IMR Press / FBL / Volume 27 / Issue 5 / DOI: 10.31083/j.fbl2705166
Open Access Review
Immunomodulatory and Anti-Inflammatory Effects of Berberine in Lung Tissue and its Potential Application in Prophylaxis and Treatment of COVID-19
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1 Department of Biology, Chemistry, and Environmental Sciences, College of Arts and Sciences, American University of Sharjah, 26666 Sharjah, United Arab Emirates
2 Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, 2713 Doha, Qatar
3 Biomedical Research Center, Qatar University, 2713 Doha, Qatar
*Correspondence: amajdalawieh@aus.edu (Amin F. Majdalawieh); gheyath.nasrallah@qu.edu.qa (Gheyath K. Nasrallah)
Academic Editor: Amedeo Amedei
Front. Biosci. (Landmark Ed) 2022, 27(5), 166; https://doi.org/10.31083/j.fbl2705166
Submitted: 24 March 2022 | Revised: 5 May 2022 | Accepted: 9 May 2022 | Published: 20 May 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Natural products with known safety profiles are a promising source for the discovery of new drug leads. Berberine presents an example of one such phytochemical that has been extensively studied for its anti-inflammatory and immunomodulatory properties against myriads of diseases, ranging from respiratory disorders to viral infections. A growing body of research supports the pluripotent therapeutic role berberine may play against the dreaded disease COVID-19. The exact pathophysiological features of COVID-19 are yet to be elucidated. However, compelling evidence suggests inflammation and immune dysregulations as major features of this disease. Being a potent immunomodulatory and anti-inflammatory agent, berberine may prove to be useful for the prevention and treatment of COVID-19. This review aims to revisit the pharmacological anti-inflammatory and immunomodulatory benefits of berberine on a multitude of respiratory infections, which like COVID-19, are known to adversely affect the airways and lungs. We speculate that berberine may help alleviate COVID-19 via preventing cytokine storm, restoring Th1/Th2 balance, and enhancing cell-mediated immunity. Furthermore, the role this promising phytochemical plays on other important inflammatory mediators involved in respiratory disorders will be underscored. We further highlight the role of berberine against COVID-19 by underscoring direct evidence from in silico, in vitro, and in vivo studies suggesting the inhibitory potential berberine may play against three critical SARS-CoV-2 targets, namely main protease, spike protein, and angiotensin-converting enzyme 2 receptor. Further preclinical and clinical trials are certainly required to further substantiate the efficacy and potency of berberine against COVID-19 in humans.

Keywords
berberine
COVID-19
SARS-CoV-2
anti-inflammatory
immunomodulatory
cytokine storm
Th1/Th2 balance
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