Therapeutic potential of alkaloids in treatment of gut-associated diseases

Abstract

Alkaloids, a broad group of naturally occurring nitrogenous compounds, have gained universal interest due to their drug value in the treatment of gut-associated diseases. The bioactive compounds have been found to exhibit varied pharmacological activities from antiinflammatory, antioxidant, antimicrobial to gut microbiota-modulating activities. Recent reports highlight their applications in the treatment of diseases such as inflammatory bowel syndrome, inflammatory bowel disease, gastroesophageal reflux disease, and peptic ulcers by modulating key molecular targets such as NF-κB, MAPK, and Nrf2. Alkaloids berberine, piperine, sanguinarine, and quinine are found to be active in regulating gut motility, enhancing intestinal barrier function, and immune response modulation. In addition, advancements in drug delivery systems, such as nanoformulations, have also improved their bioavailability and therapeutic potential. This chapter discusses an in-depth overview of the phytochemistry, mechanisms of action, preclinical and clinical trials, and areas of future interest of alkaloids in gut health. Clarification of their molecular interactions and pharmacological properties may unlock new avenues in the treatment of gastrointestinal disorders. © 2026 Elsevier Inc. All rights reserved..