Berberine pharmacology and the gut microbiota: A hidden therapeutic link
Abstract
Berberine is a natural pentacyclic isoquinoline alkaloid that has been isolated as the principal component of many popular medicinal plants such as the genus Berberis, Coptis and Hydrastis. The multifunctional nature of berberine as a therapeutic agent is an attribute of its diverse effects on enzymes, receptors and cell signalling pathways. Through specific and general antioxidant and anti-inflammatory mechanisms, its polypharmacology has been established. Intriguingly, this is despite the poor bioavailability of berberine in animal models and hence begging the question how it induces its reputed effects in vivo. A growing evidence now suggest the role of the gut microbiota, the so-called the hidden organ, as targets for the multifunctional role of berberine. Evidences are herein scrutinised to show that the structural and numerical changes in the gut microbiota under pathological conditions are reversed by berberine. Examples in the pharmacokinetics field, obesity, hyperlipidaemia, diabetes, cancer, inflammatory disease conditions, etc. are used to show the link between the gut microbiota and the polypharmacology of berberine.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Low systemic exposure does not protect against interactions; rather, it shifts their site toward the absorption and elimination interfaces, where local concentrations are high.
“In summary, low systemic exposure does not protect against interactions; rather, it shifts their site toward the absorption and elimination interfaces, where local concentrations are high (Figure 1) [37,43,48].”
From Berberine-Drug Interactions: Mechanisms, Clinical Relevance and Risk Stratification-A Narrative Review (2026) · cites this paper as [43]
An important fraction of the berberine dose is metabolized by the intestinal microbiota into better-absorbed forms, such as dihydroberberine.
“In addition, an important fraction of the dose is metabolized by the intestinal microbiota into better-absorbed forms, such as dihydroberberine, which links pharmacokinetics to the state of the microbiome [43,66].”
From Berberine-Drug Interactions: Mechanisms, Clinical Relevance and Risk Stratification-A Narrative Review (2026) · cites this paper as [43]
The microbiome biotransforms berberine into better-absorbed forms.
“the microbiome in turn biotransforms it into better-absorbed forms [43,66,102].”
From Berberine-Drug Interactions: Mechanisms, Clinical Relevance and Risk Stratification-A Narrative Review (2026) · cites this paper as [43]
Through its intrinsic antimicrobial activity and high luminal concentrations, berberine is a prototypical example of a non-antibiotic compound that perturbs the intestinal microbial ecosystem.
“Through its intrinsic antimicrobial activity and its high luminal concentrations, berberine is a prototypical example of a non-antibiotic compound that perturbs the intestinal microbial ecosystem [43,106].”
From Berberine-Drug Interactions: Mechanisms, Clinical Relevance and Risk Stratification-A Narrative Review (2026) · cites this paper as [43]
The citation lists haven’t been fetched yet
References 147 · Cited by 352
- Authors
- Habtemariam, S.
- Affiliations
- University of Greenwich (GB)
- Corresponding author
- Habtemariam, Solomon
- ORCID
- Habtemariam, Solomon
- Venue
- Pharmacological Research
- Publisher
- Elsevier BV
- Published
- 2020-05
- Volume
- 155
- Pages
- 104722
- ISSN
- 1043-6618 (ISSN-L)
- OpenAlex
- W3007238079
- Cited by
- 352
- References
- 147
- Citations by year
- 2026: 57 · 2025: 61 · 2024: 53 · 2023: 62 · 2022: 69 · 2021: 42 · 2020: 8
- FWCI
- 6.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pharmacological Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Berberine and alkaloids research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Oncology › Drug Transport and Resistance Mechanisms
- Keywords
- berberine, gut microbiota, isoquinoline alkaloids, polypharmacology, bioavailability, antioxidant activity, anti-inflammatory activity, obesity, hyperlipidemia, diabetes mellitus, cancer, inflammatory diseases, pharmacokinetics, Berberis, Coptis
- MeSH terms
- Gastrointestinal Microbiome, Animals, Berberine, Humans
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
