Berberine in Sepsis: Effects, Mechanisms, and Therapeutic Strategies

Abstract

Sepsis is defined as a dysregulated immune response to infection that leads to multiple organ dysfunction. To date, though a growing body of knowledge has gained insight into the clinical risk factors, pathobiology, treatment response, and recovery methods, sepsis remains a significant concern and clinical burden. Therefore, further study is urgently needed to alleviate the acute and chronic outcomes. Berberine (BBR), a traditional Chinese medicine with multiple actions and mechanisms, has been investigated in cellular and rodent animal models of sepsis mainly based on its anti-inflammatory effect. However, the practical application of BBR in sepsis is still lacking, and it is imperative to systematically summarize the study of BBR in sepsis. This review summarized its pharmacological activities and mechanisms in septic-related organ injuries and the potential BBR-based therapeutic strategies for sepsis, which will provide comprehensive references for scientific research and clinical application.

The development of endoplasmic reticulum-related gene signatures and the immune infiltration analysis of sepsis

“…Sepsis has been recognized as a life-threatening illness, characterized by multiorgan dysfunction, which results in high morbidity and mortality, with limited pharmacologic therapy ( 13 ). An immunosuppressive status is the main cause of increased mortality in patients with advanced sepsis ( 16 ).…”

“…Dysregulated ER stress is related to inflammation ( 12 ). It is widely established that sepsis is a systemic inflammatory response, and the core mechanism of initiation and progression of sepsis is inflammation ( 13 ). Consequently, a better understanding of the role of the ER in the progression of sepsis is essential so as to identify novel diagnostic markers and therapeutic targets for sepsis.…”

Benefits of Some Phytochemical Compounds in Experimental Sepsis Models: A Therapeutic Perspective

“…While berberine was initially approved as an antibacterial agent, it has demonstrated therapeutic potential in some diseases including cardiovascular and neurodegenerative diseases. 54 Berberine has the capacity to interact with a variety of molecular targets, attaching to active spaces characterized by specific structural and physicochemical properties. The effectiveness of berberine about treating the sepsis have been extensively explored in cellular and animal models, although there are no clinical studies on berberine for treating sepsis in practice.…”

“…Additionally, berberine suppresses the phosphorylation of MAPKs, along with reducing the level of reactive oxygen species in macrophages. 54 , 56 Berberine pretreatment has been shown to maintain the integrity of the endothelial glycocalyx, inhibit NF- κ B signaling pathway activation, and decrease the releasing of proinflammatory cytokines such as TNF-α, and IL-6 in LPS-induced ARDS mice model. 57 Studies have also reported that berberine inhibits proinflammatory cytokine expression in bone marrow-derived macrophages and improves survival in septic mice by suppressing NF- κ B- and IL-6-mediated STAT3 activation.…”