Berberine has been shown to regulate glucose and lipid metabolism in vitro and in vivo This pilot study was to determine the efficacy and safety of berberine in the treatment of type 2 diabetic patients In study A, 36 adults with newly diagnosed type 2 diabetes were randomly assigned to treatment with berberine or metformin (05 g tid) in a 3-month trial The hypoglycemic effect of berberine was similar to that of metformin Significant decreases in hemoglobin A1c (HbA1c; from 95% ± 05% to 75% ± 04%, P<001), fasting blood glucose (FBG; from 106 ± 09 mmol/L to 69 ± 05 mmol/L, P<001), postprandial blood glucose (PBG; from 198 ± 17 to 111 ± 09 mmol/L, P<001) and plasma triglycerides (from 113 ± 013 mmol/L to 089 ± 003 mmol/L, P<005) were observed in the berberine group In study B, 48 adults with poorly controlled type 2 diabetes were treated supplemented with berberine in a 3-month trial Berberine acted by lowering FBG and PBG from one week to the end of the trial HbA1c decreased from 81% ± 02% to 73% ± 03% (P<0001) Fasting plasma insulin and HOMA-IR were reduced by 281% and 447% (P<0001), respectively Total cholesterol and low-density lipoprotein cholesterol (LDL-C) were decreased significantly as well During the trial, 20 (345%) patients suffered from transient gastrointestinal adverse effects Functional liver or kidney damages were not observed for all patients In conclusion, this pilot study indicates that berberine is a potent oral hypoglycemic agent with beneficial effects on lipid metabolism

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Efficacy of berberine in patients with type 2 diabetes mellitus

Allergic asthma is caused by the aberrant expansion in the lung of T helper cells that produce type 2 (TH2) cytokines and is characterized by infiltration of eosinophils and bronchial hyperreactivity. This disease is often triggered by mast cells activated by immunoglobulin E (IgE)-mediated allergic challenge. Activated mast cells release various chemical mediators, including prostaglandin D2 (PGD2), whose role in allergic asthma has now been investigated by the generation of mice deficient in the PGD receptor (DP). Sensitization and aerosol challenge of the homozygous mutant (DP-/-) mice with ovalbumin (OVA) induced increases in the serum concentration of IgE similar to those in wild-type mice subjected to this model of asthma. However, the concentrations of TH2 cytokines and the extent of lymphocyte accumulation in the lung of OVA-challenged DP-/- mice were greatly reduced compared with those in wild-type animals. Moreover, DP-/- mice showed only marginal infiltration of eosinophils and failed to develop airway hyperreactivity. Thus, PGD2 functions as a mast cell-derived mediator to trigger asthmatic responses.

Prostaglandin D_2 as a Mediator of Allergic Asthma.

streptozotocin- induced diabetic rats

In management of metabolic syndrome, the traditional Chinese medicine (TCM) is an excellent representative in alternative and complementary medicines with a complete theory system and substantial herb remedies. In this article, basic principle of TCM is introduced and 22 traditional Chinese herbs are reviewed for their potential activities in the treatment of metabolic syndrome. Three herbs, ginseng, rhizoma coptidis (berberine, the major active compound) and bitter melon, were discussed in detail on their therapeutic potentials. Ginseng extracts made from root, rootlet, berry and leaf of Panax quinquefolium (American ginseng) and Panax ginseng (Asian ginseng), are proved for anti-hyperglycemia, insulin sensitization, islet protection, anti-obesity and anti-oxidation in many model systems. Energy expenditure is enhanced by ginseng through thermogenesis. Ginseng-specific saponins (ginsenosides) are considered as the major bioactive compounds for the metabolic activities of ginseng. Berberine from rhizoma coptidis is an oral hypoglycemic agent. It also has anti-obesity and anti-dyslipidemia activities. The action mechanism is related to inhibition of mitochondrial function, stimulation of glycolysis, activation of AMPK pathway, suppression of adipogenesis and induction of low-density lipoprotein (LDL) receptor expression. Bitter melon or bitter gourd (Momordica charantia) is able to reduce blood glucose and lipids in both normal and diabetic animals. It may also protect β cells, enhance insulin sensitivity and reduce oxidative stress. Although evidence from animals and humans consistently supports the therapeutic activities of ginseng, berberine and bitter melon, multi-center large-scale clinical trials have not been conducted to evaluate the efficacy and safety of these herbal medicines.

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Traditional Chinese Medicine in Treatment of Metabolic Syndrome

Current knowledge and pharmacological profile of berberine: An update

Effects of berberine on diabetes induced by alloxan and a high-fat/high-cholesterol diet in rats.

Berberine as a promising anti-diabetic nephropathy drug: An analysis of its effects and mechanisms

Diabetic nephropathy, a lethal diabetic complication, is a leading cause of end-stage renal disease, which is pathologically characterized by thickened tubular basal and glomerular membranes, accumulated extracellular matrix, and progressive mesangial hypertrophy. Growing evidence indicates that diabetic nephropathy is induced by multiple conditions, such as glucose metabolism disorder, oxidative stress, numerous inflammatory factors and cytokines, and haemodynamic changes that lead to the occurrence and development of diabetic nephropathy based on genetic susceptibility. A variety of abnormalities in the signalling pathway may interact to produce these pathologic processes. Research has aimed to highlight the signalling pathway mechanisms that lead to diabetic nephropathy so that preventative strategies and effective therapies might be developed. In this review, important pathways that appear to be involved in driving these processes are discussed.

Li-Qin Tang

Papers

Effects of berberine on diabetes induced by alloxan and a high-fat/high-cholesterol diet in rats.

Berberine as a promising anti-diabetic nephropathy drug: An analysis of its effects and mechanisms

Research progress in signalling pathway in diabetic nephropathy.

Reversal effect of quercetin on multidrug resistance via FZD7/β-catenin pathway in hepatocellular carcinoma cells.

Berberine attenuates podocytes injury caused by exosomes derived from high glucose-induced mesangial cells through TGFβ1-PI3K/AKT pathway