Koroljević Zrinka Djukić, Jordan Katarina, Ivković Jakov, Bender Darija Vranešić, Perić Porin
Specijalna Bolnica Sveta Katarina, Branimirova 71E, 10000, Zagreb, Hrvatska, Croatia.
Opća Bolnica Zadar, Bože Peričića 5, 23000, Zadar, Croatia.
Rheumatol Int. 2023 Apr;43(4):589-616. doi: 10.1007/s00296-022-05244-8. Epub 2022 Nov 17.
Osteoarthritis (OA) is nowadays the most common musculoskeletal progressive condition. In recent decades, incidence and prevalence of OA have increased significantly. It is estimated that the prevalence of OA among adults older than 60 is 12%, affecting about 240 million people globally. The cause has not been fully elucidated, and therefore, there is no cure at the moment. It is a multifactorial degenerative disease with an inflammatory component mediated by numerous proinflammatory and anti-inflammatory cytokines, chemokines, and growth factors. OA is not yet fully understood; therefore, therapeutic interventions are aimed primarily at reducing symptoms and slowing the progression of joint destruction. Of the therapeutic options available, the most often prescribed are nonsteroidal antirheumatic drugs, which have numerous side effects. Therefore, a need for a safe, effective substance is differentiated, which will be used in adjuvant treatment, but also in disease prevention, and which will comparatively have no or fewer side effects. One such substance is curcumin, a hydrophobic polyphenol that forms the active component of the rhizome of the Curcuma longa plant. Several studies have shown its potent antioxidant and anti-inflammatory effect, non-toxicity, and safety at high daily doses. In addition to blocking chondrocyte apoptosis, curcumin also blocks the expression of cyclooxygenase, prostaglandin E-2 and proinflammatory cytokines in chondrocytes, potentially alleviating symptomatic diseases. Although there are significant variations in quality, methodology, and research results conducted on curcumin efficiency in OA treatment, curcumin is primarily recommended as systematic short-term and medium-term adjuvant therapy that reduces inflammatory biochemical factors. Reducing inflammation leads to better pain regulation and improved joint function, significantly reducing standard prescribed doses of drugs. The most researched daily doses of curcumin intake are 1000-2000 mg/day, which would also be the doses that most of the authors recommend. Further research is needed to determine the preventive role of curcumin in the pathogenesis of OA, the effects of long-term usage of curcumin in preventive purposes and treatment of osteoarthritis, as well as to determine optimal therapeutic dosages.
骨关节炎(OA)是当今最常见的肌肉骨骼渐进性疾病。近几十年来,OA的发病率和患病率显著上升。据估计,60岁以上成年人中OA的患病率为12%,全球约有2.4亿人受其影响。其病因尚未完全阐明,因此目前尚无治愈方法。它是一种多因素退行性疾病,具有由多种促炎和抗炎细胞因子、趋化因子及生长因子介导的炎症成分。OA尚未被完全了解;因此,治疗干预主要旨在减轻症状并减缓关节破坏的进展。在现有的治疗选择中,最常开具的是非甾体类抗风湿药物,这类药物有许多副作用。因此,人们对一种安全、有效的物质有了需求,这种物质将用于辅助治疗,也用于疾病预防,并且相对而言副作用较少或没有副作用。姜黄素就是这样一种物质,它是一种疏水性多酚,是姜黄植物根茎的活性成分。多项研究表明了其强大的抗氧化和抗炎作用、无毒性以及高日剂量下的安全性。除了阻止软骨细胞凋亡外,姜黄素还能阻止软骨细胞中环氧合酶、前列腺素E-2和促炎细胞因子的表达,可能缓解症状性疾病。尽管关于姜黄素治疗OA疗效的研究在质量、方法和研究结果方面存在显著差异,但姜黄素主要被推荐作为减少炎症生化因子的系统性短期和中期辅助治疗。减轻炎症可导致更好的疼痛调节和改善关节功能,显著减少标准规定的药物剂量。研究最多的姜黄素每日摄入量为1000 - 2000毫克/天,这也是大多数作者推荐的剂量。需要进一步研究以确定姜黄素在OA发病机制中的预防作用、长期使用姜黄素用于预防目的和治疗骨关节炎的效果,以及确定最佳治疗剂量。