Background:: Epilepsy is one of the most common in all age groups and disabling neurologic disorders around the world. Objectives:: This systematic review was to explore whether berberine (BBR) has any anti-seizure or anti-epileptic effects and also reviewed this possible mechanism. Methods:: The EMBASE, Scopus, Cochrane Library, PubMed, and Web of Science databases were searched before Sep 2023. All types of studies that investigated the effects of BBR on epilepsy or chemical-induced seizures were eligible for inclusion. Two authors independently evaluated and reviewed titles/abstracts to identify publications for potential eligibility, and a third team member resolved discrepancies. Data were extracted in an Excel form, and the outcomes were discussed. Results:: BBR showed its neuroprotective properties by reducing oxidative stress, neuroinflammation, and anti-apoptosis effects. It also increases brain-derived neurotrophic factor (BDNF) release and reduces transforming growth factor-beta (TGF-β1) and hypoxia-inducible factor 1α (HIF-1α). BBR by increasing scavenging reactive oxygen species (ROS), nuclear factor erythroid 2–related factor 2 (Nrf2), endogenous antioxidant enzymes, heme oxygenase-1 (HO-1), and inhibition of lipid peroxidation insert its antioxidant activity. Moreover, BBR showed antiinflammatory activity by reducing Interleukin (IL)-1β, IL-6, and tumor necrosis factor-alpha (TNF-α) levels and through inhibiting cyclooxygenase-2 (COX-2), and including nuclear factor κB (NF-κB). In addition, it modulated c-fos expression and neuronal excitability in the brain. Conclusion:: BBR indicated promising anti-seizure effects with remarkable antioxidant, antiinflammatory, anti-apoptotic, and neuroprotective activity. Future studies should be based on well-designed clinical trial studies that are integrated with new methods related to increasing bioavailability.

中文翻译：

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小檗碱的抗癫痫作用和机制：系统评价

背景：癫痫是世界各地所有年龄段中最常见的一种致残性神经系统疾病。目的：本系统综述旨在探讨小檗碱 (BBR) 是否具有任何抗癫痫或抗癫痫作用，并综述了这种可能的机制。方法：在 2023 年 9 月之前检索了 EMBASE、Scopus、Cochrane 图书馆、PubMed 和 Web of Science 数据库。调查 BBR 对癫痫或化学诱发癫痫发作的影响的所有类型的研究均符合纳入条件。两名作者独立评估和审查标题/摘要，以确定出版物的潜在资格，第三名团队成员解决了差异。以 Excel 形式提取数据，并对结果进行讨论。结果:: BBR 通过减少氧化应激、神经炎症和抗细胞凋亡作用显示出其神经保护特性。它还增加脑源性神经营养因子 (BDNF) 的释放并减少转化生长因子-β (TGF-β1) 和缺氧诱导因子 1α (HIF-1α)。BBR 通过增加清除活性氧 (ROS)、核因子红细胞 2 相关因子 2 (Nrf2)、内源性抗氧化酶、血红素加氧酶-1 (HO-1) 和抑制脂质过氧化来增强其抗氧化活性。此外，BBR 通过降低白细胞介素 (IL)-1β、IL-6 和肿瘤坏死因子-α (TNF-α) 水平以及通过抑制环氧合酶-2 (COX-2) 和包括核因子 κB (NF) 来显示抗炎活性。 -κB）。此外，它还调节大脑中 c-fos 的表达和神经元兴奋性。结论:: BBR 具有良好的抗癫痫作用，具有显着的抗氧化、抗炎、抗凋亡和神经保护活性。未来的研究应基于精心设计的临床试验研究，这些研究与提高生物利用度相关的新方法相结合。