تأثیر بالینی کورکومین در بیماران مبتلا به آرتریت روماتوئید

نوع مقاله : Original Article(s)

نویسندگان

1 رزیدنت، گروه داخلی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشیار، گروه داخلی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 کارشناس ارشد علوم بهداشتی در تغذیه، مرکز تحقیقات تغذیه و امنیت غذایی، گروه تغذیه جامعه، دانشکده‌ی تغذیه، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

4 دانشیار، مرکز تحقیقات تغذیه و امنیت غذایی، گروه تغذیه جامعه، دانشکده‌ی تغذیه، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

5 دکتری تخصصی بیوتکنولوژی، گروه بیوتکنولوژی، دانشکده‌ی داروسازی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

6 استادیار، مرکز تحقیقات تغذیه و امنیت غذایی، گروه تغذیه جامعه، دانشکده‌ی تغذیه، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقاله پژوهشی




مقدمه: آرتریت روماتوئید، یک بیماری التهابی مزمن است که می‌تواند منجر به آسیب پیشرونده‌ی مفصل، درد و از بین رفتن عملکرد آن شود و برای آن درمان قطعی وجود ندارد. کورکومین، دارای خواص ضدالتهابی، آنتی‌اکسیدانی و ضد درد است. هدف از این مطالعه، بررسی اثر مکمل یاری با کورکومین پیپرین (فرم دارای حلالیت بالای کورکومین) بر روی علائم بالینی بیماری آرتریت روماتوئید بود.
روش‌ها: مطالعه‌ی حاضر، از نوع کارآزمایی بالینی تصادفی‌سازی شده‌ی دوسوکور بود که بر روی 54 بیمار بالغ 20 تا 65 ساله که به بیماری آتریت روماتوئید مبتلا بودند انجام شد. بیماران به صورت تصادفی به دو گروه تقسیم شدند و افراد گروه مداخله به مدت 3 ماه روزانه یک کپسول کورکومین پیپرین حاوی 500 میلی‌‌گرم کورکومین و گروه شاهد روزانه یک عدد کپسول دارونما حاوی 500 میلی‌گرم مالتودکسترین دریافت کردند.
یافته‌ها: تعداد 52 نفر مطالعه را تکمیل کردند. میانگین سنی افراد شرکت‌کننده در گروه مداخله 6/1 ± 53/5 و در گروه شاهد، 8/1 ± 54/6 بود که از لحاظ آماری معنی‌دار نبود. در انتهای مطالعه شاخص فعالیت بیماری (DAS-28) در هر دو گروه مداخله و شاهد، نسبت به ابتدای مطالعه به صورت معنی‌داری کاهش یافت. این کاهش در گروه مداخله به طور معنی‌داری بیشتر از گروه شاهد بود.
نتیجه‌گیری: مصرف مکمل کورکومین پیپرین باعث بهبود معنی‌دار شاخص‌های بالینی بیماران مبتلا به آرتریت روماتوئید گردید.

کلیدواژه‌ها


عنوان مقاله [English]

The Effect of Curcumin Supplementation on Clinical Factors in Patients with Rheumatoid Arthritis

نویسندگان [English]

  • Ashkan Akbari 1
  • Peyman Mottaghi 2
  • Mansour Salesi 2
  • Mehrnaz Shojaei 3
  • Gholamreza Askari 4
  • Amirhossein Sahebkar 5
  • Mohammad Bagherniya 6
1 Resident, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Associate Professor, Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 MSc, Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
4 Associate Professor, Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
5 PhD, Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
6 Assistant Professor, Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Rheumatoid arthritis is a chronic inflammatory disease that leads to progressive joint damage, pain and loss of function, which has no known therapy so far. Curcumin has anti-inflammatory, antioxidant and analgesic properties. The aim of this study was to investigate the effect of supplementation with curcumin piperine (a highly soluble form of curcumin) on the clinical symptoms of rheumatoid arthritis.
Methods: The present study was a double-blind randomized controlled trial study, which was conducted on 54 adult patients aged 20 to 65 years who were suffering from rheumatoid arthritis. The patients were randomly divided into two groups; (i) intervention group received a curcumin piperine capsule containing 500 mg curcumin, and (ii) control group received a placebo capsule containing 500 mg maltodextrin daily for three months.
Findings: A total of 52 samples completed the study. The average age of participants in the intervention group was 53.5 ± 6.1 and in the control group was 54.6 ± 8.1, which was not statistically significant. The erythrocyte sedimentation rate (ESR) and finally the disease activity index (DAS-28) decreased significantly in both groups at the end of the study compared to the beginning of the study. But this reduction in the intervention group was significantly higher than the control group (erythrocyte sedimentation rate and disease activity index).
Conclusion: Use of curcumin - piperine supplement significantly improved the clinical indicators of patients with rheumatoid arthritis.

کلیدواژه‌ها [English]

  • Anti-inflammatory agents
  • Blood sedimentation
  • Curcumin
  • Pain measurement
  • Rheumatoid arthritis
  1. Kahlenberg JM, Fox DA. Advances in the medical treatment of rheumatoid arthritis. Hand Clin 2011; 27(1): 11-20.
  2. Gavrilă B, Ciofu C, Stoica V. Biomarkers in rheumatoid arthritis, what is new? J Med Life 2016; 9(2): 144-8.
  3. Rudan I, Sidhu S, Papana A, Meng SJ, Xin-Wei Y, Wang W, et al. Prevalence of rheumatoid arthritis in low–and middle–income countries: A systematic review and analysis. J Glob Health 2015; 5(1): 010409
  4. Rezaei F, Doost HTN, Molavi H, Abedi MR, Karimifar M. Depression and pain in patients with rheumatoid arthritis: Mediating role of illness perception. The Egyptian Rheumatologist 2014; 36(2): 57-64.
  5. Hunter TM, Boytsov NN, Zhang X, Schroeder K, Michaud K, Araujo AB. Prevalence of rheumatoid arthritis in the United States adult population in healthcare claims databases, 2004-2014. Rheumatol Int 2017; 37(9): 1551-7.
  6. Jamshidi A-R, Banihashemi AT, Roknsharifi S, Akhlaghi M, Salimzadeh A, Davatchi F. Estimating the prevalence and disease characteristics of rheumatoid arthritis in Tehran: A WHO-ILAR COPCORD Study (from Iran COPCORD study, Urban Study stage 1). Med J Islam Repub Iran 2014; 28: 93.
  7. Sparks JA, Barbhaiya M, Tedeschi SK, Leatherwood CL, Tabung FK, Speyer CB, et al. Inflammatory dietary pattern and risk of developing rheumatoid arthritis in women. Clin Rheumatol 2019; 38(1): 243-250.
  8. de Oliveira RA, Fierro IM. New strategies for patenting biological medicines used in rheumatoid arthritis treatment. Expert Opin Ther Pat 2018; 28(8): 635-46.
  9. Bagherniya M, Nobili V, Blesso CN, Sahebkar A. Medicinal plants and bioactive natural compounds in the treatment of non-alcoholic fatty liver disease: A clinical review. Pharmacol Res 2018; 130 :213-240.
  10. White CM, Lee JY. The impact of turmeric or its
    curcumin extract on nonalcoholic fatty liver disease: a systematic review of clinical trials. Pharm Pract (Granada). 2019; 17(1): 1350.
  11. Leclercq IA, Farrell GC, Sempoux C, dela Peña A, Horsmans Y. Curcumin inhibits NF-κB activation and reduces the severity of experimental steatohepatitis in mice. J Hepatol 2004; 41(6):
    926-34.
  12. Wu S-J, Lin YH, Chu CC, Tsai YH, Chao JCJ. Curcumin or saikosaponin a improves hepatic antioxidant capacity and protects against CCl4-induced liver injury in rats. J Med Food 2008; 11(2): 224-9.
  13. Kuo JJ, Chang HH, Tsai TH, Lee TY. Positive effect of curcumin on inflammation and mitochondrial dysfunction in obese mice with liver steatosis. Int J Mol Med 2012; 30(3): 673-9.
  14. Thota RN, Acharya SH, Garg ML. Curcumin and/or omega-3 polyunsaturated fatty acids supplementation reduces insulin resistance and blood lipids in individuals with high risk of type 2 diabetes: a randomised controlled trial. Lipids Health Dis 2019; 18(1): 31.
  15. Poolsup N, Suksomboon N, Kurnianta PDM, Deawjaroen K. Effects of curcumin on glycemic control and lipid profile in prediabetes and type 2 diabetes mellitus: A systematic review and meta-analysis. PLoS One 2019; 14(4): e0215840.
  16. Zhang D, Huang C, Yang C, Liu RJ, Wang J, Niu J, et al. Antifibrotic effects of curcumin are associated with overexpression of cathepsins K and L in bleomycin treated mice and human fibroblasts. Respir Res 2011; 12(1): 154.
  17. Sahebkar A. Why it is necessary to translate curcumin into clinical practice for the prevention and treatment of metabolic syndrome? Biofactors 2013; 39(2): 197-208.
  18. Hewlings SJ, Kalman DS. Curcumin: a review of its’ effects on human health. Foods 2017; 6(10): 92.
  19. Henrotin Y, Priem F, Mobasheri A. Curcumin: a new paradigm and therapeutic opportunity for the treatment of osteoarthritis: curcumin for osteoarthritis management. Springerplus 2013; 2(1): 56.
  20. Daily JW, Yang M, Park S. Efficacy of turmeric extracts and curcumin for alleviating the symptoms of joint arthritis: a systematic review and meta-analysis of randomized clinical trials. J Med Food 2016; 19(8): 717-29.
  21. Al‐Karawi D, Al Mamoori DA, Tayyar Y. The role of curcumin administration in patients with major depressive disorder: mini meta‐analysis of clinical trials. Phytother Res 2016; 30(2): 175-83.
  22. Gera M, Sharma N, Ghosh M, Huynh DL, Lee SJ, Min T, et al. Nanoformulations of curcumin: an emerging paradigm for improved remedial application. Oncotarget 2017; 8(39): 66680-98.
  23. Cicero AFG, Sahebkar A, Fogacci F, Bove M, Giovannini M, Borghi C. Effects of phytosomal curcumin on anthropometric parameters, insulin resistance, cortisolemia and non-alcoholic fatty liver disease indices: a double-blind, placebo-controlled clinical trial. European journal of nutrition. Eur J Nutr 2020; 59(2): 477-83.
  24. Amalraj A, Varma K, Jacob J, Divya C, Kunnumakkara AB, Stohs SJ, et al. A novel highly bioavailable curcumin formulation improves symptoms and diagnostic indicators in rheumatoid arthritis patients: A randomized, double-blind, placebo-controlled, two-dose, three-arm, and parallel-group study. J Med Food 2017; 20(10): 1022-30.
  25. Panahi Y, Badeli R, Karami GR, Sahebkar A.
    Investigation of the efficacy of adjunctive therapy with bioavailability‐boosted curcuminoids in major depressive disorder. Phytother Res 2015; 29(1): 17-21.
  26. Esmaily H, Sahebkar A, Iranshahi M, Ganjali S, Mohammadi A, Ferns G, et al. An investigation of the effects of curcumin on anxiety and depression in obese individuals: A randomized controlled trial. Chin J Integr Med 2015; 21(5): 332-8.
  27. Rahimnia AR, Panahi Y, Alishiri G, Sharafi M, Sahebkar A. Impact of supplementation with curcuminoids on systemic inflammation in patients with knee osteoarthritis: findings from a randomized double-blind placebo-controlled trial. Drug Res (Stuttg) 2015; 65(10): 521-5.
  28. Saberi-Karimian M, Keshvari M, Ghayour-Mobarhan M, Salehizadeh L, Rahmani S, Behnam B, et al. Effects of curcuminoids on inflammatory status in patients with non-alcoholic fatty liver disease: A randomized controlled trial. Complement Ther Med 2020; 49: 102322.
  29. Bagherniya M, Darand M, Askari G, Guest PC, Sathyapalan T, Sahebkar A. The clinical use of curcumin for the treatment of rheumatoid arthritis: a systematic review of clinical trials. Adv Exp Med Biol 2021; 1291: 251-63.
  30. Javadi M, Khadem Haghighian H, Goodarzy S, Abbasi M, Nassiri‐Asl M. Effect of curcumin nanomicelle on the clinical symptoms of patients with rheumatoid arthritis: A randomized, double‐blind, controlled trial. Int J Rheum Dis 2019; 22(10): 1857-62.