Curcuminoids from Curcuma Longa: New adjuvants for the treatment of crohn's disease and ulcerative colitis?

Abstract

Crohn's Disease (CD) and Ulcerative Colitis (UC) result from an overreaction of the bowel to multifactorial stimuli leading to discomfort, pain, and it is associated with high morbidity and lethality. The medications commonly used are expensive and associated with multiple side effects. Curcuma longa exerts anti-inflammatory and antioxidant actions and has shown positive effects on CD and UC treatment, possibly due to the presence of curcuminoids. The objective of this review was to evaluate the role of curcuminoids in the treatment of IBD. A search for articles associating curcuminoids and CD and UC was performed using MEDLINE-PubMed. It has been found that curcumin can reduce oxidative stress and inhibit the migration of neutrophils and inducible nitric oxide synthase in the intestine. It may also improve micro and macroscopic lesions, prevent apoptosis of intestinal cells and also induce the restoration of the mitogen-activated protein kinase immune reaction. As the incidence of CD and UC is growing in many populations, there is an urgency to find an appropriate and accessible therapeutic approach to improve quality of life of patients. The use of curcumin is cheap, efficient and associated with no side effects, and may become an alternative to the IBD treatment.

Efficacy of Curcuma Longa in the Treatment of Diversion Colitis in Rats

“…In the present study, it was observed that the exclusion of faecal transit in the colonic segment in rats for 21 days actually promoted an inflammatory process, considering the average of 2.7 degrees observed, on a scale ranging from 0 to 3, characterized by mild to severe inflammation. The same has been observed by other authors, and this is the starting point for the evaluation of the therapeutic efficacy of Curcuma longa 1 , 2 , 3 , 4 , 5 . The method of histological evaluation was also the same, which facilitates comparison, as it is well characterized by infiltration with mononuclear cells, which include macrophages, lymphocytes and plasma cells; tissue destruction by inflammatory cells and attempts at healing by the replacement of tissue damaged by connective tissue by small vessel proliferation (angiogenesis) and fibrosis 7 , 8 , 13 , 14 , 15 , 16 .…”

“…Thus, it is up to us to compare the results obtained here with other situations of intestinal inflammation. Cunha Neto et al 3 . observed in a review article on the effects of Curcuma longa on the inflammatory bowel process in diseases such as ulcerative colitis and Crohn’s disease; this plant could act as a coadjuvant, since it is proven to reduce oxidative stress and inhibit leukocyte migration.…”

The Effects of Curcumin on Diabetes Mellitus: A Systematic Review

“…Curcuminoids are nontoxic polyphenolic that exerts a wide range of biological activities (58,59), such as the production of significant immunosuppressants that inhibit the production of IL-2 and IL-12. This compound inhibits the expression of iNOS (inducible nitric oxide synthase), COX-2 (cyclooxygenase-2), lipoxygenase-5, and many other pro-inflammatory cytokines, such as TNF-a, IL-1, IL-6, and IL-8 (60)(61)(62).…”

Food and Food Groups in Inflammatory Bowel Disease (IBD): The Design of the Groningen Anti-Inflammatory Diet (GrAID)

“…In patients with quiescent UC, curcumin vs. sulfasalazine or mesalamine, curcumin showed lower relapse rates and enhanced clinical activity and endoscopic scores after 6 months, but these differences were not sustained after 12 months [257]. A Cochrane review and a later review both concluded that curcumin may be a safe and effective therapy for maintenance of remission in quiescent UC when used in combination with mesalamine or sulfasalazine but more research was needed [258,259].…”