Panahi Yunes, Saadat Alireza, Beiraghdar Fatemeh, Sahebkar Amirhossein
Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Phytother Res. 2014 Oct;28(10):1461-7. doi: 10.1002/ptr.5149. Epub 2014 Mar 19.
Curcuminoids are bioactive polyphenolics with potent antiinflammatory properties. Although several lines of in vitro and preclinical evidence suggest potent anticancer effects of curcuminoids, clinical findings have not been conclusive. The present randomized double-blind placebo-controlled trial aimed to evaluate the efficacy of curcuminoids as adjuvant therapy in cancer patients. Eighty subjects with solid tumors who were under standard chemotherapy regimens were randomly assigned to a bioavailability-boosted curcuminoids preparation (180 mg/day; n = 40) or matched placebo (n = 40) for a period of 8 weeks. Efficacy measures were changes in the health-related quality of life (QoL) score (evaluated using the University of Washington index) and serum levels of a panel of mediators implicated in systemic inflammation including interleukins 6 (IL-6) and 8 (IL-8), TNF-α, transforming growth factor-β (TGFβ), high-sensitivity C-reactive protein (hs-CRP), calcitonin gene-related peptide (CGRP), substance P and monocyte chemotactic protein-1 (MCP-1). Curcuminoid supplementation was associated with a significantly greater improvement in QoL compared with placebo (p < 0.001). Consistently, the magnitude of reductions in TNF-α (p < 0.001), TGFβ (p < 0.001), IL-6 (p = 0.061), substance P (p = 0.005), hs-CRP (p < 0.001), CGRP (p < 0.001) and MCP-1 (p < 0.001) were all significantly greater in the curcuminoids versus placebo group. In contrast, the extent of reduction in serum IL-8 was significantly greater with placebo versus curcuminoids (p = 0.012). Quality of life variations were associated with changes in serum TGFβ levels in both correlation and regression analyses. Adjuvant therapy with a bioavailable curcuminoid preparation can significantly improve QoL and suppress systemic inflammation in patients with solid tumors who are under treatment with standard chemotherapy protocols.
姜黄素类化合物是具有强大抗炎特性的生物活性多酚类物质。尽管多项体外和临床前证据表明姜黄素类化合物具有强大的抗癌作用,但临床研究结果尚无定论。本随机双盲安慰剂对照试验旨在评估姜黄素类化合物作为癌症患者辅助治疗的疗效。80例接受标准化疗方案的实体瘤患者被随机分为生物利用度提高的姜黄素类化合物制剂组(180毫克/天;n = 40)或匹配的安慰剂组(n = 40),为期8周。疗效指标包括健康相关生活质量(QoL)评分的变化(使用华盛顿大学指数评估)以及一组与全身炎症相关的介质的血清水平,这些介质包括白细胞介素6(IL - 6)、白细胞介素8(IL - 8)、肿瘤坏死因子 - α(TNF - α)、转化生长因子 - β(TGFβ)、高敏C反应蛋白(hs - CRP)、降钙素基因相关肽(CGRP)、P物质和单核细胞趋化蛋白 - 1(MCP - 1)。与安慰剂相比,补充姜黄素类化合物与QoL的显著更大改善相关(p < 0.001)。同样,姜黄素类化合物组中TNF - α(p < 0.001)、TGFβ(p < 0.001)、IL - 6(p = 0.061)、P物质(p = 0.005)、hs - CRP(p < 0.001)、CGRP(p < 0.00)和MCP - 1(p < 0.001)的降低幅度均显著大于安慰剂组。相比之下,安慰剂组血清IL - 8的降低程度显著大于姜黄素类化合物组(p = 0.012)。在相关性和回归分析中,生活质量变化均与血清TGFβ水平的变化相关。对于接受标准化疗方案治疗的实体瘤患者,使用生物可利用的姜黄素类化合物制剂进行辅助治疗可显著改善QoL并抑制全身炎症。