Sophora
Also known as: Sophora flavescens, Ku Shen, Shrubby Sophora, Five-Flavor Sophora
Overview
Sophora flavescens, commonly known as Ku Shen or Shrubby Sophora, is a perennial shrub native to East Asia. Its roots and rhizomes have been used in traditional Chinese medicine (TCM) for centuries. The plant contains bioactive alkaloids, primarily matrine, oxymatrine, sophocarpine, and sophoridine, which are responsible for its pharmacological effects. Sophora flavescens is available in various forms, including extracts, capsules, and injections (used mainly in clinical settings). It is investigated for its anti-inflammatory, anti-cancer, and immunomodulatory properties. Research suggests potential benefits in conditions like ulcerative colitis and as an adjunct therapy for certain cancers. While the evidence base is growing, further research is needed to fully understand its efficacy and safety across diverse populations and conditions. The quality of available evidence is considered good for specific indications like ulcerative colitis, but more limited for broader health claims.
Benefits
Sophora flavescens has demonstrated potential benefits in specific health conditions. A systematic review and meta-analysis of RCTs showed that enteric-coated capsules of Five-Flavor Sophora flavescens significantly improved clinical remission rates in patients with ulcerative colitis compared to placebo (OR 2.41, 95% CI 1.54–3.77, p < 0.001). Remission rates were around 60–70% in treatment groups versus 30–40% in controls. As an adjunct therapy for advanced esophageal cancer, combined chemotherapy with compound Sophora flavescens injection improved short-term efficacy (effective rate: CR + PR = ~60–70% vs. ~40–50% in controls), increased median survival, and improved immune markers (CD3+, CD4+). Preclinical studies also suggest anti-inflammatory, anti-angiogenic, and pro-apoptotic effects. Most evidence is concentrated in patients with ulcerative colitis or specific cancers, indicating population-specific benefits.
How it works
The primary mechanism of action of Sophora flavescens is attributed to its main alkaloid, matrine. Matrine induces apoptosis via mitochondrial pathways, involving cytochrome C release and activation of caspase-9 and caspase-3. It also inhibits NF-kappa B, a key regulator of inflammation, and downregulates MMP-9 and VEGF/VEGFR-2, reducing inflammation and angiogenesis. These actions affect immune, inflammatory, and cancer cell pathways. While matrine and oxymatrine are absorbed orally, their bioavailability can be variable. Enteric-coated formulations may improve delivery and reduce gastric irritation, enhancing the overall effectiveness of the supplement.
Side effects
Sophora flavescens is generally well-tolerated in clinical studies, with most adverse events being mild to moderate. Common side effects (occurring in >5% of users) include nausea, vomiting, and mild gastrointestinal discomfort. Uncommon side effects (1–5%) may include leukopenia, thrombocytopenia, and hemoglobin reduction, particularly in cancer patients receiving combined therapy. Rare side effects (<1%) are not well-documented, but possible allergic reactions should be considered. Due to in vitro estrogenic effects, patients with hormone-sensitive cancers should avoid Sophora flavescens. Limited data exists on drug interactions, but potential additive effects with chemotherapy or immunosuppressants should be considered. It is not recommended for pregnant or breastfeeding women, and caution is advised in patients with hormone-sensitive conditions.
Dosage
The minimum effective dose of Sophora flavescens is not well-established, but clinical studies have used 0.5–1.0 g/day of extract (standardized to matrine/oxymatrine content) for ulcerative colitis. Optimal dosage ranges from 0.5–2.0 g/day of standardized extract, depending on the specific indication. The maximum safe dose is not clearly defined, and higher doses may increase the risk of side effects. It is usually taken in divided doses with meals to reduce gastrointestinal discomfort. Enteric-coated capsules are preferred for gastrointestinal conditions to improve absorption and reduce gastric irritation. No specific cofactors are identified as required for its use.
FAQs
When should I consider using Sophora flavescens?
Sophora flavescens is best used under medical supervision for specific indications like ulcerative colitis or as an adjunct therapy for certain cancers, where clinical evidence supports its potential benefits.
Is Sophora flavescens safe for everyone?
It is generally safe for short-term use, but individuals with hormone-sensitive cancers should avoid it due to potential estrogenic effects. Pregnant or breastfeeding women should also avoid its use.
How should I take Sophora flavescens to minimize side effects?
Take it with meals to minimize gastrointestinal side effects. Follow dosing guidelines from clinical studies, typically ranging from 0.5-2.0g of standardized extract per day, divided into multiple doses.
What kind of results can I expect from taking Sophora flavescens?
Expected results vary depending on the condition being treated. In ulcerative colitis, it may improve remission rates. In cancer, it may improve immune markers and short-term efficacy when used as an adjunct to chemotherapy.
Is Sophora flavescens a cure-all?
No, it is not a cure-all. The evidence is strongest for specific medical conditions like ulcerative colitis and as an adjunct therapy for certain cancers. It should not be considered a substitute for conventional medical treatments.
Research Sources
- https://pubmed.ncbi.nlm.nih.gov/35069773/ – This systematic review and meta-analysis of RCTs found that Five-Flavor Sophora flavescens enteric-coated capsules significantly improved clinical remission rates in patients with ulcerative colitis compared to placebo. The analysis included multiple RCTs with a total of over 500 patients, showing a statistically significant improvement in remission rates after 8-12 weeks of treatment.
- https://jgo.amegroups.org/article/view/59644/html – This systematic review and meta-analysis focused on the use of compound Sophora flavescens injection combined with chemotherapy in patients with advanced esophageal cancer. The study found improvements in short-term efficacy, increased median survival, and improved immune markers. However, the authors noted that most studies were conducted in China, which may limit the generalizability of the findings.
- https://www.mskcc.org/cancer-care/integrative-medicine/herbs/sophora-flavescens – This resource provides a general overview of Sophora flavescens, including its traditional uses, active compounds, and potential benefits. It highlights that matrine, the main alkaloid, induces apoptosis and inhibits inflammation and angiogenesis. The resource also cautions against its use in patients with hormone-sensitive cancers due to potential estrogenic effects.
- https://japsonline.com/abstract.php?article_id=3416&sts=2 – This abstract details the pharmacological activities of Sophora flavescens, focusing on its anti-inflammatory, anti-cancer, and immunomodulatory effects. It mentions the various alkaloids present in the plant and their mechanisms of action, including the induction of apoptosis and inhibition of NF-kappa B signaling.
- https://www.repository.cam.ac.uk/items/34119f98-c309-45a9-9526-ac38b357a3ca – This repository item likely contains research related to Sophora flavescens, potentially covering its chemical composition, pharmacological properties, or clinical applications. Further investigation of the full content would be needed to provide a more detailed summary of its key findings.
