Curcumin: hopeful treatment of hemophilic arthropathy via inhibition of inflammation and angiogenesis

ABSTRACT

Introduction: Hemophilic arthropathy (HA) is a serious complication among hemophilic patients causing a wide range of morbidity due to the inflammatory reactions followed by repeated episodes of bleeding. This condition has recently been shown to be accompanied by angiogenesis. The cascade starts with iron accumulation leading to an increase in CD⁶⁸⁺ and CD^11b+ cells responsible for initiating the inflammation.

Areas covered: During inflammation, different factors and cytokines such as interleukin 1 (IL-1), IL-6, and tumor necrosis factor α (TNF-α) actively play parts in the pathogenesis of HA and also angiogenesis. It has been demonstrated that different pro-angiogenic and angiogenic factors such as hypoxia-inducible factor 1α (HIF-1α), vascular endothelial growth factor (VEGF), oxidative stress and matrix metalloproteinases (MMPs) are also important in the pathogenesis of HA. Curcumin is known for its strong anti-inflammatory and anti-angiogenic potentials. This agent is able to inhibit the mentioned inflammatory and angiogenic factors such as IL-1, IL-6, TNF-α, VEGF, MMPs, and HIF-1α. Also, as well as anti-angiogenic and anti-inflammatory activity, curcumin has a strong antioxidant potential and can decrease oxidative stress.

Expert opinion: It seems that curcumin could be considered as a possible agent for the treatment of HA through inhibition of inflammation, oxidative stress, and angiogenesis.

KEYWORDS:

• Hemophilic arthropathy
• curcumin
• inflammation
• angiogenesis
• cytokine
• oxidative stress

Article highlights

• Hemophilic arthropathy causes a wide range of morbidity due to the inflammatory reactions followed by repeated hemarthroses. This condition has recently been shown to be accompanied by angiogenesis.

• Different pro-inflammatory cytokines and pro-angiogenic factors such as, IL-1, IL-6, TNF-α, HIF-1α, VEGF, and MMPs are involved in the pathogenesis of Hemophilic arthropathy.

• The cascade begins with iron accumulation leading to an increase in CD⁶⁸⁺ and CD^11b+ cells responsible for starting the inflammation.

• Curcumin (diferuloylmethane) is an active chemical compound of Curcuma Longa (turmeric) and a traditional food additive.

• Some clinical trials have been conducted on the role of curcumin in knee osteoarthritis yielding successful results without any noticeable or major side effects.

• Curcumin might have promise as applied to the hemophilia population for treatment of its articular manifestation: hemophilic arthropathy.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This paper was not funded.