Abstract

Atherosclerosis is an epidemic across the globe[A1], and its morbidity and mortality remain high, involving various complications and poor prognoses. In atherosclerosis, endothelial cells (ECs) dysfunction, vascular smooth muscle cells (VSMCs) migration and proliferation, foam cell formation, and inflammatory cell recruitment contribute to disease progression. Vascular stem cells (VSCs) also play a critical role in the cardiovascular system. Important data showed that the simultaneous increase of proliferation and apoptosis of VSMCs is the main cause of graft vein stenosis, suggesting that inhibition of VSMCs proliferation and apoptosis simultaneously is an important strategy for the treatment of atherosclerotic stenosis. Complementary and alternative medicine use among patients with cardiovascular disease (CVD) is growing. Berberine is an extract of Chinese traditional herbs that is known for its antimicrobial and anti-inflammatory effects in the digestive system. Its underlying anti-CVD mechanisms are currently attracting interest, and its pharmacological actions, such as antioxidation, regulation of neurotransmitters and enzymes, and cholesterol-lowering effects, have been substantiated. Recent studying found that berberine could inhibit both the proliferation and apoptosis of VSMCs induced by mechanical stretch stress simultaneously, which suggests that berberine might be an excellent drug to treat atherosclerosis. This review will focus on the recent progress of the effect of berberine on vascular cells, especially VSMCs, to provide important data and a new perspective for the application of berberine in anti-atherosclerosis.

Highlights

  • Cardiovascular disease (CVD) has reached pandemic proportions, and clinical treatment remains problematic

  • In a murine model of diabetic atherosclerosis, both proliferation and apoptosis of vascular smooth muscle cells (VSMCs) could be induced by hypertension-induced stretch stress and advanced glycation end products (AGEs) alone or together, and berberine could inhibit this progress by decrease PDI expression to prevent vein graft stenosis (Ping et al, 2017)

  • Animal experiments of insulin resistance have shown that berberine exerts its anti-inflammatory effects through enhanced activation of AMPK-dependent autophagy in adipose tissue macrophages (Zhou et al, 2017)—a finding that may illuminate the study of cholesterol efflux

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Summary

Effects of Berberine on Atherosclerosis

Endothelial cells (ECs) dysfunction, vascular smooth muscle cells (VSMCs) migration and proliferation, foam cell formation, and inflammatory cell recruitment contribute to disease progression. Vascular stem cells (VSCs) play a critical role in the cardiovascular system. Its underlying anti-CVD mechanisms are currently attracting interest, and its pharmacological actions, such as antioxidation, regulation of neurotransmitters and enzymes, and cholesterol-lowering effects, have been substantiated. Recent studying found that berberine could inhibit both the proliferation and apoptosis of VSMCs induced by mechanical stretch stress simultaneously, which suggests that berberine might be an excellent drug to treat atherosclerosis. This review will focus on the recent progress of the effect of berberine on vascular cells, especially VSMCs, to provide important data and a new perspective for the application of berberine in anti-atherosclerosis

BACKGROUND
Vascular Smooth Muscle Adipocytes in Tunica Adventitia
BERBERINE INHIBITS ECS DYSFUNCTION
ECs Function in the Atherosclerosis
Berberine Protects ECs From Damage
EFFECT OF BERBERINE ON VSMCS
VSMCs Play Roles in Atherosclerosis
EFFECT OF BERBERINE ON MACROPHAGES
Macrophage Functions and Phenotype Change
Monocyte Migration and Plaque Formation
Berberine Attenuates Macrophage Atherosclerotic Activities
EFFECT OF BERBERINE ON VSCS
IN VIVO AND CLINICAL TRIALS
Berberine and Hyperlipidemia
Monocyte recruitment
Berberine and Hypertension
Berberine and Hyperglycemia
Diabetes Mellitus
Probiotics placebo powder
Findings
CONCLUSION AND PERSPECTIVES

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