Herbal Medicines Targeting the Improved ß-Cell Functions and ß-Cell Regeneration for the Management of Diabetes Mellitus.

ABSTRACT

There is an increasing trend of investigating natural bioactive compounds targeting pancreatic ß-cells for the prevention/treatment of diabetes mellitus (DM). With the exploration of multiple mechanisms by which ß-cells involve in the pathogenesis of DM, herbal medicines are gaining attention due to their multitasking ability as evidenced by traditional medicine practices. This review attempts to summarize herbal medicines with the potential for improvement of ß-cell functions and regeneration as scientifically proven by in vivo/in vitro investigations. Furthermore, attempts have been made to identify the mechanisms of improving the function and regeneration of ß-cells by herbal medicines. Relevant data published from January 2009 to March 2020 were collected by searching electronic databases "PubMed," "ScienceDirect," and "Google Scholar" and studied for this review. Single herbal extracts, polyherbal mixtures, and isolated compounds derived from approximately 110 medicinal plants belonging to 51 different plant families had been investigated in recent years and found to be targeting ß-cells. Many herbal medicines showed improvement of ß-cell function as observed through homeostatic model assessment-ß-cell function (HOMA-ß). Pancreatic ß-cell regeneration as observed in histopathological and immunohistochemical studies in terms of increase of size and number of functional ß-cells was also prominent. Increasing ß-cell mass via expression of genes/proteins related to antiapoptotic actions and ß-cell neogenesis/proliferation, increasing glucose-stimulated insulin secretion via activating glucose transporter-2 (GLUT-2) receptors, and/or increasing intracellular Ca2+ levels were observed upon treatment of some herbal medicines. Some herbal medicines acted on various insulin signaling pathways. Furthermore, many herbal medicines showed protective effects on ß-cells via reduction of oxidative stress and inflammation. However, there are many unexplored avenues. Thus, further investigations are warranted in elucidating mechanisms of improving ß-cell function and mass by herbal medicines, their structure-activity relationship (SAR), and toxicities of these herbal medicines.