Does nano‐curcumin supplementation improve hematological indices in critically ill patients with sepsis? A randomized controlled clinical trial

Abstract

Sepsis is the final common pathway to death for severe infectious diseases worldwide. The present trial aimed to investigate the effects of nano‐curcumin supplementation on hematological indices in critically ill patients with sepsis. Fourteen ICU‐admitted patients were randomly allocated into either nano‐curcumin or placebo group for 10 days. The blood indices, serum levels of inflammatory biomarker and presepsin as well as nutrition status, and clinical outcomes were assessed before the intervention and on days 5 and 10. White blood cells, neutrophils, platelets, erythrocyte sedimentation rate (ESR), and the levels of interleukin‐8 significantly decreased in the nano‐curcumin group compared to the placebo after 10 days of intervention (p = .024, p = .045, p = .017, p = .041, and p = .004, respectively). There was also a marginal meaningful decrease in serum presepsin levels in the intervention group compared to the placebo at the end of the study (p = .054). However, total lymphocyte count showed a significant increase in the nano‐curcumin group compared to the placebo at the end‐point (p = .04). No significant differences were found in the level of lymphocyte and the ratios of neutrophil/lymphocyte and platelet/lymphocyte between the study groups. Moreover, no significant between‐group differences were observed for other study outcomes, post‐intervention. Collectively, nano‐curcumin may be a useful adjuvant therapy in critically ill patients with sepsis. However, further trials are suggested to examine the effects of nano‐curcumin in the management of sepsis and its complications. Practical applications Curcumin (1,7‐bis[4‐hydroxy‐3‐methoxyphenyl]‐1,6‐heptadiene‐3,5‐ dione) or diferuloylmethane is widely used in medicine due to its several biological properties. Recent evidence has shown that curcumin possesses multiple pharmacological activities including immune‐modulatory, antioxidant, anti‐inflammatory, anti‐cancer, and anti‐microbial effects. In this study, it was observed that nano‐curcumin at a dose of 160 mg for 10 days, without side effects, reduced some inflammatory factors and regulated the immune responses in sepsis patients. For the first time, this trial was conducted to determine the effect of nano‐curcumin on hematological indices and the serum levels of presepsin and IL‐8.

Curcumin Formulations for Better Bioavailability: What We Learned from Clinical Trials Thus Far?

“…Nanocurcumin formulation in COVID-19 patients led to reduced levels of GM-CSF, IFNγ, IL-1β, IL-6, IL-17, IL-18, IL-21, IL-23, RORγ t, T-box transcription factor 21 (TBX21), and TNF-α, and induced FOXP3, IL-4, IL-10, IL-35, and TGF-β levels. − It also improved lymphocyte count, oxygen saturation levels, symptoms, and Treg cell frequency and reduced symptom resolution time, hospitalized duration, and mortality rate in COVID-19 patients. ,,− Several studies have also revealed the beneficial effects of nanocurcumin formulation in treating critically ill patients with sepsis. Nanocurcumin from Exir-Nano-Sina (Iran) suppressed Bcl-2, inflammatory molecules such as ICAM-1, IL-1β, IL-6, IL-18, TLR-4, TNF-α, and VCAM-1, creatinine, lipid profile, liver enzymes and reduced mechanical ventilation period in these patients. ,, In addition, nanocurcumin treatment enhanced clinical response rate and ameliorated radiation-induced dermatitis in various cancers including bladder, head and neck, and prostate cancers. ,, It also reduced DNA damage and micronuclei formation in lymphocytes of thyroid cancer patients . Moreover, the antidiabetic properties of nanocurcumin were attributed their capacity in reducing FBG, glycated Hb, insulin, hs-CRP, TC, TAC, TN, LDL-C, VLDL-C, TC/HDL-C, MDA, and augmented insulin sensitivity, TAC, peroxisome proliferator-activated receptor gamma (PPARγ), LDLR, and GSH levels in T2D patients. − It also suppressed neuropathy, depression, and anxiety in T2D-associated peripheral neuropathy patients. , Nanocurcumin supplementation for 10 weeks improved sperm count, sperm motility, and testosterone levels in patients with infertility complaints .…”

Profiling Inflammatory Biomarkers following Curcumin Supplementation: An Umbrella Meta‐Analysis of Randomized Clinical Trials

“…Curcumin is remarkable bioactive polyphenol extracted from the rhizome of turmeric (Curcuma longa) [ 9 , 10 ]. Curcumin has a wide range of medicinal effects such as hepatoprotective, antimicrobial, anti-inflammatory, antioxidant, and antitumor activities [ 11 , 12 ].…”

Nano-curcumin supplementation in critically ill patients with sepsis: a randomized clinical trial investigating the inflammatory biomarkers, oxidative stress indices, endothelial function, clinical outcomes and nutritional status

“…This combat in turn causes extensive coagulation and inflammatory responses in the body. 2,3 During sepsis, the dysregulation or overreaction of the immune system with the purpose of elimination of pathogens can ultimately lead to tissue damage, organ failure, and death. 4 According to global statistics, the prevalence of sepsis is estimated to be more than 30 million cases in the world each year, which has increased by 9 to 13 percent annually.…”