Mehrab Hasan, Sharifi Mehran, Akhavan Ali, Aarabi Mohammad-Hosein, Mansourian Marjan, Mosavi Elaheh, Moghaddas Azadeh
Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, I.R. Iran.
Department of Internal Medicine, Oncology and Haematology Section, School of Medicine, Isfahan University of Medical Sciences, Isfahan, I.R. Iran.
Res Pharm Sci. 2023 Nov 23;18(6):648-662. doi: 10.4103/1735-5362.389952. eCollection 2023 Dec.
Cisplatin-induced nephrotoxicity (CIN) remains the most prevailing unfavorable influence and may affect its clinical usage. This study sought to explore the possible impacts of curcumin on preventing CIN in human subjects.
The investigation was a placebo-controlled, double-blinded, randomized clinical trial conducted on 82 patients receiving nano-curcumin (80 mg twice daily for five days) or an identical placebo with standard nephroprotective modalities against CIN. Data was gathered on patients' demographics, blood, urinary nitrogen, creatinine (Cr) levels, urinary electrolytes, and urine neutrophil gelatinase-associated lipocalin (NGAL) levels in treatment and placebo groups, 24 h and five days after initiating the administration of cisplatin.
FINDINGS/RESULTS: Both investigation groups were alike considering the demographic characteristics and clinical baseline data. Curcumin administration led to a significant improvement in blood-urine nitrogen (BUN). BUN, Cr, glomerular filtration rate (GFR), and the ratio of NGAL-to-Cr considerably altered during the follow-up periods. However, the further alterations in other indices, including urinary sodium, potassium, magnesium, NGAL values, and potassium-to-Cr ratio were not statistically noteworthy. The significant differences in the NGAL-to-Cr ratio between the two groups may indicate the potential protective impact of curcumin supplementation against tubular toxicity. Curcumin management was safe and well-accepted; only insignificant gastrointestinal side effects were reported.
Curcumin supplementation may have the potential to alleviate CIN and urinary electrolyte wasting in cancer patients. Future research investigating the effects of a longer duration of follow-up, a larger participant pool, and a higher dosage of curcumin are recommended.
顺铂诱导的肾毒性（CIN）仍然是最主要的不良影响，可能会影响其临床应用。本研究旨在探讨姜黄素对预防人类CIN的可能影响。
该调查是一项安慰剂对照、双盲、随机临床试验，对82例接受纳米姜黄素（每日两次，每次80毫克，共五天）或相同安慰剂并采用标准肾保护方案预防CIN的患者进行。在顺铂给药后24小时和五天，收集治疗组和安慰剂组患者的人口统计学数据、血液、尿氮、肌酐（Cr）水平、尿电解质和尿中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平。
考虑到人口统计学特征和临床基线数据，两个研究组相似。给予姜黄素导致血尿素氮（BUN）显著改善。在随访期间，BUN、Cr、肾小球滤过率（GFR）以及NGAL与Cr的比值有显著变化。然而，其他指标的进一步变化，包括尿钠、钾、镁、NGAL值以及钾与Cr的比值，在统计学上并不显著。两组之间NGAL与Cr比值的显著差异可能表明补充姜黄素对肾小管毒性有潜在的保护作用。姜黄素治疗安全且耐受性良好；仅报告了轻微的胃肠道副作用。
补充姜黄素可能有减轻癌症患者CIN和尿电解质流失的潜力。建议未来进行研究，调查更长随访时间、更大参与者群体以及更高剂量姜黄素的影响。
