What is barberry

Barberry also known as berberis is a large genus of deciduous and evergreen shrubs from 1–5 m (3.3–16.4 ft) tall found throughout the temperate and subtropical regions of of Asia, Europe, Africa, North America, and South America. The genus Berberis (Berberidaceae) includes about 500 species that commonly occur in most areas of central and southern Europe, the northeastern region of the United States and in South Asia including the northern area of Pakistan and Iran 1, 2. Many of the species have spines on the shoots and along the margins of the leaves 3. Among the several species of this genus, Berberis vulgaris (barberry) is well known and its fruits have been used in the preparation of a special dish with rice and also in Berberis juice 4, 5, 6. The fruits of most plants from Berberidaceae family have a sour taste which is due mainly to the presence of ascorbic acid or vitamin C.

In traditional medicine, different organs of this plant are used to treat diseases. Fruit, bark, root, and stem are the pharmaceutical organs of Berberis vulgaris. Barberry fruit is the most frequently used organ of this plant in traditional and modern medicine 7. Sometimes Berberis vulgaris has been used as a tea made from the bark of the plant 8. Besides nutritional consumption, various parts of this plant including roots, bark, leaves and fruits have been employed in folk and traditional medicine for a long time in Iran 8, 9. The stem and root barks are used for their cathartic (laxative effect), diuretic (increased passing of urine), antipyretic (reduce fever), anti-bilious (anti nausea or vomiting), and antiseptic properties. Also, the decoction of leaves is used as anti-scorbutic (preventing or curing scurvy) in dysentery, scurvy angina, and sore throat 10.

In Iran, dried barberry fruit is used in many foods — the fruit or its derivatives are used to produce certain products such as sauce, jelly, juice, jam, marmalade, and carbonated drinks. Besides that, barberry is used to season, flavor, and garnish foods to satisfy different flavors 11. This fruit is also used in industries. For example, the anthocyanin found in barberry fruit is used as a nature-based color 12.

Iran is the biggest producer of Berberis vulgaris (barberry) fruit in the world, with 11,000 hectares of land under cultivation. Over 10,000 tons of dried barberry    fruit are produced in Iran per year. Among the provinces of Iran, Southern Khorasan is one of the biggest producers of Berberis vulgaris. Over 97% of all the lands under Berberis vulgaris cultivation are located in Ghaenat County, Southern Khorasan province, producing 95% of the whole Berberis vulgaris fruit in Iran 13.

Different organs of Berberis vulgaris are used in food and pharmaceutical industries and the decorative species are used to decorate different places. According to traditional medicine, Berberis vulgaris is used to treat fever, cough, liver disease, depression, hyperlipidemia, hyperglycemia and bleeding 14, 15.

Figure 1. Barberry fruit


Barberry fruit

Various species of the genus Berberis which occur around the world are cultivated and grown for specific purposes 16. Berberis vulgaris is the most widely known barberry which is mainly used as a food is cooked with rice (seedless or red), Berberis integerrima, also referred to as black barberry and wild barberry, are used mainly for juice extraction in food industries and as medication 17, 18.

Nutrition facts of barberry (Berberis vulgaris fruit)

Berberis vulgaris fruit is sour and contains different nutrients including dextrose, fructose, malic acid, tartaric acid, citric acid, pectin, and resin. It is also rich in vitamins C and A, calcium, iron, and potassium 19, 20. In Berberis vulgaris fruit, the concentrations of iron, zinc, copper, and manganese are estimated 2,650 mg/kg, 27.5 mg/kg, 33.7 mg/kg, and 58.6 mg/kg, respectively 18. Decomposition of Berberis vulgaris fruit shows that this fruit contains 79.6% humidity, 1.16% fat, 2% protein, 16.24% carbohydrate, and 0.99% ash. The amount of anthocyanin is estimated 281 mg/l 21.

Barberry benefits

Medicinal uses of barberry (Berberis vulgaris) in Chinese medicine date back to over 3000 years ago and in some other countries to over 2500 years ago 9. There are a variety of alkaloids in the various organs of this plant, most important of which is berberine 22. Berberine, an isoquinoline alkaloid, is a member of naturally occurring protoberberines class (Figure 2), can exert different effects, including antioxidant, anti-inflammatory, hypoglycemic, hypotensive, and hypolipidemic activities 23, 24..

Figure  2. Chemical structure of Berberine and its metabolites

berberine chemical structure and its metabolites
[Source 25]

This alkaloid is present in plants of Berberidaceae, Papaveraceae and Ranunculaceae families including Arcangelisia flava (menispermaceae), B. vulgaris (barberry), B. aristata (tree turmeric), B. aquifolium (Oregon prape), B. lyceum, B. crataegina, Hydrastis canadensis (goldenseal) and Coptis chinensis (Chinese goldthread). Berberine widely consumed in Ayurvedic and Chinese medicine 26, 27, 28. Berberine has been isolated from various parts of these species such as root, stem, bark, fruit and rhizome 27.

Traditional use of root, bark, leaf and fruits of barberry as an immunemodulator and anti-microbial agent as well as a treatment for central nervous system, cardiovascular, gastrointestinal, endocrine, and renal problems have been shown in two pharmacological studies 26, 29. Recently published articles using animal subjects and laboratory test tubes test have demonstrated that barberry and berberine (its main constituents) have anti-oxidant 14, anti-inflammatory 30, anti-tumor 31, anti-mutagenic 32 and anti-diabetic 14 effects. Their hypoglycemic and cholesterol lowering properties 33, neuroprotective 34, and hepatoprotective 35, effects have scientifically been proved by numerous studies. B. vulgaris may possesses preventive effects in relapse of morphine consumption in addicted individuals 36. It has been demonstrated that B. vulgaris and berberine induces inhibitory effects on Leishmania species 37. Also, it has been reported as an anti-fungal compound 38. There are evidences in vivo and in vitro that berberine hydrochloride has beneficial effects on colitis 39.

Although there are over 500 plants from genus Berberis that are accessible to people across the world, only four barberry plants are being used to treat different diseases 19, 40, 41.

  • Berberis vulgaris (barberry),
  • Berberis orthobotrys,
  • Berberis khorasanica,
  • Berberis integerrima, Berberis crataegina, Berberis lycium, and Berberis aristata are used in traditional medicine more frequently in Iran and other parts of the world.

Table 1. Pharmacological and biological activity of the various species of Berberis genus

Barberry benefits
[Source 23]

Many metabolites of various species of Berberis vulgaris have been reported, but the main isolated compounds from Berberis vulgaris are tannins, vitamin C, carotenoid, phenolic compounds, triterpenes (lupeol, oleanolic acid), sterols (stigmasterol, stigmasterol glucoside), alkaloids (berberamine, palmatine, berberine, oxyberberine, columbamine, isocorydine, lambertinea and magniflo-rine), anthocyanin and phenolic compounds 42. Besides, bisbenzlisoquinolines (oxycanthine), N-(p-trans- coumaroyl) tyramine, cannabisin G and (±)-lyoniresinol have been isolated from this plant 23.

Table 2. The main isolated compounds reported from different species of Berberis

compounds isolated from berberis species
[Source 43]

Most compounds are summarized in Table 2. The highest amounts of phenolic compounds and anthocyanins can be found in Berberis vulgaris juice and the highest amount of flavonoid compounds in B. vulgaris leaves. Regarding the importance of investigating B. vulgaris quality, the amount of anthocyanin in the fruit to be an important index of B. vulgaris quality 44. The concentrations of flavonol, flavonoid, and phenol of B. vulgaris fruit are 25.3 mg/g, 12.2 mg/g, and 0.54 mg/g, respectively 18.

In all parts of B. vulgaris plant, certain alkaloids such as berberine, oxyaconthine, berbamine, brolicin, and columbamine are found. The amount of alkaloid is higher in the root bark than other organs of B. vulgaris. Berberine is one of the most important alkaloids of this plant that can be effective in preventing coronary artery disease and possibly reducing the levels of total cholesterol and triglyceride 45. The most important property of berbamine is to block calcium channels. This alkaloid was found to be active in the tests of lipids peroxidation in red blood cells and can exert anti-myocardial ischemia and antiarrhythmic effects. Besides that, oxyaconthine has a sympatholytic and vasodilatory agent 46.

Table 3. Summary of active metabolites in Barberry

DiseaseType of studyBerberis speciesPart of plantResultsReferences
CancerExperimental (mice)Berberis aristataFruitEthanolic extract was observed to be efficient and the presence of alkaloids and flavonoids may be responsible for the observed anticancer effects.47
Human colon cancer cell lineB. aristataStemMethanolic extract induces a concentration- dependent inhibition of HT29 cells, with an IC50 of 1.8964 μg/ml after 72 hours of incubation.48
Experimental ( rat)Berberis vulgarisFruitThe fruit can reduce the activity of liver enzymes and inhibit the gene expression of alpha-fetoprotein in rats during hepatocarcinogenesis.49
Human prostate cancer cell linesBerberis libanoticaRootAmmonia-dichloromethane extract showed a high therapeutic potential to target prostate cancer and its cancer stem cells.50
P53-deficient HL- 60 cellsBerberis lyciumRootBerberine and the butanolic extract inhibited the expression of the proto-oncogene cyclin D1 and induced the acetylation of α-tubulin. This correlated with the induction of apoptosis. The data demonstrate that berberine is a potent anti-neoplastic compound that acts via anti-proliferative and pro-apoptotic mechanisms independent of genotoxicity.51
Experimental (Rat)Berberis vulgarisFruitMicroscopic examinations of the TUNEL- positive apoptotic cells demonstrated a significant difference between cancer control and normal control group. Increasing concentration of B. vulgaris aqueous extract in cancerous treated groups showed considerable increase in TUNEL-positive cells compared with the cancer control group, and apoptotic cells increased with increase in B. vulgaris extract concentration in cancerous groups.52
AntihistaminicExperimental (guinea-pig ileum) Experimental (male Sprague- Dawley rats)Berberis vulgarisFruitThe results indicated antihistaminic and anticholinergic activities of the extract, potentially competitive.53
Experimental (male Sprague-Dawley rats)Berberis vulgarisFruitAqueous extract has beneficial effects on both cardiovascular and neural systems, suggesting a potential use to treat hypertension, tachycardia, and some neurological disorders, such as epilepsy and convulsion.54
Cardiovascular / HypertensionExperimental ( rat)Berberis orthobotrysRootIt causes decrease in systolic blood pressure55
Experimental ( rat)Berberis integerrimafruitB. integerrima reduced systolic blood pressure in the right ventricle.56
Experimental (rat)B. vulgarisFruitAqueous extract has beneficial effects on both cardiovascular and neural systems, suggesting a potential use to treat hypertension, tachycardia, and some neurological disorders, such as epilepsy and convulsion.54
Experimental (mice and rat)Berberis crataeginaRootThe anti-inflammatory activity of the extracts and fractions, inhibited oil-induced diarrhea. The active constituent, berberine also showed a dose-dependent and potent analgesic activity against acetic acid-induced writhing reflex in mice57
GastrointestinalIn vitro and in vivoB. aristataBarkThe onset of castor oil-induced diarrhea was delayed and the number of diarrheal episodes was reduced by the extract in a dose- dependent manner.58
Experimental (Swiss albino mice)B. aristataStemB. aristata produces antidiarrheal effect through decreasing intestinal secretions and antispasmodic effect through inhibiting intestinal motility.59
Experimental (mice)Berberis integerrima L.RootB. integerrima has anticonvulsant activity in pentylenetetrazol-induced seizures.60
EpilepsyExperimental (mice)B. vulgarisisoquinoline alkaloid of berberine.Berberine exhibits anticonvulsant activity by modulating neurotransmitter systems and may have clinical uses.61
Fever / Antibacteriallaboratory experimentalB. aristataRoot and StemB. aristata root extract gave low MICs values against Bacillus cereus, Escherichia coli, Staphylococcus aureus, and Aspergillusflavus while stem extract against B. cereus and Streptococcus pneumoniae.62
laboratory experimentalB. vulgarisBark of barberry rootThe root bark exhibited anti-parasitic and antiseptic effects and is prescribed to lower fever.63
Experimental (rat)B. vulgarisRootThe amount of cholesterol, triglyceride, and LDL decreased significantly.64
Experimental (white rabbits)B. aristataB. aristata caused a significant reduction in serum cholesterol, triglycerides, and LDL levels; moreover, there was an increase in thrombin and fibrinogen time.65
Experimental (rat)B. aristata DCStemSignificant hypoglycemic activity and hypolipidemic activity was exhibited by the methanolic extract.66
Lipid profileExperimental (rat)B. orthobotrysRrootThe crude extract significantly prevented the increase in LDL, VLDL, total cholesterol, triglyceride, atherogenic index, and coronary risk index in high fat diet, cholesterol, fructose and olive oil-induced hyperlipidemic rat model.67
Experimental (rabbit)B. lyciumRootB. lycium treatment increased the levels of high density lipids.68
Experimental (rat)B. lyciumRootThe extracts also lowered the levels of cholesterol, triglycerides, LDL, VLDL, serum glutamic oxaloacetic transaminase, serum glutamic-pyruvic transaminase, and serum ALP in diabetic rats.69
DiabetesExperimental (rat)B. vulgarisBark of barberry rootBlood glucose levels of the diabetic rats treated with aqueous extract decreased on the first day. This condition remained roughly constant for three weeks. Both extracts also declined biochemical parameters significantly.70
Experimental (rat)B. aristataRootThe extract has strong potential to regulate glucose homeostasis through decreased gluconeogenesis and oxidative stress.71
Experimental (rat)B. lyceumRootOral administration of 50 mg/kg of the extract and berberine to normal and experimental diabetic rats caused a significant reduction in blood glucose levels from day 3 to day 7 of treatment. As well, significant effects were observed on the glucose tolerance, glycosylated hemoglobin, serum lipid profiles, and body weight of experimental animals.72
Experimental (rat)B. integerrimaRootAqueous extract improves renal dysfunction in streptozotocin-induced diabetes in rats through controlling blood glucose and renal protective effects.73
Experimental (rat)B. integerrimaRootAqueous extract has hypoglycemic, hypolipidemic, and antioxidant effects in streptozocin-induced diabetes in rats.74
Experimental (rat)B. integerrimaRootAqueous extract had a desirable effect on the testosterone level, blood glucose, and histological changes of testes during the course of diabetes.75
[Source 76]

Recently, berberine has been reported to decrease cholesterol through a mechanism different from that through which statins decrease cholesterol. If a statin and berberine are used simultaneously, they seem to control cholesterol more efficiently. In a controlled study, berberine was found to cause increase in a type of protein receptor in the liver, which could bond to cholesterol and facilitate its excretion 11. Despite extensive use and several properties of different organs of B. vulgaris, the action mechanisms of this plant remain to be clearly known. Some of these properties can be attributed to the antihistaminic and anticholinergic effects of this plant 77. There are large amounts of vitamin C in B. vulgaris fruit. Vitamin C is an antioxidant and water-soluble organic compound.

This vitamin is essential to the production and maintenance of collagen tissue and the strength of other tissues, and can help to reinforce immunity system and to speed up wound healing 78. As well, vitamin C prevents the formation of carcinogenic nitrosamines and nitrous ureas, and is considered a strong antioxidant agent and an effective cause of restoring cell enzymatic activities and electron transfer processes 47. It is also involved in the metabolism of carbohydrates, the conversion of folic acid to folinic acid, the metabolism of phenylalanine and thyrosine, the conversion of plasma transferine to liver ferritin, and the production of serotonin in the body 79.

A study on aqueous B. vulgaris fruit extract on antihistaminic and anticholinergic activities in guinea pig ileum confirmed that this extract could exert these effects 53.

Table 4. Summary of the findings on some species from genus Berberis most frequently used to treat different diseases

DiseaseTitle of articleBerberis speciesPart of plantResultsReferences
Acne vulgarisAqueous extract of dried fruit of Berberis vulgaris L. in acne vulgaris, a clinical trialBerberis vulgarisFruitOral aqueous extract of dried barberry is a safe, well-tolerated, and effective choice in teenagers with moderate to severe acne vulgaris.80
Cardiovascular / HypertentionThe Effect of Berberis Vulgaris extract on blood pressure and weight of the patients suffered from Non-alcoholic fatty liver diseaseB.vulgarisFruitMean systolic and diastolic blood pressure was significant compared to control group.81
Cardiovascular / HypertentionEffect of processed Berberis vulgaris in apple vinegar on blood pressure and inflammatory markers in type 2 diabetic patients.B.vulgaris in apple vinegarFruit Offindings had shown processed B.vulgaris had no effect on systolic- and diastolic blood pressure but apple vinegar had positive effect on interleukin-6. Nevertheless, further investigations about B.vulgaris effect on blood pressure and inflammatory markers are necessary.82
DiabetesClinical trial ( patients with diabetes type 2)BerberisFruitThe fruit had a significant reducing effect on serum glucose and decreased HbA1c levels during the 8 weeks of study.83
DiabetesClinical trial (type 2 diabetic patients )B.vulgarisFruitMean nutritional intake, anthropometric indices, hs CRP concentration, and systolic and diastolic blood pressure did not change in processed B. vulgaris. Also, interleukin-6 concentration did not change in processed B. vulgaris and control groups.82
DiabetesThe effects of Berberis vulgaris fruit extract on serum lipoproteins, apoB, apoA-I, homocysteine, glycemic control and total antioxidant capacity in type 2 diabetic patientsBerberis vulgarisFruitThe intake of 3 g/d B. vulgaris fruit extract for 3 months may have benefical effects on lipoproteins, apoproteins, glycemic control and total antioxidant capacity in type 2 diabetic patients.84
Lipid profileClinical trial (dyslipidemic patients)Berberis aristataFruitB. aristata reduced total cholesterol, triglycerides, and LDL cholesterol and increased HDL cholesterol after three months.85
[Source 76]

Many researchers reported pharmacological effects of B. vulgaris (Table 2 and 3). For example, Berberis aristata root extract caused decrease in glycemia and helped to regulate carbohydrate metabolism in diabetic rats 71. Moreover, the extract of Berberis vulgaris tree root is effective in treating and preventing the formation of stones in gastrointestinal tract 86. Berberis croatica Horvat is rich in berberine, phenol, and flavonol. The root extract of this plant can exert antimicrobial effects against Bacillus subtilis, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans 87. One of the main compounds of Berberis integerrima is berberine. Berberine can exert protective effects on central nervous system and help to treat the diseases of this system 60.

Moreover, this alkaloid can protect islets of Langerhans in diabetic mice and cause increase in insulin secretion, decrease in cholesterol and low-density lipoprotein, and increase in high-density lipoprotein 88. As with other fruits, B. vulgaris fruit contains salts and different vitamins including vitamin C. Ascorbic acid was found to exert positive effects on dementia progression in Alzheimer’s disease patients 89. In addition, the plasma levels of ascorbic acid were found to be lower in patients with dementia compared to the controls, representing the protective effect of ascorbic acid on the brain function and in preventing cognitive disorders 90. Moreover, ascorbic acid, a nature-based agent, has been reported to be effective in improving memory in patients and older animals 91.

These results briefly indicate that B. vulgaris contains a large number of phytochemical materials including ascorbic acid (vitamin C), vitamin K, several triterpenoids, more than 10 phenolic compounds and more than 30 alkaloids. Therefore B. vulgaris may have antihypertensive, anti-cancer, anti-inflammatory, antioxidant, antibacterial, analgesic and anti-nociceptive and hepato-protective effects 15, 92, 55.

Barberry side effects and toxicity

Results in animal and laboratory test tube studies have proved the potential of berberine (alkaloid derived from barberry) to induce gastrointestinal upset and ulceration, immunotoxicity, phototoxicity, neurotoxicity and cardiotoxicity in a dose dependent manner (Figure 3). Besides, there are controversial data in using berberine and its derivative during pregnancy, so the use of them should be cautioned in pregnancy and neonatal. Berberine by inhibiting adenine nucleotide translocase, promoting ROS (reactive oxygen species) formation, apoptosis and necrosis pathways induces its toxicity on both normal and cancer cell in a time and concentration dependent manner. In a biological context, ROS (reactive oxygen species) are formed as a natural byproduct of the normal metabolism of oxygen and have important roles in cell signaling and homeostasis. However, during times of environmental stress (e.g., UV or heat exposure), ROS levels can increase dramatically 93. This may result in significant damage to cell structures. Cumulatively, this is known as oxidative stress. Finally, the inhibitory effects of berberine on CYP enzymes should be mentioned which could evoke indirect toxicity. This interaction is important in co-administration with narrow therapeutic index drugs which may increase the drug plasma concentration and toxicity.

Nevertheless, as mentioned, these data mostly have been gathered from animal studies and there are differences between animals and human body, so more clinical studies in future could reveal the concealed toxicity of berberine and its derivatives.

Figure 3. Schematic diagram showing toxic effects of Berberis vulgaris and berberine in different animal toxicity tests

Barberry toxicity and toxic effects
[Source 42]
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