Natural plant extract Berbamine is a potent inhibitor of cell growth and survival of human Tenon’s fibroblasts

INTRODUCTION: Post-trabeculectomy scaring due to excessive proliferation of human Tenon's fibroblasts (HTFs) often led to operation failure. Developing a new anti-fibrosis drug with high efficacy to inhibit HTFs' cell growth will greatly improve the effectiveness of trabeculectomy. OBJECTIVE: This study aims to investigate the effect of berbamine (BBM) treatment on the cell growth and survival of HTFs. METHODS: Cultured human fetal Tenon's fibroblasts (HFTFs) were treated with or without different concentrations of BBM. Cell morphology was observed with a phase contrast microscope. A CCK-8 method and Ki67 immunofluorescence were used to determine cell viability and cell proliferation. A scratch test was used to study cell migration. Flow cytometry and TUNEL staining were performed to detect cell apoptosis. The expression of BAX/BCL-2, ERK and AKT/mTOR pathway components was determined by western blotting. RESULTS: BBM treatment disrupted HFTF's normal morphology and inhibited its cell growth in a dose-dependent manner. Ki67 immunofluorescence and scratch assay showed BBM suppressed HFTF's cell proliferation and migration. Importantly, BBM dose-dependently increased the BAX/BCL-2 ratio and induced apoptosis in HFTF cells. Western blotting showed BBM significantly inhibited the ERK and AKT/mTOR pathway, and PTEN inhibition ameliorates the inhibitory effect of BBM on cell viability and survival in HFTFs. CONCLUSIONS: BBM potently inhibits the cell growth and survival of HTFs through AKT/mTOR and has the potential to serve as an anti-fibrosis drug after trabeculectomy.