A Comprehensive Review on Physiological Effects of Curcumin
Rabiya Ahsan, Md Arshad, Mohammad Khushtar, Mohd Afroz Ahmad, Mohammad Muazzam, Md Sohel Akhter, Gudiya Gupta, Mohd Muzahid
Turmeric (Curcuma longa Linn) is an herbal medicine that is traditionally used as a spice, food coloring, or flavoring agent and widely used for several diseases such as biliary disorders, cough, hepatic disorders, rheumatism, wound healing, sinusitis, diabetes, cardiac disorders, and neurological disorder. It belongs to the Zingiberaceae family. Turmeric is a popular domicile remedy used in Indian food, is mainly a native of south-east Asia, is widely cultivated in India, Sri Lanka, Indonesia, China, Jamaica, Peru, Haiti, and Taiwan and it is very less expensive. Curcumin is the main principle of turmeric. Curcumin has shown various biological properties pre-clinically and clinically. Curcumin is a highly pleiotropic molecule that can be modulators of various intracellular signaling pathways that maintain cell growth. It has been reported as anti-inflammatory, anti-angiogenic, antioxidant, wound healing, anti-cancer, anti-Alzheimer, and anti-arthritis and possesses an excellent safety profile. All previous review articles on curcumin have collected the biological/pharmacological activities but this review article summarises the most interesting in vitro and in vivo studies of curcumin on most running diseases around the whole world.
anti-inflammatory drugs – cardiovascular pharmacology – pharmacology – pulmonary & respiratory pharmacology – inflammation – cardiovascular diseasesABBREVIATION
DMSO Dimethyl sulfoxide
NSCLC Non-Small Cell Lung Cancer
XIAP X-Linked Inhibitor of Apoptosis
ROS Reactivity Oxygen Species
SCLC Small Cell Lung Cancer
FOXO1 Forkhead Box Protein O1
RARβ Retinoic Acid Receptor Beta
MMPs Metalloproteinases or Matrixins
NF-κβ Nuclear Factor Kappa Β
NADPH Nicotinamide Adenine Dinucleotide Phosphate
ATF-2 Activation of Transcription Factor-2
LDH Lactate Dehydrogenase
CK Creatine Kinase
ECM Extracellular Matrix
AMPK Adenosine Monophosphate Activated Protein Kinase
PPAR-y Peroxisome proliferator-activated receptor gamma
Historically plants were used in India for medicinal purposes. Turmeric is herbal medicine. It belongs to the species of Curcuma longa Linn. It is a medicinal plant broadly employed in Ayurveda, Unani and Siddha system of medicine. It is also used as a home remedy for various diseases . Curcumin (diferuloylmethane) is the main constituent of the popular Indian spice turmeric, turmeric belongs to the ginger family (Zingiberaceae) . The derivative of Curcumin is curcuminoids (Curcuminoids is linear diarylheptanoid, polyphenolic molecules). The other two main forms of curcuminoids are desmethoxycurcumin and bis-desmethoxycurcumin and it is important for the yellow color of turmeric . Curcumin has two tautomeric compounds form ketonic and enolic. The enolic group has more stability in the solid phase and solution. Curcumin is a bright yellow color compound and it is applied as a food coloring agent . Curcumin has been acquired a wide range of pharmacological and biological activities including anti-inflammatory, anti-cancer, anti-oxidant, wound healing, anti-microbial, and many other biological properties  . Turmeric was characterized as C. Longa Linn by Linnaeus, Liliopsida is the class of C. longa Linn, the subclass is commelinids, the order is zingiberaceous, and the family is Zingiberaceae, the genus is Curcuma and Species is Curcuma longa. The primitive turmeric is C. aromatica and the domiciliary species is called C. longa Linn .
Physical and chemical properties of Curcumin
Curcumin is a brightly yellow color pigment compound with anti-oxidant and anti-tumor activities. Chemical name – diferuloylmethane, IUPAC name is 1, 7-bis (hydroxyl-3-methoxyphenyl)-1, 6-heptadiene 3,5-dione  . The molecular formula is C21H20O6, appearance-bright yellow-orange powder, melting point is 183°C (361°F; 456 K), molar mass-368.385 g mol−1 and Curcumin solubility in DMSO (>11mg/mL) , Curcumin is rapidly soluble in organic solvents such as acetone, ethanol, DMSO, and dimethyl formamide . The maximum oral dose of Curcumin is 8 g/day for 3 months (human) at this dose Curcumin has not caused any toxic and hazardous effects .
Pharmacokinetics properties of Curcumin
Curcumin pharmacokinetics and bioavailability studies have been indicated low intestinal absorption. Oral administration of 400 mg of Curcumin shows an absorption rate of 60–66%  and rapid clearance from the body. Curcumin clinical use is limited largely because it has low solubility and fast metabolism that leads to low bioavailability . It is permeable across blood-brain barrier   .
Pharmacological properties of Curcumin
Curcumin possesses so many properties like anti-oxidant, anti-inflammatory, anti-viral, and anti-fungal actions. Some investigators proved that Curcumin has not been shown any toxic effect in humans. Curcumin prevents the growth of Helicobacter pylori which induces gastric ulcers . Curcumin shows anti-inflammatory activity by inhibition of molecules that play an important role in inflammatory disorder . Turmeric is effective in preventing post-surgical inflammation and exerts anti-osteoporotic activity. Curcumin can bind with heavy metals such as cadmium and lead which can reduce the toxic effect of these heavy metals . Curcumin inhibits the pathway of cyclooxygenase, 5-lipoxygenase, and glutathione S-transferase. Curcumin prevents atherosclerosis by reducing the formation of blood clumps . Curcumin has the potential for scavenging superoxide radicals, hydrogen peroxide and nitric oxide (NO) from activated macrophages, reduces the iron complex and lipid peroxidation both in vitro and in vivo  .
Role of Curcumin in Alzheimer disease
Curcumin has shown its beneficial action by binding the copper, lowering the cholesterol level, inhibiting the enzyme acetylcholinesterase, modifying the insulin signaling pathway, suppressing the tau, and enhancing the phagocytosis of Aβ by microglia/microphages     .
Effect of Curcumin on respiratory disorder (lungs cancer)
Curcumin inhibits the apoptosis through modulation of the miRNA pathways which is important for inhibition of caspase-3, and which to prevent the Pi3K/Akt pathway (implicated in growth factor-mediated cell survival) , and also inhibit the XIAP. Curcumin has cytotoxic properties of NSCLC and SCLC, which are mediated by an increase of ROS and apoptosis. Curcumin inhibited lung cancer cell proliferation via the JAK/STAT3 pathway which is incriminated in tumor recurrence and drug resistance  . This inhibition leads to the prevention of abnormal cell growth and suppressed the proliferation, migration, invasion, and angiogenesis of SCLC cells. Another mechanism by which Curcumin reduces the proliferation of SCLC cells is the induction of FOXO1, a transcription factor that regulates cell proliferation, differentiation, and DNA damage repair. Curcumin’s induction of FOXO1 upregulates p21 and p27 gene codes and down-regulates cyclin D, inducing cycle arrest, and apoptosis . Inhibition of cell proliferation by Curcumin also appears from epigenetic effects by reactivation of silenced tumor cells suppressor genes. In NSCLC cells, Curcumin decreases the RARβ (retinoic acid receptor beta) promoter methylation , which induces the expression of RARβ and leads to prevent the tumor cells growth. The antineoplastic role of Curcumin is also mediated by the decrease the cancer cell migration. In patients of NSCLC Curcumin downregulates early growth response protein 1 (EGR-1) and enhancement of cell-cell adhesion . Furthermore, Curcumin prevents the production and activity of MMPs (Metalloproteinases or matrixes) by several mechanisms . In NSCLC patients Curcumin inhibits phosphokinase A, preventing the NADPH oxidase-2 and reduces ROS production. ROS is important for activation of transcription factor-2 (ATF-2), induces MMP-9 production. Another mechanism is reducing the Rac1/PAK1 pathway , which leads to the downregulation of MMP-2 and MMP-9 and reducing cell migration. Curcumin helps in the downregulation of adiponectin, a cytokine produced by adipose tissue and implicated in lung cancer. This downregulation prevents the NF-κβ and reduces the production of MMPs which causes a reduction in the migration and invasion capability of these cells. Curcumin decreases the expression of DNA repair proteins and enhances p53 levels, inducing apoptosis of cells   .
Effect of Curcumin in Osteoarthritis (inflammatory disorder)
Osteoarthritis is a chronic joint disorder of the liftable joints affecting the older-age population worldwide. It is estimated by loss of cartilage, remodeling of adjacent bone, and bony overgrowth . The mechanism-based antiarthritic potential of Curcumin includes chondrocyte regeneration and apoptosis, inflammation, and oxidative stress. Curcumin inhibits inﬂammation in osteoarthritis by intraperitoneal administration of curcumin at 50 mM ([Fig. 1]) .
Effect of Curcumin on cardiac disorder
Curcumin has anti-inflammatory and antioxidant properties thereby this compound reduces cardiovascular complications, such as unstable angina, CHF, and arrhythmia . Curcumin has an antioxidative property that inhibits oxidative stress. Inhibits apoptosis and also has anti-inflammatory properties. This compound exerts a cardioprotective role on myocardial ischemia . It reduces the release of cardiac LDH and CK and increases the post-ischemic cardiac function. Curcumin also plays a protective role in cardiomyocyte structure, attenuating extracellular matrix (ECM) remodeling, and promotes cardiac contraction . Oxidative stress is an important factor contributing to ischemic myocardial injury (IMI). Curcumin reduces the isoproterenol-induced myocardial ischemia by improving the levels of SOD catalase, glutathione, suppressing the production of thiobarbituric acid reactive substances, and the leakage of lactate dehydrogenase (LDH) . Wang et al. Study proved that Curcumin reduces mitochondrial hydrogen peroxide activity . This compound also suppresses malondialdehyde levels . Curcumin by improving the anti-apoptotic protein Bcl-2 level favor a protective effect against cerebral Ischemia/reperfusion injury (IRI) by the activation of the JAK2/STAT3 signaling pathway  . It also recovers post-ischemic cardiac function, myocardial infarct size, and lactate dehydrogenase release in the coronary flow. This compound reduces the myocardial IRI by preventing inflammation, which may be a critical pathway of myocardial ischemia. Curcumin has been shown to lower the upregulation of IL-1, IL-6, IL8, and TNFα ([Fig. 2]) . Curcumin releases the cytoplasmic inflammatory cytokine NF-κβ. This compound also inhibits TLR2, reduces infarct size, and myocardial injury  . Some studies have been proved that inactivation of TLR2 reduces the myocardial IRI . Curcumin ameliorates the heat stress and enhances the stabilization of the cytoskeletal structures, it increases the level of mitochondrial energy production to ensure sufficient energy supply and also improves cardiac contractility .
Curcumin potential in hepatic disorder (liver disease)
Hepatic disorders cover all the problems that cause hepatic damage to perform their functions . Abuse of drugs is the most common cause of hepatic disease. Toxic Drug effects on hepatic cells cause hepatic cell damage and hepatic inflammation. Accumulation of fats occurs in hepatic cells which affect their function in chronic alcohol abuse  . Curcumin lowers the level of PGI2, LDL, and increases the HDL .
- Effect of Curcumin in non-alcoholic liver diseaseCurcumin in the dose of 200 mg/kg/day (orally) for 3 weeks prevent the inflammation of non-alcoholic liver male Wistar-Albino rat . Curcumin prevents the development and progression of fibrosis. Reduces the tissue inhibitor metalloproteinase-1 (TIMP-1) secretion and prevents 8-OH-deoxyguanosine-mediated liver oxidative stress. Curcumin inhibits the inflammation of the non-alcoholic liver, by preventing the proinflammatory cytokines, lipid peroxidation products, PI3K/Akt, and hepatic stellate cells activation. It ameliorates non-alcoholic steatohepatitis (NASH) via lipid reduction, increases insulin resistance, improved anti-inflammatory and antioxidant effects which possibly related to activation of Nrf2  . Curcumin inhibits the NF-κβ pathway which is responsible for the transcription of DNA and protein .
- Effect of Curcumin in alcoholic hepatic DiseaseCurcumin acts in AMPK (adenosine monophosphate-activated protein kinase) to reduce the liver fat and serum alanine transaminase (ALT). Curcumin prevents the impairment in lipid metabolism and it can prevent fatty acid biosynthesis . Curcumin decreases the elevated biomarker AST, ALT, LDH, ALP, and reduces the damaged liver cell in animals ([Fig. 3]) .
- The effect of Curcumin in oxidative stress in liverROS is the main principle for oxidative stress, generation of free radicals, and cellular abnormality. Curcumin inhibits the initiation of styrene oxidation and reduces chronic disorders and prevents bacterial cell growth in the liver .
- Effect of Curcumin in liver injury
Single-dose at 100 mg/kg of Curcumin given by intraperitoneal route is responsible for the inhibition of lipid peroxidation, free radical formation, and DNA abnormal function. Curcumin inhibits the D-galactosamine, protects the impacted nitric oxide synthase-2 (NOS-2) down-regulation, and reduces the level of NO in the liver ([Fig. 3]) .
Effect of Curcumin on glucose level and pancreatic B cell (diabetes mellitus)
Curcumin acts as an antidiabetic in some experimental diabetes models. The structural and functional fault in the deficiency of insulin-producing and insulin-responsive tissues in the body have been shown some complicated pathogenesis of T2DM. Wojcik et al. showed that Curcumin acts at multiple molecular targets and pathways which shown an effective role in diabetic patients . Juenger et al declared that Curcumin improves various microvascular diabetic complications such as retinopathies, nephropathies, cardiomyopathies, and neurological disorders which are eventually linked to diabetes-induced oxidative stress and inﬂammatory disorders . Curcumin demonstrated its effect on diabetes by lowering blood glucose level, enhancing carbohydrate metabolism, and restoring the activities of multiple antioxidant enzymes such as superoxide dismutase, glutathione peroxidase, catalase, and glutathione-S transferase. Curcumin also inhibits lipid peroxidation . Curcumin can modulate the functions of multiple cell signaling and it inhibits the level of thiobarbituric acid reactive substances (TBARS) and reduces the sorbitol dehydrogenase (SDH). Curcumin activates the liver enzyme connected with gluconeogenesis, glycolysis, and lipid metabolic pathways. It activates the function of nuclear factor erythroid-2-related factor-2 (NRF2) . It can also induce the peroxisome proliferator-activated receptor gamma (PPAR-y) activation. Curcumin can also increase the levels of plasma insulin and lipoprotein lipase (LPL) activity . Curcumin prevents the IL-6, TNF-α, maintained the extracellular matrix proteins, vasoactive factors, and a key transcriptional co-activator (p300) in cultured human retinal microvascular endothelial cells (HRECS) and dermal-derived human microvascular endothelial cells (HMVECS) in hyperglycemic tissues . Curcumin inhibits poly ADP-ribose polymerase-1 activation and prevents cytokine (TNF-α, IL-1β, etc.) Induced NF-kβ translocation enhances islet neogenesis and prevents the level of reactive oxygen species (ROS) production within the islet ([Fig. 4]) .
Turmeric is a popular household remedy used in Indian food. Curcumin is a principal constituent of turmeric. Although Curcumin has been found effective in patients with rheumatoid arthritis, inflammatory eye diseases, inflammatory bowel disease, chronic pancreatitis, psoriasis, hyperlipidemia, post-operative inflammation, and cancers in preliminary studies but well-controlled clinical trials are still needed. Further, Keeping in view the biological safety, efficacy, cost-effectiveness, and easier availability well-controlled clinical studies are advocated to confirm its efficacy in various other most running disorders such as diabetes, Alzheimer, cardiovascular, liver injury, and osteoarthritis as sufficient in vitro and preclinical data is available to support for conducting clinical studies in these areas.
Conflict of Interest
The authors declare that they have no conflict of interest to disclose.
Author is thankful to Integral University Lucknow for providing manuscript number IU/R&D/2020-MCN000808
- 1 Maheshwari RK, Singh AK, Gaddipati J. et al. Multiple biological activities of curcumin: A short review. Life Sciences 2006; 78: 2081-2087
- 2 Chattopadhyay I, Biswas K, Bandyopadhyay U. et al Turmeric and curcumin: Biological actions and medicinal applications. Current Science-Bangalore 2004; 87: 44-53
- 3 Beevers CS, Huang S. Pharmacological and clinical properties of curcumin. Botanics. Targets and Therapy 2011; 1: 5-18
- 4 Akram M, Shahab-Uddin AA, Usmanghani K. et al. Curcuma longa and curcumin: a review article. Rom J Biol. Plant Biol 2010; 55: 65-70
- 5 Parvathy KS, Negi PS, Srinivas P. Antioxidant, antimutagenic and antibacterial activities of curcumin-β-diglucoside. Food Chemistry 2009; 115: 265-271
- 6 Akbik D, Ghadiri M, Chrzanowski W. et al. Curcumin as a wound healing agent. Life Sciences 2014; 116: 1-7
- 7 Ravindranath V, Chandrasekhara N. Absorption and tissue distribution of curcumin in rats. Toxicology 1980; 16: 259-265
- 8 Ravindranath V, Chandrasekhara N. In vitro studies on the intestinal absorption of curcumin in rats. Toxicology 1981; 20: 251-257
- 9 Doktorovova S, Souto EB, Silva AM. Hansen solubility parameters (HSP) for prescreening formulation of solid lipid nanoparticles (SLN): In vitro testing of curcumin-loaded SLN in MCF-7 and BT-474 cell lines. Pharmaceutical Development and Technology 2018; 23: 96-105
- 10 Dhivya S, Rajalakshmi AN. Curcumin nano drug delivery systems: A review on its type and therapeutic application. Pharmatutor 2017; 5: 30-39
- 11 Chainani-Wu N. Safety and anti-inflammatory activity of curcumin: A component of tumeric (Curcuma longa). The Journal of Alternative & Complementary Medicine 2003; 9: 161-168
- 12 Dao TT. et al. Demethoxycurcumin is a potent inhibitor of p-type atpases from diverse kingdoms of life. PLoS One 2016; 11: e0163260
- 13 Negi PS, Jayaprakasha GK, Jagan Mohan Rao L. et al. Antibacterial activity of turmeric oil: A by product from curcumin manufacture. Journal of Agricultural and Food Chemistry 1999; 47: 4297-4300
- 14 Anand P, Kunnumakkara AB, Newman RA. et al. Bioavailability of curcumin: Problems and promises. Molecular Pharmaceutics 2007; 4: 807-818
- 15 Singh P, Mogra P, Sankhla V. et al. Protective effects of curcumin on cadmium chloride induced colon toxicity in Swiss albino mice. Journal of Cell and Molecular Biology 2011; 9: 31
- 16 Ak T, Gülçin İ. Antioxidant and radical scavenging properties of curcumin. Chemico-Biological Interactions 2008; 174: 27-37
- 17 Alok A, Singh ID, Singh S. et al. Curcumin–pharmacological actions and its role in oral submucous fibrosis: A review. Journal of Clinical and Diagnostic Research: JCDR 2015; 9: ZE01
- 18 Kim M, Kim Y. Hypocholesterolemic effects of curcumin via up-regulation of cholesterol 7α-hydroxylase inrats fed a high fat diet. Nutr Res Pract 2010; 4: 191-195
- 19 Ahmed T, Gilani AH. Inhibitory effect of curcuminoids on acetylcholinesterase activity and attenuation of scopolamine-induced amnesia may explain medicinal use of turmeric in Alzheimer’s disease. Pharmacol Biochem Behav 2009; 91: 554-559
- 20 Tang M, Taghibiglou C. The mechanisms of action of curcumin in Alzheimer’s disease. Journal of Alzheimer’s Disease 2017; 58: 1003-1016
- 21 Lim GP, Chu T, Yang FA. et al. The curry spice curcumin reduces oxidative damage and amyloid pathology in an Alzheimer transgenic mouse. The Journal of Neuroscience 2001; 21: 8370-8377
- 22 Zhang L, Fiala M, Cashman J. et al. Curcuminoids enhance amyloid-beta uptake by macrophages of Alzheimer’s disease patients. J Alzheimers Dis 2006; 10: 1-7
- 23 Jiao D, Wang J, Lu W. et al. Curcumin inhibited HGF-induced EMT and angiogenesis through regulating c-Met dependent PI3K/Akt/mtorsignaling pathways in lung cancer. Molecular Therapy-Oncolytics 2016; 3: 16018
- 24 Xu X, Zhu Y. Curcumin inhibits human non-small cell lung cancer xenografts by targeting STAT3 pathway. American Journal of Translational Research 2017; 9: 3633
- 25 Yang CL, Liu YY, Ma YG. et al. Curcumin blocks small cell lung cancer cells migration, invasion, angiogenesis, cell cycle and neoplasia through Janus kinase-STAT3 signalling pathway. PLoS One 2012; 7 (5): e37960
- 26 Li ZC, Zhang LM, Wang HB. et al. Retracted article: Curcumin inhibits lung cancer progression and metastasis through induction of FOXO1. Tumor Biology 2014; 35: 111-116
- 27 Wan H, Hong WK, Lotan R. Increased retinoic acid responsiveness in lung carcinoma cells that are nonresponsive despite the presence of endogenous retinoic acid receptor (RAR) β by expression of exogenous retinoid receptors retinoid X receptor α, RARα, and RARγ. Cancer Research 2001; 61: 556-564
- 28 Lelli D, Sahebkar A, Johnston TP. et al. Curcumin use in pulmonary diseases: State of the art and future perspectives. Pharmacological Research 2017; 115: 133-148
- 29 Kumar D, Kumar M, Saravanan C. et al. Curcumin: A potential candidate for matrix metalloproteinase inhibitors. Expert Opinion on Therapeutic Targets 2012; 16: 959-972
- 30 Chen QY, Zheng Y, Jiao DM. et al Curcumin inhibits lung cancer cell migration and invasion through Rac1-dependent signaling pathway. The Journal of Nutritional Biochemistry 2014; 25: 177-185
- 31 Lelli D, Pedone C, Majeed M. et al. Curcumin and lung cancer: The role of micrornas. Current Pharmaceutical Design 2017; 23: 3440-3444
- 32 Ting CY, Wang HE, Yu CC. et al. Curcumin triggers DNA damage and inhibits expression of DNA repair proteins in human lung cancer cells. Anticancer Research 2015; 35: 3867-3873
- 33 Kraus VB, Blanco FJ, Englund M. et al. Call for standardized definitions of osteoarthritis and risk stratification for clinical trials and clinical use. Osteoarthritis Cartilage 2015; 23: 1233-1241
- 34 Sun Y, Liu W, Zhang H. et al. Curcumin prevents osteoarthritis by inhibiting the activation of inflammasome NLRP3. Journal of Interferon & Cytokine Research 2017; 37: 449-455
- 35 Ahmed S, Khan H, Mirzaei H. Mechanics insights of curcumin in myocardial ischemia: Where are we standing?. European Journal of Medicinal Chemistry 2009; 183: 111658
- 36 Jiang S, Han J, Li T. et al Curcumin as a potential protective compound against cardiac diseases. Pharmacological Research 2017; 119: 373-383
- 37 Tanwar V, Sachdeva J, Kishore K. et al. Dose-dependent actions of curcumin in experimentally induced myocardial necrosis: A biochemical, histopathological, and electron microscopic evidence. Cell Biochemistry and Function: Cellular Biochemistry and Its Modulation by Active Agents or Disease 2010; 28: 74-82
- 38 Wang X, Gao J, Wang Y. et al. Curcuminpretreatment prevents hydrogen peroxide-induced oxidative stress through enhanced mitochondrial function and deactivation of Akt/Erksignaling pathways in rat bone marrowmesenchymal stem cells. Molecular and Cellular Biochemistry 2018; 443: 37-45
- 39 Akinyemi AJ, Onyebueke N, Faboya OA. et al. Curcumin inhibits adenosine deaminaseandarginase activities in cadmium-induced renal toxicity in rat kidney. Journal of Food and Drug Analysis 2017; 25: 438-446
- 40 Li W, Wu M, Tang L. et al. Novelcurcumin analogue 14p protects against myocardial ischemia reperfusion injury through Nrf2-activating anti-oxidative activity. Toxicology and Applied Pharmacology 2015; 282: 175-183
- 41 Li L, Li H, Li M. Curcumin protects against cerebral ischemia-reperfusion injury by activating JAK2/STAT3 signaling pathway in rats. International journal of Clinical and Experimental Medicine 2015; 8: 14985
- 42 Park K, Lee JH, Cho HC. et al. Down-regulation of IL-6, IL-8, TNF-α and IL-1β by glucosamine in HaCaT cells, but not in the presence of TNF-α. Oncology Letters 2010; 1: 289-292
- 43 Dai J, Gu L, Su Y. et al. Inhibition of curcumin on influenza A virus infection and influenzal pneumonia via oxidative stress, TLR2/4, p38/JNK MAPK and NF-κb pathways. International Immunopharmacology 2018; 54: 177-187
- 44 Aslanabadi N, Entezari-Maleki T, Rezaee H. et al. Curcumin for the prevention of myocardial injury following elective percutaneous coronary intervention; A pilot randomized clinical trial. European Journal of Pharmacology 2019; 858: 172471
- 45 Sahin K, Orhan C, Tuzcu Z. et al. Curcuminameloriates heat stress via inhibition of oxidative stress and modulation of Nrf2/HO-1 pathway in quail. Food and Chemical Toxicology 2012; 50: 4035-4041
- 46 Fauci AS. et al. Harrison’s Principles of Internal Medicine. 20th Ed.. United States: McGraw-Hill Education; 2018
- 47 Chacko KR, Reinus J. Spectrum of alcoholic liver disease. Clin. Liver Dis 2016; 20: 419-427
- 48 Fischer M, You M, Matsumoto M. et al. Peroxisome proliferator-activated receptor α (PPARα) agonist treatment reverses PPARα dysfunction and abnormalities in hepatic lipid metabolism in ethanol-fed mice. Journal of Biological Chemistry 2003; 278: 27997-28004
- 49 Mahfouz MM, Zhou SQ, Kummerow FA. Curcumin prevents the oxidation and lipid modification of LDL and its inhibition of prostacyclin generation by endothelial cells in culture. Prostaglandins & Other Lipid Mediators 2009; 90: 13-20
- 50 Hismiogullari SE, Hismiogullari AA, Sunay FB. et al. The protective effect of curcumin on carbon tetrachloride induced liver damage. Revue Méd Vét 2014; 165: 194-200
- 51 Li B, Wang L, Lu Q. et al. Liver injury attenuation by curcumin in a rat NASH model: An Nrf2 activation-mediated effect?. Ir J Med Sci 2016; 185: 93-100
- 52 Farzaei MH, Zobeiri M, Parvizi F. et al. Curcumin in liver diseases: A systematic review of the cellular mechanisms of oxidative stress and clinical perspective. Nutrients 2018; 10: 855
- 53 Afrin R, Arumugam S, Rahman A. et al. Curcumin ameliorates liver damage and progression of NASH in NASH-HCC mouse model possibly by modulating HMGB1-NF-κb translocation. International Immunopharmacology 2017; 44: 174-182
- 54 Guo C, Ma J, Zhong Q. et al. Curcumin improves alcoholic fatty liver by inhibiting fatty acid biosynthesis. Toxicology and Applied Pharmacology 2017; 328: 1-9
- 55 Lee HI, MCgregor RA, Choi MS. et al. Low doses of curcumin protect alcohol-induced liver damage by modulation of the alcohol metabolic pathway, CYP2E1 and AMPK. Life Sciences 2013; 93: 693-699
- 56 Cerný D, Lekic’ N, Vánˇová K. et al. Hepatoprotective effect of curcumin in lipopolysaccharide/-galactosamine model of liver injury in rats: Relationship to HO-1/CO antioxidant system. Fitoterapia 2011; 82: 786-791
- 57 Wojcik M, Krawczyk M, Wojcik P. et al. Molecular mechanisms underlying curcumin-mediated therapeutic effects in type 2 diabetes and cancer. Oxidative Medicine and Cellular Longevity. 2018
- 58 Jeenger MK, Shrivastava S, Yerra VG. et al. Curcumin: A pleiotropic phytonutrient in diabetic complications. Nutrition 2015; 31: 276-282
- 59 Pari L, Karthikesan K, Menon VP. Comparative and combined effect of chlorogenic acid and tetrahydrocurcumin on antioxidant disparities in chemical induced experimental diabetes. Molecular and Cellular Biochemistry 2010; 341: 109-117
- 60 El-Azab MF AttiaFM, El-Mowafy AM. Novel role of curcumin combined with bone marrow transplantation in reversing experimental diabetes: Effects on pancreatic islet regeneration, oxidative stress, and inflammatory cytokines. Eur J Pharmacol 2011; 658: 41-48
- 61 Ghosh S, Banerjee S, Sil PC. The beneficial role of curcumin on inflammation, diabetes and neurodegenerative disease: A recent update. Food and Chemical Toxicology 2015; 83: 111-124
- 62 Biswas S, Chen S, Liang G. et al. Curcuminanalogs reduce stress and inflammation indices in experimental models of diabetes. Frontiers in Endocrinology 2019; 10: 887
- 63 Chanpoo M, Petchpiboonthai H, Panyarachun B. et al. Effect of curcumin in the amelioration of pancreatic islets in streptozotocin-induced diabetic mice. J Med Assoc Thai 2010; 93: S152-S159