Mitigation of Systemic Oxidative Stress by Curcuminoids in Osteoarthritis: Results of a Randomized Controlled Trial
J Diet Suppl. 2016;13(2):209-20.
Osteoarthritis (OA) is a degenerative joint disease and is the most common type of arthritis. In OA the protective cartilage at the end of the bone wears away with time. This causes bones under the cartilage to rub together. The friction causes pain, swelling and loss of motion of the joint. Over the time, the joint may also lose its normal shape. People with joint injury are also at risk of developing OA. Ongoing researches have shown that obesity could lead to OA of knee.
Pathophysiology of OA is no more only “mechanical stress” but has gone beyond in the last decade of research. In the recent times, biochemical alterations such as oxidative stress, characterized by increased formation of reactive oxygen species (ROS) and the insufficiency of biological defense mechanisms to detoxify these species have come up as key contributors in etiopathogenesis of OA.
It has been found that overproduction of ROS in the joint tissue causes several structural damages to biological membranes and extracellular matrix proteins. Additionally, degradation of cartilage matrix results due to release of matrix metalloproteinases (MMPs) such as collagenases, gelatinases and stromelysins. In numerous earlier studies on OA patients, elevated levels of pro-oxidant species and altered levels of antioxidants have been reported in plasma and synovial fluid.
Current treatment for OA is limited to use of analgesic and non-steroidal anti-inflammatory drugs (NSAIDs). The use of turmeric in Asian traditional medicine as a treatment of joint pain and inflammation has suggested its role in the treatment of OA. Curcuminoids being the active moiety of turmeric can be useful in managing OA.
To evaluate the efficacy of Curcumin supplementation in reducing the oxidative stress by measuring the levels of serum concentration of important biomarkers in patients with knee OA.
In this randomized, double-blind, placebo-controlled, parallel-group, 6-week trial 53 subjects who complied with inclusion criteria were included in the trial and were divided in two groups. Subjects were administered either 3 capsules of Curcumin C3 Complex® formulation (500 mg Curcumin C3 Complex® and 5 mg BioPerine® combination) daily or matching placebo.
The primary efficacy measures of this trial were changes in clinical symptoms of OA using Osteo-arthritic index such as LPFI, WOMAC, VAS and improvement in stiffness, pain and increase in mobility of the joints. The biomarkers for oxidative stress (as a secondary efficacy measure) were evaluated in both Curcumin and placebo groups.
- Out of 53, 40 subjects (Curcumin C3 Complex®; n=19 and placebo; n=21) completed the 6-week duration of study and were included in the final analysis.
- The primary outcome of the clinical study showed the improvement in the Osteo-arthritic index such as LPFI, WOMAC, VAS and improvement in stiffness, pain and increase in mobility of the joints in patients treated with Curcumin C3 Complex®- BioPerine® group.
- Serum samples evaluation demonstrated that oxidative stress was reduced significantly with increase in serum levels of SOD (superoxide dismutase) and glutathione s-transferase (GSH) and concurrently there was decrease in the malondialdehyde (MDA) concentration in Curcumin C3 Complex®- BioPerine® group
Findings of the present study clearly indicated that following 6 weeks of supplementation with Curcumin C3 Complex®- BioPerine®, a significant improvement in systemic oxidative stress biomarkers was seen, which further validates antioxidant effects of Curcuminoids in chronic disease like OA.