“…As shown in Table 6, berberine ameliorated renal inflammation and injury in diabetic models [79,83,85,86,90,96]. Underlying mechanisms include inhibition of kidney fibrosis via tumor growth factor (TGF)- signaling suppression and Nrf2 activity enhancement [76,77,80,82,86,91,93,144], suppression of HG-induced mesangial cell proliferation and hypertrophy via suppression of NF-B and AP-1 [81,84,90], and attenuation of ECM accumulation [87], possibly by restoring β-arrestin [88] and E prostanoid receptor 4 (EP4)-Gαs-cAMP signaling pathway [83,85]. In addition, berberine directly protected podocytes from HG-induced injury in vitro [23,94], possibly by inhibiting podocyte apoptosis via AMPK-dependent autophagy induction [92].…”