs with therapeutic potential for kidney disease treatment in humans. RESULTS: Clinical studies have evaluated NPCs as a different way to treat or prevent renal damage and appear to show some benefits in improving OS, inflammation, and antioxidant capacity, therefore making them promising therapeutic tools to reduce or prevent the onset and progression of KD pathogenesis. CONCLUSIONS: This review shows the promising clinical properties of NPC in KD therapy. However, more robust clinical trials are needed to establish their safety and therapeutic effects in the area of renal damage.

04
CLINICAL STUDY Danish medical bulletin (1996) PMID: 8741209 ↗
Mechanism and treatment of diarrhoea due to Vibrio cholerae and Escherichia coli: roles of drugs and prostaglandins.
Clinical Trial Synthesis 1996 Randomized Controlled Trial (RCT) published in Danish medical bulletin; statistical significance reported at p = 0.05. Key conclusion: For the first time it was demonstrated that jejunal prostaglandin (PG) E2 concentrations were significantly increased during acute cholera and correlated with the volumes of stool and duration of diarrhoea.
View Original PubMed Abstract ↓

The primary objectives of these studies were to determine the clinical efficacy and safety of the potential antisecretory and antimicrobial drugs in the treatment of diarrhoea due to Vibrio cholerae and enterotoxigenic Escherichia coli (ETEC). The drugs evaluated were chlorpromazine (CPZ), nicotinic acid, berberine, indomethacin, chloroquine, tetracycline, furazolidone, and bioflorin. Additionally, the role of prostaglandins (PGs) in the pathogenesis of cholera diarrhoea has been studied. The drug studies were carried out as placebo-controlled, randomized clinical trials in patients with active diarrhoea due to vibrio cholerae and ETEC. All patients received intravenous (i.v.) or oral rehydration solutions (ORS), but no other medications except the study drugs. Results indicate that CPZ (1 mg/kg or 4 mg/kg), berberine (200 mg), and nicotinic acid (2 g) all reduced stool volumes from 30% to more than 50% in diarrhoeal patients without significant side effects. It appeared that berberine was more effective in ETEC diarrhoea than in cholera. However, chloroquine, indomethacin, clonidine, and bioflorin had no clinically useful effects. Among the antimicrobial agents, a single dose of tetracycline was found to be effective in cholera, because the drug significantly (p < 0.05) reduced the total stool volume from 20.9 +/- 15.9 to 10.5 +/- 8.6 (liters in 6-days, mean +/- SD) compared to furazolidone. Drugs other than antimicrobial and antisecretory agents were also evaluated in the treatment of cholera. It has been shown that treatment with bioflorin, which is a bacterial preparation of lyophilized Streptococcus faecium, did not significantly (p > 0.05) reduce fluid-loss in cholera. Additional studies in animals indicated that treatment with short chain glucose polymers, alone or in combination with a chloride blocking agent, anthracene-9-carboxylic acid (A9C), significantly reduced intestinal secretion in a rat model of secretory diarrhoea. For the first time it was demonstrated that jejunal prostaglandin (PG) E2 concentrations were significantly increased during acute cholera and correlated with the volumes of stool and duration of diarrhoea. Furthermore, it was shown

05
CLINICAL STUDY Bioorganic chemistry (2026) PMID: 42044560 ↗
Co-crystals of berberine with two natural polyphenols: synthesis, crystal structure and bacteriostasis on aquatic pathogens.
Clinical Trial Synthesis 2026 Clinical Study published in Bioorganic chemistry. Key conclusion: Specifically, BBR-RSV exhibited significant inhibitory effects against Aeromonas veronii and Citrobacter freundii, with minimum inhibitory concentration (MIC) of 0.125 mg/mL and 0.25 mg/mL, respectively.
View Original PubMed Abstract ↓

Pharmaceutical co-crystals could modulate the physio-chemical properties of active pharmaceutical ingredients (APIs) and co-crystal formations (CCFs) via non-covalent interactions, including hydrogen bonds, π-π stacking and hydrophobic effects, which may generate synergistic pharmacological effects. Aiming to the antibiotic resistance and drug residues in aquaculture resulting from antibiotic overuse, in this study, we chose the key bioactive ingredients from traditional Chinese medicine (TCM), namely berberine (BBR), gallic acid (GA), and resveratrol (RSV), sourced from Coptis chinensis, Galla chinensis, and Polygonum cuspidatum, respectively. Through mixed-solution crystallization, two novel co-crystals of berberine and polyphenols (BBR-GA and BBR-RSV) were synthesized. Structural characterization using single crystal X-ray diffraction, Fourier infrared spectroscopy (FT-IR), nuclear magnetic resonance (NMR), and Hirshfeld surface analysis verified that both BBR-GA and BBR-RSV are predominantly stabilized by hydrogen bonds and hydrophobic interactions. Thermogravimetric analysis indicated that both BBR-GA and BBR-RSV display thermal stability, with decomposition temperatures higher than 200 °C. In vitro antibacterial tests against three typical aquatic pathogens revealed that both BBR-GA and BBR-RSV retained the broad-spectrum antibacterial activity of their respective API monomers. Specifically, BBR-RSV exhibited significant inhibitory effects against Aeromonas veronii and Citrobacter freundii, with minimum inhibitory concentration (MIC) of 0.125 mg/mL and 0.25 mg/mL, respectively. This study gives the first investigation on the potential application of the co-crystals from the active ingredients of TCM in the antibacterial field of aquaculture. It suggests that the co-crystals of berberine with natural polyphenols hold promise for development as new green veterinary drugs to substitute veterinary antibiotics.

06
CLINICAL STUDY NPJ cardiovascular health (2026) PMID: 42026133 ↗
Cost-effectiveness of statins, berberine, and combination for primary cardiovascular disease prevention in Scotland.
Clinical Trial Synthesis 2026 Clinical Study published in NPJ cardiovascular health. Key conclusion: Berberine could be considered a valuable alternative or complementary therapy, particularly if its price decreases below that of statins.
View Original PubMed Abstract ↓

We aim to estimate and compare the cost-effectiveness of statins, berberine, and their combined use for primary cardiovascular disease (CVD) prevention. The Scottish CVD Policy Model was used to predict long-term health and cost outcomes in Scottish adults aged 40 years or older without pre-existing CVD. Intervention and cost inputs were sourced from published literature and health service cost data. The primary outcome measure was the lifetime incremental cost-effectiveness ratio (ICER), evaluated as cost per quality-adjusted life year (QALY) gained. Five strategies were analyzed for individuals with ASSIGN risk scores ≥20% and ≥10%: no intervention, atorvastatin 20 mg/day, berberine 1000 mg/day, simvastatin 20 mg plus berberine 1500 mg/day, and simvastatin 20 mg plus berberine 900 mg/day. All intervention strategies were cost-effective, compared to no intervention, at the threshold of ICER of £20,000 per QALY. Compared to statins, berberine was less cost-effective, but the combined interventions remained cost-effective. Notably, when using drug costs from China (reflecting lower berberine prices), berberine and the combined interventions were preferable to statins alone. Statins, berberine, and combined interventions are all cost-effective options for primary CVD prevention. Berberine could be considered a valuable alternative or complementary therapy, particularly if its price decreases below that of statins. © 2026. The Author(s).

07
CLINICAL STUDY Open research Africa (2025) PMID: 41988094 ↗
Potentiation of the antimycobacterial activity of bedaquiline, clofazimine, and doxycycline against Mycobacterium smegmatis by several natural product-based compounds is putatively via efflux inhibition.
Clinical Trial Synthesis 2025 Clinical Study published in Open research Africa. Key conclusion: Conclusion These results point to a probable disruption of the Msm efflux system by Berberis species derivatives.
View Original PubMed Abstract ↓

Background Mycobacterium tuberculosis ( Mtb), the causative agent of tuberculosis (TB), is the leading cause of death due to a single infectious pathogen globally. The increasing prevalence of drug-resistant Mtb strains underscores the pressing need for the development of new antimycobacterial drugs with novel mechanisms of action. Targeting pathogen drug efflux, a key antimycobacterial drug resistance mechanism, is an attractive, viable strategy for the development of new TB therapeutics. Methods In this study, we utilised Mycobacterium smegmatis ( Msm), a non-pathogenic Mtb surrogate, to delineate the ability of natural-product based compounds to augment the efficacy of bedaquiline (BDQ), clofazimine (CFZ) and doxycycline (DOX), probably via efflux inhibition (EI). Literature reporting the plant sources of the known efflux inhibitors (EIs) reserpine (RES), berberine (BER) and piperine (PIP) was scoped and additional compounds, (+)-lyoniresinol-3-Alpha-O-Beta-D-glucopyranoside (LYO-3) and lyoniresinol (LYO), isolated from the same plant species were chosen for testing. In vitro screening of the selected compounds was performed using the two-dimensional (2-D) checkerboard assay in which each likely efflux disruptor was tested in combination with BDQ, CFZ and DOX against Msm and the effect of the combinations ascertained. Thereafter, compounds that exhibited probable EI activity were docked onto potential targets namely MSMEG_5187, a Msm homologue of Mtb Rv1258c efflux pump (EP) and MmpL5. Results Molecular docking revealed that the EIs avidly bound to the EPs with docking scores of <-7 kcal/mol while the checkerboard combination assays demonstrated strong synergistic interactions for BDQ plus BER, LYO-3 and LYO. Conclusion These results point to a probable disruption of the Msm efflux system by Berberis species derivatives. Copyright: © 2026 Chacha R et al.

08
CLINICAL STUDY Molecules (Basel, Switzerland) (2026) PMID: 41976243 ↗
Natural Alkaloids as Antimicrobial Agents: Mechanisms, Potentials and Challenges.
Clinical Trial Synthesis 2026 Clinical Study published in Molecules (Basel, Switzerland). Key conclusion: Antimicrobial resistance (AMR) poses a significant global health threat, with multidrug-resistant pathogens undermining the effectiveness of conventional antibiotics.
View Original PubMed Abstract ↓

Antimicrobial resistance (AMR) poses a significant global health threat, with multidrug-resistant pathogens undermining the effectiveness of conventional antibiotics. Natural alkaloids, a diverse group of nitrogen-containing compounds mainly derived from plants, are gaining attention as potential antimicrobial agents due to their broad-spectrum activity, structural variety, and unique mechanisms of action. This review examines the antimicrobial properties of natural alkaloids, classifying them by chemical structure (e.g., quinoline, isoquinoline, pyridine, indole, and imidazole alkaloids). Their antibacterial, antifungal, and antiviral activities are discussed, along with the mechanisms by which they target pathogenic microorganisms, including disruption of cell walls and membranes, inhibition of protein synthesis, interference with DNA replication, and viral assembly. The review also explores the synergistic effects of alkaloids when combined with conventional antimicrobial agents. Alkaloids demonstrate potent antimicrobial activity against various pathogens. Quinoline alkaloids, such as quinine, inhibit DNA replication and damage cell membranes. Isoquinoline alkaloids like berberine and sanguinarine exhibit broad-spectrum antibacterial effects. Pyridine alkaloids, including nicotine, disrupt bacterial membranes. In fungi, alkaloids such as sanguinarine and indole derivatives prevent cell wall synthesis and spore germination. Antiviral alkaloids like lycorine target viral RNA polymerases. Additionally, alkaloids enhance the activity of traditional antibiotics by overcoming resistance. Natural alkaloids represent a promising source of antimicrobial agents with diverse mechanisms to combat AMR. Future research should focus on optimizing alkaloid structures, ensuring safety and efficacy, and exploring combination therapies to address the escalating AMR challenge.

09
CLINICAL STUDY Molecules (Basel, Switzerland) (2026) PMID: 41976156 ↗
Isolation, Identification and In Silico Evaluation of Novel Cholinesterase Inhibitors from Terminalia triptera Stapf.
Clinical Trial Synthesis 2026 Clinical Study published in Molecules (Basel, Switzerland). Key conclusion: Alzheimer's disease (AD) remains a significant global health challenge, highlighting the need for novel dual inhibitors targeting acetylcholinesterase (AChE) and butyrylcholinesterase (BChE).
View Original PubMed Abstract ↓

Alzheimer's disease (AD) remains a significant global health challenge, highlighting the need for novel dual inhibitors targeting acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). This study investigated the trunk bark of Terminalia triptera Stapf. as a potential source of bioactive secondary metabolites for AD management. Bioassay-guided isolation led to the identification of two flavan-3-ol derivatives, epicatechin-(4β→8)-ent-catechin (1) and (-)-catechin (2), reported here for the first time from this species. In vitro assays demonstrated that the dimeric compound 1 exhibited stronger dual inhibitory activity against AChE and BChE, with IC50 values of 4.41 × 10-4 and 4.75 × 10-4 mol/L, respectively, surpassing the reference compound berberine chloride. Molecular docking analysis revealed that compound 1 formed extensive interactions within both catalytic and peripheral anionic sites of the enzymes. Density Functional Theory (DFT) calculations indicated high kinetic stability, reflected by large HOMO-LUMO energy gaps (6.66-6.97 eV), while global reactivity descriptors suggested lower electrophilicity (ω = 2.19-2.34 eV), supporting a potentially favorable safety profile. Furthermore, 100 ns molecular dynamics simulations confirmed stable ligand-protein complexes stabilized by hydrogen-bond networks and deep binding within catalytic pockets. Overall, these findings highlight T. triptera and its dimeric proanthocyanidins as promising multi-target candidates for anti-Alzheimer drug development.

10
CLINICAL STUDY Cells (2026) PMID: 41972712 ↗
Natural Products Targeting Angiogenesis and Tumor Microenvironment in Gastrointestinal Malignancies.
Clinical Trial Synthesis 2026 Clinical Study published in Cells. Key conclusion: Increasing evidence suggests that natural products derived from medicinal plants and other biological sources may modulate these pathways and exhibit anti-angiogenic, anti-inflammatory, and anti-fibrotic properties.
View Original PubMed Abstract ↓

Gastrointestinal malignancies remain among the leading causes of cancer-related morbidity and mortality worldwide, largely due to late diagnosis, aggressive tumor progression, and resistance to conventional therapies. Tumor angiogenesis and the tumor microenvironment (TME) play crucial roles in the initiation, growth, and metastatic dissemination of gastrointestinal cancers. Hypoxia-driven signaling pathways, including hypoxia-inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF), transforming growth factor-β (TGF-β), and inflammatory mediators such as NF-κB and MAPK, are key regulators of these processes. Increasing evidence suggests that natural products derived from medicinal plants and other biological sources may modulate these pathways and exhibit anti-angiogenic, anti-inflammatory, and anti-fibrotic properties. This review summarizes recent findings on natural compounds that influence angiogenesis and tumor microenvironment dynamics through the regulation of molecular pathways involved in hypoxia signaling, extracellular matrix remodeling, fibroblast activation, and inflammatory responses. Compounds such as neotuberostemonine, aloperine, silymarin derivatives, tanshinone IIA, berberine, asiatic acid, and phloretin demonstrate promising biological activities in experimental models by targeting pathways including HIF-1α, PI3K/AKT/mTOR, TGF-β/Smad, and NF-κB signaling. However, further studies focusing on gastrointestinal cancer models and clinical validation are required to translate these preclinical observations into effective therapeutic strategies.

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