Review
The protective role of curcumin in cardiovascular diseases

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Abstract

Curcumin (diferuloylmethane) is a polyphenol responsible for the yellow color of the curry spice turmeric. It has been used in a variety of diseases in traditional medicine. Modern scientific research has demonstrated its anti-inflammatory, anti-oxidant, anti-carcinogenic, anti-thrombotic, and cardiovascular protective effects. In this review, we focused mainly on the effects of curcumin on the cardiovascular system. The antioxidant effects of curcumin have been shown to attenuate adriamycin-induced cardiotoxicity and may prevent diabetic cardiovascular complications. The anti-thrombotic, anti-proliferative, and anti-inflammatory effects of curcumin and the effect of curcumin in decreasing the serum cholesterol level may protect against the pathological changes occurring with atherosclerosis. The p300-HAT inhibitory effects of curcumin have been demonstrated to ameliorate the development of cardiac hypertrophy and heart failure in animal models. The inflammatory effects of curcumin may have the possibility of preventing atrial arrhythmias and the possible effect of curcumin for correcting the Ca2+ homeostasis may play a role in the prevention of some ventricular arrhythmias. The preclinical studies from animal to clinical data in human are discussed.

Introduction

Curcumin (diferuloylmethane) is a polyphenol responsible for the yellow color of turmeric, a curry spice. The yellow-pigmented fraction of turmeric contains curcuminoids, which are chemically related to its principal ingredient, curcumin. The major curcuminoids present in turmeric are demethoxycurcumin (curcumin II), bisdemethoxycurcumin (curcumin III), and the recently identified cyclocurcumin [1]. In traditional Chinese and Indian medicine, curcumin has been used to treat a variety of diseases. A large body of evidence suggests that curcumin has a diverse range of molecular targets, including transcription factors, growth factors and their receptors, cytokines, enzymes, and genes regulating cell proliferation and apoptosis. As a result, several therapeutic effects of curcumin such as its anti-inflammatory, anti-oxidant, anti-carcinogenic, anti-thrombotic, and cardiovascular protective effects have been demonstrated [2]. A large number of studies have extensively investigated the anti-cancer effects of curcumin in both animal and human subjects. Curcumin has been reported to suppress the carcinogenic activity of a wide variety of carcinogens in cancers of the colon, duodenum, esophagus, stomach, liver, breast, oral cavity, and prostate, as well as leukemia [3]. In addition, previous studies have shown that the anti-inflammatory effects of curcumin may result in the favorable outcomes in the treatment of rheumatoid arthritis, postoperative inflammation and inflammatory bowel disease [4], [5], [6]. The anti-oxidant effects of curcumin may also account for early renal graft function [7] and the benefits seen in the treatment of patients with chronic pancreatitis [8]. Furthermore, it has been reported that curcumin may also improve cognitive function in the elderly [9]. At the time of the review, there are several ongoing clinical trials on curcumin in patients with different diseases, including several types of cancer, Alzheimer's disease, epilepsy and psoriasis [2].

The protective effects of curcumin on the cardiovascular system have been previously described and its use as a therapeutic agent to mitigate cardiovascular disease and other vascular dysfunctions is currently being investigated. This review focuses mainly on the effects of curcumin on the cardiovascular system Fig. 1.

Section snippets

Curcumin and adriamycin-induced cardiotoxicity

Adriamycin is a potent drug for the treatment of a broad spectrum of cancers. However, the cardiotoxicity induced by adriamycin limits its clinical dosage in cancer treatment [10]. It is well established that oxidative stress plays an important role in the mechanism of adriamycin-induced cardiotoxicity while antioxidant compounds have been shown to possess some protective effects [11], [12]. A study in rats has shown that adriamycin causes an increased heart rate, ST segment elevation, a

Preclinical and clinical studies in humans

A large body of evidence showed that curcumin possessed a variety of beneficial activities. Many clinical trials have been conducted in patients with cancer, rheumatoid arthritis, cystic fibrosis, inflammatory bowel disease, psoriasis, pancreatitis, and other disorders [2], [60]. However, very few have been conducted in patients with cardiovascular disorders.

Conclusions

The therapeutic effects of curcumin have been extensively investigated, particularly in the treatment of cancer and anti-inflammatory diseases [2], [60]. In addition, curcumin is well tolerated when taken at doses as high as 12 g/day and has low toxicity and low cost [64]. However, very little is known regarding the effect of curcumin on the cardiovascular diseases. There is growing evidence that curcumin has a potential role in the protection against many cardiovascular diseases. The

Acknowledgments

We thank Dr. Praness Krailadsiri for her editorial review.

The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology [67].

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