Curcumin
Curcumin is the main yellow phenolic pigment or “curcuminoid” in turmeric (Curcuma longa), a spice used to make curry blends. It is used extensively in the traditional Eastern Indian medicinal system of ayurveda, and has been studied extensively in modern Western research for its antioxidant, anti-inflammatory, neuroprotective, and immunomodulatory effects. An extensive systematic review and meta-analysis of studies performed with curcumin showed it to have a strong positive impact on health-related quality of life1.
In an animal model of MS (experimental autoimmune encephalomyelopathy or EAE), curcumin was shown to hinder the travel of inflammatory cells across the blood-brain barrier, reducing illness by 70%2. Further, curcumin may regulate the activation of autophagy (a key “quality-control” renewal pathway in cells) and balance overall CNS and peripheral nerve autophagy3. Other animal studies have suggested that curcumin could restore the production of myelin basic protein (MBP) that is reduced in MS4 and protect against myelin loss5.
A randomized, double-blind, placebo-controlled human trial with BCM95 – a highly bioavailable form of curcumin – found it to enhance the anti-lesion activity of interferon beta-1a (also known as Avonex® and Rebif®)6. The dosing of curcumin used was 500 mg twice per day. Other clinical trials found that that another highly bioavailable form of curcumin “nanocurcumin” (curcumin-loaded nanoparticles) could restore the decreased levels of Treg cells and anti-inflammatory compounds7 and deregulation of key micro RNA (miRNA)8 observed in MS.
When selecting a curcumin supplement, it is generally recommended to seek a standardized extract yielding 95% curcuminoids, as this reflects use in successful research studies9.
Curcumin is naturally poorly bioavailable to the body on its own1,10,11, and is often available specially formulated6-8and/or combined with the black pepper phenol “piperine”1,10,12,13 to enable its benefits.
Curcumin is considered to be generally non-toxic14, including in treatment of neonates as demonstrated in pig studies15. However, it has also been shown to have contraceptive effects in other animal models16. When used after conception, curcumin appears to be protective against the damaging effects of fetal growth impairment17,18 and maternal high blood pressure19, likely due to its antioxidant and anti-inflammatory properties17-19. No undesirable side effects have thus far been identified in pregnant test animals receiving curcumin doses of up to 1000 mg/kg/day. No clinical evaluations of this nature are yet available17.
In an animal model, curcumin through breastfeeding has been found to protect against oxidation in stressed neonates20. However, because this study is unique in finding curcumin to be transmitted through breastmilk, it is still recommended to avoid high maternal intake until there is more supportive evidence. Of note, turmeric has been used as to enhance breastmilk production in India and Thailand, though in scientific research, it was shown to suppress milk production in isolated lactating breast cells21.
References
1.Sadeghian M, Rahmani S, Jamialahmadi T, Johnston TP, Sahebkar A. The effect of oral curcumin supplementation on health-related quality of life: A systematic review and meta-analysis of randomized controlled trials. J Affect Disord. Jan 1 2021;278:627-636. doi:10.1016/j.jad.2020.09.091
2.Lu L, Qi S, Chen Y, et al. Targeted immunomodulation of inflammatory monocytes across the blood-brain barrier by curcumin-loaded nanoparticles delays the progression of experimental autoimmune encephalomyelitis. Biomaterials. Jul 2020;245:119987. doi:10.1016/j.biomaterials.2020.119987
3.Boyao Y, Mengjiao S, Caicai B, Xiaoling L, Zhenxing L, Manxia W. Dynamic expression of autophagy-related factors in autoimmune encephalomyelitis and exploration of curcumin therapy. J Neuroimmunol. Dec 15 2019;337:577067. doi:10.1016/j.jneuroim.2019.577067
4.Mavaddatiyan L, Khezri S, Abtahi Froushani SM. Molecular effects of curcumin on the experimental autoimmune encephalomyelitis. Vet Res Forum. Winter 2021;12(1):47-52. doi:10.30466/vrf.2019.98789.2356
5.Motavaf M, Sadeghizadeh M, Babashah S, Zare L, Javan M. Protective Effects of a Nano-Formulation of Curcumin against Cuprizone-Induced Demyelination in the Mouse Corpus Callosum. Iran J Pharm Res. Summer 2020;19(3):310-320. doi:10.22037/ijpr.2020.112952.14033
6.Petracca M, Quarantelli M, Moccia M, et al. ProspeCtive study to evaluate efficacy, safety and tOlerability of dietary supplemeNT of Curcumin (BCM95) in subjects with Active relapsing MultIple Sclerosis treated with subcutaNeous Interferon beta 1a 44 mcg TIW (CONTAIN): A randomized, controlled trial. Mult Scler Relat Disord. Nov 2021;56:103274. doi:10.1016/j.msard.2021.103274
7.Dolati S, Babaloo Z, Ayromlou H, et al. Nanocurcumin improves regulatory T-cell frequency and function in patients with multiple sclerosis. J Neuroimmunol. Feb 15 2019;327:15-21. doi:10.1016/j.jneuroim.2019.01.007
8.Dolati S, Aghebati-Maleki L, Ahmadi M, et al. Nanocurcumin restores aberrant miRNA expression profile in multiple sclerosis, randomized, double-blind, placebo-controlled trial. J Cell Physiol. Jul 2018;233(7):5222-5230. doi:10.1002/jcp.26301
9.Hewlings SJ, Kalman DS. Curcumin: A Review of Its Effects on Human Health. Foods. Oct 22 2017;6(10)doi:10.3390/foods6100092
10.Jabczyk M, Nowak J, Hudzik B, Zubelewicz-Szkodzinska B. Curcumin in Metabolic Health and Disease. Nutrients. Dec 11 2021;13(12)doi:10.3390/nu13124440
11.Nelson KM, Dahlin JL, Bisson J, Graham J, Pauli GF, Walters MA. The Essential Medicinal Chemistry of Curcumin. J Med Chem. Mar 9 2017;60(5):1620-1637. doi:10.1021/acs.jmedchem.6b00975
12.Anand P, Thomas SG, Kunnumakkara AB, et al. Biological activities of curcumin and its analogues (Congeners) made by man and Mother Nature. Biochem Pharmacol. Dec 1 2008;76(11):1590-611. doi:10.1016/j.bcp.2008.08.008
13.Bisht S, Maitra A. Systemic delivery of curcumin: 21st century solutions for an ancient conundrum. Curr Drug Discov Technol. Sep 2009;6(3):192-9. doi:10.2174/157016309789054933
14.Soleimani V, Sahebkar A, Hosseinzadeh H. Turmeric (Curcuma longa) and its major constituent (curcumin) as nontoxic and safe substances: Review. Phytother Res. Jun 2018;32(6):985-995. doi:10.1002/ptr.6054
15.Tang X, Xiong K, Wassie T, Wu X. Curcumin and Intestinal Oxidative Stress of Pigs With Intrauterine Growth Retardation: A Review. Front Nutr. 2022;9:847673. doi:10.3389/fnut.2022.847673
16.Saifi B, Haftcheshmeh, S.M., Feligioni, M., Izadpanah, E., Rahimi, K., Hassanzadeh, K., Mohammadi, A., Sahebkar, A. An overview of the therapeutic effects of curcumin in reproductive disorders with a focus on the antiinflammatory and immunomodulatory activities. Phytother Res
2022;35(2):808-823.
17.Naemi M, Farahani Z, Norooznezhad AH, et al. Possible potentials of curcumin for pregnancies complicated by intra-uterine growth restriction: role of inflammation, angiogenesis, and oxidative stress. Heliyon. Sep 2021;7(9):e08034. doi:10.1016/j.heliyon.2021.e08034
18.Tossetta G, Fantone S, Giannubilo SR, Marzioni D. The Multifaced Actions of Curcumin in Pregnancy Outcome. Antioxidants (Basel). Jan 17 2021;10(1)doi:10.3390/antiox10010126
19.Ozarowski M, Karpinski TM, Szulc M, et al. Plant Phenolics and Extracts in Animal Models of Preeclampsia and Clinical Trials-Review of Perspectives for Novel Therapies. Pharmaceuticals (Basel). Mar 16 2021;14(3)doi:10.3390/ph14030269
20.Yamaoka S, Sasaki K, Sato S. Curcumin intake during lactation suppresses oxidative stress through upregulation of nuclear factor erythroid 2-related factor 2 in the kidneys of fructose-loaded female rat offspring exposed to maternal protein restriction. Birth Defects Res. Apr 15 2023;115(7):674-686. doi:10.1002/bdr2.2158
21.Turmeric. Drugs and Lactation Database (LactMed(R)). 2006.