Berberine as a Promising Antifungal Agent: Insights into Molecular Mechanisms and Therapeutic Potential

Due to the increasing prevalence of antifungal resistance and the limitations of existing therapeutic options, fungal infections represent a significant global health burden. Berberine (BBR), a naturally occurring isoquinoline alkaloid compound derived from various medicinal plants such as Coptis chinensis, has garnered attention for the antifungal activities. In this review, we present the current knowledge-base on the multifaceted antifungal effects of BBR and its underlying mechanisms. It involves the inhibition of the biofilm formation, the disruption of fungal cell membrane integrity, the interference with key metabolic pathways and the induction of apoptotic cell death. BBR also exhibited potential significant synergistic effects with some common antifungal drugs. Beneficially, BBR has been ″demonstrated to improve oxidative stress damage and inflammatory response induced by fungal infections. We also discuss its safety, clinical applications, formulation strategies and existing challenges. Finally, we propose future directions for leveraging BBR in the fight against antifungal resistance. The integration of BBR into antifungal therapy represents a compelling strategy to address the urgent need for effective, safe and affordable treatments for fungal infections.