Effects of the Use of Curcumin on Ulcerative Colitis and Crohn's Disease: A Systematic Review
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Published on: January 5, 2017
Ricardo de Alvares Goulart1, Sandra M Barbalho1,2,3, Vinícius Marinho Lima2
1Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marília (UNIMAR), Marília, Brazil.
Insights
Curcumin, derived from Curcuma longa, shows promise as an adjuvant therapy for inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC). Further research is needed to clarify its efficacy due to variability in study designs.
Area of Science:
- Gastroenterology
- Pharmacology
- Natural Product Medicine
Background:
- Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), significantly impacts patient quality of life.
- Conventional therapies are ineffective for some IBD patients, leading to interest in alternative treatments like Curcuma longa derivatives.
- Curcumin, a derivative of Curcuma longa, possesses anti-inflammatory and antioxidant properties, making it a potential therapeutic agent for IBD.
Purpose of the Study:
- To systematically review randomized clinical trials (RCTs) evaluating Curcuma longa compounds as an adjuvant therapy for CD and UC.
- To reconcile controversial findings from previous meta-analyses regarding curcumin's efficacy in IBD treatment.
- To determine if Curcuma longa compounds remain a viable therapeutic option for IBD patients.
Main Methods:
- Searched MEDLINE-PubMed, EMBASE, and Cochrane databases.
- Adhered to Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) guidelines.
- Analyzed results from randomized clinical trials (RCTs) on curcumin use in CD and UC.
Main Results:
- RCTs indicated promising results for curcumin in managing both UC and CD.
- Some meta-analyses reported controversial findings, potentially due to bias in included studies.
- Curcumin exerts its effects by reducing pro-inflammatory cytokines (e.g., IL-1, IL-6, IL-12, TNF-α) and reactive oxygen species.
Conclusions:
- Curcumin demonstrates potential as an adjunctive therapy for inflammatory bowel diseases.
- Variability in curcumin dosage, formulation, treatment duration, administration route, and small sample sizes in RCTs complicate efficacy evaluation.
- Further standardized research is necessary to establish definitive therapeutic recommendations for curcumin in CD and UC management.
Abstract:
Inflammatory bowel disease (IBD) is an umbrella term used to describe chronic inflammatory disorders related to a substantial reduction in the quality of life of patients. Some patients with Crohn's disease (CD) and ulcerative colitis (UC) are refractory to conventional therapies, and Curcuma longa derivatives have been considered as adjuvants. Owing to the anti-inflammatory and antioxidant effects, some clinical trials used this plant in the therapeutic approach of IBD, and some meta-analyses evaluated the outcomes found in these studies. Owing to controversial findings, our systematic review aimed to evaluate these studies to show whether C. longa compounds can still be considered in the therapeutic approach of patients with CD and UC. MEDLINE-PubMed, EMBASE, and Cochrane were searched, and Preferred Reporting Items for a Systematic Review and Meta-Analysis guidelines were followed. The results of the randomized clinical trials (RCTs) showed promising results with the use of curcumin in the therapeutic approach of both UC and CD patients. Some meta-analyses show controversial results, possibly due to the presence of bias in the included studies. The actions of curcumin are achieved by several mechanisms, such as reducing the expression of interleukin (IL)-1, IL-6, IL-12, and tumor necrosis factor-α. Moreover, it reduces the levels of reactive oxygen species, such as superoxide anions and malondialdehyde. The results of using curcumin in CD and UC patients are challenging to be evaluated because RCTs are variable in the dose and the formulations of curcumin, in the time of treatment, and the route of administration. The number of patients in the samples is also usually small.
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