Berberine as a Natural Modifier of Gut Microbiota to Promote Metabolic Status in Animal Studies and Clinical Trials: A Systematic Review

Mohammad Sadegh  Adel Mehraban; Zahra Aghabeiglooei; Rasha Atlasi; Nazli Namazi; Mohammad Hossein Ayati

doi:10.18502/tim.v8i2.13086

Mohammad Sadegh Adel Mehraban Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
Zahra Aghabeiglooei Traditional Medicine Clinical Trial Research Center, Shahed University, Tehran, Iran
Rasha Atlasi Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Ira
Nazli Namazi Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Hossein Ayati Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/tim.v8i2.13086

Keywords: Berberine; Gut flora; Metabolic status; Systematic review

Abstract

As a phytochemical, berberine can modulate metabolic parameters via altering gut flora. However, findings are conflicting. In the present systematic review, we aimed to summarize the effects of berberine on gut microbiota in the models of metabolic disorders in both animal studies and clinical trials. Publications in five electronic databases including PubMed, Scopus, Embase, Web of Science, and Cochrane Library were searched systematically up to 31 May 2021 to find relevant articles with English language. Out of 4102 studies (including 2125 duplicates), 35 studies were included. In animal studies, various effects of berberine on beneficial and harmful microbiota were reported. However, findings also indicated that berberine can decrease the Firmicutes to Bacteroidetes (F/B) ratio. Three out of five studies showed positive effects of berberine on the production of short-chain fatty acids (SCFA), particularly butyrate. In three animal studies, lipopolysacaride (LPS) concentrations decreased with berberine administration. In clinical trials (n=3) positive effects on microbiota and metabolic status were also reported. However, the quality of clinical trials was mainly low. The present systematic review showed that berberine can modulate key metabolic parameters through improving the balance of intestinal microbiome, decreasing the abundance of harmful microbiota and LPS concentrations, and increasing the production of SCFAs, particularly butyrate in animal models. However, there are limited high-quality evidence regarding the effects of berberine on gut flora in clinical trials. Although berberine can be an effective prebiotic supplement to modulate metabolic parameters, further high-quality clinical trials are needed to confirm this potential.