Effects of Curcumin in Management of Endometriosis a Hormonal Disorder Disease in Female

 

Priti B. Savant1*, Manjusha S. Kareppa2, Akshata U. Shinde2

1Radheya Charitable Trust’s Dinesh Bembade College of Pharmacy Latur Nanded Highway Village Mahalangra Tq Chakur Dist Latur, 413513 Maharashtra, India.

2SBSPM’S B Pharmacy College, Ambajogai-431517, Maharashtra, India.

*Corresponding Author E-mail: preetisawant409@gmail.com

 

ABSTRACT:

A disorder in which endometrial tissues develop outer side the uterus or uterine cavity is called as endometriosis. It affects mainly females in their reproductive years, and is an oestrogen-dependent condition. Endometriosis a gynaecological disease or disorders, occurs in about 10% of female in reproductive age and in upto 50% of females with in-fertility. It is serious type of Hormonal disease or disorders in female which is caused due to hormonal imbalance these diseases totally change the quality of womens life. Decreased quality of life is the most significant predictor of direct health care and total costs so avoid this next step greater way to take care “Prevention is always better than cure”. Curcumin is a natural polyphenolic compound extracted from the spice, turmeric and has been reported to evidence anti-inflammatory (agent which reduce inflammation), antioxidant (the agent which reduce oxidation), and anti-proliferative properties via the modulation of multiple cellular. However, it remains to be determined whether effect of curcumin affects in the management of process of endometriosis. Turmeric contain especially its most active compound Curcumin have many scientifically proven health benefits, it’s a potent Anti-inflammatory and antioxidant and may also help improve symptoms of endometrosis.

 

KEYWORDS: Endometriosis, Uterus, Turmeric, Curcumin, Inflammation, Anti-inflammatory.

 

 


INTRODUCTION:

A disorder in which endometrial tissues develop outer side the uterus or uterine cavity is called as endometriosis. It affects mainly females in their reproductive years, and is an oestrogen-dependent condition.1 endometriosis a gynaecological disease or disorders, occurs in about 10% of female in reproductive age and in upto 50% of females with in-fertility2. Endometrial tissue is established in place outer side the uterus where the ectopic endometrium, it responds to the hormonal stimuli and develops internal bleeding, inflammation and fibrosis i.e. thickening of the tissue3.

 

Decreased quality of life is the most significant predictor of direct health care and total costs so avoid this next step greater way to take care “Prevention is always better than cure”4. In particular, increased concentrations of prostaglandins (PGs) and leukotrienes have been found in the peritoneal fluid of endometriosis patients. These are the major constituents of group of biologically active oxygenated fatty acids called as eicosanoids and have been implicated in various inflammatory diseases. In endometriosis, they seem to play an important role in disease associated pain, basically treated with Non-Steroidal Anti-inflammatory Drugs (NSAIDS). These inflammatory mediators, mainly prostaglandins PGs, may also be directly involved in the pathogenesis means the manner of development of the a disease of endometriosis, as recent in vitro studies have demonstrated that improved synthesis is involved in enhancing proliferation while inhibiting apoptosis (a type of cell death), increasing both angiogenesis (development of new blood vessels) and immunosuppression. The cyclooxygenase pathway yield to the formation of prostaglandin’s (PG) Curcumin is a natural polyphenolic compound extracted from the spice, turmeric and has been reported to evidence anti-inflammatory (agent which reduce inflammation), antioxidant (the agent which reduce oxidation), and anti-proliferative properties via the modulation of multiple cellular. However, it remains to be determined whether curcumin affects in the process of endometriosis.5

 

Endometriosis occurred when tissue found inside the uterus growth and it is occur in the outside part of the uterus, and also in other parts of the body. In this condition this growth increases and affects other part of the female reproductive system, attach to the ovaries, fallopian tubes, the outside part of the uterus, the bowel, or other internal parts. When the hormonal changes occur in the body during the menstruation cycle, this tissues break and cause pain around the time of their periods and sometimes it may longtime painful adhesions or scar tissue is produced.6,7

 

Figure1: Diagram of endometriosis8

 

Symptoms of endometriosis include:

·       painful cramping, similar to menstrual cramps

·       long-term lower back and pelvic pain

·       periods lasting longer than 7 days

·       heavy menstrual bleeding

·       bowel and urinary problems, including pain, diarrhoea, constipation, and bloating

·       blood in the stool or urine

·       nausea and vomiting

·       fatigue

·       pain during sex

·       spotting or bleeding between periods

·       difficulty becoming pregnant

Pain is the most common sign of endometriosis, but the severity of the pain does not always corelate with the extent of the disease. Pain sometimes or often disappears after menopause, when the body stops producing oestrogen hormone. However, if a person uses hormonal therapy during menopause, symptoms may persist.

 

Complications of endometriosis include:

·       infertility, which can affect up to 50% Trusted Source of those with the condition

·       a higher risk of ovarian cancer or endometriosis-linked adenocarcinoma

·       ovarian cysts

·       inflammation

·       scar tissue and adhesion development

·       intestinal and bladder complications

 

Herbal drug used in the treatment of endometriosis:

Turmeric are of the natural antiseptic and disinfectants used in medical practice. Antiseptic are the chemical sterilizing substances which are used to kill pathogenic microbes or for prevention of their growth. They should be sufficiently non-toxic for superficial application on the living tissues. Antiseptic are applied on broken skin after burn and wounds or they are applied to intact skin before surgical operation or injections. Sometimes they are also applied to mucous membranes like conjunctiva to prevent or treat superficial infections.

 

The term disinfectant indicate destruction or to make a surface free from pathogenic organisms. The disinfectants are therefore, the substance which kills bacteria and their spores generally, the term disinfectant is applied only to those substances which not directly applied to tissues due to their toxicity, but are used for decontaminating drains and faecal matter and also for the sterilisation of instruments and apparatus. According to research turmeric used in the treatment of endometriosis.9,10

 

Turmeric:

Synonyms:

The various synonyms used turmeric are as follows

·       Curcuma

·       curcuma longa

·       Haldi

·       Indian perennial herb

·       curcuma domestica


 

Vernacular Names: The various Vernacular Names used Turmeric are as follows:

Table 1: Vernacular names

Languages

Marathi

Hindi

Bengali

Gujrati

Kannada

Sanskrit

Tamil

Telgu

Vernacular Name

Halad

Haldi

Halud

Halada

Arishina

Haldi, Harida

Manjal

Pasupu

 


Biological source:

Turmeric consists of dried, as well as fresh rhizomes of plant curcuma longa Linn

 

Family: Zingiberaceae.

 

Figure 2: Rhizome of curcuma longa

 

Geographical source:

It is found throughout the tropical and especially, cultivated in west Pakistan, India, Malaysia and China. In India it is cultivated in Maharashtra, Tamil Nadu, West Bengal, U.P. and Punjab.

 

Scientific classification:

·       Kingdom:

Plantae

·       Subkingdom:

Tracheobionts

·       Super division:

Spermatophyta

·       Divison:

Mangoliophyta

·       Order:

Zingiberales

·       Family:

Zingiberaceae

·       Genus:

Curcuma

·       Species:

Longa

·       Scientific Name:

Curcuma longa11

 

Organoleptic characters:

Table 2: organoleptic characteristics

Colour

 Odour

 Taste

 Size

 Shape

Yellowish to yellowish-brown or

Yellowish-orange

 

Characteristic

 

Slightly bitter

 

2 to 5 cm in length and 1 to 2 cm thickness

ovate or oblong cylindrical and short branched

 

Chemical constituents:

 

Structure of curcumin:

Turmeric contains about 5 % of volatile oil, resins, abundant zingiberaceous starch grains and yellow colouring substances known as curcuminoids is known as curcumin. Constituents of turmeric oil are Turmerone, Zingiberene, borneol, caprylic acid etc. “Curcumin is reported to posses anti-microbial and anti-inflammatory actions”

Chemical test:

1.     powdered drug + sulphuric acid crimson colour

2.     Aq. Solution of turmeric + boric acid reddish colour alkali greenish blue

3.     Drug + acetic anhydride + Con H2SO4 violet colour

 

When test is observed under U.V. light, red fluorescence is show.

 

Mechanism of action of curcumin:

 

Figure 3: Mechanism of action of Curcumin in Endometriosis

 

Effect of Curcumin in the management of Endometriosis:

 

Figure 4: Turmeric powder

 

Curcumin is a major component of turmeric powder extracted from the rhizome of the plant Curcuma longa found in South and Southeast tropical Asia. Curcumin exhibits great promise as a therapeutic agent, and is currently in clinical trials for treating a variety of conditions. This study is an attempt to assess the effect of curcumin on inhibiting endometriosis endometrial cells and to study whether the effect is mediated by reducing estradiol production. Our findings reveal that curcumin was able to suppress the proliferation of endometrial cells by reducing E2 level. Bachmeier et al demonstrated estrogenic effects of putative phytoestrogens at physiological concentrations and showed estrogenic effects of curcumin.

The activation of E2 genes by curcumin most probably is due to an estrogen receptor α mediated estrogen-like effect. Singh and Singh also showed that curcumin was able to counteract the proliferative response of E2, and induce apoptosis. In summary, in this in vitro study we found that E2 is important in ectopic endometrium. Epithelial cell is in dominant position with E2 secretion of endometrial cells. Curcumin was able to inhibit the proliferation of endometrial cells by reducing the E2 value which may be developed into a new way to treat endometriosis.12,13

 

Figure 5: Curcumin in the management of Endometriosis14,15

 

1. Regulation of aptosis:

Curcumin decreases endometrial cell proliferation, increases apoptosis thus reducing size and number of endometriotic lesions. Result when these stromal cells are treated with curcumin then following result shown

·       The number of endometriotic stromal cells was reduced,

·       The cells growth was slowed

·       Estradiol level was lower after treatment with curcumin

 

2. Anti-inflammatory and immunomodulatory:

Endometriosis has been associated with a Th1-cell associated cytokines profile (proinflammatory). Inflammation plays a key role in the development of endometriosis and alterations of immune cells have been reported in the peritoneal fluid, ectopic lesions but also eutopic endometrium.

 

Curcumin has anti-inflammatory properties and has been shown as a valuable agent in the prevention and treatment of endometriosis.

 

3. Reduce oxidative stress:

Oxidative stress with the production of free radicals and reactive oxygen species (ROS) may promote endometriosis by increasing growth and adhesion of endometrial cells in the peritoneal cavity. Various studies and research showed that the therapeutic potential of curcumin as an antioxidant defense against oxidative stress impacting endometriosis development and infertility.16,17,18

 

4. Reduction of angiogenesis:

Angiogenesis means the development of new blood vessel from pre-existing ones. Curcumin inhibit the establishment of new endometrial lesion in the early stages of the disease.19,20

 

Formulations used:

Turmeric has anti-inflammatory properties that can be beneficial to people Experiencing endometriosis symptoms. It can also be used manage endometriosis in the long term. Some research has even found that it has ability to inhibit endometrial growth. Different formulations are used tablets, capsules and some products contain turmeric as a ingredient etc.

 

Figure 6: Turmeric capsules

 

Or make turmeric tea by boiling one cup of water adding a teaspoon of turmeric powder.21

 

Figure 7: Turmeric tea

 

CONCLUSION:

This review survey revealed that turmeric a herbal drug used in the management of endometriosis turmeric contains main active constituents curcumin, Curcumin is a natural polyphenolic compound extracted from the spice, turmeric and has been reported to evidence anti-inflammatory (agent which reduce inflammation), antioxidant (the agent which reduce oxidation), and anti-proliferative properties via the modulation of multiple cellular. However, it remains to be determined whether curcumin affects in the process of endometriosis.

 

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1.      Wei-Wei Wee – Steky, Cynthia Chia Yng Kew, Bernard Su min chern Endometriosis: A Review of the diagnosis and pain management, Gynaecology and minimally invasive therapy November 2015; 4(4): 106-109; Science Direct.

2.      Giudice LC, Tazuke SI, Swiersz L, Status of current research on endometriosis, Journal of Reproductive Medicine 01 March 1998; 43(3-suppl): 252-262.

3.      Arafan, Maria, Rashid, Sameera. Endometriosis A Comprehensive review, Advance in Anatomic Pathology: January 2021; 28(1): p 30-43.

4.      Peter A.W. Rogers, Thomas M.D. Hoogne, Asgerally Fazleabas, Linda C. Ciudice, Grant W.  Montgomery, Felice Petraglia, Robert N. Taylor; Difining Future Directions for Endometriosis research: Workshop report from the 2011 word congress of endometriosis in Montpellier, France. (PMC US National Institutes of Health; Reprod sci. 2013; 20(5): 483-499.

5.      Arafan, Maria , Rashid, Sameera. Endometriosis A Comprehensive review, Advance in Anatomic Pathology: January 2021; 28(1): p 30-43.

6.      So Young kim, Yi Yi Kyaw, Mi So Seong, Ki Hyung Kim, Jaehun Cheong; A research article curcumin suppresses an endometerial cell inflammation through inhibition of SREBP-1, Integrative Molecular Medicine a Research Article ISSN: 2056-6360 Integr mol. med 2019; 6: 1-6.

7.      Medical news today.com/articles/149109Webmed.com/women/ endometriosis/ss slideshow -endometriosis overview.

8.      Yi Yusuf Alimi, Joe lwanaga, Mario’s Loukas, R. Shane Tubbs. The clinical Anatomy of endometriosis: A Review, NCBI, Cureus Publishing Cureus, 2018; 10(9): e 3361.

9.      S.B. Gokhale, C.K. Kokate, A.P. Purohit. A Text Book of Pharmacognosy First year diploma in Pharmacy (As per E.R. 1991) 38th Edition Nirali Publication Page no. 9.109-9.111

10.   Ying Zheng Yu, M.D., Hong Cao, M.D., Zheng Yu, M.D., Hai –Ying Peng, M.D., and Chang-jun Zhang, M.D; Curcumin inhibits endometrial cells by reducing estradiol production; Iranian Journal of Reproductive Medicine, Iran J Reprod Med, 2013; 11(5): 415-422.

11.   Tanzeela Nisar, Muneeb Iqbal, Ahmed Raza, Madiha Safdar., Turmeric: A Promising Spice for Phytochemistry and Antimicrobial Activities, American-Eurasian J Agric. and Environ. Sci., 2015; 15(7): 1278-1288.

12.   Susan J Hewlings and Douglas S. Kalman, ; Curcumin : A Review of its Effect on Human Health., Food MDPI 2017; 6(10): 9.2

13.   Braverman IVF; Turmeric Curcumin: The golden Spice in the fight against endometriosis, Reproductive Immunology 15 Feb 2018.

14.   Alexandre Vallee, Yves Lecarpentier; Review: Curcumin and Endometriosis, International Journal of Molecular Science. 2020, 21, 2440.

15.   Arablou T, Kolahdouz Mohammadi R., Curcumin and Endometriosis: Review on potential roles and molecular mechanisms, Biomed Pharmacother. 2018; 97: 91-97

16.   Diala EI Khoury, Rana Matar, Tina Touma., A Review: Curcumin and endometrial carcinoma: an old spice as a novel agent

17.   Gail ohaegbulam, Indrajit Chowdhury, Winston E. Thompson. Curcumin in the Management of Endometriosis, Springer Cham. pp 663-677. https://Link.springer.com

18.   Ji Long Liu et at Genomics 2016 oct A. Pubmed – wide study of endometriosis National Library of Medicine.

19.   Thomas M.D. Hooghe et al Ann N.Y Acad Sci 2004 Dec, A Review: Future Directions in endometriosis research., National library of medicine, National Center of Biotechnology Information Pubmed.gov.

20.   Agnieszka Bien et al Qual.life Res.2020 oct; Quality of life in women with endometriosis: a cross sectional survey, National Library of Medicine (NIH) Pubmed.

21.   M.D. Laschke, M.D. Menger; Anti-angiogenic treatment startegies for the therapy of endometrosis., Human Reproductive Update, Nov/Dec 2012; 18(6); 682-702.

 

 

 

Received on 31.05.2021         Modified on 22.06.2021

Accepted on 26.07.2021       ©A&V Publications All right reserved

Res. J. Pharmacognosy and Phytochem. 2021; 13(4):182-186.

DOI: 10.52711/0975-4385.2021.00031