Division of Nephrology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Graduate Program in Biological Sciences - Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; Graduate Program in Nutrition Sciences, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.
Clin Nutr ESPEN. 2024 Feb;59:96-106. doi: 10.1016/j.clnesp.2023.11.015. Epub 2023 Nov 28.
BACKGROUND & AIMS: Turmeric (a source of curcumin) is an excellent food to modulate oxidative stress, inflammation, and gut dysbiosis in patients with chronic kidney disease (CKD). However, no studies report the benefits of curcumin in patients undergoing peritoneal dialysis (PD). This study aims to evaluate the effects of curcuminoid supplementation on oxidative stress, inflammatory markers, and uremic toxins originating from gut microbiota in patients with CKD undergoing PD.
This longitudinal, randomized, single-blind, placebo-controlled trial evaluated 48 patients who were randomized into two groups: Curcumin (three capsules of 500 mg of Curcuma longa extract, with 98.42 % total curcuminoids) or placebo (three capsules of 500 mg of starch) for twelve weeks. In the peripheral blood mononuclear cells (PBMCs), the transcriptional expression levels of Nrf2, HOX-1 and NF-κB were evaluated by quantitative real-time PCR. Oxidative stress was evaluated by malondialdehyde (MDA) and total Thiol (T-SH). TNF-α and IL-6 plasma levels were measured by ELISA. P-cresyl sulphate plasma level, a uremic toxin, was evaluated by high-performance liquid chromatography (HPLC) with fluorescent detection.
Twenty-four patients finished the study: 10 in the curcumin group (57.5 ± 11.6 years) and 14 in the placebo group (56.5 ± 10.0 years). The plasma levels of MDA were reduced after 12 weeks in the curcumin group (p = 0.01), while the placebo group remained unchanged. However, regarding the difference between the groups at the endpoint, no change was observed in MDA. Still, there was a trend to reduce the p-CS plasma levels in the curcumin group compared to the placebo group (p = 0.07). Likewise, the concentrations of protein thiols, mRNA expression of Nrf2, HOX-1, NF-κB, and cytokines plasma levels did not show significant changes.
Curcuminoid supplementation for twelve weeks attenuates lipid peroxidation and might reduce uremic toxin in patients with CKD undergoing PD. This study was registered on Clinicaltrials.gov as NCT04413266.
姜黄（姜黄素的来源）是一种极好的食物，可以调节慢性肾脏病（CKD）患者的氧化应激、炎症和肠道菌群失调。然而，尚无研究报告姜黄素对腹膜透析（PD）患者的益处。本研究旨在评估姜黄素补充剂对接受 PD 的 CKD 患者的氧化应激、炎症标志物和源自肠道菌群的尿毒症毒素的影响。
这是一项纵向、随机、单盲、安慰剂对照试验，评估了 48 名患者，他们被随机分为两组：姜黄素（三粒 500mg 的姜黄提取物，含 98.42%的总姜黄素）或安慰剂（三粒 500mg 的淀粉），为期 12 周。在外周血单核细胞（PBMCs）中，通过定量实时 PCR 评估 Nrf2、HOX-1 和 NF-κB 的转录表达水平。通过丙二醛（MDA）和总巯基（T-SH）评估氧化应激。通过 ELISA 测量 TNF-α 和 IL-6 血浆水平。通过高效液相色谱（HPLC）与荧光检测评估尿毒症毒素对苯硫酸酯（p-CS）的血浆水平。
24 名患者完成了研究：姜黄素组 10 名（57.5±11.6 岁），安慰剂组 14 名（56.5±10.0 岁）。姜黄素组治疗 12 周后血浆 MDA 水平降低（p=0.01），而安慰剂组无变化。然而，在终点时两组之间的差异，MDA 无变化。尽管如此，与安慰剂组相比，姜黄素组 p-CS 血浆水平有降低的趋势（p=0.07）。同样，蛋白质巯基浓度、Nrf2、HOX-1、NF-κB 的 mRNA 表达和细胞因子的血浆水平没有明显变化。
姜黄素补充剂治疗 12 周可减轻脂质过氧化作用，并可能降低接受 PD 的 CKD 患者的尿毒症毒素水平。本研究在 Clinicaltrials.gov 上注册为 NCT04413266。
