METHODS: A search was conducted following guidelines in the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) using the PubMed, Google Scholar, Scopus, and MEDLINE electronic databases to retrieve relevant studies assessing the impact of curcumin supplementation on SLE.
RESULTS: The initial search yielded three double-blind, placebo-controlled, randomized clinical trials, three human in vitro studies, and seven mouse-model studies. In human trials, curcumin decreased 24-h and spot proteinuria, but the trials were small, ranging from 14 to 39 patients, with varied curcumin doses and different study durations ranging from 4 to 12 weeks. There was no change in C3, dsDNA, or the Systemic Lupus Erythematosus Disease Activity (SLEDAI) scores even in the longer trials. The mouse-model trials yielded more data. NF-κβ activation was suppressed along with inducible nitric oxide synthase (NOS) species expression when 1 mg/kg/day of curcumin was administered for 14 weeks, leading to significant decreases in dsDNA, proteinuria, renal inflammation, and IgG subclasses. Another study suggested that curcumin reduced B cell-activating factor (BAFF) when used for up to 8 weeks at 50 mg/kg/day. A reduction in pro-inflammatory Th1 and Th17 percentages, IL-6 and anti-nuclear antibody (ANA) levels were reported. The doses used in the murine models were much higher than those used in human trials, with 12.5 mg-200 mg/kg/day used for over 16 weeks; highlighting that the optimal time for an immunological effect to be observed may require 12-16 weeks of curcumin use.
CONCLUSIONS: Despite the wide use of curcumin in everyday life, its molecular and anti-inflammatory use has only been partially explored. Current data show a potential benefit on disease activity. Still, no uniform dose can be advised because long-duration, large-scale randomized trials using defined dosing are needed in different subsets of SLE, including lupus nephritis patients.
方法:根据系统评价和荟萃分析(PRISMA)的首选报告项目指南,谷歌学者,Scopus,和MEDLINE电子数据库检索评估姜黄素补充对SLE影响的相关研究。
结果:最初的搜索产生了三个双盲,安慰剂对照,随机临床试验,三项人体体外研究,和七项小鼠模型研究。在人体试验中,姜黄素减少24小时和斑点蛋白尿,但是试验很小,从14到39名患者,不同的姜黄素剂量和不同的研究持续时间从4到12周。C3,dsDNA没有变化,或系统性红斑狼疮疾病活动(SLEDAI)评分,即使在较长的试验中。小鼠模型试验产生了更多的数据。当施用1mg/kg/天的姜黄素达14周时,NF-κβ激活与诱导型一氧化氮合酶(NOS)物种表达一起被抑制,导致dsDNA显著减少,蛋白尿,肾脏炎症,和IgG亚类。另一项研究表明,姜黄素以50mg/kg/天的剂量使用长达8周时,会降低B细胞活化因子(BAFF)。促炎Th1和Th17百分比的减少,报告IL-6和抗核抗体(ANA)水平。小鼠模型中使用的剂量远高于人体试验中使用的剂量,使用12.5mg-200mg/kg/天超过16周;强调观察到免疫效果的最佳时间可能需要使用姜黄素12-16周。
结论:尽管姜黄素在日常生活中广泛使用,其分子和抗炎用途仅得到部分探索。当前数据显示对疾病活动的潜在益处。尽管如此,没有统一的剂量可以建议,因为持续时间长,在SLE的不同亚组中需要使用定义剂量的大规模随机试验,包括狼疮肾炎患者。