The effect of black barberry hydroalcoholic extract on immune mediators in patients with active rheumatoid arthritis: A randomized, double–blind, controlled clinical trial

Abstract

Rheumatoid arthritis (RA) is an autoimmune disease associated with inflammation. In this trial, we aimed to investigate the Immunomodulatory effect of hydroalcoholic extract of black barberry on immune mediators in patients with active rheumatoid arthritis. In this randomized, double–blind, placebo‐controlled clinical trial, 80 women with active RA were randomly assigned into two groups of two capsules, each containing 1,000 mg black barberry extract (n = 40) or maltodextrin placebo (n = 40) daily for 12 weeks. Demographic indices, physical activity, dietary intake, and disease activity were investigated using suitable questionnaires. Concentration of cytokines IL‐2, IL‐4, IL‐10, and IL‐17 in blood sample were measured using PBMC method. Statistical analysis was performed using SPSS (version 22). At baseline, there were no differences between the two groups in terms of demographic indices, physical activity, and dietary intake (p > .05). Black barberry supplementation reduced the severity of RA. It showed no significant effect on IL‐2 and IL‐4 cytokines (p > .05). IL‐17 levels decreased significantly after the intervention within the black barberry group, while IL‐10 had a significant increase in this group (p < .05). Barberry extract may reduce inflammatory and increase anti‐inflammatory cytokines in RA, and stimulates the immune response by increasing Th2 production.

A Systematic Review of Nutritional Interventions on Key Cytokine Pathways in Rheumatoid Arthritis and Its Implications for Comorbid Depression: Is a More Comprehensive Approach Required?

“…Dietary consumption of antioxidants, PUFAs, and fiber have preferable disease outcomes in patients with RA, whereas salt does not [32][33][34][35][36][37][38]; 3. Flavanoid supplementation, particularly with barbary extract, cinnamon, cranberry juice, curcumin, garlic, saffron, pomegranate extract, sesamin, and diindolylmethane (DIM) in patients with RA has shown promising results in reducing inflammatory cytokines active in the RA disease process [39][40][41][42][43][44][45][46][47][48][49][50][51]; and 4. Probiotic supplementation may be beneficial in ameliorating the profile of gut microbiota in patients with RA, also resulting in decreased disease activity [52][53][54][55][56].…”

“…Thirteen of the 41 articles analyzed involved supplement and food interventions known to be high in flavanoid concentrations. RCTs evaluating barbary extract, cinnamon, cranberry juice, garlic, saffron, pomegranate extract, sesamin, polyphenolic extract from olive oil, and DIM extract from cruciferous vegetables showed reductions in several inflammatory cytokines (see Table 1 for cytokines measured with p values) [39][40][41][42][43][44][45][46][47][48][49][50][51]. There were mixed results with curcumin with one RCT finding no significant improvements, while another did see decreased CRP, ERP, and other inflammatory markers in patients with RA [44][45].…”

Rheumatoid Arthritis and Reactive Oxygen Species: A Review

“…Black barberry extract (1000 mg/day for 12 weeks) intervention significantly decreased IL-17 levels and increased IL-10 [ 92 ]. The trial of Brazilian propolis (508.5 mg daily for 24 weeks) did not show a significant difference in DAS28-ESR, CRP, simplified disease activity index, or clinical disease activity index [ 93 ].…”