title: Curcuma longa extract reduces inflammatory and oxidative stress biomarkers in osteoarthritis of knee: a four-month, double-blind, randomized, placebo-controlled trial.
abstract: OBJECTIVE
  Curcuma longa L. (CL), an Indian herb, has been used to treat many disorders because of its wide spectrum of pharmacological activities. It has been shown to exhibit anti-oxidant and anti-inflammatory properties, and is being used as herbal remedy since ancient times. Osteoarthritis of knee (KOA) is a chronic painful disorder in which prolong use of non-steroidal anti-inflammatory drugs (NSAIDs) or steroids may result into many serious side effects; hence, there is a need to develop herbal drugs, having good analgesia without side effects. Therefore, we planned to evaluate the efficacy of CL in KOA.
  
  
  METHODS
  The study was designed as a randomized, double-blind, placebo-controlled trial in patients of KOA. After obtaining ethical clearance and written informed consent, a total of 160 patients of KOA were randomly enrolled into two groups to receive either CL extract or placebo along with the standard drug regimen. The patients were assessed on day 0, day 60, and day 120. On the days of their visit, the clinical prognosis was assessed by visual analog scale (VAS) and Western Ontario and McMaster Universities (WOMAC) Osteoarthritis index. On these days, the radiographs were also taken for Kellgren and Lawrence grading and blood samples were collected for assessing the changes in levels of IL-1β and biomarkers of oxidative stress, such as reactive oxygen species and malondialdehyde (MDA).
  
  
  RESULTS
  Over all significant improvement was observed in the patients of CL extract group as compared to placebo group. Clinically, the VAS and WOMAC scores became better, and simultaneously, the levels of biomarkers, viz., IL-1β, ROS, and MDA, were also significantly (p < 0.05) improved.
  
  
  CONCLUSIONS
  It may be concluded that on chronic administration, CL suppresses inflammation and brings clinical improvement in patients of KOA, which may be observed by decreased level of IL-1β and VAS/WOMAC scores, respectively. At the same time, CL decreases the oxidative stress also.
authors.affiliation: Department of Pharmacology and Therapeutics, King George's Medical University, Chowk, Lucknow, 226003, India.
authors.forename: Shobhit
authors.initials: S
authors.lastname: Srivastava
authors.affiliation: Department of Pharmacology and Therapeutics, King George's Medical University, Chowk, Lucknow, 226003, India. saksenaa54@yahoo.co.in.
authors.forename: Anil K
authors.initials: AK
authors.lastname: Saksena
authors.affiliation: Department of Pharmacology and Therapeutics, King George's Medical University, Chowk, Lucknow, 226003, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Khattri
authors.affiliation: Department of Orthopaedic Surgery, King George's Medical University, Lucknow, India.
authors.forename: Santosh
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Centre for Advance Research, King George's Medical University, Lucknow, India.
authors.forename: Raghubendra Singh
authors.initials: RS
authors.lastname: Dagur
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000302:isolation & purification / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D030024:Curcuma / Q000737:chemistry*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D053583:Interleukin-1beta / Q000097:blood; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D018384:Oxidative Stress / Q000187:drug effects*; D010147:Pain Measurement / Q000187:drug effects; D010936:Plant Extracts / Q000008:administration & dosage / Q000302:isolation & purification / Q000627:therapeutic use*; D017382:Reactive Oxygen Species / Q000097:blood; D020127:Recovery of Function
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D053583:Interleukin-1beta; D010936:Plant Extracts; D017382:Reactive Oxygen Species; D008315:Malondialdehyde
keywords: Curcuma longa L.; Inflammatory biomarkers; Osteoarthritis of knee; WOMAC