Ramessar Nina, Borad Abhilasha, Schlesinger Naomi
Indiana University, School of Medicine, Fort Wayne, IN, USA.
Rutgers University, Robert Wood Johnson Medical School (RWJMS), New Brunswick, NJ, USA.
Lupus. 2023 Apr;32(5):644-657. doi: 10.1177/09612033231161961. Epub 2023 Mar 3.
Curcumin is the active ingredient in the curry spice turmeric. It has anti-inflammatory properties due to the inhibition of transcription factors and inflammatory mediators such as nuclear factor- (NF-), cyclooxygenase-2 (COX2), lipoxygenase (LOX), tumor necrosis factoralpha (TNF-alpha), and interleukin-1 (IL-1) and 6 (IL-6). This review examines the literature regarding the efficacy of curcumin on systemic lupus erythematosus disease activity.
A search was conducted following guidelines in the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) using the PubMed, Google Scholar, Scopus, and MEDLINE electronic databases to retrieve relevant studies assessing the impact of curcumin supplementation on SLE.
The initial search yielded three double-blind, placebo-controlled, randomized clinical trials, three human in vitro studies, and seven mouse-model studies. In human trials, curcumin decreased 24-h and spot proteinuria, but the trials were small, ranging from 14 to 39 patients, with varied curcumin doses and different study durations ranging from 4 to 12 weeks. There was no change in C3, dsDNA, or the Systemic Lupus Erythematosus Disease Activity (SLEDAI) scores even in the longer trials. The mouse-model trials yielded more data. NF- activation was suppressed along with inducible nitric oxide synthase (NOS) species expression when 1 mg/kg/day of curcumin was administered for 14 weeks, leading to significant decreases in dsDNA, proteinuria, renal inflammation, and IgG subclasses. Another study suggested that curcumin reduced B cell-activating factor (BAFF) when used for up to 8 weeks at 50 mg/kg/day. A reduction in pro-inflammatory Th1 and Th17 percentages, IL-6 and anti-nuclear antibody (ANA) levels were reported. The doses used in the murine models were much higher than those used in human trials, with 12.5 mg-200 mg/kg/day used for over 16 weeks; highlighting that the optimal time for an immunological effect to be observed may require 12-16 weeks of curcumin use.
Despite the wide use of curcumin in everyday life, its molecular and anti-inflammatory use has only been partially explored. Current data show a potential benefit on disease activity. Still, no uniform dose can be advised because long-duration, large-scale randomized trials using defined dosing are needed in different subsets of SLE, including lupus nephritis patients.
姜黄素是咖喱香料姜黄中的活性成分。它具有抗炎特性，可抑制转录因子和炎症介质，如核因子-κB（NF-κB）、环氧合酶-2（COX2）、脂氧合酶（LOX）、肿瘤坏死因子-α（TNF-α）、白细胞介素-1（IL-1）和白细胞介素-6（IL-6）。本综述研究了关于姜黄素对系统性红斑狼疮疾病活动疗效的文献。
按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行检索，使用PubMed、谷歌学术、Scopus和MEDLINE电子数据库检索评估补充姜黄素对系统性红斑狼疮影响的相关研究。
初步检索得到三项双盲、安慰剂对照、随机临床试验、三项人体体外研究和七项小鼠模型研究。在人体试验中，姜黄素可降低24小时尿蛋白和随机尿蛋白，但试验规模较小，患者人数从14至39人不等，姜黄素剂量各异，研究持续时间从4至12周不等。即使在较长时间的试验中，C3、双链DNA或系统性红斑狼疮疾病活动指数（SLEDAI）评分也没有变化。小鼠模型试验产生了更多数据。当以1毫克/千克/天的剂量给予姜黄素14周时，NF-κB激活以及诱导型一氧化氮合酶（NOS）种类表达受到抑制，导致双链DNA、蛋白尿、肾脏炎症和IgG亚类显著降低。另一项研究表明，当以50毫克/千克/天的剂量使用姜黄素长达8周时，可降低B细胞活化因子（BAFF）。据报道，促炎Th1和Th17百分比、IL-6和抗核抗体（ANA）水平降低。小鼠模型中使用的剂量远高于人体试验中使用的剂量，使用12.5毫克至200毫克/千克/天的剂量超过16周；这突出表明，观察到免疫效果的最佳时间可能需要使用姜黄素12至16周。
尽管姜黄素在日常生活中广泛使用，但其分子和抗炎用途仅得到部分探索。目前的数据显示对疾病活动有潜在益处。然而，由于需要在包括狼疮性肾炎患者在内的不同系统性红斑狼疮亚组中进行使用明确剂量的长期、大规模随机试验，因此无法给出统一的剂量建议。
