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Turmeric is a rhizomatous herbaceous perennial plant (Curcuma longa) of the ginger family and is commonly known as spice, which has long been recognized for its medicinal properties. Curcumin (1,7-bis (4-hydroxy-3-methoxyphenyl)-1,6-heptadiene-3,5-Dione), also called diferuloylmethane, is the main natural polyphenol found in turmeric. Curcumin is being used worldwide in many different forms for multiple health benefits.
For example, in India curcumin is used in curries; in Japan, it is served in tea; in Thailand, it is used in cosmetics; in China, it is used as a colorant; in Korea, it is served in drinks; in Malaysia, it is used as an antiseptic; in Pakistan, it is used as an anti-inflammatory agent; and in the United States, it is used in mustard sauce (Hewlings & Kalman, 2017). Curcuminoids, also known as derivatives of curcumin, have been approved by the Food and Drug Administration (FDA) as safe and with good tolerability; safety profiles have been shown by clinical trials, even at doses between 4000 and 8000 mg/day (Basnet & Basnet, 2011).
Recently, curcumin has been extensively researched for its antioxidant and anti-inflammatory properties. However, despite its numerous reported anti-inflammatory and antioxidant benefits, one of the major problems with curcumin itself is poor bioavailability, which appears to be primarily due to poor absorption, rapid metabolism, and rapid elimination (Anand et al., 2007). Several agents have been identified successfully in blocking the metabolic pathway of curcumin and increasing its bioavailability (Shoba et al., 1998). Piperine, the major active component of black pepper has been identified as the most known bioavailability enhancer, and has been associated with an increase of 2000% in the bioavailability of curcumin (Shoba et al., 1998). Therefore, when consuming turmeric, it is best to be taken with black pepper, or in a form of supplement, a combination of curcumin and piperine.
Curcumin is considered as a chain-breaking antioxidant. Being a lipophilic compound, it is also efficient scavenger of free radicals. Curcumin’s effect on free radicals is carried out by several different mechanisms. It can scavenge different forms of free radicals such as reactive oxygen (ROS) and reactive nitrogen (RNS) species (Menon & Sudheer, 2007); it can inhibit ROS-generating enzymes such as lipoxygenase/cyclooxygenase and xanthine hydrogenase/oxidase (Lin et al., 2007); it can also modulate the activity of superoxide dismutase (SOD) enzymes which are important for the neutralization of free radicals (Marchiani et al., 2014). A recent systematic review and meta-analysis of randomized control trial examining the efficacy of purified curcuminoids on oxidative stress demonstrated a significant effect of curcuminoids on different oxidative stress parameters including plasma activities of SOD and catalase, as well as serum concentrations of glutathione peroxidase (GSH) and lipid peroxides (Sahebkar et al., 2015).
Inflammation is closely related with oxidative stress; inflammatory cells release a number of reactive species at the site of inflammation leading to oxidative stress. In addition, a number of reactive oxygen and nitrogen species initiate an intracellular signalling cascade that could further enhance pro-inflammatory gene expression (Hewlings & Kalman, 2017). Curcumin is known to block nuclear factor (NF-kB), which is a transcription factor associated with inflammation; and is activated by tumour necrosis factor (TNF-α), known as major mediator of inflammation in most diseases, including Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, epilepsy, cerebral injury, cardiovascular disease, metabolic syndrome, rheumatoid arthritis, cancer, allergy, asthma, bronchitis, colitis, arthritis, renal ischemia, psoriasis, diabetes, obesity and depression. Therefore, by blocking the activation of NF-kB, curcumin has been confirmed as potent anti-inflammatory agent with ability to supress inflammatory processes in the body (Panahi et al., 2016).
Osteoarthritis is a chronic joint condition that affects over 250 million people worldwide. It is associated with elevated cytokine levels and inflammation. Being already identified as potent anti-inflammatory agent, curcumin could be highly beneficial in the treatment of osteoarthritis. Colitti et al. (2012) found that oral delivery of curcumin in patients with osteoarthritis leads to decreased production of TNF-α, and inhibition of the inflammatory transcription factor NF-kB in white blood cells. In another study, a randomized double blind placebo controlled trial, 40 subjects with mild to moderate knee pain received either curcuminoid (500 mg/day in three divided doses) with 5 mg piperine added to each 500-mg dose, or a matched placebo for six weeks. The study further demonstrated significantly greater reductions in all parameters in the group that received curcuminoids, comparing to the placebo group. There was also a decrease in systemic oxidative stress, as measured via serum activities of superoxide dismutase (Kuptniratsaikul et al., 2014).
Metabolic syndrome includes a variety of conditions such as: insulin resistance, hyperglycaemia, hypertension, low levels of good cholesterol (HDL), elevated levels of bad cholesterol (LDL), elevated triglyceride levels, and visceral obesity. Pro-inflammatory cytokines are one of the major complications associated with metabolic syndrome disorders. Being already identified as potent anti-inflammatory agent, curcumin could be highly beneficial in the treatment of various metabolic syndrome disorders. Curcuminoids have been identified significantly capable in the treatment of cardiovascular disorders due to their ability to modulate the expression of genes and the activity of enzymes involved in lipoprotein metabolism that lead to a reduction in plasma triglycerides and LDL cholesterol levels (Sahebkar, 2014). A study published by Chuengsamarn et al. (2012) suggested that regular consumption of curcumin may help prevent the onset of type 2 diabetes. In this study, over the course of nine months, researchers monitored 240 pre-diabetics who were given either a placebo or a curcumin supplement. Results indicated that 16.4 percent of the group who were provided a placebo had developed diabetes, whereas the curcumin group did not.
Inflammatory bowel disease is a chronic immune disorder that involves an overactive immune component in the intestinal mucosa. IBD is divided into two major categories, ulcerative colitis (UC) and Crohn’s disease (CD) that manifest with similar symptoms such as: abdominal pain, cramping, diarrhoea, rectal bleeding, urgency, nausea, fever, and weight loss. Certain cytokines have been associated with IBD, including TNF-α, IL-1, IL-6, IL-8, and others. Curcumin, being identified with strong anti-inflammatory properties and ability to block nuclear factor (NF-kB), which is the transcription factor associated with inflammation, and activated by tumour necrosis factor (TNF-α), may have a positive effect on reducing symptoms of inflammatory bowel disease. In a study that involved five people affected with inflammatory bowel disease, researchers found out that curcumin helped improve the symptoms of the participants (Holt et al., 2005).
Thanks to its anti-inflammatory and antioxidant properties Curcumin is also highly beneficial for skin health. In terms of skin health, curcumin neutralises free radicals and prevents cell damage; it can also accelerate wound healing and improve collagen deposition. Asawanonda & Klahan (2010) conducted a study involving 10 patients affected with vitiligo who were subjected to a procedure that combined UVB therapy and curcumin cream. Asawanonda & Klahan (2010) further demonstrated a significant reduction in the skin pigmentation after the application of curcumin cream. In another study, patients suffering from psoriasis were provided a 450-gram curcumin supplement per day for 12 weeks. After the study, several participants reported an 83 to 88 percent improvement of symptoms (Gupta et al., 2013).
BSc Herbal Medicine; MSc Pharmacology
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Colitti, M., Gaspardo, B. et al. (2012). Transcriptome modification of white blood cells after dietary administration of curcumin and non-steroidal anti-inflammatory drug in osteoarthritic affected dogs. Vet Immunol Immunopathol. 147(34), 136–146.
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