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Cystic fibrosis (CF) is a common autosomal recessive genetic disorder in Caucasian populations, which reduces the life span among those affected. Severe inflammation on pulmonary, gastrointestinal, and systemic levels was observed in CF patients. In CF lung pathology and diseases progression, inflammation plays a very important role. The chloride ion transport in the epithelial cells is altered due to the abnormal function of cystic fibrosis transmembrane conductance regulator (CFTR). This results in the dehydration of the liquid in the airway surface, causes thickening of the secreted mucin and obstructs the airway. This triggers the inflammation.1
Newer modified CFTR protein drugs such as ivacaftor, lumacaftor, tezacaftor reduce airway inflammation, but complete elimination is not possible and these drugs also affects the specific mutations and do not cover all patients with various mutations. Hence, as an alternative some natural anti-inflammatory moieties have been studied for the treatment of inflammation in CF. Curcumin obtained from turmeric has potent anti-inflammatory activity. Curcumin is chemically [1,7-bis (4-hydroxy-3-methoxyphenyl)-1,6-heptadiene-3,5-dione], a polyphenolic compound isolated from the rhizomes of Curcuma longa. The CFTR is a well-studied ion channel target for curcumin and substantially impacts on the reduction of inflammatory factors2. Studies by Egan et al. have proved that curcumin induced accumulation of complex-glycosylated F508 CFTR and increased cell surface density, it acts as a sarcoplasmic/endoplasmic reticulum calcium (SERCA) pump inhibitor and could increase the appearance of functional DF508 CFTR on the plasma membrane cells and suppressed the endogenous calreticulin mRNA transcription. Also, it was observed that Cystic fibrosis patients had chances of bacterial infection due to the absence of CFTR protein, which causes demethylation of DNA at the specific CpG sites which overlaps a minimal region to maintain activity of TLR2 promoter. Curcumin can degrade specificity protein 1 (SP1) via oxidative and proteasome degradation pathways.1
A double blind control trial was conducted at the Akbar Children′s Hospital in Mashhad, Iran, where children with CF were included and treated for 3 months with Placebo and curcumin with the maximum dose of 80 mg based on the body surface of the patients. Curcumin in the form of Nano-curcumin (Exir Nano Sina Drug Company, Iran) was prepared as nano micelle in the form of 70 mg of drops in 1 cc, and the placebo with the same color, taste, and odor.1
The primary outcome of the study was to evaluate inflammation based on serum interleukin-6, interleukin-10, and hs-CRP, stool calprotectin, and neutrophil count of nasopharyngeal swab. The secondary outcome studied was clinical assessment via spirometry, anthropometrics, and quality of life. The outcomes were studied from before 3 months to after 3 months of continuing curcumin therapy. The study concluded that Curcumin owing to its multifarious effects on CF disease could serve as a potent nutritional strategy in the treatment of cystic fibrosis.1
Thus to conclude, curumin in the form of nano formulation results in the increased bioavailability of curcumin and enhances its anti-inflammatory processes and can prove to be effective in treating cystic fibrosis.
- Talebi S, Safarian M, Jaafari MR, Sayedi SJ, Abbasi Z, Ranjbar G, et al. The effects of nano-curcumin as a nutritional strategy on clinical and inflammatory factors in children with cystic fibrosis: the study protocol for a randomized controlled trial. 2021;22(1):292.
- Cohen TS, Prince A. Cystic fibrosis: a mucosal immunodeficiency syndrome. Nature medicine. 2012;18(4):509-19.