Study: Berberine calms gastrointestinal problems caused by radiation therapy

reference

Li GH, Wang DL, Hu YD, et al. Berberine inhibits acute radiation bowel syndrome in humans with abdominal radiotherapy.Med Oncol. 2010;27(3):919-925.

design

Randomized, placebo-controlled, prospective study. Two subgroups of patients received study drug along with standard radiation therapy throughout the study, and two subgroups received placebo. A fifth subgroup received a placebo in the first two weeks of the study and then the active drug.

Participant

This single article reported the results of multiple cohorts. Thirty-six patients with seminoma or lymphoma were treated; Half received the study drug, the rest a placebo. In addition, 42 patients with cervical cancer were treated, half with medication and the other half with placebo. A fifth cohort was formed of 8 patients randomly selected from both groups to begin active medication two weeks after starting placebo treatment.

Study medications and dosage

Berberine, 300 mg tablet 3 times daily

Target parameters

A radiation oncologist assessed radiation-induced toxicities such as fatigue, anorexia, and nausea according to Common Toxicity Criteria (CTC) version 2.0.¹

Key findings

Berberine intake significantly reduced the frequency and severity of radiation-induced acute bowel syndrome in these patients compared to patients in the control group (P<0.05). Berberine postponed the symptoms so that if they occurred later in the course of treatment, they occurred.

Effects on practice

Approximately half of patients diagnosed with pelvic or abdominal cancer undergo radiation treatment. Resulting damage to noncancerous tissue, particularly the intestines, is common and can be serious.²Abayomi et al. reported in 2009 that of 117 women treated with radiation therapy for cervical or endometrial cancer, 47% developed chronic radiation enteritis.3 Although only acute symptoms were examined in this work, we believe or hope that a reduction in acute toxicities may reduce progression to chronic inflammatory states or delayed sequelae of radiation treatments.

This is not the first report suggesting that berberine protects against radiation damage. An article published in August 2010 by the same authors, Li et al., also reported that berberine protects against radiation-induced intestinal damage. This previous study was conducted on mice, not humans. Mice were given berberine and then exposed to high doses of radiation. Berberine reduced the measurement of radiation damage and delayed mortality, i.e. h. it reduced the lethality of the treatment.⁴

A previous human clinical trial evaluating the effect of berberine on toxicities resulting from radiation treatment of non-small cell lung cancer (NSCLC) was published in 2008. Liu et al. gave 90 patients undergoing breast radiation therapy either berberine or placebo. Radiation to the chest causes injuries in a similar way to irradiation to the pelvis, but in this case it is called radiation-induced lung injury (RILI).

After 6 weeks, only 45.2% of patients taking berberine had symptoms of RILI, compared to 72.1% of patients taking placebo. After 6 months, the numbers were 35.7% and 65.1%, respectively. Measurements of lung function were also significantly better in those who took berberine.⁵

Therefore, berberine can reduce the radiation-induced toxicity symptoms caused by radiation treatments to the pelvic, abdominal and chest areas. Does this also reduce the cytotoxicity of the treatments?

At this point, there is evidence that berberine makes cancer cells more sensitive to radiation treatment, at least in some types of cancer.

At this point, there is evidence that berberine makes cancer cells more sensitive to radiation treatment, at least in some types of cancer. Peng et al. reported in 2008 that berberine has a synergistic effect with radiation against lung cancer.⁶

Berberine without radiation certainly has significant anti-cancer effects against a variety of cancers. It induces apoptosis in glioblastoma cells.⁷Work published in recent months suggests that berberine also has activity against cervical cancer.⁸Liver,⁹and colon cancer.10 Berberine potentiates the cytotoxic effect of the chemotherapy drug cisplatin.¹¹

It is possible that berberine reduces the peripheral damage and toxic side effects of radiation therapy and improves patient outcomes by enhancing the effects of radiation.