Pilot study on the additive effects of berberine and oral type 2 diabetes agents for patients with suboptimal glycemic control

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Berberine, an isoquinoline alkaloid of the protoberberine type and found in an array of plants, has been used in Indian and Chinese medicine for many decades. It is present in Hydrastis canadensis (goldenseal), Coptis chinensis (Coptis or goldenthread), Berberis aquifolium (the Oregon grape), Berberis vulgaris (barberry), and Berberis aristata (tree turmeric). Berberine and extracts of berberine have demonstrated significant antimicrobial activity against a variety of organisms, including bacteria, viruses, fungi, protozoans, helminths, and chlamydia. The predominant clinical uses of berberine, at least in the recent past, have included bacterial diarrhea and intestinal parasite infections.4

More recently, clinical research on berberine has revealed novel pharmacological properties and multiple therapeutic applications, mainly concerning hypercholesterolemia and diabetes.5 With regard to the lipid profile, berberine upregulates low-density lipoprotein receptor expression independent of sterol regulatory element-binding proteins, but dependent on extracellular signal-regulated kinases and c-Jun N-terminal kinase activation, leading to reductions in total cholesterol and low-density lipoprotein cholesterol of about 30% and 25%, respectively. This upmodulation occurs via a post-transcriptional mechanism that stabilizes mRNA and enables berberine to act as a cholesterol-lowering drug via a mechanism of action different from that of the statins.6 In addition to its cholesterol-lowering properties, berberine reduces triglycerides by about 35%. These effects on the lipid profile have been observed in both animals and humans.6,7

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