The Potential use of a Curcumin-Piperine Combination as an Antimalarial Agent: A Systematic Review

Abstract

Malaria remains a significant global health problem, but the development of effective antimalarial drugs is challenging due to the parasite’s complex life cycle and lack of knowledge about the critical specific stages. Medicinal plants have been investigated as adjuvant therapy for malaria, so this systematic review summarizes 46 primary articles published until December 2020 that discuss curcumin and piperine as antimalarial agents. The selected articles discussed their antioxidant, anti-inflammatory, and antiapoptosis properties, as well as their mechanism of action against Plasmodium species. Curcumin is a potent antioxidant, damages parasite DNA, and may promote an immune response against Plasmodium by increasing reactive oxygen species (ROS), while piperine is also a potent antioxidant that potentiates the effects of curcumin. Hence, combining these compounds is likely to have the same effect as chloroquine, that is, attenuate and restrict parasite development, thereby reducing parasitemia and increasing host survival. This systematic review presents new information regarding the development of a curcumin-piperine combination for future malaria therapy.

Oral Administration of Piperine as Curative and Prophylaxis Reduces Parasitaemia in Plasmodium berghei ANKA-Infected Mice

“…The ability of piperine to inhibit the progression of parasitaemia, reduce clinical symptoms, and prolong the survival of animals was presumably due to it acting on the erythrocytic phase, specifically changing the morphology of infected red blood cells. At the late ring to trophozoites stages, the cytoplasm of infected red blood cells condenses, rendering them defective [ 28 , 34 ].…”

Piperine Enhances the Antimalarial Activity of Curcumin in Plasmodium berghei ANKA-Infected Mice: A Novel Approach for Malaria Prophylaxis

“…Hence, the novel combination therapy that can inhibit multiple stages of parasite life cycle as well as having a broader mode of action is required. The potent and sustained antimalarial activity of curcumin [ 26 , 27 , 39 , 48 – 50 ] and the antimalarial activity of piperine [ 37 , 39 , 51 , 52 ] prompted us to assess the potential prophylactic activity of combined curcumin and piperine as an alternative strategy in the fight against malaria.…”

“…Recently, oral administration of piperine 40 mg/kg BW in curative and prophylactic tests exhibited the parasitemia chemosuppression of 79.21% and 58.8% ( p < 0.05), respectively, prolonged survival rate compared with the negative control group, and an ability to protect vital organs (i.e., lungs, liver, spleen, and kidneys) from damage [ 37 ]. Furthermore, the combination of piperine and curcumin can enhance the bioavailability of curcumin in human and animal models [ 38 , 39 ].…”

“…The traditional prophylactic use of medicinal herbs that possess acute multistage activity is available from limited studies [ 40 ]. Recent studies reviewed that the curcumin and piperine combination possibly has prophylactic activity [ 39 ]; however, it must be proven empirically in animal models. Therefore, this study was designed to determine the prophylactic activity of the combined curcumin and piperine as antimalarial in Plasmodium berghei ANKA-infected mice.…”

Bioactive Compounds from Plants Used as Therapeutic Agents in Biomedical Applications – a Literature Review –

“…This research was based on strong antioxidant effects of individually applied curcumin and piperine causing damage to the parasites' DNA. Their combination is thought to limit the development of parasites but requires extensive studies to understand the mechanism of action on this therapy [50]. N. Li et al investigated the application of the two molecules together in the case of human HL60 leukemic cells.…”