{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:05:26Z","timestamp":1789545926017,"version":"build-2803163510"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Chin. J. Integr. Med."],"DOI":"10.1007\/s11655-026-3961-y","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:36:32Z","timestamp":1789544192000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Berberine Suppresses Inflammatory Response in Severe Pneumonia by Specifically Targeting Upregulation of SIRT1 to Activate Nrf2 Signaling Pathway"],"prefix":"10.1007","author":[{"given":"Liang","family":"Cheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin-guo","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-ping","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue-jing","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi-qi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu-chen","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-hua","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"3961_CR1","doi-asserted-by":"publisher","first-page":"1145","DOI":"10.1016\/S0140-6736(22)01485-4","volume":"400","author":"LDJ Bos","year":"2022","unstructured":"Bos LDJ, Ware LB. Acute respiratory distress syndrome: causes, pathophysiology, and phenotypes. Lancet 2022;400:1145\u20131156.","journal-title":"Lancet"},{"key":"3961_CR2","doi-asserted-by":"publisher","first-page":"420","DOI":"10.3389\/fmed.2020.00420","volume":"7","author":"P Manohar","year":"2020","unstructured":"Manohar P, Loh B, Nachimuthu R, Hua X, Welburn SC, Leptihn S. Secondary bacterial infections in patients with viral pneumonia. Front Med 2020;7:420.","journal-title":"Front Med"},{"key":"3961_CR3","doi-asserted-by":"publisher","first-page":"1603287","DOI":"10.3389\/fphar.2025.1603287","volume":"16","author":"F Wang","year":"2025","unstructured":"Wang F, Ge R, Cai Y, Zhao M, Fang Z, Li J, et al. Oxidative stress in ARDS: mechanisms and therapeutic potential. Front Pharmacol 2025;16:1603287.","journal-title":"Front Pharmacol"},{"key":"3961_CR4","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1042\/CS20210879","volume":"136","author":"ME Long","year":"2022","unstructured":"Long ME, Mallampalli RK, Horowitz JC. Pathogenesis of pneumonia and acute lung injury. Clin Sci (Lond) 2022;136:747\u2013769.","journal-title":"Clin Sci (Lond)"},{"key":"3961_CR5","doi-asserted-by":"publisher","first-page":"13","DOI":"10.3390\/tropicalmed9010013","volume":"9","author":"AA Al-Qahtani","year":"2024","unstructured":"Al-Qahtani AA, Alhamlan FS, Al-Qahtani AA. Pro-inflammatory and anti-inflammatory interleukins in infectious diseases: a comprehensive review. Trop Med Infect Dis 2024;9:13.","journal-title":"Trop Med Infect Dis"},{"key":"3961_CR6","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1007\/s11655-025-3932-8","volume":"32","author":"LH Shang","year":"2026","unstructured":"Shang LH, Fan GH, Chen LP, Liu JH, Wang XG, Liu B, et al. Andrographolide Sulfonate Injection for adjunctive treatment of non-severe community-acquired pneumonia in adults: a multicenter, double-blind, randomized controlled trial. Chin J Integr Med 2026;32:771\u2013779.","journal-title":"Chin J Integr Med"},{"key":"3961_CR7","doi-asserted-by":"publisher","first-page":"557","DOI":"10.3389\/fphar.2018.00557","volume":"9","author":"MA Neag","year":"2018","unstructured":"Neag MA, Mocan A, Echeverr\u00eda J, Pop RM, Bocsan CI, Cri\u015fan G, et al. Berberine: botanical occurrence, traditional uses, extraction methods, and relevance in cardiovascular, metabolic, hepatic, and renal disorders. Front Pharmacol 2018;9:557.","journal-title":"Front Pharmacol"},{"key":"3961_CR8","doi-asserted-by":"publisher","first-page":"157030","DOI":"10.1016\/j.phymed.2025.157030","volume":"146","author":"W Zhou","year":"2025","unstructured":"Zhou W, Asif A, Situ C, Wang J, Hao H. Multiple target and regulatory pathways of berberine. Phytomedicine 2025;146:157030.","journal-title":"Phytomedicine"},{"key":"3961_CR9","doi-asserted-by":"publisher","first-page":"805","DOI":"10.1007\/s43440-023-00492-2","volume":"75","author":"X Li","year":"2023","unstructured":"Li X, Bai Y, Ma Y, Li Y. Ameliorating effects of berberine on sepsis-associated lung inflammation induced by lipopolysaccharide: molecular mechanisms and preclinical evidence. Pharmacol Rep 2023;75:805\u2013816.","journal-title":"Pharmacol Rep"},{"key":"3961_CR10","doi-asserted-by":"publisher","first-page":"100252","DOI":"10.1016\/j.phyplu.2022.100252","volume":"2","author":"J Cao","year":"2022","unstructured":"Cao J, Li L, Xiong L, Wang C, Chen Y, Zhang X. Research on the mechanism of berberine in the treatment of COVID-19 pneumonia pulmonary fibrosis using network pharmacology and molecular docking. Phytomed Plus 2022;2:100252.","journal-title":"Phytomed Plus"},{"key":"3961_CR11","doi-asserted-by":"publisher","first-page":"344","DOI":"10.3390\/v12030344","volume":"12","author":"P Botwina","year":"2020","unstructured":"Botwina P, Owczarek K, Rajfur Z, Ochman M, Urlik M, Nowakowska M, et al. Berberine hampers influenza A replication through inhibition of MAPK\/ERK pathway. Viruses 2020;12:344.","journal-title":"Viruses"},{"key":"3961_CR12","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1002\/JLB.3MA0320-358RR","volume":"108","author":"H Liu","year":"2020","unstructured":"Liu H, You L, Wu J, Zhao M, Guo R, Zhang H, et al. Berberine suppresses influenza virus-triggered NLRP3 inflammasome activation in macrophages by inducing mitophagy and decreasing mitochondrial ROS. J Leukoc Biol 2020;108:253\u2013266.","journal-title":"J Leukoc Biol"},{"key":"3961_CR13","doi-asserted-by":"publisher","first-page":"12234","DOI":"10.1111\/jcmm.15803","volume":"24","author":"P Shen","year":"2020","unstructured":"Shen P, Jiao Y, Miao L, Chen JH, Momtazi-Borojeni AA. Immunomodulatory effects of berberine on the inflamed joint reveal new therapeutic targets for rheumatoid arthritis management. J Cell Mol Med 2020;24:12234\u201312245.","journal-title":"J Cell Mol Med"},{"key":"3961_CR14","doi-asserted-by":"publisher","first-page":"1923","DOI":"10.7150\/thno.30787","volume":"9","author":"X Feng","year":"2019","unstructured":"Feng X, Sureda A, Jafari S, Memariani Z, Tewari D, Annunziata G, et al. Berberine in cardiovascular and metabolic diseases: from mechanisms to therapeutics. Theranostics 2019;9:1923\u20131951.","journal-title":"Theranostics"},{"key":"3961_CR15","doi-asserted-by":"publisher","first-page":"831168","DOI":"10.3389\/fimmu.2022.831168","volume":"13","author":"Y Yang","year":"2022","unstructured":"Yang Y, Liu Y, Wang Y, Chao Y, Zhang J, Jia Y, et al. Regulation of SIRT1 and its roles in inflammation. Front Immunol 2022;13:831168.","journal-title":"Front Immunol"},{"key":"3961_CR16","doi-asserted-by":"publisher","first-page":"e21","DOI":"10.4110\/in.2022.22.e21","volume":"22","author":"Y Zhou","year":"2022","unstructured":"Zhou Y, Zhang F, Ding J. As a modulator, multitasking roles of SIRT1 in respiratory diseases. Immune Netw 2022;22:e21.","journal-title":"Immune Netw"},{"key":"3961_CR17","doi-asserted-by":"publisher","first-page":"1657829","DOI":"10.3389\/fphar.2025.1657829","volume":"16","author":"Y Tie","year":"2025","unstructured":"Tie Y, Liu H, Zhang T, Meng T, Liang Q. Natural products alleviate viral pneumonia by modulating inflammatory and oxidative-stress pathways. Front Pharmacol 2025;16:1657829.","journal-title":"Front Pharmacol"},{"key":"3961_CR18","doi-asserted-by":"publisher","first-page":"400","DOI":"10.3389\/fendo.2020.00400","volume":"11","author":"W Xu","year":"2020","unstructured":"Xu W, Zhao T, Xiao H. The implication of oxidative stress and AMPK-Nrf2 antioxidative signaling in pneumonia pathogenesis. Front Endocrinol (Lausanne) 2020;11:400.","journal-title":"Front Endocrinol (Lausanne)"},{"key":"3961_CR19","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1089\/rej.2022.0023","volume":"25","author":"N Chen","year":"2022","unstructured":"Chen N, Wang XC, Fan LL, Zhu YH, Wang Q, Chen YB. Berberine ameliorates lipopolysaccharide-induced cognitive impairment through SIRT1\/NRF2\/NF-\u03baB signaling pathway in C57BL\/6J mice. Rejuvenation Res 2022;25:233\u2013242.","journal-title":"Rejuvenation Res"},{"key":"3961_CR20","doi-asserted-by":"publisher","first-page":"e45","DOI":"10.1164\/rccm.201908-1581ST","volume":"200","author":"JP Metlay","year":"2019","unstructured":"Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med 2019;200:e45\u2013e67.","journal-title":"Am J Respir Crit Care Med"},{"key":"3961_CR21","first-page":"53","volume":"33","author":"X Li","year":"2021","unstructured":"Li X, Yang G, Shen F, Zheng X, He T, Li S, et al. Berberine dose-dependently inhibits the expression of procoagulant and fibrinolytic inhibitory factors in lipopolysaccharide-induced rat type II alveolar epithelial cells. Chin Crit Care Med (Chin) 2021;33:53\u201358.","journal-title":"Chin Crit Care Med (Chin)"},{"key":"3961_CR22","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1080\/02770903.2016.1180530","volume":"53","author":"Z Li","year":"2016","unstructured":"Li Z, Zheng J, Zhang N, Li C. Berberine improves airway inflammation and inhibits NF-kappaB signaling pathway in an ovalbumin-induced rat model of asthma. J Asthma 2016;53:999\u20131005.","journal-title":"J Asthma"},{"key":"3961_CR23","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1007\/s12192-022-01257-1","volume":"27","author":"H Tian","year":"2021","unstructured":"Tian H, Xiong Y, Zhang Y, Leng Y, Tao J, Li L, et al. Activation of NRF2\/FPN1 pathway attenuates myocardial ischemia\u2013reperfusion injury in diabetic rats by regulating iron homeostasis and ferroptosis. Cell Stress Chaperones 2021;27:149\u2013164.","journal-title":"Cell Stress Chaperones"},{"key":"3961_CR24","doi-asserted-by":"publisher","first-page":"1702084","DOI":"10.3389\/fimmu.2026.1702084","volume":"17","author":"X Zhao","year":"2026","unstructured":"Zhao X, Gao J, Wang T, Sun Q, Yu J, Pan W. Advances in infection-immunity mechanisms and molecular regulatory networks in severe pneumonia-associated lung injury. Front Immunol 2026;17:1702084.","journal-title":"Front Immunol"},{"key":"3961_CR25","doi-asserted-by":"publisher","first-page":"188","DOI":"10.22159\/ijap.2024v16i2.49922","volume":"16","author":"R Sachdeo","year":"2024","unstructured":"Sachdeo R, Khanwelkar C, Shete A. In silico exploration of berberine as a potential wound healing agent via network pharmacology, molecular docking, and molecular dynamics simulation Int J App Pharm 2024;16:188\u2013194.","journal-title":"Int J App Pharm"},{"key":"3961_CR26","doi-asserted-by":"publisher","first-page":"5521","DOI":"10.1038\/s41598-024-55923-8","volume":"14","author":"N Chang","year":"2024","unstructured":"Chang N, Li J, Lin S, Zhang J, Zeng W, Ma G, et al. Emerging roles of SIRT1 activator, SRT2104, in disease treatment. Sci Rep 2024;14:5521.","journal-title":"Sci Rep"},{"key":"3961_CR27","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1007\/s11655-026-3846-0","volume":"32","author":"YJ Guo","year":"2026","unstructured":"Guo YJ, Wu F, Gong MM, Wu WB, Lu FE, Wang DK. Berberine regulates hepatic fatty acid metabolism via AMPK\/ SIRT1\/PGC-1\u03b1 pathway. Chin J Integr Med 2026;32:702\u2013708.","journal-title":"Chin J Integr Med"},{"key":"3961_CR28","doi-asserted-by":"publisher","first-page":"851255","DOI":"10.3389\/fnut.2022.851255","volume":"9","author":"J Chen","year":"2022","unstructured":"Chen J, Huang Y, Bian X, He Y. Berberine ameliorates inflammation in acute lung injury via NF-\u03baB\/Nlrp3 signaling pathway. Front Nutr 2022;9:851255.","journal-title":"Front Nutr"},{"key":"3961_CR29","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1111\/bcpt.13818","volume":"132","author":"Z Yang","year":"2023","unstructured":"Yang Z, Bian M, Ma J, Dong Y, Yang D, Qiu M, et al. Berberine regulates pulmonary inflammatory microenvironment and decreases collagen deposition in response to bleomycin-induced pulmonary fibrosis in mice. Basic Clin Pharmacol Toxicol 2023;132:154\u2013170.","journal-title":"Basic Clin Pharmacol Toxicol"},{"key":"3961_CR30","doi-asserted-by":"publisher","first-page":"153211","DOI":"10.1016\/j.phymed.2020.153211","volume":"69","author":"R Yang","year":"2020","unstructured":"Yang R, Song C, Chen J, Zhou L, Jiang X, Cao X, et al. Limonin ameliorates acetaminophen-induced hepatotoxicity by activating Nrf2 antioxidative pathway and inhibiting NF-\u03baB inflammatory response via upregulating SIRT1. Phytomedicine 2020;69:153211.","journal-title":"Phytomedicine"},{"key":"3961_CR31","doi-asserted-by":"publisher","first-page":"104385","DOI":"10.1016\/j.phrs.2019.104385","volume":"148","author":"DQ Liu","year":"2019","unstructured":"Liu DQ, Chen SP, Sun J, Wang XM, Chen N, Zhou YQ, et al. Berberine protects against ischemia\u2013reperfusion injury: a review of evidence from animal models and clinical studies. Pharmacol Res 2019;148:104385.","journal-title":"Pharmacol Res"},{"key":"3961_CR32","doi-asserted-by":"publisher","first-page":"3374","DOI":"10.3892\/etm.2017.4402","volume":"13","author":"LC Zhang","year":"2017","unstructured":"Zhang LC, Wang Y, Tong LC, Sun S, Liu WY, Zhang S, et al. Berberine alleviates dextran sodium sulfate-induced colitis by improving intestinal barrier function and reducing inflammation and oxidative stress. Exp Ther Med 2017;13:3374\u20133382.","journal-title":"Exp Ther Med"},{"key":"3961_CR33","doi-asserted-by":"publisher","first-page":"4","DOI":"10.2174\/0127724328281178240225082456","volume":"20","author":"M Sotoudeheian","year":"2025","unstructured":"Sotoudeheian M, Mirahmadi SM, Pirhayati M, Farahmandian N, Azarbad R, Toroudi HP. Targeting SIRT1 by scopoletin to inhibit XBB.1.5 COVID-19 life cycle. Curr Rev Clin Exp Pharmacol 2025;20:4\u201313.","journal-title":"Curr Rev Clin Exp Pharmacol"}],"container-title":["Chinese Journal of Integrative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11655-026-3961-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11655-026-3961-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11655-026-3961-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:36:33Z","timestamp":1789544193000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11655-026-3961-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,16]]},"references-count":33,"alternative-id":["3961"],"URL":"https:\/\/doi.org\/10.1007\/s11655-026-3961-y","relation":{},"ISSN":["1672-0415","1993-0402"],"issn-type":[{"value":"1672-0415","type":"print"},{"value":"1993-0402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,16]]},"assertion":[{"value":"10 September 2025","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 September 2026","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"There are no interests to declare.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}}]}}