curcumin and Peptic-Ulcer

Extensive research over the past half century has shown that curcumin (diferuloylmethane), a component of the golden spice turmeric (Curcuma longa), can modulate multiple cell signaling pathways. Extensive clinical trials over the past quarter century have addressed the pharmacokinetics, safety, and efficacy of this nutraceutical against numerous diseases in humans. Some promising effects have been observed in patients with various pro-inflammatory diseases including cancer, cardiovascular disease, arthritis, uveitis, ulcerative proctitis, Crohn's disease, ulcerative colitis, irritable bowel disease, tropical pancreatitis, peptic ulcer, gastric ulcer, idiopathic orbital inflammatory pseudotumor, oral lichen planus, gastric inflammation, vitiligo, psoriasis, acute coronary syndrome, atherosclerosis, diabetes, diabetic nephropathy, diabetic microangiopathy, lupus nephritis, renal conditions, acquired immunodeficiency syndrome, β-thalassemia, biliary dyskinesia, Dejerine-Sottas disease, cholecystitis, and chronic bacterial prostatitis. Curcumin has also shown protection against hepatic conditions, chronic arsenic exposure, and alcohol intoxication. Dose-escalating studies have indicated the safety of curcumin at doses as high as 12 g/day over 3 months. Curcumin's pleiotropic activities emanate from its ability to modulate numerous signaling molecules such as pro-inflammatory cytokines, apoptotic proteins, NF-κB, cyclooxygenase-2, 5-LOX, STAT3, C-reactive protein, prostaglandin E(2), prostate-specific antigen, adhesion molecules, phosphorylase kinase, transforming growth factor-β, triglyceride, ET-1, creatinine, HO-1, AST, and ALT in human participants. In clinical trials, curcumin has been used either alone or in combination with other agents. Various formulations of curcumin, including nanoparticles, liposomal encapsulation, emulsions, capsules, tablets, and powder, have been examined. In this review, we discuss in detail the various human diseases in which the effect of curcumin has been investigated.

Topics: Arthritis; Clinical Trials as Topic; Curcumin; Humans; Inflammatory Bowel Diseases; Irritable Bowel Syndrome; Neoplasms; Peptic Ulcer; Vitiligo

To compare the efficacy and safety of combination of curcuminoid complex and diclofenac vs diclofenac alone in the treatment of knee osteoarthritis (OA).. In this randomized trial, 140 patients of knee OA received either curcuminoid complex 500 mg (BCM-95) with diclofenac 50 mg 2 times daily or diclofenac 50 mg alone 2 times daily for 28 days. Patients were assessed at baseline, day 14 and day 28. Primary efficacy measures were Knee injury and OA outcome score (KOOS) subscale at day 14 and day 28. Anti-ulcer effect and patient-physician's global assessment of therapy at day 28 were included as secondary endpoints. Safety after treatment was evaluated by recording adverse events and laboratory investigations.. Both treatment groups showed improvement in primary endpoints at each evaluation visit. Patients receiving curcuminoid complex plus diclofenac showed significantly superior improvement in KOOS subscales, viz. pain and quality of life at each study visit (P < .001) when compared to diclofenac. Less number of patients required rescue analgesics in curcuminoid complex plus diclofenac group (3%) compared to diclofenac group (17%). The number of patients who required histamine 2 (H2) blockers was significantly less in curcuminoid complex plus diclofenac group compared to diclofenac group (6% vs 28%, respectively; P < .001). Adverse effects were significantly less in curcuminoid complex plus diclofenac group (13% vs 38% in diclofenac group; P < .001). Patient's and physician's global assessment of therapy favored curcuminoid complex plus diclofenac than diclofenac.. Combination of curcuminoid complex and diclofenac showed a greater improvement in pain and functional capacity with better tolerability and could be a better alternative treatment option in symptomatic management of knee OA.. ISRCTN, ISRCTN10074826.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Curcuma; Diarylheptanoids; Diclofenac; Female; Histamine H2 Antagonists; Humans; Male; Middle Aged; Osteoarthritis, Knee; Peptic Ulcer; Phytotherapy; Plant Extracts

Curcumin, the bioactive ingredient of turmeric, has been shown to improve the treatment of peptic ulcer (PU) in animal studies. However, clinical studies confirming this effect of curcumin have been scant.. To assess the efficacy of adjunctive therapy with curcumin on the eradication of Helicobacter pylori infection and severity of dyspepsia in patients with PU.. In this randomized double-blind placebo-controlled parallel-group trial, patients diagnosed with PU were assigned to standard H. pylori eradication triple therapy with clarithromycin (500 mg b.i.d.), amoxicillin (1 000 mg b.i.d.) and pantoprazole (40 mg b.i.d.), and randomized to receive either curcumin (500 mg/day) or placebo as adjunct to standard treatment. Severity of dyspepsia symptoms was evaluated using the Hong Kong dyspepsia index (HKDI). Eradication of H. pylori infection was assessed using the urea breath test (UBT) at 4 weeks following the end of treatment.. Adjunctive therapy with curcumin was associated with a greater improvement of dyspepsia symptoms according to the HKDI score (change score: -12.90±2.81 vs. -9.60±3.39 in the curcumin and control group, respectively; p<0.001). The number of subjects whose dyspepsia was resolved during the course of treatment was significantly higher in the curcumin (27.6%) vs. placebo (6.7%) group (p=0.042). Nevertheless, the results of UBT test showed equal rate (73.3%) of H. pylori eradication in the study groups. Curcumin was safe during the course of trial.. Addition of curcumin on top of the standard anti-helicobacter regimen in patients with PU is safe and improves dyspepsia symptoms but has no enhancing effect on the eradication of H. pylori infection.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Adult; Amoxicillin; Anti-Bacterial Agents; Anti-Ulcer Agents; Clarithromycin; Curcumin; Double-Blind Method; Drug Therapy, Combination; Dyspepsia; Female; Helicobacter pylori; Humans; Male; Pantoprazole; Peptic Ulcer

The study examined patients who had symptoms indicating peptic ulcer. Forty-five patients, 24 males and 21 females, aged between 16-60 years were included in the study. Twenty-five patients, 18 males and 7 females, were endoscoped, their ulcers located in the duodenal bulb and gastric (angulus). The ulcer sizes varied between 0.5 to 1.5 cm in diameter. Capsule-filled turmeric was given orally in the dose of 2 capsules (300 mg each) five times daily, one half to an hour before meals, at 16.00 hours and at bedtime continuously. The result after 4 weeks of treatment showed that ulcers were absent in 48% or 12 cases (DU 9 and GU 3). Eighteen cases (DU 13 and GU 5) had absence of ulcer after 8 weeks of treatment. Nineteen cases (76%) (DU 14 and GU 5) did not have ulcers after 12 weeks of treatment. The rest, 20 cases were not found to have ulcers and some were not endoscoped. They appeared to have erosions, gastritis and dyspepsia. They received turmeric capsules for 4 weeks of treatment. The abdominal pain and discomfort satisfactorily subsided in the first and second week. They could take normal foods instead of soft meals. Blood chemistry and hematology of all 54 patients had no significant changes in hematological system, liver and renal functions both before and after treatment.

Topics: Adolescent; Adult; Curcuma; Female; Humans; Male; Middle Aged; Peptic Ulcer; Phytotherapy; Plant Preparations; Thailand

Antiulcer potency and inhibitory effects on Helicobacter pylori of structurally defined low molecular weight modified pectin from turmeric (MTrPP) has been previously demonstrated by us. Given that ulcer is a disorder characterized by inflammatory responses leading to initiation, aggravation and perpetuation of disease conditions, the present study aims to understand the possible anti-inflammatory mechanisms through which MTrPP delivered antiulcer effects. Rats triggered with early phase gastric inflammation (LPS) followed by ulcer induction (swim-stress) were pretreated with MTrPP (150 mg/kg b.w.) for 14 days. Inflammation and ulcer-specific markers were screened to assess the protective effects. MTrPP offered up to 91% protection by limiting the production of pro-inflammatory factors (TNF-α, IL-8, NF-κB) and by the tight differential regulation of cyclooxygenase (COX-1, 2), mitogen-activated-protein-kinase (p-p38, p-ERK-1/2) and matrix metalloproteinase (pro-MMP-9). MTrPP showed modulatory effects through inhibition of galectin-3, oxidative stress, H

Topics: Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents; Curcuma; Helicobacter Infections; Helicobacter pylori; Interleukin-10; Male; Pectins; Peptic Ulcer; Rats; Rats, Wistar