Reference
Li GH, Wang DL, Hu YD, et al. Berberine inhibits acute radiation intestinal syndrome in human with abdomen radiotherapy. Med Oncol. 2010;27(3):919-925.
Design
Randomized, placebo-controlled, prospective trial. Two subgroups of patients received the study medication throughout the trial along with standard radiotherapy, and 2 subgroups received placebo. A 5th subgroup received placebo for the first 2 weeks of the trial and then was given the active medication.
Participants
The results of several cohorts were reported in this single paper. Thirty-six patients with seminoma or lymphomas were treated; half received the trial medication, the remainder placebo. Forty-two patients with cervical cancer were also treated, again half with medication and half with placebo. A 5th cohort was formed from 8 patients randomly selected from both groups to begin active medication 2 weeks after starting with placebo.
Study Medication and Dosage
Berberine, 300 mg tablet 3 times a day
Outcome Measures
A radiation oncologist graded radiation-induced toxicities, such as fatigue, anorexia, and nausea, according to the common toxicity criteria (CTC) version 2.0.1
Key Findings
Taking berberine significantly decreased the incidence and severity of radiation-induced acute intestinal syndrome in these patients compared to the patients in the control group (P<0.05). Berberine postponed the symptoms so that if they occurred they did so later in the course of treatment.
Practice Implications
Approximately half of the patients diagnosed with pelvic or abdominal cancers will receive radiation treatment. Resultant damage to the noncancerous tissue, particularly the intestines, is common and can be severe.2 Abayomi et al reported in 2009 that of 117 women who had been treated with radiation therapy for cervical or endometrial cancer, 47% ended up with chronic radiation enteritis.3 Although this paper examined only acute symptoms, our assumption or hope is that decreasing 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. A paper by the same authors, Li et al, published in August 2010, also reported that berberine protects against radiation-caused intestinal injury. This earlier study was on mice, not people. In it mice were given berberine and then subjected to high doses of radiation. Berberine reduced measurements of radiation damage and delayed mortality that is, it reduced the lethality of treatment.4
An earlier human clinical trial that assessed 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 either berberine or placebo to 90 patients who underwent chest radiation therapy. Chest radiation causes injury in a way similar to what pelvic radiation does, though 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 those taking the placebo. At 6 months the numbers were 35.7% and 65.1% respectively. Measurements of lung function were also significantly better in those taking berberine.5
Thus berberine may reduce the radiation-induced toxicity symptoms caused by pelvic, abdominal, and chest radiation treatments. Will it also reduce the cytotoxicity of the treatments?
At this point, there are hints that at least in some cancers, berberine makes the cancer cells more sensitive to radiation treatment.
At this point, there are hints that at least in some cancers, berberine makes the cancer cells more sensitive to radiation treatment. Peng et al reported in 2008 that berberine has a synergistic effect with radiation against lung cancer.6
Berberine without radiation certainly has a significant anticancer effect against a wide range of cancer types. It induces apoptosis in glioblastoma cells.7 Papers published in the last few months suggest berberine also acts against cervical,8 liver,9 and colon cancer.10 Berberine enhances the cytoxic effect of the chemotherapy drug cisplatin.11
It is possible that berberine will decrease the peripheral damage and toxic side effects of radiation therapy, as well as improve patient outcomes by enhancing radiation action.
