Abstract
The incidences of diabetes mellitus and other metabolic diseases are increasing worldwide. However, the current treatments for diabetes mellitus and other metabolic diseases are far from being clearly understood. Berberis species from the Barberry family, Berberidaceae, better known as Barberries are widely distributed worldwide. Several extracts and compounds obtained from Berberis species, particularly berberine, revealed effectiveness in the treatment of diabetes mellitus and other metabolic diseases. In the present study, a systematic search in the literature was performed to provide animal and clinical evidences regarding the therapeutic effects of berberine in metabolic diseases and diabetes mellitus. Also, its possible mechanism of action is described, in addition to the reported complication for berberine use and its drug interactions.
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Amini MR, Sheikhhossein F, Naghshi S, Djafari F, Askari M, Shahinfar H, Safabakhsh M, Jafari A, Shab-Bidar S (2020) Effects of berberine and barberry on anthropometric measures: a systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 49:102337. https://doi.org/10.1016/j.ctim.2020.102337
An Y, Sun Z, Zhang Y, Liu B, Guan Y, Lu M (2014) The use of berberine for women with polycystic ovary syndrome undergoing IVF treatment. Clin Endocrinol 80:425–431. https://doi.org/10.1111/cen.12294
Arora A, Balasubramanian C, Kumar N, Agrawal S, Ojha RP, Maiti S (2008) Binding of berberine to human telomeric quadruplex-spectroscopic, calorimetric and molecular modeling studies. FEBS J 275:3971–3983. https://doi.org/10.1111/j.1742-4658.2008.06541.x
Asai M, Iwata N, Yoshikawa A, Aizaki Y, Ishiura S, Saido TC, Maruyama K (2007) Berberine alters the processing of Alzheimer’s amyloid precursor protein to decrease Aβ secretion. Biochem Biophys Res Commun 352:498–502. https://doi.org/10.1016/j.bbrc.2006.11.043
Asbaghi O, Ghanbari N, shekari M, Reiner Ž, Amirani E, Hallajzadeh J, Mirsafaei L, Asemi Z, (2020) The effect of berberine supplementation on obesity parameters, inflammation and liver function enzymes: a systematic review and meta-analysis of randomized controlled trials. Clin Nutr ESPEN 38:43–49. https://doi.org/10.1016/j.clnesp.2020.04.010
Chae HW, Kim IW, Jin HE, Kim DD, Chung SJ, Shim CK (2008) Effect of ion-pair formation with bile salts on the in vitro cellular transport of berberine. Arch Pharm Res 31:103–110. https://doi.org/10.1007/s12272-008-1127-4
Chang W, Li K, Guan F, Yao F, Yu Y, Zhang M, Hatch GM, Chen L (2016a) Berberine pretreatment confers cardioprotection against ischemia-reperfusion injury in a rat model of type 2 diabetes. J Cardiovasc Pharmacol Ther 21:486–494. https://doi.org/10.1177/1074248415627873
Chang X, Wang Z, Zhang J, Yan H, Bian H, Xia M, Lin H, Jiang J, Gao X (2016b) Lipid profiling of the therapeutic effects of berberine in patients with nonalcoholic fatty liver disease. J Transl Med 14:1–11. https://doi.org/10.1186/s12967-016-0982-x
Chen Y, Li Y, Wang Y, Wen Y, Sun C (2009) Berberine improves free-fatty-acid-induced insulin resistance in L6 myotubes through inhibiting peroxisome proliferator-activated receptor γ and fatty acid transferase expressions. Metab Clin Exp 58:1694–1702. https://doi.org/10.1016/j.metabol.2009.06.009
Chen W, Miao YQ, Fan DJ, Yang SS, Lin X, Meng LK, Tang X (2011) Bioavailability study of berberine and the enhancing effects of TPGS on intestinal absorption in rats. AAPS Pharm Sci Tech 12:705–711. https://doi.org/10.1208/s12249-011-9632-z
Cok A, Plaisier C, Salie MJ, Oram DS, Chenge J, Louters LL (2011) Berberine acutely activates the glucose transport activity of GLUT1. Biochimie 93:1187–1192. https://doi.org/10.1016/j.biochi.2011.04.013
Dean DD, Martel-Pelletier J, Pelletier JP, Howell DS, Woessner JF (1989) Evidence for metalloproteinase inhibitor imbalance in human osteoarthritic cartilage. J Clin Invest 84:678–685. https://doi.org/10.1172/JCI114215
Deng Y, Xu J, Zhang X, Yang J, Zhang D, Huang J, Lv P, Shen W, Yang Y (2014) Berberine attenuates autophagy in adipocytes by targeting BECN1. Autophagy 10:1776–1786. https://doi.org/10.4161/auto.29746
di Pierro F, Villanova N, Agostini F, Marzocchi R, Soverini V, Marchesini G (2012) Pilot study on the additive effects of berberine and oral type 2 diabetes agents for patients with suboptimal glycemic control. Diabetes Metab Syndr Obes Targets Ther 5:213–217. https://doi.org/10.2147/dmso.s33718
Dong H, Wang N, Zhao L, Lu F (2012) Berberine in the treatment of type 2 diabetes mellitus: a systemic review and meta-analysis. Evid-Based Compl Alt Med 2012:591654. https://doi.org/10.1155/2012/591654
Fan J, Li B, Ge T, Zhang Z, Lv J, Zhao J, Wang P, Liu W, Wang X, Mlyniec K, Cui R (2017) Berberine produces antidepressant-like effects in ovariectomized mice. Sci Rep 7:1–9. https://doi.org/10.1038/s41598-017-01035-5
Feng X, Sureda A, Jafari S, Memariani Z, Tewari D, Annunziata G, Barrea L, Hassan ST, Smejkal K, Malaník M, Sychrová A, Barreca D, Ziberna L, Mahomoodally MF, Zengin G, Xu S, Nabavi SM, Shen AZ (2019) Berberine in cardiovascular and metabolic diseases: from mechanisms to therapeutics. Theranostics 9:1923–1951. https://doi.org/10.7150/thno.30787
Feng X, Wang K, Cao S, Ding L, Qiu F (2021) Pharmacokinetics and excretion of berberine and its nine metabolites in rats. Front Pharmacol 11:2238. https://doi.org/10.3389/fphar.2020.594852
Gomes AP, Duarte FV, Nunes P, Hubbard BP, Teodoro JS, Varela AT, Jones JG, Sinclair DA, Palmeira CM, Rolo AP (2012) Berberine protects against high fat diet-induced dysfunction in muscle mitochondria by inducing SIRT1-dependent mitochondrial biogenesis. Biochim Biophys Acta Mol Basis of Dis 1822:185–195. https://doi.org/10.1016/j.bbadis.2011.10.008
Gu L, Li N, Gong J, Li Q, Zhu W, Li J (2011) Berberine ameliorates intestinal epithelial tight-junction damage and down-regulates myosin light chain kinase pathways in a mouse model of endotoxinemia. J Infect Dis 203:1602–1612. https://doi.org/10.1093/infdis/jir147
Guo Y, Chen Y, Tan ZR, Klaassen CD, Zhou HH (2012) Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 68:213–217. https://doi.org/10.1007/s00228-011-1108-2
Guo BJ, Bian ZX, Qiu HC, Wang YT, Wang Y (2017) Biological and clinical implications of herbal medicine and natural products for the treatment of inflammatory bowel disease. Ann N Y Acad Sci 1401:37–48. https://doi.org/10.1111/nyas.13414
Hazra S, Hossain M, Suresh Kumar G (2013) Binding of isoquinoline alkaloids berberine, palmatine and coralyne to hemoglobin: structural and thermodynamic characterization studies. Mol BioSyst 9:143–153. https://doi.org/10.1039/c2mb25345c
He Y, Yuan X, Zuo H, Sun Y, Feng A (2018) Berberine exerts a protective effect on gut-vascular barrier via the modulation of the wnt/beta-catenin signaling pathway during sepsis. Cell Physiol Biochem 49:1342–1351. https://doi.org/10.1159/000493412
Hering NA, Fromm M, Schulzke JD (2012) Determinants of colonic barrier function in inflammatory bowel disease and potential therapeutics. J Physiol 590:1035–1044. https://doi.org/10.1113/jphysiol.2011.224568
Hu PF, Chen WP, Tang JL, Bao JP, Wu LD (2011) Protective effects of berberine in an experimental rat osteoarthritis model. Phytother Res 25:878–885. https://doi.org/10.1002/ptr.3359
Hwang YH, Cho WK, Jang D, Ha JH, Jung K, Yun HI, Ma JY (2012) Effects of berberine and Hwangryunhaedok-Tang on oral bioavailability and pharmacokinetics of ciprofloxacin in rats. Evid-Based Compl Alt Med 2012:673132. https://doi.org/10.1155/2012/673132
Imanshahidi M, Hosseinzadeh H (2008) Pharmacological and therapeutic effects of Berberis vulgaris and its active constituent, berberine. Phytother Res 22:999–1012. https://doi.org/10.1002/ptr.2399
Imenshahidi M, Hosseinzadeh H (2019) Berberine and barberry (Berberis vulgaris): a clinical review. Phytother Res 33:504–523. https://doi.org/10.1002/ptr.6252
Khan AY, Hossain M, Kumar GS (2013) Binding of plant alkaloids berberine and palmatine to serum albumins: a thermodynamic investigation. Mol Biol Rep 40:553–566. https://doi.org/10.1007/s11033-012-2092-z
Kong W, Wei J, Abidi P, Lin M, Inaba S, Li C, Wang Y, Wang Z, Si S, Pan H, Wang S, Wu J, Wang Y, Li Z, Liu J, Jiang JD (2004) Berberine is a novel cholesterol-lowering drug working through a unique mechanism distinct from statins. Nat Med 10:1344–1351. https://doi.org/10.1038/nm1135
Kong WJ, Wei J, Zuo ZY, Wang YM, Song DQ, You XF, Zhao LX, Pan HN, Jiang JD (2008) Combination of simvastatin with berberine improves the lipid-lowering efficacy. Metab Clin Exp 57:1029–1037. https://doi.org/10.1016/j.metabol.2008.01.037
Kong WJ, Zhang H, Song DQ, Xue R, Zhao W, Wei J, Wang YM, Shan N, Zhou ZX, Yang P, You XF, Li ZR, Si SY, Zhao LX, Pan HN, Jiang JD (2009) Berberine reduces insulin resistance through protein kinase C-dependent up-regulation of insulin receptor expression. Metab Clin Exp 58:109–119. https://doi.org/10.1016/j.metabol.2008.08.013
Kulkarni SK, Dhir A (2008) On the mechanism of antidepressant-like action of berberine chloride. Eur J Pharmacol 589:163–172. https://doi.org/10.1016/j.ejphar.2008.05.043
Kulkarni SK, Dhir A (2009) σ-1 receptors in major depression and anxiety. Expert Rev Neurother 9:1021–1034. https://doi.org/10.1586/ern.09.40
Lee YS, Kim WS, Kim KH, Yoon MJ, Cho HJ, Shen Y, Ye JM, Lee CH, Oh WK, Kim CT, Hohnen-Behrens C, Gosby A, Kraegen EW, James DE, Kim JB (2006) Berberine, a natural plant product, activates AMP-activated protein kinase with beneficial metabolic effects in diabetic and insulin-resistant states. Diabetes 55:2256–2264. https://doi.org/10.2337/db06-0006
Li GH, Zhang YP, Tang JL, Chen ZT, Hu YD, Wei H, Li DZ, Hao P, Wang DL (2010) Effects of berberine against radiation-induced intestinal injury in mice. Int J Radiat Oncol Biol Phys 77:1536–1544. https://doi.org/10.1016/j.ijrobp.2010.02.062
Li Y, Ren G, Wang YX, Kong WJ, Yang P, Wang YM, Li YH, Yi H, Li ZR, Song DQ, Jiang JD (2011) Bioactivities of berberine metabolites after transformation through CYP450 isoenzymes. J Transl Med 9:1–10. https://doi.org/10.1186/1479-5876-9-62
Li C, Xi Y, Li S, Zhao Q, Cheng W, Wang Z, Zhong J, Niu X, Chen G (2015) Berberine ameliorates TNBS induced colitis by inhibiting inflammatory responses and Th1/Th17 differentiation. Mol Immunol 67:444–454. https://doi.org/10.1016/j.molimm.2015.07.013
Li Q, Zhao C, Zhang Y, Du H, Xu T, Xu X, Zhang J, Kuang T, Lai X, Fan G, Zhang Y (2020) 1H NMR-based metabolomics coupled with molecular docking reveal the anti-diabetic effects and potential active components of berberis vernae on type 2 diabetic rats. Fron Pharmacol 11:932. https://doi.org/10.3389/fphar.2020.00932
Liu L, Liu J, Huang Z, Yu X, Zhang X, Dou D, Huang Y (2015) Berberine improves endothelial function by inhibiting endoplasmic reticulum stress in the carotid arteries of spontaneously hypertensive rats. Biochem Biophys Res Commun 458:796–801. https://doi.org/10.1016/j.bbrc.2015.02.028
Liu Y, Liu X, Hua W, Wei Q, Fang X, Zhao Z, Ge C, Liu C, Chen C, Tao Y, Zhu Y (2018) Berberine inhibits macrophage M1 polarization via AKT1/SOCS1/NF-κB signaling pathway to protect against DSS-induced colitis. Int Immunopharmacol 57:121–131. https://doi.org/10.1016/j.intimp.2018.01.049
Lou G, Xiong H, Gan Q, Hu J, Peng C, Yan Z, Yan H, Huang Q (2021) UPLC-Q-Orbitrap HRMS analysis of Coptis chinensis aerial parts and its regulatory activity on glucose-lipid metabolism. Rev Bras Farmacogn 31:24–31. https://doi.org/10.1007/s43450-020-00124-3
Lv XY, Li J, Zhang M, Wang CM, Fan Z, Wang CY, Chen L (2010) Enhancement of sodium caprate on intestine absorption and antidiabetic action of berberine. AAPS Pharm Sci Tech 11:372–382. https://doi.org/10.1208/s12249-010-9386-z
Ma Y, Ou TM, Tan JH, Hou JQ, Huang SL, Gu LQ, Huang ZS (2009) Synthesis and evaluation of 9-O-substituted berberine derivatives containing aza-aromatic terminal group as highly selective telomeric G-quadruplex stabilizing ligands. Bioorganic Med Chem Lett 19:3414–3417. https://doi.org/10.1016/j.bmcl.2009.05.030
Maeng HJ, Yoo HJ, Kim IW, Song IS, Chung SJ, Shim CK (2002) P-glycoprotein-mediated transport of berberine across Caco-2 cell monolayers. J Pharm Sci 91:2614–2621. https://doi.org/10.1002/jps.10268
Naasani I, Seimiya H, Yamori T, Tsuruo T (1999) FJ5002: a potent telomerase inhibitor identified by exploiting the disease-oriented screening program with COMPARE analysis. Cancer Res 59:4004–4011. https://cancerres.aacrjournals.org/content/59/16/4004
Neag MA, Mocan A, Echeverría J, Pop RM, Bocsan CI, Crisan G, Buzoianu AD (2018) Berberine: botanical occurrence, traditional uses, extraction methods, and relevance in cardiovascular, metabolic, hepatic, and renal disorders. Front Pharmacol 9:557. https://doi.org/10.3389/fphar.2018.00557
Neidle S (2010) Human telomeric G-quadruplex: the current status of telomeric G-quadruplexes as therapeutic targets in human cancer. FEBS J 277:1118–1125. https://doi.org/10.1111/j.1742-4658.2009.07463.x
Pan GY, Wang GJ, Liu XD, Fawcett JP, Xie YY (2002a) The involvement of P-glycoprotein in berberine absorption. Pharmacol Toxicol 91:193–197. https://doi.org/10.1034/j.1600-0773.2002.t01-1-910403.x
Pan GY, Wang GJ, Sun JG, Huang ZJ, Zhao X, Gu Y, Liu XD (2003) Inhibitory action of berberine on glucose absorption. Yaoxue Xuebao 38:911–914. https://europepmc.org/article/med/15040083
Pan JF, Yu C, Zhu DY, Zhang H, Zeng JF, Jiang SH, Ren JY (2002) Identification of three sulfate-conjugated metabolites of berberine chloride in healthy volunteers’ urine after oral administration. Acta Pharmacol Sin 23:77–82
Pan GY, Huang ZJ, Wang GJ, Fawcett JP, Liu XD, Zhao XC, Sun JG, Xie YY (2003a) The antihyperglycaemic activity of berberine arises from a decrease of glucose absorption. Planta Med 69:632–636. https://doi.org/10.1055/s-2003-41121
Peng WH, Lo KL, Lee YH, Hung TH, Lin YC (2007) Berberine produces antidepressant-like effects in the forced swim test and in the tail suspension test in mice. Life Sci 81:933–938. https://doi.org/10.1016/j.lfs.2007.08.003
Pérez-Rubio KG, González-Ortiz M, Martínez-Abundis E, Robles-Cervantes JA, Espinel-Bermúdez MC (2013) Effect of berberine administration on metabolic syndrome, insulin sensitivity, and insulin secretion. Metab Syndr Relat Disord 11:366–369. https://doi.org/10.1089/met.2012.0183
Pham TPT, Kwon J, Shin J (2011) Berberine exerts anti-adipogenic activity through up-regulation of C/EBP inhibitors, CHOP and DEC2. Biochem Biophys Res Commun 413:376–382. https://doi.org/10.1016/j.bbrc.2011.08.110
Pradhan D, Biswasroy P, Suri KA (2013) Isolation of berberine from Berberis vulgaris Linn. and standardization of aqueous extract by RP-HPLC. Int J Herb Med 1:106–111
Qiu F, Zhu Z, Kang N, Piao S, Qin G, Yao X (2008) Isolation and identification of urinary metabolites of berberine in rats and humans. Drug Metab Dispos 36:2159–2165. https://doi.org/10.1124/dmd.108.021659
Qiu W, Jiang XH, Liu CX, Ju Y, Jin JX (2009) Effect of berberine on the pharmacokinetics of substrates of CYP3A and P-gp. Phytother Res 23:1553–1558. https://doi.org/10.1002/ptr.2808
Shan CY, Yang JH, Kong Y, Wang XY, Zheng MY, Xu YG, Wang RHZ, Chang BC, Chen LM (2013) Alteration of the intestinal barrier and GLP2 secretion in berberine-treated type 2 diabetic rats. J Endocrinol 218:255–262. https://doi.org/10.1530/JOE-13-0184
Singh B, Katare AK (2020). Botanical sources, chemistry aspects and biological functions of berberine: an updated critical review. In: Singh B. (eds) Botanical leads for drug discovery. Springer, Singapore. pp. 421–462. https://doi.org/10.1007/978-981-15-5917-4_20
Sun C, Li J, Wang X, Duan W, Zhang T, Ito Y (2014) Preparative separation of quaternary ammonium alkaloids from Coptis chinensis Franch by pH-zone-refining counter-current chromatography. J Chromatogr A 1370:156–161. https://doi.org/10.1016/j.chroma.2014.10.043
Tillhon M, Guamán Ortiz LM, Lombardi P, Scovassi AI (2012) Berberine: new perspectives for old remedies. Biochem Pharmacol 84:1260–1267. https://doi.org/10.1016/j.bcp.2012.07.018
Tsai PL, Tsai TH (2002) Simultaneous determination of berberine in rat blood, liver and bile using microdialysis coupled to high-performance liquid chromatography. J Chromatogr A 961:125–130. https://doi.org/10.1016/S0021-9673(02)00378-3
Vrzal R, Zdařilová A, Ulrichová J, Bláha L, GiesyJ P, Dvořák Z (2005) Activation of the aryl hydrocarbon receptor by berberine in HepG2 and H4IIE cells: biphasic effect on CYP1A1. BiochemPharmacol 70:925–936. https://doi.org/10.1016/j.bcp.2005.06.016
Wang C, Li J, Lv X, Zhang M, Song Y, Chen L, Liu Y (2009) Ameliorative effect of berberine on endothelial dysfunction in diabetic rats induced by high-fat diet and streptozotocin. EurJ Pharmacol 620:131–137. https://doi.org/10.1016/j.ejphar.2009.07.027
Wang H, Liu D, Cao P, Lecker S, Hu Z (2010) Atrogin-1 affects muscle protein synthesis and degradation when energy metabolism is impaired by the antidiabetes drug berberine. Diabetes 59:1879–1889. https://doi.org/10.2337/db10-0207
Wang YX, Kong WJ, Li YH, Tang S, Li Z, Li YB, Shan YQ, Bi CW, Jiang JD, Song DQ (2012) Synthesis and structure-activity relationship of berberine analogues in LDLR up-regulation and AMPK activation. Bioorg Med Chem 20:6552–6558. https://doi.org/10.1016/j.bmc.2012.09.029
Wang Y, Shou JW, Li XY, Zhao ZX, Fu J, He CY, Feng R, Ma C, Wen BY, Guo F, Yang XY, Han YX, Wang LL, Tong Q, You XF, Lin Y, Kong WJ, Si SY, Jiang JD (2017) Berberine-induced bioactive metabolites of the gut microbiota improve energy metabolism. Metabolism 70:72–84. https://doi.org/10.1016/j.metabol.2017.02.003
Watanabe-Fukuda Y, Yamamoto M, Miura N, Fukutake M, Ishige A, Yamaguchi R, Nagasaki M, Saito A, Imoto S, Miyano S, Takeda J, Watanabe K (2009) Orengedokuto and berberine improve indomethacin-induced small intestinal injury via adenosine. J Gastroenterol 44:380–389. https://doi.org/10.1007/s00535-009-0005-2
Wu X, Li Q, Xin H, Yu A, Zhong M (2005) Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 61:567–572. https://doi.org/10.1007/s00228-005-0952-3
Xiao X, Zhang Q, Feng K, Wang T, Li W, Yuan T, Sun X, Sun Q, Xiang H, Wang H (2011) Berberine moderates glucose and lipid metabolism through multipathway mechanism. Evid-Based Complement Alternat Med 2011:924851 https://doi.org/10.1155/2011/924851
Xin HW, Wu XC, Li Q, Yu AR, Zhong MY, Liu YY (2006) The effects of berberine on the pharmacokinetics of ciclosporin A in healthy volunteers. Methods Find Exp Clin Pharmacol 28:25–29. https://doi.org/10.1358/mf.2006.28.1.962774
Xiong P, Niu L, Talaei S, Kord-Varkaneh H, Clark CCT, Găman MA, Rahmani J, Dorosti M, Mousavi SM, Zarezadeh M, Taghizade-Bilondi H, Zhang J (2020) The effect of berberine supplementation on obesity indices: a dose- response meta-analysis and systematic review of randomized controlled trials. Complement Ther Clin Pract 39:101113. https://doi.org/10.1016/j.ctcp.2020.101113
Yan F, Wang L, Shi Y, Cao H, Liu L, Washington MK, Chaturvedi R, Israel DA, Cao H, Wang B, Peek RM Jr, Wilson KT, Polk DB (2012) Berberine promotes recovery of colitis and inhibits inflammatory responses in colonic macrophages and epithelial cells in DSS-treated mice. Am J Physiol Gastrointest Liver Physiol 302:G504–G514. https://doi.org/10.1152/ajpgi.00312.2011
Yang F, Zhang T, Zhang R, Ito Y (1998) Application of analytical and preparative high-speed counter-current chromatography for separation of alkaloids from Coptis chinensis Franch. J Chromatogr A 829:137–141. https://doi.org/10.1016/S0021-9673(98)00776-6
Yang J, Yin J, Gao H, Xu L, Wang Y, Xu L, Li M (2012) Berberine improves insulin sensitivity by inhibiting fat store and adjusting adipokines profile in human preadipocytes and metabolic syndrome patients. Evid Based Complement Alternat Med 2012:363845. https://doi.org/10.1155/2012/363845
Yin J, Gao Z, Liu D, Liu Z, Ye J (2008) Berberine improves glucose metabolism through induction of glycolysis. Am J Physiol Endocrinol Metab 294:E148–E156. https://doi.org/10.1152/ajpendo.00211.2007
Zeng X, Zeng X (1999) Relationship between the clinical effects of berberine on severe congestive heart failure and its concentration in plasma studied by HPLC. Biomed Chromatogr 13:442–444. https://doi.org/10.1002/(SICI)1099-0801(199911)13:7%3c442::AID-BMC908%3e3.0.CO;2-A
Zhang Y, Ye J (2012) Mitochondrial inhibitor as a new class of insulin sensitizer. Acta Pharm Sin B 2:341–349. https://doi.org/10.1016/j.apsb.2012.06.010
Zhang WJ, Ou TM, Lu YJ, Huang YY, Wu WB, Huang ZS, Zhou JL, Wong KY, Gu LQ (2007) 9-Substituted berberine derivatives as G-quadruplex stabilizing ligands in telomeric DNA. Bioorg Med Chem 15:5493–5501. https://doi.org/10.1016/j.bmc.2007.05.050
Zhang H, Wei J, Xue R, Wu JD, Zhao W, Wang ZZ, Wang SK, Zhou ZX, Song DQ, Wang YM, Pan HN, Kong WJ, Jiang JD (2010) Berberine lowers blood glucose in type 2 diabetes mellitus patients through increasing insulin receptor expression. Metabolism 59:285–292. https://doi.org/10.1016/j.metabol.2009.07.029
Zhang X, Qiu F, Jiang J, Gao C, Tan Y (2011) Intestinal absorption mechanisms of berberine, palmatine, jateorhizine, and coptisine: involvement of P-glycoprotein. Xenobiotica 41:290–296. https://doi.org/10.3109/00498254.2010.529180
Zhang M, Lv X, Li J, Meng Z, Wang Q, Chang W, Li W, Chen L, Liu Y (2012) Sodium caprate augments the hypoglycemic effect of berberine via AMPK in inhibiting hepatic gluconeogenesis. Mol Cell Endocrinol 363:122–130. https://doi.org/10.1016/j.mce.2012.08.006
Zhang X, Zhao Y, Zhang M, Pang X, Xu J, Kang C, Li M, Zhang C, Zhang Z, Zhang Y, Li X, Ning G, Zhao L (2012) Structural changes of gut microbiota during berberine-mediated prevention of obesity and insulin resistance in high-fat diet-fed rats. PLoS ONE 7:e42529. https://doi.org/10.1371/journal.pone.0042529
Zhi D, Feng PF, Sun JL, Guo F, Zhang R, Zhao X, Li BX (2015) The enhancement of cardiac toxicity by concomitant administration of berberine and macrolides. Eur J Pharm Sci 76:149–155. https://doi.org/10.1016/j.ejps.2015.05.009
Zhou J, Zhou S (2010) Berberine regulates peroxisome proliferator-activated receptors and positive transcription elongation factor b expression in diabetic adipocytes. Eur J Pharmacol 649:390–397. https://doi.org/10.1016/j.ejphar.2010.09.030
Zhu F, Wu F, Ma Y, Liu G, Li Z, Sun Y, Pei Z (2011) Decrease in the production of β-amyloid by berberine inhibition of the expression of β-secretase in HEK293 cells. BMC Neurosci 12:125. https://doi.org/10.1186/1471-2202-12-125
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The current study was supported by Isfahan University of Medical Sciences, Isfahan, Iran.
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MG and KA conceived and designed the study; KA and EM collected data; KA wrote the primary draft of the manuscript; ZB wrote and completed the main content of the manuscript; MG participated in all revisions of the manuscript. All the authors have read the final manuscript and approved its submission.
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Khashayar, A., Bahari, Z., Elliyeh, M. et al. Therapeutic Effects of Berberine in Metabolic Diseases and Diabetes Mellitus. Rev. Bras. Farmacogn. 31, 272–281 (2021). https://doi.org/10.1007/s43450-021-00159-0
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DOI: https://doi.org/10.1007/s43450-021-00159-0