Ameliorating effects of berberine on sepsis-associated lung inflammation induced by lipopolysaccharide: molecular mechanisms and preclinical evidence

Pharmacol Rep. 2023 Aug;75(4):805-816. doi: 10.1007/s43440-023-00492-2. Epub 2023 May 15.

Abstract

As a life-threatening disorder, sepsis-associated lung injury is a dysregulated inflammatory response to microbial infection, characterized by the infiltration of inflammatory cells into lung tissues and excessive production of pro-inflammatory mediators. Therefore, immunomodulatory/anti-inflammatory agents are a potential treatment for sepsis-associated lung injury. Berberine, one of the well-studied medicinal plant-derived compounds, has shown promising anti-inflammatory potential in inflammatory conditions, through modulating excessive immune responses induced by various immune cells. A systematic literature search in electronic databases indicated several publications that studied the effect of berberine on lipopolysaccharide (LPS)-induced sepsis in preclinical investigations. The current review article aims to provide evidence on the effects of berberine against LPS-induced acute lung injury (ALI), together with underlying molecular mechanisms. The findings reveal that berberine through inhibiting the excessive production of multiple pro-inflammatory cytokines, suppressing the infiltration of immune cells into lung tissues, as well as preventing pulmonary edema and coagulation, can relieve pulmonary histopathological changes from LPS-mediated inflammation, thereby attenuating sepsis-associated lung injury and lethality in the experimental models. In conclusion, berberine shows great potential as a preventing and therapeutic agent for sepsis-associated lung injury, however, further proof-of-concept studies and clinical investigations are warranted for translating these preclinical findings into clinical practices.

Keywords: Alveolar; Berberine; Lipopolysaccharide; Lung inflammation; Pulmonary; Sepsis.

Publication types

  • Review

MeSH terms

  • Acute Lung Injury* / chemically induced
  • Acute Lung Injury* / drug therapy
  • Acute Lung Injury* / pathology
  • Anti-Inflammatory Agents / adverse effects
  • Berberine* / pharmacology
  • Berberine* / therapeutic use
  • Humans
  • Inflammation / drug therapy
  • Inflammation / pathology
  • Lipopolysaccharides / toxicity
  • Lung
  • Pneumonia* / drug therapy
  • Pneumonia* / pathology
  • Sepsis* / complications
  • Sepsis* / drug therapy
  • Sepsis* / pathology

Substances

  • Lipopolysaccharides
  • Berberine
  • Anti-Inflammatory Agents