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. 2021 Dec 22;12:764994. doi: 10.3389/fphar.2021.764994

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Copyright © 2021 Cao, Zhang, Feng, Liu, Liu, Zheng and Yang.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Interaction of berberine with the gut-heart axis. Berberine interacts with the gut-heart axis through two pathways: 1) berberine regulates gut microbiota compositions and related functional metabolites, for example inhibition of proatherogenic metabolite TMAO and promotion of antiatherogenic metabolite SCFA, which circulate to the distal organ heart and contribute to reduce coronary atherosclerosis; 2) berberine via its metabolites, digested by intestinal microbiota and absorbed into blood stream, contribute to modulate oxidative stress and inflammation related dyslipidemia, obesity, and atherosclerosis to inhibit cardiac injury via multiple molecular signaling pathways.