curcumin and Vitiligo

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

Vitiligo is an autoimmune and acquired disease characterized by the destruction of epidermal melanocytes leading to depigmentation of the skin. Although vitiligo is a common disease, there is not a definite cure and conventional therapies can lead to serious adverse effects. Turmeric has been widely studied for its anti-inflammatory, antioxidant, and anti-cell proliferation, while it is a cost-benefit and available treatment for a variety of diseases.. The aim of this study was to evaluate the efficacy of topical turmeric cream on vitiligo's lesion appearance including size and repigmentation.. Following the screening, 30 patients were enrolled according to inclusion criteria. The patients received training to apply turmeric and placebo cream at the specified side of their body twice a day for 4 months. Patients were evaluated at the baseline and at monthly intervals to access possible side effects. Lesion size, vitiligo area scoring index (VASI), vitiligo noticeability scale (VNS), and physician global assessment (PGA) were evaluated at the baseline and after four months to compare the changes induced by turmeric and placebo cream.. Twenty-four patients completed the trial. Applying turmeric cream reduced the size of lesions and improved lesion's appearance significantly compared to the placebo group (p < 0.001), and also, patient's satisfaction score was higher following applying turmeric cream compared to placebo (p < 0.05).. Turmeric cream can be used as an alternative remedy or adjuvant therapy in mild to moderate vitiligo lesions and in those who cannot tolerate the adverse effects of conventional therapies.

Topics: Curcuma; Double-Blind Method; Emollients; Humans; Pilot Projects; Skin Pigmentation; Treatment Outcome; Vitiligo

The aim of this study was to compare the efficacy of targeted narrowband UVB phototherapy plus topical tetrahydrocurcuminoid with that of targeted narrowband UVB monotherapy for induction of repigmentation in vitiligo.. The 308-nm excimer laser and targeted narrowband UVB phototherapy have recently been shown to be effective in repigmenting vitiligo. Studies have suggested that the combination of the 308-nm excimer laser and various topical treatments is more effective than UV monotherapy in the treatment of vitiligo.. Ten subjects with focal or generalized vitiligo were enrolled in this study. Two similar lesions were treated with either targeted narrowband UVB plus topical tetrahydrocurcuminoid cream or targeted UVB alone. The UV treatments were carried out twice a week for 12 weeks. The degree of repigmentation, documented by monthly digital photography, was assessed by a blinded dermatologist.. On completion of the study, statistically significant repigmentation, compared with baseline, occurred in both treatment groups. The overall degree of repigmentation was slightly better in the combination group at 8 and 12 weeks (p = 0.078 and 0.158 respectively). Adverse effects were minor and well tolerated.. Targeted narrowband UVB phototherapy plus topical tetrahydrocurcuminoid cream was slightly more effective than targeted narrowband UVB monotherapy for vitiligo located in UV-sensitive areas. However, the differences in degrees of repigmentation did not reach statistically significant levels.

Topics: Administration, Cutaneous; Adult; Aged; Combined Modality Therapy; Curcumin; Double-Blind Method; Emollients; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prospective Studies; Radiation Dosage; Reference Values; Severity of Illness Index; Skin Pigmentation; Statistics, Nonparametric; Treatment Outcome; Ultraviolet Therapy; Vitiligo

Topics: Curcumin; Humans; Male; PUVA Therapy; Saudi Arabia; Steroids; Vitiligo

Vitiligo is a common disease of unknown cause that produces disfiguring white patches of depigmentation that can be treated using various new and experimental therapies, such as narrow-band ultraviolet B (NB-UVB) microphototherapy, NB-UVB excimer laser, and monochromatic excimer light. Medical treatments include topical corticosteroids and other topical treatments, such as antioxidants, tacrolimus and pimecrolimus, prostaglandin E, and vitamin D derivatives (Lotti, Berti, & Moretti, 2009). The goal of treating vitiligo is to make it less noticeable either by restoring lost pigment or by eliminating remaining pigment. Functional foods and healthy diet, with nutrients, form a variety of sources, could be considered an integral part, as well as helpful, of vitiligo's medical therapy.

Topics: Curcumin; Dietary Supplements; Food, Fortified; Ginkgo biloba; Humans; Khellin; Oxidative Stress; Polypodium; Reactive Oxygen Species; Tea; Vitiligo

Oxidative stress has been suggested as the initial pathogenetic event in melanocyte degeneration in vitiligo. Our previous results indicate that keratinocytes from perilesional skin show the features of damaged cells. In the present study, biopsies were taken from the perilesional skin of 12 patients suffering from nonsegmental vitiligo. The intracellular pathways involved in keratinocyte damage and apoptosis and the antioxidant protection of curcumin and capsaicin in these cells were investigated. In keratinocytes from perilesional vitiligo skin, we observed high levels of activated p38, NF-kB p65 subunit, p53, and Smac/DIABLO proteins. In contrast, low levels of ERK phosphorylation were present. To investigate the relationship between these pathways, we used specific inhibitors and evaluated the alteration of each pathway. For the first time, our study demonstrates the pivotal role of p38 MAP kinase as an upstream signal of perilesional keratinocyte damage, and the important contribution of p38 and NF-kB on p53 accumulation. Curcumin and capsaicin also increase ERK phosphorylation, thus inhibiting apoptosis. Moreover, pretreatment with such natural antioxidants inhibited caspase activation, increased total antioxidant capacity, repressed intracellular ROS generation and lipid peroxidation, and improved mitochondrial activity. These results suggest that antioxidants might represent an alternative approach to protect against vitiligo progression.

Topics: Antioxidants; Apoptosis; Apoptosis Regulatory Proteins; Capsaicin; Cells, Cultured; Curcumin; Humans; Intracellular Signaling Peptides and Proteins; Keratinocytes; MAP Kinase Signaling System; Melanocytes; Mitochondria; Mitochondrial Proteins; NF-kappa B; Oxidative Stress; p38 Mitogen-Activated Protein Kinases; Phosphorylation; Reactive Oxygen Species; Skin; Tumor Suppressor Protein p53; Vitiligo

Oxidative stress is widely believed to be a contributing factor in vitiligo pathogenesis. To explore mechanisms by which epidermis responds to mounting oxidative stress, we investigated the involvement of phase II detoxification genes in vitiligo. Phase II detoxification pathways have recently been identified as being important in the regulation of epidermal skin homeostasis. In this study we show that the key transcription factor nuclear factor E2-related factor 2 (Nrf2) and the downstream genes NAD(P)H:quinone oxidase-1 (NQO-1), γ-glutamyl cystine ligase catalytic subunit (GCLC), and γ-glutamyl cystine ligase modifying subunit (GCLM) are upregulated in the lesional epidermal skin of subjects with vitiligo vulgaris. The differences between lesional and nonlesional skin were further investigated by studying the induced expression of Nrf2-dependent transcripts in skin punch biopsies using curcumin and santalol. Surprisingly, nonlesional skin showed induction of all transcripts while a similar effect was not observed for the skin punches from the lesional skin. The use of curcumin and santalol on epidermal cells showed that keratinocytes were more susceptible to apoptosis, whereas melanocytes induced phase II genes under the same concentrations with negligible apoptosis. Our studies provide new insights into the role of phase II detoxification pathway in maintaining skin homeostasis and sustaining redox balance in vitiligo patients.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Biopsy; Curcumin; Epidermis; Glutamate-Cysteine Ligase; Homeostasis; Humans; Keratinocytes; Melanocytes; Metabolic Detoxication, Phase II; NAD(P)H Dehydrogenase (Quinone); NF-E2-Related Factor 2; Oxidative Stress; Polycyclic Sesquiterpenes; Sesquiterpenes; Transcriptional Activation; Up-Regulation; Vitiligo