Using Curcumin as an Compound to the Treatment Regime in the Patients With Peptic Ulcer Disease

Introduction

Curcumin, a principal polyphenolic Curcuminoid and a yellow pigment obtained from the turmeric rhizome referred to as Curcumina longa, is customarily incorporated in food as food -coloring agent. Studies propose that numerous beneficial properties of Curcumin, such as anti-cancer, anti-fungal, anti-inflammatory, anti-microbial, anti-oxidant, and anti-proliferative (Frantz, 2005). Such pleiotropic activities have provoked a few research groups to clarify the role of the agent Helicobacter Pylori (H. Pylori) disease, alongside its potential in various gastrointestinal infections. Given a few in vitro, cell culture, clinical trials, cell culture, and animal research, Curcumin was anticipated as a possible therapeutic candidate against gastric pathogenesis, primarily H. Pylori. The study will shed light on the effects of Curcumin on H. Pylori in various models with fastidious accentuation on its anti-cancer, anti-fungal, anti-inflammatory, anti-microbial, anti-oxidant, and antiproliferative properties (Sharma et al., 2001). Astoundingly, non-toxic Curcumin molecule meets the attributes of an ideal chemopreventive agent against gastric carcinogenesis in combination with other therapeutic approaches.

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It was anticipated long before that Curcumin, commonly known for its anti-carcinogenic and anti-inflammatory properties, should possess anti-H. Pylori effect. The first study on the direct effect of H. Pylori emerged in 2002 (Gupta, Patchva, Koh & Aggarwal, 2009). To comprehend the reason of the wide-ranging sensibility, the sequence of uniformity of the aroE gene encoding shikimate dehydrogenase (SDH) of disease, which plays a role in shikimate pathway that, assumes a significant role in the development of harmless antimicrobial agents? Although Curcumin is a potent inhibitor of SDH, it was not possible to establish the link between MIC of Curcumin and aroE sequence towards H. Pylori. These outcomes unmistakably affirmed that Curcumin is an inhibitor for H. Pylori of Indian strains regardless of disease status and genetic makeup. The H. Pylori disease's mouse model has been widely utilized as a part of examinations of host responses towards the H. Pylori infection and also in eradication studies. In such studies, it has been demonstrated that Curcumin treatment annihilated H. Pylori from the stomach of the infected mouse (Aggarwal & Sung, 2008). The annihilation by Curcumin was not based on the bacterial genotype, which is free of the existence of the cag PAI. Accordingly, histological analysis demonstrated that Curcumin is strikingly effective in the repair of damaged tissue. The microscopical observations uncovered significant damage in the gastric tissues of the mouse contaminated with H. Pylori compared to the control. Intact glandular cells and epithelial layer with continuous gastric pits in gastric mucosa of control were harmed through the denudation of the H. Pylori surface epithelial layer in an infected gastric tissue of the mouse, which was nearly reestablished upon treatment with Curcumin.

Objectives

To assess the possibility of using Curcumin in the development of therapeutic medication against H. Pylori based gastric infirmities through enhanced delivery systems and formulation.

To assess anti-H. Pylori, the anti-ulcer activity of the combination of the standard tripped therapy and Curcumina longa.

Methodology

Clinical trials was undertaken to ascertain Curcumin as a possible therapeutic remedy against H. Pylori infections. Considering the strong linkage of gastric cancer and H. Pylori, and informed by Schraufstatter and Bernt (2009) studies, it was hypothesized that Curcumin could induce its chemopreventive action through direct inhibition of H. Pylori. The focus will be to demonstrate that Curcumin extract hindered the development of distinct strains of H. Pylori. Curcumin extract were 25mg/mL and 12.5mg/mL respectively. Participants were randomly classed into two groups with one of them as a control.

Subjects

From the fifteen subject recruited, only twelve participants completed the study (1 female, 11 male; height 181.7 6.1 centimeters; age 24.0 3.1years; and weight 81.2 4.2 kilograms; 11 Caucasians and I African American). Two of the participants opted out of the study due to personal reasons while the other was left out because of health reasons. In the study, volunteers needed to meet some parameters: aged between 20 and 35 years and not have consumed Curcumin-enriched foods or supplements for two weeks before the testing; history of hyperacidity, duodenal/gastric ulcers, and gastrointestinal problems; non-diabetic; non-hemophiliac; and no known allergy to Curcumin. The relevant bodies approved the protocol within the University. Subjected were taken through screening and provided written consent to guarantee voluntary willingness and eligibility for participation.

Study Materials

Products names were omitted because of the lack of disclosure content. The aggregate mass of all preparations was matched through the use of microcrystalline cellulose (inert filler material). In the study, six volunteers were supplied with six visually identical hard gel capsules for all the study materials according to the setting, resulting in three hundred and seventy-six Curcuminoids for CSL, CW8, CEO and one thousand eight hundred milligrams of aggregate Curcuminoids for standard C as per the study dosage. Before the commencement of the study, capsules of all products were evaluated and the actual content of Curcuminoids computed as means. As a control group, the remaining six participants were administered with the standard therapy for the treatment of H-Pylori.

Cell proliferation was investigated based on the MTT essay with cell apoptosis assessed through the measurement of the activity of caspace-3/7 activity. In the study, molecular cells that cause cell damage were assessed using PCR (polymerase chain reaction) array of human, containing eighty nine apoptosis-based genes. Activation of apoptosis-based proteins, survival and cell growth were examined through Western blotting.

Results

From the empirical study, it was established that the concentration of Curcumin of 12.5 mg/mL repressed 100% development of all strains in a concentration range of 6.25 and 12.5 mg/mL. Besides, a significant amount of isolates was likewise observed to be in concurrence concerning MIC outcome. It was reported that Curcuma longa MIC ranged between 5 mg/mL and 50 mg/mL and most of the strains (81%) demonstrated a MIC of the range between 10 and 15 mg/mL (Schraufstatter & Bernt, 2007). In the gastric pit cells of the contaminated tissue, inflammation was altogether lessened by Curcumin treatment. Disruption of muscularis mucosal layers and the atrophy of contaminated gastric tissues of the mouse were likewise significantly covered following treatment by Curcumin.

In the control group, insignificant inflammatory cells infiltered more within the submucosal area of H. Pylori-tainted gastric tissues and were remediated in no small extent in Curcumin-treated human participants. Consequently, these outcomes pointed towards that elevated level of efficacy of Curcumin in the treatment of the general harm caused by H. Pylori disease. These revelations not only exhibit the therapeutic capacity of Curcumin against gastric cancer but also illuminate the mitigating impact of Curcumin and furthermore attract the attention of scholars of its potential to combine with other therapeutic interventions against the H. Pylori infection. Various conventional techniques, such as pH, heat, and complexations with polymers, metal ions and serum have been used in the improvement of the efficacy and solubility of Curcumin. It has been asserted that Curcumin's solubility can be elevated by twelvefold through the use of heat.

Discussion

Some novel approaches to overcome the less bioavailability of Curcumin are adjuvants, which hinder Curcumin's metabolic pathway, active delivery systems, such as liposomes, micelles, nanoparticles, and phospholipid complexes (Aggarwal & Harikumar, 2009). Adjuvants are compounds that improve the existing medical regimens, as a pharmacological agent incorporated to a medication to aid or increase its effect. It is commonly known that the glucuronidation of Curcumin tends to reduce its effect (Oppenheimer, 2007). Metabolic interaction of Curcumin can be repressed by Piperine, an adjuvant, which is a universal inhibitor of intestinal and hepatic glucuronidation. Associated use of piperine with Curcumin improved the bioavailability of Curcumin by two thousand percent in human volunteers (Mencher & Wang, 2005). For that matter, other adjuvants that have indicated synergistic effect when combined with Curcumin are quercetin, genistein, and terpineol/eugenol (Kanai et al., 2011).

Curcumin structure assumes an urgent role in the determination of metabolic and biological activity. Accordingly, a few endeavors have been made using the derivatives or analog of Curcumin with multiple successes. A Curcumin analog, EF-24, was accounted for to be a lead compound exhibiting high anti-tumor properties both in vivo and in vitro same as Curcumin and less lethal. EF-24 demonstrated its higher bioavailability than Curcumin of thirty-five and sixty percent with ip and oral respectively. A study on the biochemical property of Curcumin explained lucidly various cases where scholars have examined distinctive Curcumin complexes, such as boron, copper, gallium, indium, manganese, and vanadyl complexes, which can be examined further for anti-H-Pylori effect (Gupta et al., 2011).

Conclusion

The study sought to assess the possibility of using Curcumin in the development of therapeutic medication against H. Pylori based gastric infirmities through enhanced delivery systems and formulation. It established that the application of nanoparticle is a possible answer to compounds whose bioavailability is compromised, such as Curcuma longa. The delivery system based on nanoparticle will in all likelihood be suitable for extremely hydrophobic agents, such as Curcumin, sidestepping the downsides of compromised aqueous solubility. NanoCurcumin is discovered to have significant anti-inflammatory attributes and provides more protection to the apoptosis and oxidative stress. The primary objective of using nanocarcumin is to have more scattered and accessible Curcumin in aqueous solution (Dhillon et al., 2011). The application of nanoCurcumin in various types of cancer is presently a matter of consistent discourse because of its improved efficacy in comparison to the native Curcumin. Oral bioavailability has been enhanced significantly with nano-based delivery system compared to the administration of piperine adjuvant. Polylactic-co-glycolic acid (PLGA) nanoformulation of turmeric extract has shown enhanced bioavailability of up to twenty-two times, as well as pre-clinical studies although H. Pylori infection is yet to be analyzed.

References

Aggarwal BB, Harikumar KB. Potential therapeutic effects of Curcumin, the anti-inflammatory agent, against neurodegenerative, cardiovascular, pulmonary, metabolic, autoimmune and neoplastic diseases. Int J Biochem Cell Biol. 2009;41(1):40-59. doi: 10.1016/j.biocel.2008.06.010.

Aggarwal BB, Sung B. Pharmacological basis for the role of Curcumin in chronic diseases: an age-old spice with modern targets. Trends Pharmacol Sci. 2009;30(2):85-94. doi: 10.1016/j.tips.2008.11.002.

Dhillon N, Aggarwal BB, Newman RA, Wolff RA, Kunnumakkara AB, Abbruzzese JL, et al. Phase II trial of Curcumin in patients with advanced pancreatic cancer. Clin Cancer...