Download PDF
Drug Res (Stuttg) 2016; 66(08): 444-448
DOI: 10.1055/s-0042-109394
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Adjunctive Therapy with Curcumin for Peptic Ulcer: a Randomized Controlled Trial

A. Khonche
1   Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, Tehran, Iran
,
O. Biglarian
1   Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, Tehran, Iran
,
Y. Panahi
2   Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
,
G. Valizadegan
1   Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, Tehran, Iran
,
S. S. Soflaei
3   Neurogenic Inflammation Research Center, Department of Modern Sciences and Technologies, Mashhad University of Medical Sciences, Mashhad, Iran
,
M. E. Ghamarchehreh
1   Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, Tehran, Iran
,
M. Majeed
4   Sabinsa Inc, Princeton, NJ, United States
,
A. Sahebkar
5   Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
6   Metabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
› Author Affiliations
Further Information

Publication History

received 03 May 2016

accepted 27 May 2016

Publication Date:
28 June 2016 (online)

Also available at
    Permissions and Reprints

Abstract

Background: Curcumin, the bioactive ingredient of turmeric, has been shown to improve the treatment of peptic ulcer (PU) in animal studies. However, clinical studies confirming this effect of curcumin have been scant.

Objective: To assess the efficacy of adjunctive therapy with curcumin on the eradication of Helicobacter pylori infection and severity of dyspepsia in patients with PU.

Methods: In this randomized double-blind placebo-controlled parallel-group trial, patients diagnosed with PU were assigned to standard H. pylori eradication triple therapy with clarithromycin (500 mg b.i.d.), amoxicillin (1 000 mg b.i.d.) and pantoprazole (40 mg b.i.d.), and randomized to receive either curcumin (500 mg/day) or placebo as adjunct to standard treatment. Severity of dyspepsia symptoms was evaluated using the Hong Kong dyspepsia index (HKDI). Eradication of H. pylori infection was assessed using the urea breath test (UBT) at 4 weeks following the end of treatment.

Results: Adjunctive therapy with curcumin was associated with a greater improvement of dyspepsia symptoms according to the HKDI score (change score: −12.90±2.81 vs. −9.60±3.39 in the curcumin and control group, respectively; p<0.001). The number of subjects whose dyspepsia was resolved during the course of treatment was significantly higher in the curcumin (27.6%) vs. placebo (6.7%) group (p=0.042). Nevertheless, the results of UBT test showed equal rate (73.3%) of H. pylori eradication in the study groups. Curcumin was safe during the course of trial.

Conclusion: Addition of curcumin on top of the standard anti-helicobacter regimen in patients with PU is safe and improves dyspepsia symptoms but has no enhancing effect on the eradication of H. pylori infection.

Key words

peptic ulcer - dyspepsia - helicobacter pylori - curcumin - randomized controlled trial
 

  • References

  • 1 Najm WI. Peptic ulcer disease. Primary Care: Clinics in Office Practice 2011; 38: 383-394
    CrossrefPubMedGoogle Scholar
  • 2 Ford A, Delaney B, Forman D et al. Eradication therapy for peptic ulcer disease in Helicobacter pylori positive patients. The Cochrane Library; 2007
    Google Scholar
  • 3 Kuipers E. Helicobacter pylori and the risk and management of associated diseases: gastritis, ulcer disease, atrophic gastritis and gastric cancer. Alimentary pharmacology & therapeutics 1997; 11: 71-88
    CrossrefPubMedGoogle Scholar
  • 4 Vanni E, Bugianesi E, Kotronen A et al. From the metabolic syndrome to NAFLD or vice versa?. Digestive and Liver Disease 2010; 42: 320-330
    CrossrefPubMedGoogle Scholar
  • 5 Rinella M, Charlton M. The globalization of non-alcoholic fatty liver disease – prevalence and impact on world health. Hepatology 2016;
    PubMedGoogle Scholar
  • 6 Chey WD, Wong BC. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. The American journal of gastroenterology 2007; 102: 1808-1825
    CrossrefPubMedGoogle Scholar
  • 7 Sarkar A, De R, Mukhopadhyay AK. Curcumin as a potential therapeutic candidate for Helicobacter pylori associated diseases. World journal of gastroenterology 2016; 22: 2736
    CrossrefPubMedGoogle Scholar
  • 8 Momtazi AA, Derosa G, Maffioli P et al. Role of microRNAs in the Therapeutic Effects of Curcumin in Non-Cancer Diseases. Mol Diagn The 2016; May 30. [Epub ahead of print] Review. DOI: 10.1007/s40291-016-0202-7.
    PubMedGoogle Scholar
  • 9 Panahi Y, Badeli R, Karami GR et al. Investigation of the efficacy of adjunctive therapy with bioavailability-boosted curcuminoids in major depressive disorder. Phytotherapy Research 2015; 29: 17-21
    CrossrefPubMedGoogle Scholar
  • 10 Esmaily H, Sahebkar A, Iranshahi M et al. An investigation of the effects of curcumin on anxiety and depression in obese individuals: A randomized controlled trial. Chinese journal of integrative medicine 2015; 21: 332-338
    CrossrefPubMedGoogle Scholar
  • 11 Panahi Y, Alishiri GH, Parvin S et al. Mitigation of systemic oxidative stress by curcuminoids in osteoarthritis: results of a randomized controlled trial. Journal of dietary supplements 2015;
    PubMedGoogle Scholar
  • 12 Panahi Y, Rahimnia AR, Sharafi M et al. Curcuminoid treatment for knee osteoarthritis: a randomized double-blind placebo-controlled trial. Phytotherapy Research 2014; 28: 1625-1631
    CrossrefPubMedGoogle Scholar
  • 13 Panahi Y, Hosseini MS, Khalili N et al. Antioxidant and anti-inflammatory effects of curcuminoid-piperine combination in subjects with metabolic syndrome: A randomized controlled trial and an updated meta-analysis. Clinical Nutrition 2015;
    PubMedGoogle Scholar
  • 14 Panahi Y, Khalili N, Hosseini MS et al. Lipid-modifying effects of adjunctive therapy with curcuminoids-piperine combination in patients with metabolic syndrome: Results of a randomized controlled trial. Complementary therapies in medicine 2014; 22: 851-857
    CrossrefPubMedGoogle Scholar
  • 15 Sahebkar A. Curcuminoids for the management of hypertriglyceridaemia. Nature Reviews Cardiology 2014; 11: 123-123
    PubMedGoogle Scholar
  • 16 Mohammadi A, Sahebkar A, Iranshahi M et al. Effects of supplementation with curcuminoids on dyslipidemia in obese patients: a randomized crossover trial. Phytotherapy Research 2013; 27: 374-379
    CrossrefPubMedGoogle Scholar
  • 17 Panahi Y, Kianpour P, Mohtashami R et al. Curcumin lowers serum lipids and uric acid in subjects with non-alcoholic fatty liver disease: A randomized controlled trial. Journal of cardiovascular pharmacology 2016;
    PubMedGoogle Scholar
  • 18 Rahmani S, Asgary S, Askari G et al. Treatment of Non-alcoholic Fatty Liver Disease with Curcumin: A Randomized Placebo-controlled Trial. Phytother Res 2016; June 8 DOI: 10.1002/ptr.5659. .
    PubMedGoogle Scholar
  • 19 Sahebkar A. Dual effect of curcumin in preventing atherosclerosis: the potential role of pro-oxidant-antioxidant mechanisms. Natural product research 2014; 1-2
    PubMedGoogle Scholar
  • 20 Sahebkar A. Molecular mechanisms for curcumin benefits against ischemic injury. Fertility and sterility 2010; 94: e75-e76
    CrossrefPubMedGoogle Scholar
  • 21 Panahi Y, Ghanei M, Bashiri S et al. Short-term curcuminoid supplementation for chronic pulmonary complications due to sulfur mustard intoxication: positive results of a randomized double-blind placebo-controlled trial. Drug research 2014;
    PubMedGoogle Scholar
  • 22 Panahi Y, Sahebkar A, Parvin S et al. A randomized controlled trial on the anti-inflammatory effects of curcumin in patients with chronic sulphur mustard-induced cutaneous complications. Annals of clinical biochemistry 2012; 49: 580-588
    CrossrefPubMedGoogle Scholar
  • 23 Panahi Y, Ghanei M, Hajhashemi A et al. Effects of curcuminoids-piperine combination on systemic oxidative stress, clinical symptoms and quality of life in subjects with chronic pulmonary complications due to sulfur mustard: a randomized controlled trial. Journal of dietary supplements 2014;
    PubMedGoogle Scholar
  • 24 Panahi Y, Sahebkar A, Amiri M et al. Improvement of sulphur mustard-induced chronic pruritus, quality of life and antioxidant status by curcumin: results of a randomised, double-blind, placebo-controlled trial. British Journal of Nutrition 2012; 108: 1272-1279
    CrossrefPubMedGoogle Scholar
  • 25 Panahi Y, Saadat A, Beiraghdar F et al. Adjuvant therapy with bioavailability-boosted curcuminoids suppresses systemic inflammation and improves quality of life in patients with solid tumors: a randomized double-blind placebo-controlled trial. Phytotherapy Research 2014; 28: 1461-1467
    CrossrefPubMedGoogle Scholar
  • 26 Sharma R, Gescher A, Steward W. Curcumin: the story so far. European journal of cancer 2005; 41: 1955-1968 DOI: 10.1007/s40291-016-0202-7.
    CrossrefPubMedGoogle Scholar
  • 27 Sahebkar A. Are curcuminoids effective c-reactive protein-lowering agents in clinical practice? evidence from a meta-analysis. Phytotherapy Research 2014; 28: 633-642
    CrossrefPubMedGoogle Scholar
  • 28 Panahi Y, Hosseini MS, Khalili N et al. Effects of supplementation with curcumin on serum adipokine concentrations: a randomized controlled trial. Nutrition 2016;
    PubMedGoogle Scholar
  • 29 Münzenmaier A, Lange C, Glocker E et al. A secreted/shed product of Helicobacter pylori activates transcription factor nuclear factor-kappa B. The Journal of Immunology 1997; 159: 6140-6147
    PubMedGoogle Scholar
  • 30 Mahady G, Pendland S, Yun G et al. Turmeric (Curcuma longa) and curcumin inhibit the growth of Helicobacter pylori, a group 1 carcinogen. Anticancer research 2001; 22: 4179-4181
    PubMedGoogle Scholar
  • 31 Foryst-Ludwig A, Neumann M, Schneider-Brachert W et al. Curcumin blocks NF-κB and the motogenic response in Helicobacter pylori-infected epithelial cells. Biochemical and biophysical research communications 2004; 316: 1065-1072
    CrossrefPubMedGoogle Scholar
  • 32 Han C, Wang L, Yu K et al. Biochemical characterization and inhibitor discovery of shikimate dehydrogenase from Helicobacter pylori. Febs Journal 2006; 273: 4682-4692
    CrossrefPubMedGoogle Scholar
  • 33 De R, Kundu P, Swarnakar S et al. Antimicrobial activity of curcumin against Helicobacter pylori isolates from India and during infections in mice. Antimicrobial agents and chemotherapy 2009; 53: 1592-1597
    CrossrefPubMedGoogle Scholar
  • 34 Zaidi SFH, Yamamoto T, Refaat A et al. Modulation of activation-induced cytidine deaminase by curcumin in helicobacter pylori-infected gastric epithelial cells. Helicobacter 2009; 14: 588-595
    CrossrefPubMedGoogle Scholar
  • 35 Kundu P, De R, Pal I et al. Curcumin alleviates matrix metalloproteinase-3 and-9 activities during eradication of Helicobacter pylori infection in cultured cells and mice. PloS one 2011; 6: e16306
    CrossrefPubMedGoogle Scholar
  • 36 Sintara K, Thong-Ngam D, Patumraj S et al. Curcumin suppresses gastric NF-kappaB activation and macromolecular leakage in Helicobacter pylori-infected rats. World J Gastroenterol 2010; 16: 4039-4046
    CrossrefPubMedGoogle Scholar
  • 37 Santos AM, Lopes T, Oleastro M et al. Curcumin inhibits gastric inflammation induced by Helicobacter pylori infection in a mouse model. Nutrients 2015; 7: 306-320
    CrossrefPubMedGoogle Scholar
  • 38 Di Mario F, Cavallaro LG, Nouvenne A et al. A curcumin-based 1-week triple therapy for eradication of helicobacter pylori infection: something to learn from failure?. Helicobacter 2007; 12: 238-243
    CrossrefPubMedGoogle Scholar
  • 39 Koosirirat C, Linpisarn S, Changsom D et al. Investigation of the anti-inflammatory effect of Curcuma longa in Helicobacter pylori-infected patients. International immunopharmacology 2010; 10: 815-818
    CrossrefPubMedGoogle Scholar
  • 40 Atal CK, Dubey RK, Singh J. Biochemical basis of enhanced drug bioavailability by piperine: evidence that piperine is a potent inhibitor of drug metabolism. The Journal of pharmacology and experimental therapeutics 1985; 232: 258-262
    PubMedGoogle Scholar
  • 41 Shoba G, Joy D, Joseph T et al. Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers. Planta medica 1998; 64: 353-356
    Article in Thieme ConnectPubMedGoogle Scholar
  • 42 Hu WH, Lam KF, Wong YH et al. The Hong Kong index of dyspepsia: a validated symptom severity questionnaire for patients with dyspepsia. J Gastroenterol Hepatol 2002; 17: 545-551
    CrossrefPubMedGoogle Scholar
  • 43 Prucksunand C, Indrasukhsri B, Leethochawalit M et al. Phase II clinical trial on effect of the long turmeric (Curcuma longa Linn.) on healing of peptic ulcer. Southeast Asian journal of tropical medicine and public health 2001; 32: 208-215
    PubMedGoogle Scholar
  • 44 Kim D-C, Kim S-H, Choi B-H et al. Curcuma longa extract protects against gastric ulcers by blocking H2 histamine receptors. Biological and Pharmaceutical Bulletin 2005; 28: 2220-2224
    CrossrefPubMedGoogle Scholar