Berberine exhibits antioxidative effects and reduces apoptosis of the vaginal epithelium in bacterial vaginosis

Abstract

Bacterial vaginosis (BV) is a common type of vaginitis. Berberine is a natural alkaline product that reduces oxidative stress and apoptosis in cells. The aim of the present study was to investigate the effects of berberine on oxidative stress and apoptotic rates of BV. Vaginal epithelial and discharge samples were obtained from 60 healthy individuals and 180 patients with BV before and after one month of berberine treatment. Clinical observation was documented for all patients before and after treatment for comparison. Additionally, an in vitro study was performed; the samples were divided into groups the following groups: Control, model (H 2 O 2 -treated), LT (low-dose berberine), MT (medium-dose berberine) and HT (high-dose berberine). Expression levels of the oxidative stress related proteins were detected by western blotting. Clinical symptoms of patients with BV significantly improved following berberine treatment. Oxidative stress in vaginal discharge was significantly lower following treatment, indicated by the increased activity of superoxide dismutase (SOD) and catalase, as well as the reduced levels of malondialdehyde and H 2 O 2 . Apoptosis of the vaginal epithelial cells was also reduced, which was indicated by the reduced expression of apoptosis proteins caspase-3, cytochrome C, capase-12 and Bax, and increased expression of Bcl-2. The results of the in vitro experiments demonstrated a dose-dependent decrease in apoptosis with berberine treatment compared with levels before treatment. Oxidative stress relief was demonstrated by the reduced reactive oxygen species level and increased SOD and endothelial nitric oxide synthase levels, whereas suppression of apoptosis was further supported by the reduction in apoptotic proteins, as well as a decreased Bax/Bcl-2 ratio. Berberine exhibited effects on lowering oxidative stress in vaginal discharge and reducing oxidative damage, as well as apoptosis of the vaginal epithelium, which are beneficial to patients with bacterial vaginosis.

Apoptosis of vaginal epithelial cells in clinical samples from women with diagnosed bacterial vaginosis

“…Vaginal ECs from healthy donors (n = 9) were washed three times, counted, adjusted to 2×10 5 /ml in RPMI 1640 supplemented with 10% FCS. Cells were then cultured for 18 h at 37 °C under 5% CO 2 in 96-well microtiter plates (100 µl/well) with or without cycloheximide (CHX) 100 μg/ml, GV 1, GV 2 and GV 3 at 2×10 5 /ml, 100 µl/well (1:1) or GV 1, GV 2 and GV 3 at 2×10 6 /ml, 100 µl/well (10: www.nature.com/scientificreports www.nature.com/scientificreports/ Even though the apoptotic process of ECs has been previously described in BV 24,25 , this study provides evidence of a direct involvement of G. vaginalis in vaginal apoptosis of epithelial cells during BV. The existence of a cell death pathway regulated by G. vaginalis provides a possible explanation for increased vaginal EC exfoliation and highlights the potential of pharmacological manipulation of EC apoptosis as a novel strategy for treating BV.…”

Evaluation of Berberine as an Adjunct to TB Treatment

“…Furthermore, berberine treatment resulted in decreased levels of nitric oxide (NO) (Figure 1E), pro-inflammatory cytokines IL-1a (Figure 1F), IL-6 (Figure 2A); while it did not effect TNFa (Figure 2B) levels in vitro. Berberine can exert its antibacterial effects through the increase of reactive oxygen species (ROS), although there are studies also reporting antioxidant activities of berberine (27)(28)(29). We have measured intracellular ROS levels of berberine-treated murine macrophages which showed no change in ROS accumulation (Figure 2C).…”

A review study on the anti-trichomonas activities of medicinal plants

“…Berberine hydrochloride intravaginal therapy had shown significant improvement in bacterial vaginosis patients' clinical symptoms as observed from a reduction in oxidative stress in vaginal discharge and apoptosis of vaginal epithelial cells. The activities of superoxide dismutase and catalase were noted as reduced levels of malondialdehyde and hydrogen peroxide ( Ma et al, 2019 ). However, the exact infection cause of vaginitis was not identified in these patients.…”