“…Berberine (BBR) is a natural isoquinoline alkaloid isolated from plants of the genus Berberis, with therapeutic effects on gastroenteritis, hyperlipidemia, coronary heart disease, and other diseases. − Notably, BBR showed inhibition of tumor cell proliferation, migration, and invasion in a variety of tumors. , Studies have shown that BBR not only has the ability to selectively reduce the viability of HCC cells without affecting normal hepatocytes but also effectively induces cell cycle arrest in the G1/S phase . AMP-activated protein kinase (AMPK), a metabolism-sensitive protein kinase, is involved in the regulation of cell growth, metabolism, apoptosis, autophagy, proliferation, and other physiological processes. − AMPK has a strong pro-apoptotic potential under activated conditions, and BBR induces selective apoptosis in HCC cells by inhibiting the expression of the antiapoptotic factor BCL-2 and through an AMPK-mediated mitochondrial/caspase pathway. , Similarly, AKT is a serine/threonine kinase that plays a major role in the PI3K/AKT signaling pathway and is involved in regulating the cell cycle, autophagy, and apoptotic processes. , Clinical findings have shown that higher levels of phosphorylated (p)-AKT in tumors are one of the major contributors to the increase in tumor drug resistance. , BBR can also inhibit tumor progression and overcome tumor drug resistance through PI3K/AKT. , BBR is a potential natural anticancer drug due to its multiple anticancer targets and low biological toxicity.…”