Baptisia & Coptis - Two Under-Acknowledged Antibacterial Plants

Posted: June 2021
Author: Phil Rasmussen |  M.Pharm., M.P.S., Dip. Herb. Med.; M.N.I.M.H.(UK),  F.N.Z.A.M.H. 
 

Bacterial infections have been one of the biggest influencers of human health and illness since we emerged as a species, and with antibiotic resistance continuing to be a huge concern to the future of mainstream healthcare, we are fortunate to have a large number of plants that can help us in the management of these. This issue of Phytobrief will delve into two such herbs, Wild Indigo root (Baptisia tinctoria) and Coptis rhizome (Coptis chinensis).

Wild Indigo Root

A herb that has always held some mystery to me, is Wild Indigo root (Baptisia tinctoria).  Native to eastern North America, Wild Indigo root has a somewhat bitter and acrid taste and was a treasured herb to some native American Indians^{(1, 2)}. The young shoots were also sometimes eaten for greens⁽³⁾. While having yellow flowers, all parts of Wild Indigo when dried yield a blue dye.  Another species, Baptisia australis, which grew well in my garden years ago, has blue rather than yellow flowers and has been said to be able to be used interchangeably⁽⁴⁾, although this claim has not been validated.

Antimicrobial

A list of traditional medicinal uses for Wild Indigo is impressive, rather like those for Echinacea angustifolia and Echinacea purpurea. They include conditions such as pneumonia, tuberculosis and influenza, diarrhoea with offensive discharges, typhoid fever, scarlet fever and putrid sore throat.  All manifestations of typhoid conditions were said by the early Eclectic physicians to respond to use of Wild Indigo^{(3, 5)}, and much of the literature discusses this. It was also used in the management of smallpox, meningitis, septicaemia following abortion, and as a douche for leucorrhoea and vaginal infections^{(4, 5)}. Topical applications made from Wild Indigo were in fact amongst its most predominant uses, with others including a rinse for smallpox, a dressing for all kinds of ulcerations and gangrenous wounds, and as a mouthwash for a sore mouth and toothache^{(2 3)}.

These indications are reflective of a good antimicrobial phytomedicine. Moderate in vitro activity has been reported for extracts against Staphylococcus aureus⁽⁶⁾, and yet surprisingly few other studies into antimicrobial activity or clinical studies appear to have been published on the use of Wild Indigo alone.  Clinical trials involving combinations of Baptisia tinctoria root, Echinacea purpurea root, Echinacea pallida root and Thuja occidentalis reported an improvement in cold symptoms earlier than placebo^{(7, 8, 9)}. Enhanced phagocytic activity by leukocytes was also reported for a combination of Baptisia tinctoria, Eupatorium cannabinum and Arnica with Echinacea angustifolia, than that measured for Echinacea alone⁽¹⁰⁾.

The fact that large doses can be emetic, may account for some of this relative paucity of scientific studies into the Wild Indigo’s antimicrobial potential. However, early investigations into its use as a fresh tincture by the Eclectic physicians for typhoid, spurred by the fact that excessive doses can produce fever and other symptoms similar to those of typhoid, appear also to have clouded our view of this phytomedicine.

Large polysaccharide fractions were reported by German researchers in 1985 to show significant immunostimulant activities⁽¹¹⁾ and enhance production of antibodies against sheep red blood cells⁽¹²⁾. A contribution of arabinogalactan proteins extracted from polysaccharides found in Wild Indigo root to its claimed immune-stimulant properties has also been reported^{(13, 14)}. These are said to be mediated through a specific antigen-antibody reaction rather than non-specific immune system activation. These effects and reported efficacy using low doses of Wild Indigo root for the treatment of typhoid, has attracted the interest of homoeopathic researchers and product manufacturers⁽¹⁵⁾. However, little published evidence of such effects from low doses in human studies appears to exist, and it would seem this impression of Wild Indigo’s therapeutic properties has perhaps contributed to a blurred understanding of how best to use it, and in what dose.

Typhoid (Salmonella typhi) used to be a serious bacterial infection in much of the world until the development of a vaccine 120 years ago, and still remains a serious infectious bacterial disease in third world countries. Successful management of typhoid fever using antibiotics is also becoming increasingly difficult due to emerging and spreading drug resistance⁽¹⁶⁾. As such, further research into Wild Indigo’s relevant activities in the management of this infectious disease seems warranted.

Other applications

Wild Indigo was also sometimes taken in large doses as a purgative. In the 1870’s two chemists Weaver and Greene characterised certain alkaloids including baptisine (baptotoxine), said to be poisonous and likely to contribute to these effects⁽³⁾. Baptisine was however subsequently shown to be identical with another quinolizidine alkaloid cytisine⁽¹⁷⁾. This is a well-known constituent of various medicinal and somewhat poisonous plants such as the unripe seeds of Laburnum (Cytisus laburnum) and species of Sophora, including those used in traditional Chinese medicine as well as the New Zealand native Kowhai (various Sophora species)^{(18, 19)}.

All medicines including plant-derived ones can produce adverse effects, particularly in sensitive individuals or when excessive doses are taken. However, one person’s poison can be another person’s medicine, and while probably contributory to nausea and vomiting when excessive doses of Wild Indigo are taken, cytisine is also used as a medicine. As an alkaloid with nicotinic acetylcholine receptor-agonist properties, it is being increasingly used in small doses for smoking cessation⁽²⁰⁾. Various clinical trials in New Zealand have in fact found cytisine to have promising potential as an aid to smoking cessation^{(21, 22, 23, 24)}.

Case reports of poisoning following ingestion of Wild Indigo mistaken for asparagus have been made, although doses taken were much higher than recommended when used as a medicine (Anderson). As with Wild Indigo poisoning in North America, poisoning due to ingestion of too high a dose of Kowhai (particularly of the high cytisine-containing seeds or aerial parts rather than bark), is  not uncommon here in New Zealand ⁽²⁵⁾.  Notably, the effects of such poisoning or overdose are similar to the most frequently reported adverse reactions of cytisine when used as a drug, and include gastrointestinal symptoms that are mostly reported as either mild or moderate in severity⁽²⁰⁾.

While its content of cytisine and thus tolerance to different doses will vary between individuals, the use of Wild Indigo bark in smoking cessation treatment is potentially indicated. Analogies to the use of Lobelia inflata, which contains another nicotinic receptor-agonist lobeline, for smoking cessation treatment but invokes emesis in excessive doses (hence its common name ‘Pukeweed’), also spring to mind.  Novel nicotinic partial agonists including cytisine also show potential protective effects against Parkinson’s disease⁽²⁶⁾, depression and anxiety in animal studies⁽²⁷⁾.

Coptis

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 are also becoming hard to come by, as this is a difficult herb to grow, and cultivation takes many years. In order to reduce our dependence on Golden Seal, and thus lessen the pressure on its supply and support its sustainability, substituting it for other berberine-rich medicinal plants, is a worthwhile consideration.

Most research into the therapeutic uses of Golden Seal herb is focussed on berberine, and one of its actions is as a multidrug resistance pump inhibitor.  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 (known as Huanglian in Chinese) rhizome are available from sustainable sources and generally contain significantly higher levels of berberine than Golden Seal. 

Antimicrobial

Applications for irritable and inflammatory bowel conditions are an important aspect of Coptis’s characteristics, and berberine acts to reduce inflammation, reduce cramping and delay intestinal transit time. Apart from berberine’s antibacterial activity, other phytochemicals found in Coptis also exhibit therapeutic effects of potential benefit in inflammatory bowel disease, through oxidative stress inhibition, analgesic actions, protection of the intestinal mucosal epithelial barrier, and regulation of T helper cells⁽²⁸⁾.

The anti-infective properties of berberine also extend to more acute conditions such as gastroenteritis and gut parasites. Effectiveness and safety as a treatment for common gastrointestinal infections, including Escherichia coli (a common cause of ‘traveller’s diarrhoea’), Salmonella typhimurium (food poisoning), and Shigella dysenteriae, has been reported. Coptis extracts also strongly inhibit Candida spp. growth and biofilm, Blastocystis spp., Entamoeba histolytica and Giardia lambl. 

Antibiofilm and P-glycoprotein inhibitory effects by berberine and other alkaloids, may contribute to the synergistic effects shown with several antibiotics against resistant bacteria.

Another small molecular weight compound found in Coptis root, coptisine, also seems to contribute to antibacterial and potentially anti-cancer and anti-inflammatory effects of this herb, though its oral bioavailability is low⁽²⁹⁾.

Other uses:

Apart from these antimicrobial actions, Coptis can also exhibit beneficial effects in the treatment of polycystic ovarian syndrome, type 2 diabetes and metabolic syndrome, and can sometimes also aid in weight reduction and hyperlipidaemia, while regulating the gut microflora.

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

References:

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