Cancer is a group of
diseases that is common all over the world and the death rate due to cancer is
increasing day by day. Gastric cancer is contributing to the most number of
deaths among cancer patients. Various therapies are available and chemotherapy
is most widely used but they have many harmful effects and are also less efficient.
For this purpose, investigations are being done on active ingredients derived
from natural sources which will have minimum side effects and high efficiency
one such is berberine.
What berberine is?
Berberine is quaternary ammonium salt derived from protoberberine group of isoquinoline alkaloids (2,3–methylenedioxy-9,10-dimethoxyprotoberberine
chloride; C20H18NO4+). It is
usually concentrated in rhizomes and roots of various plants. It is an active
ingredient derived from Berberis vulgaris
and has many important medical uses. Previously, it has also
been used as anti-inflammatory, anti-diabetic and anti-bacterial against many
bacterial infections. Nowadays
investigations are also being done on the usage of berberine for treating
various types of cancers. Berberine is less toxic as compared to other different chemicals used in chemotherapy or some other
therapies.
Pathway leading to uncontrolled cell growth
The mammalian target of rapamycin (mTOR) is linked with growth factors
and is an active inhibitor of autophagy. An
enzyme ribosomal protein S6 kinase (p70S6K) is involved in phosphorylation of mTOR.
The autophagy regulatory signalling pathways of
phosphoinositide 3-kinase (PI3K) and mitogen-activated protein kinase (MAPK)
are the major contributors to the evolution of the different types of cancers
among mammals. Different kinases lead to the activation of mTOR. mTOR is an
intracellular signalling pathway that is usually involved in the development or
growth of cancer cells. Berberine work by down-regulating mTOR signalling
pathway i.e. inhibiting the mTOR pathway and promoting autophagy and thus the death
of cancer cells. Since mTOR/p70S6K is involved in various growth factors and
inhibition of mTOR/p60S70K, reduced the growth of cancer cells. So any drug
that will inhibit the mTOR/p60S70K pathway will ultimately inhibit the growth
of cancer cells.
How berberine controls cancer?
Berberine works by inhibiting mTOR and phosphoinositide
3-kinase (PI3K) and mitogen-activated protein kinase (MAPK) signalling pathways.
Since induction or in some cases inhibition of autophagy play a major role in the
treatment of cancer. Among various types of therapies involved in treating
cancer, cytoprotective and cytostatic autophagy are two major functional forms
of autophagy. Berberine stimulates cytostatic autophagy and represses the
gastric cancer cell growth.
In
vitro
and in vivo investigations of
cytostatic autophagy induced by berberine
MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium
bromide) assay is a colorimetric assay which is used to evaluate the metabolic
activity of a cell. MTT assays used for investigation of cytotoxicity showed
that berberine strongly inhibited the growth of human gastric cancer BGC-823
cell growth showing maximum toxicity to gastric cancer cell while the normal
cells were inhibited weakly verifying little toxicity to them. The formation of
autophagosomes after staining with monodansylcadaverine (MDC), in vivo marker for autophagic vacuoles, and autophagosomes observed
by green fluorescent protein (GFP)-fused LC3 marker it was confirmed that berberine
caused autophagy. The autophagy inhibitors 3-methyladenine (3-MA) and
chloroquine (CQ) and Baf-A1 inhibited autophagy which was caused by berberine in
GGC-823 cells which proved the role of berberine in cancer treatment. The
mTOR/p70S6K signalling pathways which are regulated by the MPAK signalling
pathway usually inhibits autophagy and growth of cell and berberine inhibit
that pathway promoting autophagy and thus ultimately cancerous cell death.
Future of drugs derived from
herbs or natural products
As we all know that chemotherapeutic drugs have a lot
of side effects and also show very little efficiency against the treatment of
certain diseases. On the other hand, the drugs derived from herbs or other
natural products show very little harmful effects. In this article, the role of
berberine which is active isoquinoline alkaloid is highlighted. Berberine has a
potential role in cancer treatment. In some cases it inhibits autophagy whilst
in others promotes autophagy both to treat cancer. So there is a need to
discover and investigate more such drugs which will help in the treatment of
disease when chemotherapeutic drugs play no significant role. Such drugs mostly
act on diseased cells/parts while showing no or very little toxicity to normal
cells/parts. These active ingredients derived from herbs may also be helpful
for later stages of certain diseases where chemotherapeutic drugs are usually not effective.
Author
Maria Abbas, a student of BS biotechnology, has written this article and Ms Iqra (M.Phil Biochemistry), Lecturer & Recourse Person of Biochemistry at University of Management & Technology, Sialkot, Punjab, Pakistan, has motivated and mentored her students to write article summaries.
Reviewer & Editor
Muhammad Numan, PhD Scholar (Biochemistry), has reviewed and
edited this article.
References
Rawla, P., & Barsouk, A. (2019). Epidemiology of gastric cancer: global trends, risk factors and prevention. Przeglad gastroenterologiczny, 14(1), 26
Caliceti, C., Franco, P., Spinozzi, S., Roda, A.,
& FG Cicero, A. (2016). Berberine: new insights from pharmacological
aspects to clinical evidences in the management of metabolic disorders. Current
medicinal chemistry, 23(14), 1460-1476.
Imenshahidi, M., &
Hosseinzadeh, H. (2016). Berberis vulgaris and berberine: an update review.
Phytotherapy research, 30(11), 1745-1764.
Siegel, R. L., Miller, K. D., & Jemal, A. (2019). Cancer statistics, 2019. CA: a cancer journal for clinicians, 69(1), 7-34.
Zhang, Q., Wang, X., Cao, S., Sun, Y., He, X., Jiang, B., ... & Kang, N. (2020). Berberine represses human gastric cancer cell growth in vitro and in vivo by inducing cytostatic autophagy via inhibition of MAPK/mTOR/p70S6K and Akt signaling pathways. Biomedicine & Pharmacotherapy, 128, 110245.
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