Nutrition for Inflammation and Arthritis
The management of osteoarthritis represents a real challenge. This complex and multi-factorial disease evolves over decades and requires not only the alleviation of symptoms, i. Nutraceuticals are good candidates for the management of OA due to their safety profile and potential efficacy.
However, they are not part of the treatment guidelines and published recommendations. Curcumin is the yellow pigment isolated from the rhizomes of Curcuma longacommonly known as turmeric.
Curcumin is a highly pleiotropic molecule with Behandlung von Osteoarthritis in Murom excellent safety profile. Strong molecular evidence has been published for its potency to target multiple inflammatory diseases. Behandlung von Osteoarthritis in Murom, naturally occurring curcumin cannot achieve its optimum therapeutic outcomes due to its low solubility and poor Behandlung von Osteoarthritis in Murom.
Nevertheless, curcumin presents great potential for treating OA and has been categorized as Behandlung von Osteoarthritis in Murom preclinical evidence of efficacy. This review aimed at gathering most of the available information to document the potential efficacy of curcumin based on the results obtained in in vitro models of cartilage and osteoarthritis and in other diseases.
The management of osteoarthritis OA is a challenge. As a multifactorial disease evolving over decades, OA is one of the most disabling rheumatic diseases. In addition, no cure has been discovered to date. There is growing interest in the medical management of OA.
However, this area requires new therapeutic strategies and approaches to deal with OA in a rapidly growing elderly population. It defines foods or food-derived products that provide health and medical benefits, including prevention and treatment Ameye and Chee ; Henrotin et al. The benefit of such products comes not only from their safety and efficacy but also by the fact that they are, by definition, and by legislation, devoid of adverse effects.
Curcumin is the yellow pigment isolated from the rhizomes of Curcuma longacommonly known as turmeric Henrotin et al. Curcumin exists as 2 tautomeric forms, keto and enol. The enol form is the most energetically stable in the solid phase or in solution. In solution, keto-enol tautomers are present. The latest being both Behandlung von Osteoarthritis in Murom anti-oxidants Masuda et al.
Strong molecular evidence has been published to support its potency for targeting multiple inflammatory diseases. However, naturally occurring curcumin cannot achieve its optimum therapeutic outcomes in vivo due to Behandlung von Osteoarthritis in Murom low solubility and poor gastrointestinal absorption and systemic bioavailability.
Based on our previous review Henrotin et al. In addition, our narrative review Henrotin et al. The aim of the present review is to summarize most of the latest information regarding the therapeutic effects of curcumin in OA.
In addition, special attention was given to the pharmacokinetic issues associated with curcumin. Eleven trials used specifically turmeric extract. Taken together, it represented a total of 86 different clinical trials.
Ten of them aimed at studying various new formulations or curcumin pharmacokinetics. Finally the last eleven trials dealt with other conditions such as asthma, cardiovascular diseases or effect in healthy volunteers. Two clinical trials Behandlung von Osteoarthritis in Murom with OA and curcumin. The first one ClinicalTrials.
This study was completed but no data have been available yet. Its efficacy was evaluated on pain using a visual analog scale after 15 days of treatment. This study was completed but the data not yet divulgated.
The study is sponsored by University of California at Los Angeles. It is a randomized, placebo-controlled crossover study in which 40 subjects will receive a total of 4 g of curcumin per day capsule form, precise composition not disclosed and then switch to placebo.
By completion of the study, all 40 subjects will have taken curcumin and placebo for 4 months each. Subjects will have blood tests, complete questionnaires, and be seen by the study doctor. At the present time status of this study is unknown and it looks like the original completion deadline will not be met and a larger and more comprehensive clinical trial may be necessary.
Behandlung von Osteoarthritis in Murom, when the study is completed it will be interesting to see if curcumin has provided any benefits for RA patients as this information will be useful for the design of future clinical trials of curcumin in OA. These clinical trials illustrate the ongoing interest in curcumin and its applicability to a wide range of diseases.
Curcumin has been used for centuries in traditional Chinese and Ayurvedic medicine for its anti-inflammatory Behandlung von Osteoarthritis in Murom Goel et al. Turmeric has at least 53 different names in Sanskrit, each one referring to specific properties, including jawarantika, which destroys fever, mehagni, killer of fat, or rabhangavasa, which dissolve fat Aggarwal Over the last few decades many scientific and clinical studies have focused on the potential of curcumin for treating various pathological conditions.
Curcumin was investigated mainly for its anti-inflammatory and anti-oxidant potency. Oxidative damage and inflammation are now known to be a root cause of cancer and neurodegenerative diseases Basnet and Skalko-Basnet Recently, these therapeutic effects have been reviewed in depth by Gupta et al.
Gupta et al. Herein, a particular attention was paid to the potential therapeutic effects of curcumin on OA. Obesity is a major risk factor for type 2 diabetes, atherosclerosis, cancer and other chronic diseases. Metabolic syndrome is defined as obesity, type 2 diabetes, hypertension and dyslipidemia Aggarwal All these pathologies are closely linked to Behandlung von Osteoarthritis in Murom resistance.
This condition is closely related to OA. Indeed, OA has been shown to be induced, at least in part, by metabolic syndrome Velasquez and Katz In addition, inflammation has been strictly linked to all these conditions see Aggarwal for review. Curcumin has been extensively studied as a treatment of obesity and obesity-related metabolic diseases Aggarwal Curcumin was shown to directly interact with adipocytes, pancreatic cells, hepatic stellate cells, macrophages and muscle cells.
Curcumin has been shown to reverse insulin-resistance, hyperlipidemia, hyperglycemia and other symptoms linked to obesity through the interaction with various key mediators, most of them are also involved in OA pathophysiology. Thus curcumin acts directly and strongly in mechanisms that sustain obesity and inflammation.
In addition, most of these signaling intermediates and mediators also play key role in OA pathophysiology. Many evidences support the use of curcumin in OA Shen et al. Most of the Behandlung von Osteoarthritis in Murom effects observed and published for curcumin in chondrocytes and OA between and were reported in our previous narrative review Behandlung von Osteoarthritis in Murom et al.
The following section will present the most recent data reported for curcumin and OA. The anti-inflammatory property of curcumin has been known for centuries. It has been investigated and explained by studies showing how curcumin acts on inflammatory pathways.
The effects of curcumin have been documented through its impact on cell signaling. Another study has described its effect on signaling and its inhibitory potency in chondrocytes in agarose constructs Chowdhury et al.
In this culture model, curcumin 0. This in vitro study demonstrated no toxic effect of curcumin on cell viability.
Furthermore, it was able to produce an anti-inflammatory effect by inhibiting the pro-inflammatory mediators, i. In bovine chondrocytes in monolayer, the biological activity of indomethacin, celecoxib and curcumin have been compared.
Interestingly, curcumin but not non-steroidal anti-inflammatory drugs inhibited NO production. The anti-inflammatory potency of curcumin was also demonstrated in another connective tissue cell type. The shared lineage and phenotypic similarities between cartilage and tendon cells suggest that curcumin would have similar effects on these connective tissues. This effect was shown in a study of a combination treatment with curcumin and resveratrol.
The combination treatment with resveratrol produced a synergistic effect. The previously mentioned work with highly bioavailable curcumin Mathy-Hartert et al. In addition, curcumin 0. Anti-catabolic effects were also demonstrated in tenocytes Buhrmann et al.
Thus curcumin might be able to reverse the imbalance between anabolic and catabolic factors that occur in OA joint tissues by reducing the catabolic part.
By this way, curcumin could prevent cartilage degradation and promote the accumulation Behandlung von Osteoarthritis in Murom the extracellular matrix of newly synthesized matrix components like aggrecan. The effects of curcumin have also been studied in adult mesenchymal stem cells. All together these results support the potential structural and functional effects that curcumin could exert on joint tissues in OA.
Another important feature of curcumin in OA is its effect on cell survival. Indeed, it was not only proven to be safe for chondrocytes Mathy-Hartert et al. Only a few clinical studies have been published with curcumin. One study tested the clinical Behandlung von Osteoarthritis in Murom of a herbomineral formulation containing a component rich in curcumin in subjects with OA 42 patients in a one-month randomized, double-blind, placebo-controlled, cross-over study Kulkarni et al.
Treated group reported a positive effect on pain and mobility. One hundred OA patients were included in this study. They fulfilled the criteria for primary knee OA grade 1 or 2. The improvement of physical function was also noteworthy. Finally, the markers of inflammation were significantly decreased in the treatment Behandlung von Osteoarthritis in Murom between enrollment and after 8 months of treatment.
Curcumin was tested in patients suffering rheumatoid arthritis Chandran and Goel In addition to be safe and not related to any adverse events, curcumin mg was the Behandlung von Osteoarthritis in Murom effective to improve disease activity score DAS and American College of Rheumatology ACR score. Curcumin was administered alone or in combination with diclofenac sodium 50 mg. Despite the paucity of published clinical data on curcumin and the overall poor quality of the trials, there is scope for promising future studies on curcumin in OA.