INTRODUCTION
Berberine supplements are readily available over-the-counter in the United States. It has recently gained popularity on social media and is increasingly being used as a form of complementary and alternative medicine.1 Healthcare providers should learn the mechanisms of action, potential clinical utility, and safety considerations of berberine in order to effectively counsel patients who choose to take this supplement.
Berberine is a quaternary ammonium alkaloid found in various plant families and genera. Plants belonging to the Berberis genus are the most widely distributed natural source of berberine. Commonly encountered species include Berberis vulgaris (barberry), Berberis aristata (Indian barberry), and Berberis aquifolium (Oregon grape). Berberine is also found in other plant species such as Coptis chinensis (goldthread).2 Berberine is present in the bark, stem, rhizomes, roots, leaves, and fruits. However, the bark and roots contain the highest concentrations of the alkaloid.3 These plants have been used for thousands of years for cooking and in the treatment of infections, gastrointestinal disorders, diabetes, and inflammatory conditions in traditional medicine systems, including Traditional Chinese Medicine, Ayurvedic Medicine, and traditional medicine in Iran.4
Berberine possesses a broad spectrum of pharmacological properties, which may be a result of its potent antioxidant properties,5 and its regulatory effects on the gut microbiome.6 Preclinical studies have demonstrated antimicrobial, anti-inflammatory, anti-tumor, cardioprotective, nephroprotective, neuroprotective, hypolipidemic, hypoglycemic, and anti-obesogenic properties.2,6
Berberine’s modern-day applications are just beginning to be explored. Clinical efficacy has been previously demonstrated for the treatment of dyslipidemia7 and type 2 diabetes.8 In a recent, open-label clinical trial berberine use was associated with clinical improvement in topical steroid withdrawal.9 Promising preclinical data suggest a potential role for berberine in the management of several dermatologic diseases including atopic dermatitis,10 pigmentary disorders,11 melanoma,12 skin aging,13,14 and psoriasis.15 Additional ongoing clinical trials aim to study the effectiveness in the treatment of polycystic ovarian syndrome, metabolic syndrome, non-alcoholic fatty liver disease, and the chemoprevention of colorectal cancer.16
Mechanisms of Action
The therapeutic potential of berberine in dermatologic diseases is attributed to its multifaceted mechanisms of action.
Berberine is a quaternary ammonium alkaloid found in various plant families and genera. Plants belonging to the Berberis genus are the most widely distributed natural source of berberine. Commonly encountered species include Berberis vulgaris (barberry), Berberis aristata (Indian barberry), and Berberis aquifolium (Oregon grape). Berberine is also found in other plant species such as Coptis chinensis (goldthread).2 Berberine is present in the bark, stem, rhizomes, roots, leaves, and fruits. However, the bark and roots contain the highest concentrations of the alkaloid.3 These plants have been used for thousands of years for cooking and in the treatment of infections, gastrointestinal disorders, diabetes, and inflammatory conditions in traditional medicine systems, including Traditional Chinese Medicine, Ayurvedic Medicine, and traditional medicine in Iran.4
Berberine possesses a broad spectrum of pharmacological properties, which may be a result of its potent antioxidant properties,5 and its regulatory effects on the gut microbiome.6 Preclinical studies have demonstrated antimicrobial, anti-inflammatory, anti-tumor, cardioprotective, nephroprotective, neuroprotective, hypolipidemic, hypoglycemic, and anti-obesogenic properties.2,6
Berberine’s modern-day applications are just beginning to be explored. Clinical efficacy has been previously demonstrated for the treatment of dyslipidemia7 and type 2 diabetes.8 In a recent, open-label clinical trial berberine use was associated with clinical improvement in topical steroid withdrawal.9 Promising preclinical data suggest a potential role for berberine in the management of several dermatologic diseases including atopic dermatitis,10 pigmentary disorders,11 melanoma,12 skin aging,13,14 and psoriasis.15 Additional ongoing clinical trials aim to study the effectiveness in the treatment of polycystic ovarian syndrome, metabolic syndrome, non-alcoholic fatty liver disease, and the chemoprevention of colorectal cancer.16
Mechanisms of Action
The therapeutic potential of berberine in dermatologic diseases is attributed to its multifaceted mechanisms of action.
