Barberry

Scientific Name(s): Berberis vulgaris L. and Mahonia aquifolium Nutt. Family: Berberidaceae

Common Name(s): Barberry , Oregon grape , Oregon barberry , Oregon grapeholly , trailing mahonia , berberis , jaundice berry , woodsour , sowberry , pepperidge bush , sour-spine 1 , 2

Uses

The fruits have been used in jams, jellies, and juices. Plant alkaloids have been found to be antibacterial, antifungal, anti-inflammatory, antioxidant, and antidiarrheal. Berberine is a uterine stimulant.

Dosing

Barberry berries and root bark have been used as a source of berberine. Daily doses of 2 g of the berries have been used, but there are no clinical studies to substantiate barberry's varied uses.

Contraindications

Barberry is contraindicated in patients with hypersensitivity to M. aquifolium .

Pregnancy/Lactation

Documented adverse effects (including uterine stimulant effects). Avoid use.

Interactions

None well documented.

Adverse Reactions

Hypersensitivity reactions (eg, burning, itching, redness) have occurred in some patients using topical dosage forms.

Toxicology

Symptoms of poisoning are characterized by lethargy, stupor and daze, vomiting and diarrhea, and nephritis. Barberry is contraindicated during lactation and pregnancy.

Botany

The barberry grows wild throughout Europe but has been naturalized to many regions of the eastern US. M. aquifolium is an evergreen shrub native to the northwestern US and Canada. Barberry grows to more than 10 feet with branched, spiny, holly-like leaves and is widely grown as an ornamental. Its yellow flowers bloom from May to June and develop into red to blue-black oblong berries. 3

History

The plant has a long history of use, dating back to the Middle Ages. Salishan native elders have used M. aquifolium to treat acne 4 and native American Indians utilized Mahonia berries to treat scurvy. 5 A decoction of the plant has been used to treat GI ailments and coughs. 3 The alkaloid berberine was included as an astringent in eye drops, but its use has become rare.

The edible fruits have been used to prepare jams, jellies, and juices. The use of the plant in traditional medicine has been limited by the bitter taste of the bark and root. However, more than 3 dozen medicinal uses for barberry, including cancer, cholera, and hypertension have been listed. 6 , 7 Other reported uses of M. aquifolium include the treatment of the following conditions: Fever, gout, renal and biliary diseases, rheumatic symptoms, diarrhea, gastric indigestion, and dermatosis. 8 , 9

Chemistry

The root and wood are rich in protoberberines (berberine, palmatine, jatorrhizine) and bisbenzylisoquinoline derivatives (oxyacanthine, berbamine) as well as other alkaloids such as bervulcine, magnoflorine, and columbamine. 2 , 3 , 8 , 9 The root may contain as much as 3% alkaloids, which impart a yellow color to the wood. Berberine, berbamine, and oxyacanthine are considered the 3 most important alkaloids. 10 The edible berries are rich in vitamin C, sugars, and pectin.

Uses and Pharmacology

M. aquifolium is valued for its antipsoriatic effects and its antibacterial, antifungal, anti-inflammatory, and antioxidant activity. It also has been used for treating acne, eczema, and candida infection.

Anti-inflammatory

Products of lipoxygenase metabolism enhance the pathophysiology of psoriasis. Each of the 6 bisbenzylisoquinoline alkaloids (oxyacanthine, armoline, baluchistine, berbamine, obamegine, aquifoline) isolated from M. aquifolium exhibited various lipoxygenase inhibitory activity resulting in an anti-inflammatory and antioxidant effect. 11

Animal data

Research reveals no animal data regarding the use of berberine as an anti-inflammatory agent.

Clinical data

Additional studies suggest that the antiproliferative effect is caused by the berberine content of M. aquifolium . Berbamine may reduce the synthesis of 5-lipoxygenase and cyclooxygenase, thereby reducing the activity of these enzymes in the arachidonic acid cascade. 12

Antibacterial

Berberine and several related alkaloids are bactericidal, in 1 study exceeding chloramphenicol (eg, Chloromycetin ) against Staphylococcus epidermidis , Neisseria meningitidis , Escherichia coli , and other bacteria. 2 Another study reported that a methanolic extract (containing 80 mg of dried plant material) from the root of M. aquifolium exhibited antifungal activity against Trichoderma viridae and was considered more effective than nystatin. 13

Animal data

Several alkaloids (eg, berbamine, oxyacanthine) in Mahonia reportedly block the influx of calcium. For example, M. aquifolium root extract blocked calcium-induced contraction in an in vitro experiment on isolated rat aorta. The mechanism of the vasodilation is postulated to also involve alpha-adrenoreceptors. 14 , 15

Clinical data

Research reveals no clinical data regarding the use of berberine as an antibacterial.

Anti-diarrheal

Berberine does not appear to exert its antidiarrheal effect by astringency, and the mechanism of action has not been defined. 16

Animal data

Research reveals no animal data regarding the use of berberine as an anti-diarrheal.

Clinical data

Berberine (100 mg 4 times/day), given alone or together with tetracycline (eg, Achromycin V ), has been found to significantly improve acute watery diarrhea and excretion of vibrios after 24 hours, compared with placebo in patients with noncholera diarrhea. 17

Other uses

Berberine has anticonvulsant, sedative, and uterine stimulant properties. Local anesthesia can occur following SC injection of berberine. 6 Berbamine also produces a hypotensive effect. 5

Dosage

Barberry berries and root bark have been used as a source of berberine. Daily doses of 2 g of the berries have been used, but there are no clinical studies to substantiate barberry's varied uses. 18

Pregnancy/Lactation

Documented adverse effects (including uterine stimulant effects) 19 . Avoid use. M. aquifolium is contraindicated during lactation and pregnancy because some of the alkaloids (eg, berberine, palmatine) may stimulant uterine contractions. 20 Barberry is contraindicated during lactation and pregnancy.

Interactions

None well documented.

Adverse Reactions

Burning, redness, and itching have been reported in some patients using the topical dosage forms. 8 , 9

Toxicology

Symptoms of poisoning are characterized by lethargy, stupor and daze, vomiting and diarrhea, and nephritis. 20 M. aquifolium is contraindicated during lactation and pregnancy because some of the alkaloids (eg, berberine, palmatine) may stimulant uterine contractions. 20 It is also contraindicated in patients with hypersensitivity to M. aquifolium .

Bibliography

1. Windholz M, ed. The Merck Index . 10th ed. Rahway, NJ: Merck and Co; 1983.
2. Leung AY. Encyclopedia of Common Ingredients Used in Food, Drugs, and Cosmetics . New York, NY: J Wiley and Sons; 1980.
3. Schauenberg P, Paris F. Guide to Medicinal Plants . New Canaan, CT: Keats Publishing, Inc; 1977.
4. Turner NJ, Hebda RJ. Contemporary use of bark for medicine by two Salishan native elders of southeast Vancouver Island, Canada. J Ethnopharmacol . 1990;29:59-72.
5. Foster S, Tyler VE. Tyler's Honest Herbal . 4th ed. Binghamton, NY: Haworth Press; 1999.
6. Duke JA. Handbook of Medicinal Herbs . Boca Raton, FL: CRC Press; 1985.
7. Hartwell JL. Plants used against cancer: A survey. Lloydia . 1968;31:71.
8. Gieler U, von der Weth A, Heger M. Psoriasis vulgaris-gute Erfolge mit Homoeopathika. Ars Med . 1995;14:1018-1019.
9. Gieler U, von der Weth A, Heger M. Mahonia aquifolium -a new type of topical treatment for psoriasis. J Dermatol Treat . 1995;6:31-34.
10. Muller K, Ziereis K. The antipsoriatic Mahonia aquifolium and its active constituents; I. Pro- and antioxidant properties and inhibition of 5-lipoxygenase. Planta Med . 1994;60:421-424.
11. Bezakova L, Misik V, Malekova L, et al. Lipoxygenase inhibition and antioxidant properties of bisbenzylisoquinoline alkaloids isolated from Mahonia aquifolium . Pharmazie . 1996;51:758-761.
12. Augustin M, Andrees U, Grimme H, et al. Effects of Mahonia aquifolium ointment on the expression of adhesion, proliferation, and activation markers in the skin of patients with psoriasis. Forsch Komplementarmed . 1999;6(suppl 2):19-21.
13. McCutcheon AR, Ellis SM, Hancock RE, et al. Antifungal screening of medicinal plants of British Columbian native peoples. J Ethnopharmacol . 1994;44:157-169.
14. Sotnikova R, Kettmann V, Kostalova D, et al. Relaxant properties of some aporphine alkaloids from Mahonia aquifolium . Methods Find Exp Clin Pharmacol . 1997;19:589-597.
15. Sotnikova R, Kostalova D, Vaverkova S. Effect of bisbenzylisoquinoline alkaloids from Mahonia aquifolium on the isolated rat aorta. Gen Pharmacol . 1994;25:1405-1410.
16. Akhter MH, Sabir M, Bhide NK. Possible mechanism of antidiarrhoeal effect of berberine. Indian J Med Res . 1979;70:233-241.
17. Khin-Maung-U, Myo-Khin, Nyent-Nyent-Wai, et al. Clinical trial of berberine in acute watery diarrhoea. BMJ . 1985;291:1601-1605.
18. Gruenwald J, ed. PDR for Herbal Medicines . 2nd ed. Montvale, NJ: Thomson Medical Economics; 2000: 61-62.
19. Ernst E. Herbal medicinal products during pregnancy: are they safe? BJOG . 2002;109:227-235.
20. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines . Austin, TX: American Botanical Council; 1998.

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