The Therapeutic Role of Curcumin in Inflammation and Post-Surgical Outcomes

Figures & data

Figure 1. Turmeric curcuminoid forms and their keto-enol tautomerism.

Table 1. Summary of impact of curcumin on endo/exogenous trauma.

First Author	Agent	Type of study	Duration of e↑xposure	Control	Time of measures	Dose	Outcome	Mechanism
Animal studies
Shah et al. 2016^[Citation14]	Curcumin -intraperitoneal injection	RCT	1 day	Vehicle	24 hr post middle cerebral artery occlusion	50mg/kg	Ischemia ↑↓	↑ UCH-L1 ↑ Isocitrate dehydrogenase ↑Adenosyl-homocysteinase ↑Eukaryotic initiation factor 4A
Wu, Ying, and Gomez-Pinilla 2006 ^[Citation15]	Curcumin	RCT	4 weeks	Sham	4^th week	500 ppm curcumin	Post Traumatic brain injury synaptic plasticity and cognitive function	↑ Oxidative stress ↑ BDNF ↑ cAMP ↑ CREB ↑ Synaptic plasticity ↑ Cognitive function
Laird et al. 2010^[Citation16]	intraperitoneal injection of curcumin (75, 150, 300 mg/kg) or vehicle [100 lL dimethylsulfoxide (DMSO)] either 15 min prior to TBI or post- treated (0.5 or 1 h post-TBI). intraperitoneal injection of curcumin (75, 150, 300 mg/kg) or vehicle [100 lL dimethylsulfoxide (DMSO)] either 15 min prior to TBI or post- treated (0.5 or 1 h post-TBI). intraperitoneal injection of curcumin (75, 150, 300 mg/kg) or vehicle [100 lL dimethylsulfoxide (DMSO)] either 15 min prior to TBI or post- treated (0.5 or 1 h post-TBI). Curcumin- intraperitoneal injection	RCT	15 min prior to TBI or post- treated (0.5 or 1 h post-TBI). 15 min prior to TBI or post-treated (0.5 or 1 h post-TBI)	Vehicle-100 µL dimethyl sulfoxide (DMSO)	24 hr. post-injury	Curcumin (75, 150, 300 mg/kg)	Post Traumatic brain injury and inflammation	↓ NF-kB ↓ IL-1β ↓ Inflammation
Samini et al. 2013^[Citation17]	Curcumin	RCT	5 days	Vehicle- dimethyl sulfoxide (DMSO)	1^st, 3^rd, 7^th, and 14th days after the brain injury	Curcumin groups (50 and 100 mg/kg).	Post Traumatic brain injury	↓ Size of brain lesions ↓ TLR4 ↓ Cell apoptosis ↓ Edema ↓ Inflammation
Gao et al. 2016^[Citation18]	Tetrahydro-curcumin	RCT	30 minutes post TBI	Vehicle- dimethyl sulfoxide (DMSO)	24 hr. and 72 hr. post TBI	Tetrahydro -curcumin (25 or 50 mg/kg/d)	Post Traumatic brain injury	Activated AKT pathway ↑ Autophagy Improved cell apoptosis
Zhu et al. 2014^[Citation19]	Curcumin	RCT	15 min post TBI	Vehicle- dimethyl sulfoxide (DMSO)	24 hr. post injury	Curcumin (50, 100, 200mg/kg)	Post Traumatic brain injury	↓ Macroglia/macrophage activation ↓ Neuronal apoptosis ↓ MyD88 ↓ NF-kB
Dai et al. 2018^[Citation13]	Curcumin	RCT	30 min after TBI	Vehicle- dimethyl sulfoxide (DMSO)	24 hr. post TBI	Curcumin (2 subgroups: 50 mg/kg and 100 mg/kg).	Post Traumatic brain injury	↓ Brain water content ↓ Oxidative stress ↓ Neurological severity score ↓ Neuronal apoptosis
Zhao et al. 2019^[Citation20]	Curcumin+ β-cyclodextrin + chitosan-alginate	RCT	14 days	Chitosan alginate -Curcumin, Chitosan alginate, and gauze	Days 3,7, and 14	Curcumin-β - cyclodextrin – chitosan alginate (25mg)	Wound healing	↓ SOD ↓ Lipid peroxidation ↓ PI3K ↓ P-AKT
Li et al. 2012^[Citation21]	Curcumin nano-formulation	RCT	14 days	MPEG-chitosan film	3rd, 7^th, and 14th day of post wounding	Curcumin MPEG-chitosan film (2.65 mg curcumin per piece)	Collagen deposition in wounds	↑ Collagen synthesis ↓ Lipid peroxidation ↑ Antioxidant capacity
Human Studies
Panahi et al. 2016^[Citation6]	Curcumin + 5 mg Piperine (Bioperine)	Post-hocanalysis of RCT	8 weeks	Placebo capsules - lactose + 5 mg piperine	Baseline and after 8 weeks	daily dose of 1 g (500 mg b.i.d.)	Inflammation in metabolic syndrome	↓ TNF- α ↓ IL-6 ↓ TGF-B ↓ MCP1
Sukardi et al. 2016^[Citation22]	Curcumin containing 98% curcuminoid	RCT	14 days	Placebo −45mg saccharum lactis	Baseline, after 14 days of curcumin consumption, at 6, 24, 48 hours and 5 days after ICU admission	Curcumin (45 mg oral daily)	Ischemia	↓ c-Jun N terminal kinase ↓ Temperature Improved ventricular function
Wongcharoen et al. 2012^[Citation23]	Curcuminoid	RCT	5 days	Placebo	Before surgery, at 8, 16, 24, 48, and 72 hours after ICU NT–pro-BNP level was assessed before surgery and on the 5th postoperative day	Curcuminoid 4 g/day	Ischemia	↓ In-hospital MI ↓ C-reactive protein ↓ Plasma malondialdehyde ↓ N-terminal pro-B type natriuretic peptide levels
Agarwal et al. 2011 ^[Citation24]	Curcumin	RCT	3 weeks	Placebo − 250 mg dextrose powder	3rd day, 1^st week, 2^nd week and 3^rd week post-surgery	500mg curcumin once every 6 hr. orally	Post cholecystectomy	↓ Pain ↓ Fatigue

Figure 2. Antioxidant and anti-inflammatory effects of curcumin.

Note: TLR4: Toll like receptor 4, Pl3k: Phosphoinositide 3-kinases, Akt: protein kinase B, NF-kB: nuclear factor kappa light-chain enhancer of activated B cells, COX2: Cyclooxygenase-2, IL-1β: Interleukin-1β, IL-6: Interleukin-6, TNF-α: Tumor necrosis factor-α, SIRT 1: Sirtuin 1, SIRT3: Sirtuin 3, PGC-1α: Peroxisome proliferator-activated receptor gamma coactivator 1-α, GPx: Glutathione peroxidase, SOD: superoxide dismutase, CAT: Catalase

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