36
SIMPAR (Study In Multidisciplinary PAin Research)

Curcumin in Chronic pain

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Citation preview

Page 1: Curcumin in Chronic pain

SIMPAR (Study In Multidisciplinary PAin Research)

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in chronic pain

Summary 1 Chronic pain and inflammation 2 Curcumin from Turmeric 3 Active principles of turmeric 4 Curcumin and chronic pain 5 Mechanism of action (antinflammatory) 6 Mechanism of action (anti oxidant) 7 Epigenetic activity of curcumin 8 Absortion of curcumine 9 Curcumin and liver 10 Bio-avaliability and solutions 11 Curcumin tolerability 12 Take home messages

For in

ternal u

se on

ly ndash Q1 2015

Chronic and degenerative illness

For in

ternal u

se on

ly ndash Q1 2015

Chronic and degenerative illness express high grade of inflammation

Cardiovascular diseases

INFLAMMATION

Cancer

Auto-immune diseases

Neuro degenerative diseases

Type II diabetes

High grade or Low grade

For in

ternal u

se on

ly ndash Q1 2015

Symptoms of Inflammation

For in

ternal u

se on

ly ndash Q1 2015

Acute pathological pain bull Sharp fast pricking bull Occurs very rapidly bull Carried by large diameter myelinated Aδ fibers bull Usually alleviated with the help of professional

Chronic pathological pain bull Burning aching bull Gradually increases bull Carried by small diameter non-myelinated lsquoCrsquo fibers bull Persistent pain that lasts many months to years bull Little apparent cause amp not self limiting bull Pain often increases over time amp is aggravated by many factors

For in

ternal u

se on

ly ndash Q1 2015

Drugs used for pain management

For in

ternal u

se on

ly ndash Q1 2015

Most sold SOP and OTC in Italy 2011

For in

ternal u

se on

ly ndash Q1 2015

Precautions in patients gt70 years

GI side effects

Risks of gastic ulcers

Attention in patients treated with anti-coagulatns

Risk of kidney impairment

Side effects and risks of NSAIDrsquos

ldquoGli utilizzatori di FANS hanno ulcere sintomatiche complicate 3-4 volte piugrave frequentemente rispetto ai non utilizzatorirdquo 2

ldquoDisturbi gastrici e intestinali compaiono nel 10 - 30 degli utilizzatori di FANSrdquo 1

1-2Nederlandse Huisartsen Genootschap ndash pijnbestrijding farmacotherapeutische richtlijn

3Cannon 2006 Chan 2006 Helin-Salmivaara 2006 Kearney 2006 McGettigan 2006

For in

ternal u

se on

ly ndash Q1 2015

Curcuma longa

Boswellia serrata

bull Omega 3 (EPA and DHA)

Zingiber officinale

Natural substances with anti-inflammatory activity

For in

ternal u

se on

ly ndash Q1 2015

bull Rhizomatous herbaceous perennial plant

bull Family Zingiberaceae bull Lives well with mild temperatures

(20deg-30deg C and high rains bull Reach 1 m in hight bull Nice hermafrodite flowers in 20cm

inflorescence (August) bull Active sustances are concentrated

in rhizomes

Turmeric the plant (Curcuma longa)

For in

ternal u

se on

ly ndash Q1 2015

Curcumin THE active principle of turmeric

(17-bis (4-hydroxy-3-methoxy-phenyl) hepta-16-diene-35-dione)

Turmeric powder contains 3-7 of Curcuminoids essential oils and fibers

For in

ternal u

se on

ly ndash Q1 2015

8770 studies shows pleiotroitropic effects of curcumin (Pubmed)

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

23

24

25

26

27

28

29

0

5

10

15

20

0

5

10

15

20

ldquoRandomized single blind study on efficacy and tolerability of curcumin in patients with reumatoid poliarthritis ldquo Chandran et al A Randomized Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis Phytother Res 2012261719ndash1725

deg n = 45 curcumin n =15 diclofenac n = 15 curcumin and diclofenac n = 15 deg 8 weeks 1000 mg curcumin (BCM-95 ) e 100 mg diclofenac

Curcumin vs NSAIDrsquo (diclofenac )

Tass

o d

i sed

imen

tazi

on

e er

itro

cita

ria

(ESR

)

- 11 - 8

Significative reduction of Disease Activity Score (DAS)

Significative reduction of Joints pain

- 83 - 69

- 97 - 89

Significative reduction of Joints swelling

In

cid

enza

In

cid

enza

Curcumin extract Diclofenac 1000 mg 100 mg

p lt 005 p lt 005 p lt 005

Curcumin extract Diclofenac 1000 mg 100 mg

Curcumin extract Diclofenac 1000 mg 100 mg

For in

ternal u

se on

ly ndash Q1 2015

280

290

300

310

320

330

340

350

360

Ibuprofen Curcumina

deg n = 367 curcumin extract n = 182 ibuprofen n = 185 deg After 4 weeks 1500 mg curcumin (2 capsuls 3xdie) e 1200 mg ibuprofen (2 capsuls 3xdie) deg Simple turmeric extract

Mobility Distance covered in 6 minutes

(Time 0 and after 4 weeks)

p = 0010

Met

ers

wal

ked

in 6

min

ute

s

Chronic Pain (Time 0 and after 4

weeks)

0

1

2

3

4

5

6

Ibuprofen Curcuminap = 0018

In

cid

ence

1200 mg 1500 mg

1200 mg 1500 mg )

- 41 + 14 + 11

Curcumin vs NSAIDrsquo (ibuprofen)

ldquoEfficacy and safety of curcumin vs Ibuprofen in patients with knee arthrosis a multicentric studyldquo

Kuptniratsaikul V et al Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis a multicenter study Clin Interv Aging 2014 Mar 209451-8

- 39

For in

ternal u

se on

ly ndash Q1 2015

Combination of Curcumin an ginger is effective as well as NSAIDrsquoS (indometacine)

Objective measure effective of a blend of curcumin and ginger on pain in patients with rheumatoid arthritis 3 groups NSAIDrsquoS (Indometacine) vs 200 mg (CG) vs 400 mg (CG) Results

Arthritic score 14d

Arthritic score 28d

Nsaidrsquos (Indometacine)

396 50

200 mg 417 583

400 mg 521 786

0

4

8

12

16

7 giorni 14 giorni 28 giorni

Controllo (dopo trattamento) Indometacina

200 mg curcumina +zenzero 400 mg curcumina+zenzero

- 786 - 52 A

rth

riti

c sc

ore

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 2: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in chronic pain

Summary 1 Chronic pain and inflammation 2 Curcumin from Turmeric 3 Active principles of turmeric 4 Curcumin and chronic pain 5 Mechanism of action (antinflammatory) 6 Mechanism of action (anti oxidant) 7 Epigenetic activity of curcumin 8 Absortion of curcumine 9 Curcumin and liver 10 Bio-avaliability and solutions 11 Curcumin tolerability 12 Take home messages

For in

ternal u

se on

ly ndash Q1 2015

Chronic and degenerative illness

For in

ternal u

se on

ly ndash Q1 2015

Chronic and degenerative illness express high grade of inflammation

Cardiovascular diseases

INFLAMMATION

Cancer

Auto-immune diseases

Neuro degenerative diseases

Type II diabetes

High grade or Low grade

For in

ternal u

se on

ly ndash Q1 2015

Symptoms of Inflammation

For in

ternal u

se on

ly ndash Q1 2015

Acute pathological pain bull Sharp fast pricking bull Occurs very rapidly bull Carried by large diameter myelinated Aδ fibers bull Usually alleviated with the help of professional

Chronic pathological pain bull Burning aching bull Gradually increases bull Carried by small diameter non-myelinated lsquoCrsquo fibers bull Persistent pain that lasts many months to years bull Little apparent cause amp not self limiting bull Pain often increases over time amp is aggravated by many factors

For in

ternal u

se on

ly ndash Q1 2015

Drugs used for pain management

For in

ternal u

se on

ly ndash Q1 2015

Most sold SOP and OTC in Italy 2011

For in

ternal u

se on

ly ndash Q1 2015

Precautions in patients gt70 years

GI side effects

Risks of gastic ulcers

Attention in patients treated with anti-coagulatns

Risk of kidney impairment

Side effects and risks of NSAIDrsquos

ldquoGli utilizzatori di FANS hanno ulcere sintomatiche complicate 3-4 volte piugrave frequentemente rispetto ai non utilizzatorirdquo 2

ldquoDisturbi gastrici e intestinali compaiono nel 10 - 30 degli utilizzatori di FANSrdquo 1

1-2Nederlandse Huisartsen Genootschap ndash pijnbestrijding farmacotherapeutische richtlijn

3Cannon 2006 Chan 2006 Helin-Salmivaara 2006 Kearney 2006 McGettigan 2006

For in

ternal u

se on

ly ndash Q1 2015

Curcuma longa

Boswellia serrata

bull Omega 3 (EPA and DHA)

Zingiber officinale

Natural substances with anti-inflammatory activity

For in

ternal u

se on

ly ndash Q1 2015

bull Rhizomatous herbaceous perennial plant

bull Family Zingiberaceae bull Lives well with mild temperatures

(20deg-30deg C and high rains bull Reach 1 m in hight bull Nice hermafrodite flowers in 20cm

inflorescence (August) bull Active sustances are concentrated

in rhizomes

Turmeric the plant (Curcuma longa)

For in

ternal u

se on

ly ndash Q1 2015

Curcumin THE active principle of turmeric

(17-bis (4-hydroxy-3-methoxy-phenyl) hepta-16-diene-35-dione)

Turmeric powder contains 3-7 of Curcuminoids essential oils and fibers

For in

ternal u

se on

ly ndash Q1 2015

8770 studies shows pleiotroitropic effects of curcumin (Pubmed)

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

23

24

25

26

27

28

29

0

5

10

15

20

0

5

10

15

20

ldquoRandomized single blind study on efficacy and tolerability of curcumin in patients with reumatoid poliarthritis ldquo Chandran et al A Randomized Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis Phytother Res 2012261719ndash1725

deg n = 45 curcumin n =15 diclofenac n = 15 curcumin and diclofenac n = 15 deg 8 weeks 1000 mg curcumin (BCM-95 ) e 100 mg diclofenac

Curcumin vs NSAIDrsquo (diclofenac )

Tass

o d

i sed

imen

tazi

on

e er

itro

cita

ria

(ESR

)

- 11 - 8

Significative reduction of Disease Activity Score (DAS)

Significative reduction of Joints pain

- 83 - 69

- 97 - 89

Significative reduction of Joints swelling

In

cid

enza

In

cid

enza

Curcumin extract Diclofenac 1000 mg 100 mg

p lt 005 p lt 005 p lt 005

Curcumin extract Diclofenac 1000 mg 100 mg

Curcumin extract Diclofenac 1000 mg 100 mg

For in

ternal u

se on

ly ndash Q1 2015

280

290

300

310

320

330

340

350

360

Ibuprofen Curcumina

deg n = 367 curcumin extract n = 182 ibuprofen n = 185 deg After 4 weeks 1500 mg curcumin (2 capsuls 3xdie) e 1200 mg ibuprofen (2 capsuls 3xdie) deg Simple turmeric extract

Mobility Distance covered in 6 minutes

(Time 0 and after 4 weeks)

p = 0010

Met

ers

wal

ked

in 6

min

ute

s

Chronic Pain (Time 0 and after 4

weeks)

0

1

2

3

4

5

6

Ibuprofen Curcuminap = 0018

In

cid

ence

1200 mg 1500 mg

1200 mg 1500 mg )

- 41 + 14 + 11

Curcumin vs NSAIDrsquo (ibuprofen)

ldquoEfficacy and safety of curcumin vs Ibuprofen in patients with knee arthrosis a multicentric studyldquo

Kuptniratsaikul V et al Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis a multicenter study Clin Interv Aging 2014 Mar 209451-8

- 39

For in

ternal u

se on

ly ndash Q1 2015

Combination of Curcumin an ginger is effective as well as NSAIDrsquoS (indometacine)

Objective measure effective of a blend of curcumin and ginger on pain in patients with rheumatoid arthritis 3 groups NSAIDrsquoS (Indometacine) vs 200 mg (CG) vs 400 mg (CG) Results

Arthritic score 14d

Arthritic score 28d

Nsaidrsquos (Indometacine)

396 50

200 mg 417 583

400 mg 521 786

0

4

8

12

16

7 giorni 14 giorni 28 giorni

Controllo (dopo trattamento) Indometacina

200 mg curcumina +zenzero 400 mg curcumina+zenzero

- 786 - 52 A

rth

riti

c sc

ore

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 3: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Chronic and degenerative illness

For in

ternal u

se on

ly ndash Q1 2015

Chronic and degenerative illness express high grade of inflammation

Cardiovascular diseases

INFLAMMATION

Cancer

Auto-immune diseases

Neuro degenerative diseases

Type II diabetes

High grade or Low grade

For in

ternal u

se on

ly ndash Q1 2015

Symptoms of Inflammation

For in

ternal u

se on

ly ndash Q1 2015

Acute pathological pain bull Sharp fast pricking bull Occurs very rapidly bull Carried by large diameter myelinated Aδ fibers bull Usually alleviated with the help of professional

Chronic pathological pain bull Burning aching bull Gradually increases bull Carried by small diameter non-myelinated lsquoCrsquo fibers bull Persistent pain that lasts many months to years bull Little apparent cause amp not self limiting bull Pain often increases over time amp is aggravated by many factors

For in

ternal u

se on

ly ndash Q1 2015

Drugs used for pain management

For in

ternal u

se on

ly ndash Q1 2015

Most sold SOP and OTC in Italy 2011

For in

ternal u

se on

ly ndash Q1 2015

Precautions in patients gt70 years

GI side effects

Risks of gastic ulcers

Attention in patients treated with anti-coagulatns

Risk of kidney impairment

Side effects and risks of NSAIDrsquos

ldquoGli utilizzatori di FANS hanno ulcere sintomatiche complicate 3-4 volte piugrave frequentemente rispetto ai non utilizzatorirdquo 2

ldquoDisturbi gastrici e intestinali compaiono nel 10 - 30 degli utilizzatori di FANSrdquo 1

1-2Nederlandse Huisartsen Genootschap ndash pijnbestrijding farmacotherapeutische richtlijn

3Cannon 2006 Chan 2006 Helin-Salmivaara 2006 Kearney 2006 McGettigan 2006

For in

ternal u

se on

ly ndash Q1 2015

Curcuma longa

Boswellia serrata

bull Omega 3 (EPA and DHA)

Zingiber officinale

Natural substances with anti-inflammatory activity

For in

ternal u

se on

ly ndash Q1 2015

bull Rhizomatous herbaceous perennial plant

bull Family Zingiberaceae bull Lives well with mild temperatures

(20deg-30deg C and high rains bull Reach 1 m in hight bull Nice hermafrodite flowers in 20cm

inflorescence (August) bull Active sustances are concentrated

in rhizomes

Turmeric the plant (Curcuma longa)

For in

ternal u

se on

ly ndash Q1 2015

Curcumin THE active principle of turmeric

(17-bis (4-hydroxy-3-methoxy-phenyl) hepta-16-diene-35-dione)

Turmeric powder contains 3-7 of Curcuminoids essential oils and fibers

For in

ternal u

se on

ly ndash Q1 2015

8770 studies shows pleiotroitropic effects of curcumin (Pubmed)

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

23

24

25

26

27

28

29

0

5

10

15

20

0

5

10

15

20

ldquoRandomized single blind study on efficacy and tolerability of curcumin in patients with reumatoid poliarthritis ldquo Chandran et al A Randomized Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis Phytother Res 2012261719ndash1725

deg n = 45 curcumin n =15 diclofenac n = 15 curcumin and diclofenac n = 15 deg 8 weeks 1000 mg curcumin (BCM-95 ) e 100 mg diclofenac

Curcumin vs NSAIDrsquo (diclofenac )

Tass

o d

i sed

imen

tazi

on

e er

itro

cita

ria

(ESR

)

- 11 - 8

Significative reduction of Disease Activity Score (DAS)

Significative reduction of Joints pain

- 83 - 69

- 97 - 89

Significative reduction of Joints swelling

In

cid

enza

In

cid

enza

Curcumin extract Diclofenac 1000 mg 100 mg

p lt 005 p lt 005 p lt 005

Curcumin extract Diclofenac 1000 mg 100 mg

Curcumin extract Diclofenac 1000 mg 100 mg

For in

ternal u

se on

ly ndash Q1 2015

280

290

300

310

320

330

340

350

360

Ibuprofen Curcumina

deg n = 367 curcumin extract n = 182 ibuprofen n = 185 deg After 4 weeks 1500 mg curcumin (2 capsuls 3xdie) e 1200 mg ibuprofen (2 capsuls 3xdie) deg Simple turmeric extract

Mobility Distance covered in 6 minutes

(Time 0 and after 4 weeks)

p = 0010

Met

ers

wal

ked

in 6

min

ute

s

Chronic Pain (Time 0 and after 4

weeks)

0

1

2

3

4

5

6

Ibuprofen Curcuminap = 0018

In

cid

ence

1200 mg 1500 mg

1200 mg 1500 mg )

- 41 + 14 + 11

Curcumin vs NSAIDrsquo (ibuprofen)

ldquoEfficacy and safety of curcumin vs Ibuprofen in patients with knee arthrosis a multicentric studyldquo

Kuptniratsaikul V et al Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis a multicenter study Clin Interv Aging 2014 Mar 209451-8

- 39

For in

ternal u

se on

ly ndash Q1 2015

Combination of Curcumin an ginger is effective as well as NSAIDrsquoS (indometacine)

Objective measure effective of a blend of curcumin and ginger on pain in patients with rheumatoid arthritis 3 groups NSAIDrsquoS (Indometacine) vs 200 mg (CG) vs 400 mg (CG) Results

Arthritic score 14d

Arthritic score 28d

Nsaidrsquos (Indometacine)

396 50

200 mg 417 583

400 mg 521 786

0

4

8

12

16

7 giorni 14 giorni 28 giorni

Controllo (dopo trattamento) Indometacina

200 mg curcumina +zenzero 400 mg curcumina+zenzero

- 786 - 52 A

rth

riti

c sc

ore

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 4: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Chronic and degenerative illness express high grade of inflammation

Cardiovascular diseases

INFLAMMATION

Cancer

Auto-immune diseases

Neuro degenerative diseases

Type II diabetes

High grade or Low grade

For in

ternal u

se on

ly ndash Q1 2015

Symptoms of Inflammation

For in

ternal u

se on

ly ndash Q1 2015

Acute pathological pain bull Sharp fast pricking bull Occurs very rapidly bull Carried by large diameter myelinated Aδ fibers bull Usually alleviated with the help of professional

Chronic pathological pain bull Burning aching bull Gradually increases bull Carried by small diameter non-myelinated lsquoCrsquo fibers bull Persistent pain that lasts many months to years bull Little apparent cause amp not self limiting bull Pain often increases over time amp is aggravated by many factors

For in

ternal u

se on

ly ndash Q1 2015

Drugs used for pain management

For in

ternal u

se on

ly ndash Q1 2015

Most sold SOP and OTC in Italy 2011

For in

ternal u

se on

ly ndash Q1 2015

Precautions in patients gt70 years

GI side effects

Risks of gastic ulcers

Attention in patients treated with anti-coagulatns

Risk of kidney impairment

Side effects and risks of NSAIDrsquos

ldquoGli utilizzatori di FANS hanno ulcere sintomatiche complicate 3-4 volte piugrave frequentemente rispetto ai non utilizzatorirdquo 2

ldquoDisturbi gastrici e intestinali compaiono nel 10 - 30 degli utilizzatori di FANSrdquo 1

1-2Nederlandse Huisartsen Genootschap ndash pijnbestrijding farmacotherapeutische richtlijn

3Cannon 2006 Chan 2006 Helin-Salmivaara 2006 Kearney 2006 McGettigan 2006

For in

ternal u

se on

ly ndash Q1 2015

Curcuma longa

Boswellia serrata

bull Omega 3 (EPA and DHA)

Zingiber officinale

Natural substances with anti-inflammatory activity

For in

ternal u

se on

ly ndash Q1 2015

bull Rhizomatous herbaceous perennial plant

bull Family Zingiberaceae bull Lives well with mild temperatures

(20deg-30deg C and high rains bull Reach 1 m in hight bull Nice hermafrodite flowers in 20cm

inflorescence (August) bull Active sustances are concentrated

in rhizomes

Turmeric the plant (Curcuma longa)

For in

ternal u

se on

ly ndash Q1 2015

Curcumin THE active principle of turmeric

(17-bis (4-hydroxy-3-methoxy-phenyl) hepta-16-diene-35-dione)

Turmeric powder contains 3-7 of Curcuminoids essential oils and fibers

For in

ternal u

se on

ly ndash Q1 2015

8770 studies shows pleiotroitropic effects of curcumin (Pubmed)

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

23

24

25

26

27

28

29

0

5

10

15

20

0

5

10

15

20

ldquoRandomized single blind study on efficacy and tolerability of curcumin in patients with reumatoid poliarthritis ldquo Chandran et al A Randomized Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis Phytother Res 2012261719ndash1725

deg n = 45 curcumin n =15 diclofenac n = 15 curcumin and diclofenac n = 15 deg 8 weeks 1000 mg curcumin (BCM-95 ) e 100 mg diclofenac

Curcumin vs NSAIDrsquo (diclofenac )

Tass

o d

i sed

imen

tazi

on

e er

itro

cita

ria

(ESR

)

- 11 - 8

Significative reduction of Disease Activity Score (DAS)

Significative reduction of Joints pain

- 83 - 69

- 97 - 89

Significative reduction of Joints swelling

In

cid

enza

In

cid

enza

Curcumin extract Diclofenac 1000 mg 100 mg

p lt 005 p lt 005 p lt 005

Curcumin extract Diclofenac 1000 mg 100 mg

Curcumin extract Diclofenac 1000 mg 100 mg

For in

ternal u

se on

ly ndash Q1 2015

280

290

300

310

320

330

340

350

360

Ibuprofen Curcumina

deg n = 367 curcumin extract n = 182 ibuprofen n = 185 deg After 4 weeks 1500 mg curcumin (2 capsuls 3xdie) e 1200 mg ibuprofen (2 capsuls 3xdie) deg Simple turmeric extract

Mobility Distance covered in 6 minutes

(Time 0 and after 4 weeks)

p = 0010

Met

ers

wal

ked

in 6

min

ute

s

Chronic Pain (Time 0 and after 4

weeks)

0

1

2

3

4

5

6

Ibuprofen Curcuminap = 0018

In

cid

ence

1200 mg 1500 mg

1200 mg 1500 mg )

- 41 + 14 + 11

Curcumin vs NSAIDrsquo (ibuprofen)

ldquoEfficacy and safety of curcumin vs Ibuprofen in patients with knee arthrosis a multicentric studyldquo

Kuptniratsaikul V et al Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis a multicenter study Clin Interv Aging 2014 Mar 209451-8

- 39

For in

ternal u

se on

ly ndash Q1 2015

Combination of Curcumin an ginger is effective as well as NSAIDrsquoS (indometacine)

Objective measure effective of a blend of curcumin and ginger on pain in patients with rheumatoid arthritis 3 groups NSAIDrsquoS (Indometacine) vs 200 mg (CG) vs 400 mg (CG) Results

Arthritic score 14d

Arthritic score 28d

Nsaidrsquos (Indometacine)

396 50

200 mg 417 583

400 mg 521 786

0

4

8

12

16

7 giorni 14 giorni 28 giorni

Controllo (dopo trattamento) Indometacina

200 mg curcumina +zenzero 400 mg curcumina+zenzero

- 786 - 52 A

rth

riti

c sc

ore

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 5: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Symptoms of Inflammation

For in

ternal u

se on

ly ndash Q1 2015

Acute pathological pain bull Sharp fast pricking bull Occurs very rapidly bull Carried by large diameter myelinated Aδ fibers bull Usually alleviated with the help of professional

Chronic pathological pain bull Burning aching bull Gradually increases bull Carried by small diameter non-myelinated lsquoCrsquo fibers bull Persistent pain that lasts many months to years bull Little apparent cause amp not self limiting bull Pain often increases over time amp is aggravated by many factors

For in

ternal u

se on

ly ndash Q1 2015

Drugs used for pain management

For in

ternal u

se on

ly ndash Q1 2015

Most sold SOP and OTC in Italy 2011

For in

ternal u

se on

ly ndash Q1 2015

Precautions in patients gt70 years

GI side effects

Risks of gastic ulcers

Attention in patients treated with anti-coagulatns

Risk of kidney impairment

Side effects and risks of NSAIDrsquos

ldquoGli utilizzatori di FANS hanno ulcere sintomatiche complicate 3-4 volte piugrave frequentemente rispetto ai non utilizzatorirdquo 2

ldquoDisturbi gastrici e intestinali compaiono nel 10 - 30 degli utilizzatori di FANSrdquo 1

1-2Nederlandse Huisartsen Genootschap ndash pijnbestrijding farmacotherapeutische richtlijn

3Cannon 2006 Chan 2006 Helin-Salmivaara 2006 Kearney 2006 McGettigan 2006

For in

ternal u

se on

ly ndash Q1 2015

Curcuma longa

Boswellia serrata

bull Omega 3 (EPA and DHA)

Zingiber officinale

Natural substances with anti-inflammatory activity

For in

ternal u

se on

ly ndash Q1 2015

bull Rhizomatous herbaceous perennial plant

bull Family Zingiberaceae bull Lives well with mild temperatures

(20deg-30deg C and high rains bull Reach 1 m in hight bull Nice hermafrodite flowers in 20cm

inflorescence (August) bull Active sustances are concentrated

in rhizomes

Turmeric the plant (Curcuma longa)

For in

ternal u

se on

ly ndash Q1 2015

Curcumin THE active principle of turmeric

(17-bis (4-hydroxy-3-methoxy-phenyl) hepta-16-diene-35-dione)

Turmeric powder contains 3-7 of Curcuminoids essential oils and fibers

For in

ternal u

se on

ly ndash Q1 2015

8770 studies shows pleiotroitropic effects of curcumin (Pubmed)

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

23

24

25

26

27

28

29

0

5

10

15

20

0

5

10

15

20

ldquoRandomized single blind study on efficacy and tolerability of curcumin in patients with reumatoid poliarthritis ldquo Chandran et al A Randomized Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis Phytother Res 2012261719ndash1725

deg n = 45 curcumin n =15 diclofenac n = 15 curcumin and diclofenac n = 15 deg 8 weeks 1000 mg curcumin (BCM-95 ) e 100 mg diclofenac

Curcumin vs NSAIDrsquo (diclofenac )

Tass

o d

i sed

imen

tazi

on

e er

itro

cita

ria

(ESR

)

- 11 - 8

Significative reduction of Disease Activity Score (DAS)

Significative reduction of Joints pain

- 83 - 69

- 97 - 89

Significative reduction of Joints swelling

In

cid

enza

In

cid

enza

Curcumin extract Diclofenac 1000 mg 100 mg

p lt 005 p lt 005 p lt 005

Curcumin extract Diclofenac 1000 mg 100 mg

Curcumin extract Diclofenac 1000 mg 100 mg

For in

ternal u

se on

ly ndash Q1 2015

280

290

300

310

320

330

340

350

360

Ibuprofen Curcumina

deg n = 367 curcumin extract n = 182 ibuprofen n = 185 deg After 4 weeks 1500 mg curcumin (2 capsuls 3xdie) e 1200 mg ibuprofen (2 capsuls 3xdie) deg Simple turmeric extract

Mobility Distance covered in 6 minutes

(Time 0 and after 4 weeks)

p = 0010

Met

ers

wal

ked

in 6

min

ute

s

Chronic Pain (Time 0 and after 4

weeks)

0

1

2

3

4

5

6

Ibuprofen Curcuminap = 0018

In

cid

ence

1200 mg 1500 mg

1200 mg 1500 mg )

- 41 + 14 + 11

Curcumin vs NSAIDrsquo (ibuprofen)

ldquoEfficacy and safety of curcumin vs Ibuprofen in patients with knee arthrosis a multicentric studyldquo

Kuptniratsaikul V et al Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis a multicenter study Clin Interv Aging 2014 Mar 209451-8

- 39

For in

ternal u

se on

ly ndash Q1 2015

Combination of Curcumin an ginger is effective as well as NSAIDrsquoS (indometacine)

Objective measure effective of a blend of curcumin and ginger on pain in patients with rheumatoid arthritis 3 groups NSAIDrsquoS (Indometacine) vs 200 mg (CG) vs 400 mg (CG) Results

Arthritic score 14d

Arthritic score 28d

Nsaidrsquos (Indometacine)

396 50

200 mg 417 583

400 mg 521 786

0

4

8

12

16

7 giorni 14 giorni 28 giorni

Controllo (dopo trattamento) Indometacina

200 mg curcumina +zenzero 400 mg curcumina+zenzero

- 786 - 52 A

rth

riti

c sc

ore

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 6: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Acute pathological pain bull Sharp fast pricking bull Occurs very rapidly bull Carried by large diameter myelinated Aδ fibers bull Usually alleviated with the help of professional

Chronic pathological pain bull Burning aching bull Gradually increases bull Carried by small diameter non-myelinated lsquoCrsquo fibers bull Persistent pain that lasts many months to years bull Little apparent cause amp not self limiting bull Pain often increases over time amp is aggravated by many factors

For in

ternal u

se on

ly ndash Q1 2015

Drugs used for pain management

For in

ternal u

se on

ly ndash Q1 2015

Most sold SOP and OTC in Italy 2011

For in

ternal u

se on

ly ndash Q1 2015

Precautions in patients gt70 years

GI side effects

Risks of gastic ulcers

Attention in patients treated with anti-coagulatns

Risk of kidney impairment

Side effects and risks of NSAIDrsquos

ldquoGli utilizzatori di FANS hanno ulcere sintomatiche complicate 3-4 volte piugrave frequentemente rispetto ai non utilizzatorirdquo 2

ldquoDisturbi gastrici e intestinali compaiono nel 10 - 30 degli utilizzatori di FANSrdquo 1

1-2Nederlandse Huisartsen Genootschap ndash pijnbestrijding farmacotherapeutische richtlijn

3Cannon 2006 Chan 2006 Helin-Salmivaara 2006 Kearney 2006 McGettigan 2006

For in

ternal u

se on

ly ndash Q1 2015

Curcuma longa

Boswellia serrata

bull Omega 3 (EPA and DHA)

Zingiber officinale

Natural substances with anti-inflammatory activity

For in

ternal u

se on

ly ndash Q1 2015

bull Rhizomatous herbaceous perennial plant

bull Family Zingiberaceae bull Lives well with mild temperatures

(20deg-30deg C and high rains bull Reach 1 m in hight bull Nice hermafrodite flowers in 20cm

inflorescence (August) bull Active sustances are concentrated

in rhizomes

Turmeric the plant (Curcuma longa)

For in

ternal u

se on

ly ndash Q1 2015

Curcumin THE active principle of turmeric

(17-bis (4-hydroxy-3-methoxy-phenyl) hepta-16-diene-35-dione)

Turmeric powder contains 3-7 of Curcuminoids essential oils and fibers

For in

ternal u

se on

ly ndash Q1 2015

8770 studies shows pleiotroitropic effects of curcumin (Pubmed)

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

23

24

25

26

27

28

29

0

5

10

15

20

0

5

10

15

20

ldquoRandomized single blind study on efficacy and tolerability of curcumin in patients with reumatoid poliarthritis ldquo Chandran et al A Randomized Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis Phytother Res 2012261719ndash1725

deg n = 45 curcumin n =15 diclofenac n = 15 curcumin and diclofenac n = 15 deg 8 weeks 1000 mg curcumin (BCM-95 ) e 100 mg diclofenac

Curcumin vs NSAIDrsquo (diclofenac )

Tass

o d

i sed

imen

tazi

on

e er

itro

cita

ria

(ESR

)

- 11 - 8

Significative reduction of Disease Activity Score (DAS)

Significative reduction of Joints pain

- 83 - 69

- 97 - 89

Significative reduction of Joints swelling

In

cid

enza

In

cid

enza

Curcumin extract Diclofenac 1000 mg 100 mg

p lt 005 p lt 005 p lt 005

Curcumin extract Diclofenac 1000 mg 100 mg

Curcumin extract Diclofenac 1000 mg 100 mg

For in

ternal u

se on

ly ndash Q1 2015

280

290

300

310

320

330

340

350

360

Ibuprofen Curcumina

deg n = 367 curcumin extract n = 182 ibuprofen n = 185 deg After 4 weeks 1500 mg curcumin (2 capsuls 3xdie) e 1200 mg ibuprofen (2 capsuls 3xdie) deg Simple turmeric extract

Mobility Distance covered in 6 minutes

(Time 0 and after 4 weeks)

p = 0010

Met

ers

wal

ked

in 6

min

ute

s

Chronic Pain (Time 0 and after 4

weeks)

0

1

2

3

4

5

6

Ibuprofen Curcuminap = 0018

In

cid

ence

1200 mg 1500 mg

1200 mg 1500 mg )

- 41 + 14 + 11

Curcumin vs NSAIDrsquo (ibuprofen)

ldquoEfficacy and safety of curcumin vs Ibuprofen in patients with knee arthrosis a multicentric studyldquo

Kuptniratsaikul V et al Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis a multicenter study Clin Interv Aging 2014 Mar 209451-8

- 39

For in

ternal u

se on

ly ndash Q1 2015

Combination of Curcumin an ginger is effective as well as NSAIDrsquoS (indometacine)

Objective measure effective of a blend of curcumin and ginger on pain in patients with rheumatoid arthritis 3 groups NSAIDrsquoS (Indometacine) vs 200 mg (CG) vs 400 mg (CG) Results

Arthritic score 14d

Arthritic score 28d

Nsaidrsquos (Indometacine)

396 50

200 mg 417 583

400 mg 521 786

0

4

8

12

16

7 giorni 14 giorni 28 giorni

Controllo (dopo trattamento) Indometacina

200 mg curcumina +zenzero 400 mg curcumina+zenzero

- 786 - 52 A

rth

riti

c sc

ore

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 7: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Drugs used for pain management

For in

ternal u

se on

ly ndash Q1 2015

Most sold SOP and OTC in Italy 2011

For in

ternal u

se on

ly ndash Q1 2015

Precautions in patients gt70 years

GI side effects

Risks of gastic ulcers

Attention in patients treated with anti-coagulatns

Risk of kidney impairment

Side effects and risks of NSAIDrsquos

ldquoGli utilizzatori di FANS hanno ulcere sintomatiche complicate 3-4 volte piugrave frequentemente rispetto ai non utilizzatorirdquo 2

ldquoDisturbi gastrici e intestinali compaiono nel 10 - 30 degli utilizzatori di FANSrdquo 1

1-2Nederlandse Huisartsen Genootschap ndash pijnbestrijding farmacotherapeutische richtlijn

3Cannon 2006 Chan 2006 Helin-Salmivaara 2006 Kearney 2006 McGettigan 2006

For in

ternal u

se on

ly ndash Q1 2015

Curcuma longa

Boswellia serrata

bull Omega 3 (EPA and DHA)

Zingiber officinale

Natural substances with anti-inflammatory activity

For in

ternal u

se on

ly ndash Q1 2015

bull Rhizomatous herbaceous perennial plant

bull Family Zingiberaceae bull Lives well with mild temperatures

(20deg-30deg C and high rains bull Reach 1 m in hight bull Nice hermafrodite flowers in 20cm

inflorescence (August) bull Active sustances are concentrated

in rhizomes

Turmeric the plant (Curcuma longa)

For in

ternal u

se on

ly ndash Q1 2015

Curcumin THE active principle of turmeric

(17-bis (4-hydroxy-3-methoxy-phenyl) hepta-16-diene-35-dione)

Turmeric powder contains 3-7 of Curcuminoids essential oils and fibers

For in

ternal u

se on

ly ndash Q1 2015

8770 studies shows pleiotroitropic effects of curcumin (Pubmed)

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

23

24

25

26

27

28

29

0

5

10

15

20

0

5

10

15

20

ldquoRandomized single blind study on efficacy and tolerability of curcumin in patients with reumatoid poliarthritis ldquo Chandran et al A Randomized Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis Phytother Res 2012261719ndash1725

deg n = 45 curcumin n =15 diclofenac n = 15 curcumin and diclofenac n = 15 deg 8 weeks 1000 mg curcumin (BCM-95 ) e 100 mg diclofenac

Curcumin vs NSAIDrsquo (diclofenac )

Tass

o d

i sed

imen

tazi

on

e er

itro

cita

ria

(ESR

)

- 11 - 8

Significative reduction of Disease Activity Score (DAS)

Significative reduction of Joints pain

- 83 - 69

- 97 - 89

Significative reduction of Joints swelling

In

cid

enza

In

cid

enza

Curcumin extract Diclofenac 1000 mg 100 mg

p lt 005 p lt 005 p lt 005

Curcumin extract Diclofenac 1000 mg 100 mg

Curcumin extract Diclofenac 1000 mg 100 mg

For in

ternal u

se on

ly ndash Q1 2015

280

290

300

310

320

330

340

350

360

Ibuprofen Curcumina

deg n = 367 curcumin extract n = 182 ibuprofen n = 185 deg After 4 weeks 1500 mg curcumin (2 capsuls 3xdie) e 1200 mg ibuprofen (2 capsuls 3xdie) deg Simple turmeric extract

Mobility Distance covered in 6 minutes

(Time 0 and after 4 weeks)

p = 0010

Met

ers

wal

ked

in 6

min

ute

s

Chronic Pain (Time 0 and after 4

weeks)

0

1

2

3

4

5

6

Ibuprofen Curcuminap = 0018

In

cid

ence

1200 mg 1500 mg

1200 mg 1500 mg )

- 41 + 14 + 11

Curcumin vs NSAIDrsquo (ibuprofen)

ldquoEfficacy and safety of curcumin vs Ibuprofen in patients with knee arthrosis a multicentric studyldquo

Kuptniratsaikul V et al Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis a multicenter study Clin Interv Aging 2014 Mar 209451-8

- 39

For in

ternal u

se on

ly ndash Q1 2015

Combination of Curcumin an ginger is effective as well as NSAIDrsquoS (indometacine)

Objective measure effective of a blend of curcumin and ginger on pain in patients with rheumatoid arthritis 3 groups NSAIDrsquoS (Indometacine) vs 200 mg (CG) vs 400 mg (CG) Results

Arthritic score 14d

Arthritic score 28d

Nsaidrsquos (Indometacine)

396 50

200 mg 417 583

400 mg 521 786

0

4

8

12

16

7 giorni 14 giorni 28 giorni

Controllo (dopo trattamento) Indometacina

200 mg curcumina +zenzero 400 mg curcumina+zenzero

- 786 - 52 A

rth

riti

c sc

ore

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 8: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Most sold SOP and OTC in Italy 2011

For in

ternal u

se on

ly ndash Q1 2015

Precautions in patients gt70 years

GI side effects

Risks of gastic ulcers

Attention in patients treated with anti-coagulatns

Risk of kidney impairment

Side effects and risks of NSAIDrsquos

ldquoGli utilizzatori di FANS hanno ulcere sintomatiche complicate 3-4 volte piugrave frequentemente rispetto ai non utilizzatorirdquo 2

ldquoDisturbi gastrici e intestinali compaiono nel 10 - 30 degli utilizzatori di FANSrdquo 1

1-2Nederlandse Huisartsen Genootschap ndash pijnbestrijding farmacotherapeutische richtlijn

3Cannon 2006 Chan 2006 Helin-Salmivaara 2006 Kearney 2006 McGettigan 2006

For in

ternal u

se on

ly ndash Q1 2015

Curcuma longa

Boswellia serrata

bull Omega 3 (EPA and DHA)

Zingiber officinale

Natural substances with anti-inflammatory activity

For in

ternal u

se on

ly ndash Q1 2015

bull Rhizomatous herbaceous perennial plant

bull Family Zingiberaceae bull Lives well with mild temperatures

(20deg-30deg C and high rains bull Reach 1 m in hight bull Nice hermafrodite flowers in 20cm

inflorescence (August) bull Active sustances are concentrated

in rhizomes

Turmeric the plant (Curcuma longa)

For in

ternal u

se on

ly ndash Q1 2015

Curcumin THE active principle of turmeric

(17-bis (4-hydroxy-3-methoxy-phenyl) hepta-16-diene-35-dione)

Turmeric powder contains 3-7 of Curcuminoids essential oils and fibers

For in

ternal u

se on

ly ndash Q1 2015

8770 studies shows pleiotroitropic effects of curcumin (Pubmed)

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

23

24

25

26

27

28

29

0

5

10

15

20

0

5

10

15

20

ldquoRandomized single blind study on efficacy and tolerability of curcumin in patients with reumatoid poliarthritis ldquo Chandran et al A Randomized Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis Phytother Res 2012261719ndash1725

deg n = 45 curcumin n =15 diclofenac n = 15 curcumin and diclofenac n = 15 deg 8 weeks 1000 mg curcumin (BCM-95 ) e 100 mg diclofenac

Curcumin vs NSAIDrsquo (diclofenac )

Tass

o d

i sed

imen

tazi

on

e er

itro

cita

ria

(ESR

)

- 11 - 8

Significative reduction of Disease Activity Score (DAS)

Significative reduction of Joints pain

- 83 - 69

- 97 - 89

Significative reduction of Joints swelling

In

cid

enza

In

cid

enza

Curcumin extract Diclofenac 1000 mg 100 mg

p lt 005 p lt 005 p lt 005

Curcumin extract Diclofenac 1000 mg 100 mg

Curcumin extract Diclofenac 1000 mg 100 mg

For in

ternal u

se on

ly ndash Q1 2015

280

290

300

310

320

330

340

350

360

Ibuprofen Curcumina

deg n = 367 curcumin extract n = 182 ibuprofen n = 185 deg After 4 weeks 1500 mg curcumin (2 capsuls 3xdie) e 1200 mg ibuprofen (2 capsuls 3xdie) deg Simple turmeric extract

Mobility Distance covered in 6 minutes

(Time 0 and after 4 weeks)

p = 0010

Met

ers

wal

ked

in 6

min

ute

s

Chronic Pain (Time 0 and after 4

weeks)

0

1

2

3

4

5

6

Ibuprofen Curcuminap = 0018

In

cid

ence

1200 mg 1500 mg

1200 mg 1500 mg )

- 41 + 14 + 11

Curcumin vs NSAIDrsquo (ibuprofen)

ldquoEfficacy and safety of curcumin vs Ibuprofen in patients with knee arthrosis a multicentric studyldquo

Kuptniratsaikul V et al Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis a multicenter study Clin Interv Aging 2014 Mar 209451-8

- 39

For in

ternal u

se on

ly ndash Q1 2015

Combination of Curcumin an ginger is effective as well as NSAIDrsquoS (indometacine)

Objective measure effective of a blend of curcumin and ginger on pain in patients with rheumatoid arthritis 3 groups NSAIDrsquoS (Indometacine) vs 200 mg (CG) vs 400 mg (CG) Results

Arthritic score 14d

Arthritic score 28d

Nsaidrsquos (Indometacine)

396 50

200 mg 417 583

400 mg 521 786

0

4

8

12

16

7 giorni 14 giorni 28 giorni

Controllo (dopo trattamento) Indometacina

200 mg curcumina +zenzero 400 mg curcumina+zenzero

- 786 - 52 A

rth

riti

c sc

ore

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 9: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Precautions in patients gt70 years

GI side effects

Risks of gastic ulcers

Attention in patients treated with anti-coagulatns

Risk of kidney impairment

Side effects and risks of NSAIDrsquos

ldquoGli utilizzatori di FANS hanno ulcere sintomatiche complicate 3-4 volte piugrave frequentemente rispetto ai non utilizzatorirdquo 2

ldquoDisturbi gastrici e intestinali compaiono nel 10 - 30 degli utilizzatori di FANSrdquo 1

1-2Nederlandse Huisartsen Genootschap ndash pijnbestrijding farmacotherapeutische richtlijn

3Cannon 2006 Chan 2006 Helin-Salmivaara 2006 Kearney 2006 McGettigan 2006

For in

ternal u

se on

ly ndash Q1 2015

Curcuma longa

Boswellia serrata

bull Omega 3 (EPA and DHA)

Zingiber officinale

Natural substances with anti-inflammatory activity

For in

ternal u

se on

ly ndash Q1 2015

bull Rhizomatous herbaceous perennial plant

bull Family Zingiberaceae bull Lives well with mild temperatures

(20deg-30deg C and high rains bull Reach 1 m in hight bull Nice hermafrodite flowers in 20cm

inflorescence (August) bull Active sustances are concentrated

in rhizomes

Turmeric the plant (Curcuma longa)

For in

ternal u

se on

ly ndash Q1 2015

Curcumin THE active principle of turmeric

(17-bis (4-hydroxy-3-methoxy-phenyl) hepta-16-diene-35-dione)

Turmeric powder contains 3-7 of Curcuminoids essential oils and fibers

For in

ternal u

se on

ly ndash Q1 2015

8770 studies shows pleiotroitropic effects of curcumin (Pubmed)

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

23

24

25

26

27

28

29

0

5

10

15

20

0

5

10

15

20

ldquoRandomized single blind study on efficacy and tolerability of curcumin in patients with reumatoid poliarthritis ldquo Chandran et al A Randomized Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis Phytother Res 2012261719ndash1725

deg n = 45 curcumin n =15 diclofenac n = 15 curcumin and diclofenac n = 15 deg 8 weeks 1000 mg curcumin (BCM-95 ) e 100 mg diclofenac

Curcumin vs NSAIDrsquo (diclofenac )

Tass

o d

i sed

imen

tazi

on

e er

itro

cita

ria

(ESR

)

- 11 - 8

Significative reduction of Disease Activity Score (DAS)

Significative reduction of Joints pain

- 83 - 69

- 97 - 89

Significative reduction of Joints swelling

In

cid

enza

In

cid

enza

Curcumin extract Diclofenac 1000 mg 100 mg

p lt 005 p lt 005 p lt 005

Curcumin extract Diclofenac 1000 mg 100 mg

Curcumin extract Diclofenac 1000 mg 100 mg

For in

ternal u

se on

ly ndash Q1 2015

280

290

300

310

320

330

340

350

360

Ibuprofen Curcumina

deg n = 367 curcumin extract n = 182 ibuprofen n = 185 deg After 4 weeks 1500 mg curcumin (2 capsuls 3xdie) e 1200 mg ibuprofen (2 capsuls 3xdie) deg Simple turmeric extract

Mobility Distance covered in 6 minutes

(Time 0 and after 4 weeks)

p = 0010

Met

ers

wal

ked

in 6

min

ute

s

Chronic Pain (Time 0 and after 4

weeks)

0

1

2

3

4

5

6

Ibuprofen Curcuminap = 0018

In

cid

ence

1200 mg 1500 mg

1200 mg 1500 mg )

- 41 + 14 + 11

Curcumin vs NSAIDrsquo (ibuprofen)

ldquoEfficacy and safety of curcumin vs Ibuprofen in patients with knee arthrosis a multicentric studyldquo

Kuptniratsaikul V et al Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis a multicenter study Clin Interv Aging 2014 Mar 209451-8

- 39

For in

ternal u

se on

ly ndash Q1 2015

Combination of Curcumin an ginger is effective as well as NSAIDrsquoS (indometacine)

Objective measure effective of a blend of curcumin and ginger on pain in patients with rheumatoid arthritis 3 groups NSAIDrsquoS (Indometacine) vs 200 mg (CG) vs 400 mg (CG) Results

Arthritic score 14d

Arthritic score 28d

Nsaidrsquos (Indometacine)

396 50

200 mg 417 583

400 mg 521 786

0

4

8

12

16

7 giorni 14 giorni 28 giorni

Controllo (dopo trattamento) Indometacina

200 mg curcumina +zenzero 400 mg curcumina+zenzero

- 786 - 52 A

rth

riti

c sc

ore

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 10: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Curcuma longa

Boswellia serrata

bull Omega 3 (EPA and DHA)

Zingiber officinale

Natural substances with anti-inflammatory activity

For in

ternal u

se on

ly ndash Q1 2015

bull Rhizomatous herbaceous perennial plant

bull Family Zingiberaceae bull Lives well with mild temperatures

(20deg-30deg C and high rains bull Reach 1 m in hight bull Nice hermafrodite flowers in 20cm

inflorescence (August) bull Active sustances are concentrated

in rhizomes

Turmeric the plant (Curcuma longa)

For in

ternal u

se on

ly ndash Q1 2015

Curcumin THE active principle of turmeric

(17-bis (4-hydroxy-3-methoxy-phenyl) hepta-16-diene-35-dione)

Turmeric powder contains 3-7 of Curcuminoids essential oils and fibers

For in

ternal u

se on

ly ndash Q1 2015

8770 studies shows pleiotroitropic effects of curcumin (Pubmed)

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

23

24

25

26

27

28

29

0

5

10

15

20

0

5

10

15

20

ldquoRandomized single blind study on efficacy and tolerability of curcumin in patients with reumatoid poliarthritis ldquo Chandran et al A Randomized Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis Phytother Res 2012261719ndash1725

deg n = 45 curcumin n =15 diclofenac n = 15 curcumin and diclofenac n = 15 deg 8 weeks 1000 mg curcumin (BCM-95 ) e 100 mg diclofenac

Curcumin vs NSAIDrsquo (diclofenac )

Tass

o d

i sed

imen

tazi

on

e er

itro

cita

ria

(ESR

)

- 11 - 8

Significative reduction of Disease Activity Score (DAS)

Significative reduction of Joints pain

- 83 - 69

- 97 - 89

Significative reduction of Joints swelling

In

cid

enza

In

cid

enza

Curcumin extract Diclofenac 1000 mg 100 mg

p lt 005 p lt 005 p lt 005

Curcumin extract Diclofenac 1000 mg 100 mg

Curcumin extract Diclofenac 1000 mg 100 mg

For in

ternal u

se on

ly ndash Q1 2015

280

290

300

310

320

330

340

350

360

Ibuprofen Curcumina

deg n = 367 curcumin extract n = 182 ibuprofen n = 185 deg After 4 weeks 1500 mg curcumin (2 capsuls 3xdie) e 1200 mg ibuprofen (2 capsuls 3xdie) deg Simple turmeric extract

Mobility Distance covered in 6 minutes

(Time 0 and after 4 weeks)

p = 0010

Met

ers

wal

ked

in 6

min

ute

s

Chronic Pain (Time 0 and after 4

weeks)

0

1

2

3

4

5

6

Ibuprofen Curcuminap = 0018

In

cid

ence

1200 mg 1500 mg

1200 mg 1500 mg )

- 41 + 14 + 11

Curcumin vs NSAIDrsquo (ibuprofen)

ldquoEfficacy and safety of curcumin vs Ibuprofen in patients with knee arthrosis a multicentric studyldquo

Kuptniratsaikul V et al Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis a multicenter study Clin Interv Aging 2014 Mar 209451-8

- 39

For in

ternal u

se on

ly ndash Q1 2015

Combination of Curcumin an ginger is effective as well as NSAIDrsquoS (indometacine)

Objective measure effective of a blend of curcumin and ginger on pain in patients with rheumatoid arthritis 3 groups NSAIDrsquoS (Indometacine) vs 200 mg (CG) vs 400 mg (CG) Results

Arthritic score 14d

Arthritic score 28d

Nsaidrsquos (Indometacine)

396 50

200 mg 417 583

400 mg 521 786

0

4

8

12

16

7 giorni 14 giorni 28 giorni

Controllo (dopo trattamento) Indometacina

200 mg curcumina +zenzero 400 mg curcumina+zenzero

- 786 - 52 A

rth

riti

c sc

ore

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 11: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

bull Rhizomatous herbaceous perennial plant

bull Family Zingiberaceae bull Lives well with mild temperatures

(20deg-30deg C and high rains bull Reach 1 m in hight bull Nice hermafrodite flowers in 20cm

inflorescence (August) bull Active sustances are concentrated

in rhizomes

Turmeric the plant (Curcuma longa)

For in

ternal u

se on

ly ndash Q1 2015

Curcumin THE active principle of turmeric

(17-bis (4-hydroxy-3-methoxy-phenyl) hepta-16-diene-35-dione)

Turmeric powder contains 3-7 of Curcuminoids essential oils and fibers

For in

ternal u

se on

ly ndash Q1 2015

8770 studies shows pleiotroitropic effects of curcumin (Pubmed)

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

23

24

25

26

27

28

29

0

5

10

15

20

0

5

10

15

20

ldquoRandomized single blind study on efficacy and tolerability of curcumin in patients with reumatoid poliarthritis ldquo Chandran et al A Randomized Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis Phytother Res 2012261719ndash1725

deg n = 45 curcumin n =15 diclofenac n = 15 curcumin and diclofenac n = 15 deg 8 weeks 1000 mg curcumin (BCM-95 ) e 100 mg diclofenac

Curcumin vs NSAIDrsquo (diclofenac )

Tass

o d

i sed

imen

tazi

on

e er

itro

cita

ria

(ESR

)

- 11 - 8

Significative reduction of Disease Activity Score (DAS)

Significative reduction of Joints pain

- 83 - 69

- 97 - 89

Significative reduction of Joints swelling

In

cid

enza

In

cid

enza

Curcumin extract Diclofenac 1000 mg 100 mg

p lt 005 p lt 005 p lt 005

Curcumin extract Diclofenac 1000 mg 100 mg

Curcumin extract Diclofenac 1000 mg 100 mg

For in

ternal u

se on

ly ndash Q1 2015

280

290

300

310

320

330

340

350

360

Ibuprofen Curcumina

deg n = 367 curcumin extract n = 182 ibuprofen n = 185 deg After 4 weeks 1500 mg curcumin (2 capsuls 3xdie) e 1200 mg ibuprofen (2 capsuls 3xdie) deg Simple turmeric extract

Mobility Distance covered in 6 minutes

(Time 0 and after 4 weeks)

p = 0010

Met

ers

wal

ked

in 6

min

ute

s

Chronic Pain (Time 0 and after 4

weeks)

0

1

2

3

4

5

6

Ibuprofen Curcuminap = 0018

In

cid

ence

1200 mg 1500 mg

1200 mg 1500 mg )

- 41 + 14 + 11

Curcumin vs NSAIDrsquo (ibuprofen)

ldquoEfficacy and safety of curcumin vs Ibuprofen in patients with knee arthrosis a multicentric studyldquo

Kuptniratsaikul V et al Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis a multicenter study Clin Interv Aging 2014 Mar 209451-8

- 39

For in

ternal u

se on

ly ndash Q1 2015

Combination of Curcumin an ginger is effective as well as NSAIDrsquoS (indometacine)

Objective measure effective of a blend of curcumin and ginger on pain in patients with rheumatoid arthritis 3 groups NSAIDrsquoS (Indometacine) vs 200 mg (CG) vs 400 mg (CG) Results

Arthritic score 14d

Arthritic score 28d

Nsaidrsquos (Indometacine)

396 50

200 mg 417 583

400 mg 521 786

0

4

8

12

16

7 giorni 14 giorni 28 giorni

Controllo (dopo trattamento) Indometacina

200 mg curcumina +zenzero 400 mg curcumina+zenzero

- 786 - 52 A

rth

riti

c sc

ore

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 12: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Curcumin THE active principle of turmeric

(17-bis (4-hydroxy-3-methoxy-phenyl) hepta-16-diene-35-dione)

Turmeric powder contains 3-7 of Curcuminoids essential oils and fibers

For in

ternal u

se on

ly ndash Q1 2015

8770 studies shows pleiotroitropic effects of curcumin (Pubmed)

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

23

24

25

26

27

28

29

0

5

10

15

20

0

5

10

15

20

ldquoRandomized single blind study on efficacy and tolerability of curcumin in patients with reumatoid poliarthritis ldquo Chandran et al A Randomized Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis Phytother Res 2012261719ndash1725

deg n = 45 curcumin n =15 diclofenac n = 15 curcumin and diclofenac n = 15 deg 8 weeks 1000 mg curcumin (BCM-95 ) e 100 mg diclofenac

Curcumin vs NSAIDrsquo (diclofenac )

Tass

o d

i sed

imen

tazi

on

e er

itro

cita

ria

(ESR

)

- 11 - 8

Significative reduction of Disease Activity Score (DAS)

Significative reduction of Joints pain

- 83 - 69

- 97 - 89

Significative reduction of Joints swelling

In

cid

enza

In

cid

enza

Curcumin extract Diclofenac 1000 mg 100 mg

p lt 005 p lt 005 p lt 005

Curcumin extract Diclofenac 1000 mg 100 mg

Curcumin extract Diclofenac 1000 mg 100 mg

For in

ternal u

se on

ly ndash Q1 2015

280

290

300

310

320

330

340

350

360

Ibuprofen Curcumina

deg n = 367 curcumin extract n = 182 ibuprofen n = 185 deg After 4 weeks 1500 mg curcumin (2 capsuls 3xdie) e 1200 mg ibuprofen (2 capsuls 3xdie) deg Simple turmeric extract

Mobility Distance covered in 6 minutes

(Time 0 and after 4 weeks)

p = 0010

Met

ers

wal

ked

in 6

min

ute

s

Chronic Pain (Time 0 and after 4

weeks)

0

1

2

3

4

5

6

Ibuprofen Curcuminap = 0018

In

cid

ence

1200 mg 1500 mg

1200 mg 1500 mg )

- 41 + 14 + 11

Curcumin vs NSAIDrsquo (ibuprofen)

ldquoEfficacy and safety of curcumin vs Ibuprofen in patients with knee arthrosis a multicentric studyldquo

Kuptniratsaikul V et al Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis a multicenter study Clin Interv Aging 2014 Mar 209451-8

- 39

For in

ternal u

se on

ly ndash Q1 2015

Combination of Curcumin an ginger is effective as well as NSAIDrsquoS (indometacine)

Objective measure effective of a blend of curcumin and ginger on pain in patients with rheumatoid arthritis 3 groups NSAIDrsquoS (Indometacine) vs 200 mg (CG) vs 400 mg (CG) Results

Arthritic score 14d

Arthritic score 28d

Nsaidrsquos (Indometacine)

396 50

200 mg 417 583

400 mg 521 786

0

4

8

12

16

7 giorni 14 giorni 28 giorni

Controllo (dopo trattamento) Indometacina

200 mg curcumina +zenzero 400 mg curcumina+zenzero

- 786 - 52 A

rth

riti

c sc

ore

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 13: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

8770 studies shows pleiotroitropic effects of curcumin (Pubmed)

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

23

24

25

26

27

28

29

0

5

10

15

20

0

5

10

15

20

ldquoRandomized single blind study on efficacy and tolerability of curcumin in patients with reumatoid poliarthritis ldquo Chandran et al A Randomized Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis Phytother Res 2012261719ndash1725

deg n = 45 curcumin n =15 diclofenac n = 15 curcumin and diclofenac n = 15 deg 8 weeks 1000 mg curcumin (BCM-95 ) e 100 mg diclofenac

Curcumin vs NSAIDrsquo (diclofenac )

Tass

o d

i sed

imen

tazi

on

e er

itro

cita

ria

(ESR

)

- 11 - 8

Significative reduction of Disease Activity Score (DAS)

Significative reduction of Joints pain

- 83 - 69

- 97 - 89

Significative reduction of Joints swelling

In

cid

enza

In

cid

enza

Curcumin extract Diclofenac 1000 mg 100 mg

p lt 005 p lt 005 p lt 005

Curcumin extract Diclofenac 1000 mg 100 mg

Curcumin extract Diclofenac 1000 mg 100 mg

For in

ternal u

se on

ly ndash Q1 2015

280

290

300

310

320

330

340

350

360

Ibuprofen Curcumina

deg n = 367 curcumin extract n = 182 ibuprofen n = 185 deg After 4 weeks 1500 mg curcumin (2 capsuls 3xdie) e 1200 mg ibuprofen (2 capsuls 3xdie) deg Simple turmeric extract

Mobility Distance covered in 6 minutes

(Time 0 and after 4 weeks)

p = 0010

Met

ers

wal

ked

in 6

min

ute

s

Chronic Pain (Time 0 and after 4

weeks)

0

1

2

3

4

5

6

Ibuprofen Curcuminap = 0018

In

cid

ence

1200 mg 1500 mg

1200 mg 1500 mg )

- 41 + 14 + 11

Curcumin vs NSAIDrsquo (ibuprofen)

ldquoEfficacy and safety of curcumin vs Ibuprofen in patients with knee arthrosis a multicentric studyldquo

Kuptniratsaikul V et al Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis a multicenter study Clin Interv Aging 2014 Mar 209451-8

- 39

For in

ternal u

se on

ly ndash Q1 2015

Combination of Curcumin an ginger is effective as well as NSAIDrsquoS (indometacine)

Objective measure effective of a blend of curcumin and ginger on pain in patients with rheumatoid arthritis 3 groups NSAIDrsquoS (Indometacine) vs 200 mg (CG) vs 400 mg (CG) Results

Arthritic score 14d

Arthritic score 28d

Nsaidrsquos (Indometacine)

396 50

200 mg 417 583

400 mg 521 786

0

4

8

12

16

7 giorni 14 giorni 28 giorni

Controllo (dopo trattamento) Indometacina

200 mg curcumina +zenzero 400 mg curcumina+zenzero

- 786 - 52 A

rth

riti

c sc

ore

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 14: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

23

24

25

26

27

28

29

0

5

10

15

20

0

5

10

15

20

ldquoRandomized single blind study on efficacy and tolerability of curcumin in patients with reumatoid poliarthritis ldquo Chandran et al A Randomized Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis Phytother Res 2012261719ndash1725

deg n = 45 curcumin n =15 diclofenac n = 15 curcumin and diclofenac n = 15 deg 8 weeks 1000 mg curcumin (BCM-95 ) e 100 mg diclofenac

Curcumin vs NSAIDrsquo (diclofenac )

Tass

o d

i sed

imen

tazi

on

e er

itro

cita

ria

(ESR

)

- 11 - 8

Significative reduction of Disease Activity Score (DAS)

Significative reduction of Joints pain

- 83 - 69

- 97 - 89

Significative reduction of Joints swelling

In

cid

enza

In

cid

enza

Curcumin extract Diclofenac 1000 mg 100 mg

p lt 005 p lt 005 p lt 005

Curcumin extract Diclofenac 1000 mg 100 mg

Curcumin extract Diclofenac 1000 mg 100 mg

For in

ternal u

se on

ly ndash Q1 2015

280

290

300

310

320

330

340

350

360

Ibuprofen Curcumina

deg n = 367 curcumin extract n = 182 ibuprofen n = 185 deg After 4 weeks 1500 mg curcumin (2 capsuls 3xdie) e 1200 mg ibuprofen (2 capsuls 3xdie) deg Simple turmeric extract

Mobility Distance covered in 6 minutes

(Time 0 and after 4 weeks)

p = 0010

Met

ers

wal

ked

in 6

min

ute

s

Chronic Pain (Time 0 and after 4

weeks)

0

1

2

3

4

5

6

Ibuprofen Curcuminap = 0018

In

cid

ence

1200 mg 1500 mg

1200 mg 1500 mg )

- 41 + 14 + 11

Curcumin vs NSAIDrsquo (ibuprofen)

ldquoEfficacy and safety of curcumin vs Ibuprofen in patients with knee arthrosis a multicentric studyldquo

Kuptniratsaikul V et al Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis a multicenter study Clin Interv Aging 2014 Mar 209451-8

- 39

For in

ternal u

se on

ly ndash Q1 2015

Combination of Curcumin an ginger is effective as well as NSAIDrsquoS (indometacine)

Objective measure effective of a blend of curcumin and ginger on pain in patients with rheumatoid arthritis 3 groups NSAIDrsquoS (Indometacine) vs 200 mg (CG) vs 400 mg (CG) Results

Arthritic score 14d

Arthritic score 28d

Nsaidrsquos (Indometacine)

396 50

200 mg 417 583

400 mg 521 786

0

4

8

12

16

7 giorni 14 giorni 28 giorni

Controllo (dopo trattamento) Indometacina

200 mg curcumina +zenzero 400 mg curcumina+zenzero

- 786 - 52 A

rth

riti

c sc

ore

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 15: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

23

24

25

26

27

28

29

0

5

10

15

20

0

5

10

15

20

ldquoRandomized single blind study on efficacy and tolerability of curcumin in patients with reumatoid poliarthritis ldquo Chandran et al A Randomized Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis Phytother Res 2012261719ndash1725

deg n = 45 curcumin n =15 diclofenac n = 15 curcumin and diclofenac n = 15 deg 8 weeks 1000 mg curcumin (BCM-95 ) e 100 mg diclofenac

Curcumin vs NSAIDrsquo (diclofenac )

Tass

o d

i sed

imen

tazi

on

e er

itro

cita

ria

(ESR

)

- 11 - 8

Significative reduction of Disease Activity Score (DAS)

Significative reduction of Joints pain

- 83 - 69

- 97 - 89

Significative reduction of Joints swelling

In

cid

enza

In

cid

enza

Curcumin extract Diclofenac 1000 mg 100 mg

p lt 005 p lt 005 p lt 005

Curcumin extract Diclofenac 1000 mg 100 mg

Curcumin extract Diclofenac 1000 mg 100 mg

For in

ternal u

se on

ly ndash Q1 2015

280

290

300

310

320

330

340

350

360

Ibuprofen Curcumina

deg n = 367 curcumin extract n = 182 ibuprofen n = 185 deg After 4 weeks 1500 mg curcumin (2 capsuls 3xdie) e 1200 mg ibuprofen (2 capsuls 3xdie) deg Simple turmeric extract

Mobility Distance covered in 6 minutes

(Time 0 and after 4 weeks)

p = 0010

Met

ers

wal

ked

in 6

min

ute

s

Chronic Pain (Time 0 and after 4

weeks)

0

1

2

3

4

5

6

Ibuprofen Curcuminap = 0018

In

cid

ence

1200 mg 1500 mg

1200 mg 1500 mg )

- 41 + 14 + 11

Curcumin vs NSAIDrsquo (ibuprofen)

ldquoEfficacy and safety of curcumin vs Ibuprofen in patients with knee arthrosis a multicentric studyldquo

Kuptniratsaikul V et al Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis a multicenter study Clin Interv Aging 2014 Mar 209451-8

- 39

For in

ternal u

se on

ly ndash Q1 2015

Combination of Curcumin an ginger is effective as well as NSAIDrsquoS (indometacine)

Objective measure effective of a blend of curcumin and ginger on pain in patients with rheumatoid arthritis 3 groups NSAIDrsquoS (Indometacine) vs 200 mg (CG) vs 400 mg (CG) Results

Arthritic score 14d

Arthritic score 28d

Nsaidrsquos (Indometacine)

396 50

200 mg 417 583

400 mg 521 786

0

4

8

12

16

7 giorni 14 giorni 28 giorni

Controllo (dopo trattamento) Indometacina

200 mg curcumina +zenzero 400 mg curcumina+zenzero

- 786 - 52 A

rth

riti

c sc

ore

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 16: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

280

290

300

310

320

330

340

350

360

Ibuprofen Curcumina

deg n = 367 curcumin extract n = 182 ibuprofen n = 185 deg After 4 weeks 1500 mg curcumin (2 capsuls 3xdie) e 1200 mg ibuprofen (2 capsuls 3xdie) deg Simple turmeric extract

Mobility Distance covered in 6 minutes

(Time 0 and after 4 weeks)

p = 0010

Met

ers

wal

ked

in 6

min

ute

s

Chronic Pain (Time 0 and after 4

weeks)

0

1

2

3

4

5

6

Ibuprofen Curcuminap = 0018

In

cid

ence

1200 mg 1500 mg

1200 mg 1500 mg )

- 41 + 14 + 11

Curcumin vs NSAIDrsquo (ibuprofen)

ldquoEfficacy and safety of curcumin vs Ibuprofen in patients with knee arthrosis a multicentric studyldquo

Kuptniratsaikul V et al Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis a multicenter study Clin Interv Aging 2014 Mar 209451-8

- 39

For in

ternal u

se on

ly ndash Q1 2015

Combination of Curcumin an ginger is effective as well as NSAIDrsquoS (indometacine)

Objective measure effective of a blend of curcumin and ginger on pain in patients with rheumatoid arthritis 3 groups NSAIDrsquoS (Indometacine) vs 200 mg (CG) vs 400 mg (CG) Results

Arthritic score 14d

Arthritic score 28d

Nsaidrsquos (Indometacine)

396 50

200 mg 417 583

400 mg 521 786

0

4

8

12

16

7 giorni 14 giorni 28 giorni

Controllo (dopo trattamento) Indometacina

200 mg curcumina +zenzero 400 mg curcumina+zenzero

- 786 - 52 A

rth

riti

c sc

ore

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 17: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Combination of Curcumin an ginger is effective as well as NSAIDrsquoS (indometacine)

Objective measure effective of a blend of curcumin and ginger on pain in patients with rheumatoid arthritis 3 groups NSAIDrsquoS (Indometacine) vs 200 mg (CG) vs 400 mg (CG) Results

Arthritic score 14d

Arthritic score 28d

Nsaidrsquos (Indometacine)

396 50

200 mg 417 583

400 mg 521 786

0

4

8

12

16

7 giorni 14 giorni 28 giorni

Controllo (dopo trattamento) Indometacina

200 mg curcumina +zenzero 400 mg curcumina+zenzero

- 786 - 52 A

rth

riti

c sc

ore

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 18: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

deg n = 15 curcumin 400 mg nimesulide 100mg achetominophen 1g Cicle with 3 subtances with a wash out of 48 hour

Curcumin vs Nimesulide and Acetoaminophene in acute pain

Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Merivareg) nimesulide and acetaminophen Di Pierro F1 Rapacioli G Di Maio EA Appendino G Franceschi F Togni S

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 19: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Curcumin studies in neuropatic pain in animal model

Zhao X Xu Y Zhao Q Chen CR Liu AM et al (2012) Curcumin exerts antinociceptive effects in a mouse model of neuropathic pain descending monoamine system and opioid receptors are differentially involved Neuropharmacology 62 843ndash854 14 Ji FT Liang JJ Liu L Cao MH Li F (2013) Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury Chin Med J (Engl) 126 1125ndash1131

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 20: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Curcumin in cancer patients

Objective Efficacy of curcumin in cancer patient ongoing chemio or radiotherapy measured with Karnofsky Scale as developed by Karnofsky Abelmann Craver and Burchenal - 60 days with curcumin or placebo Results

Curcumin 100 mg

A Controlled Study of a Lecithinized Delivery System of Curcumin to alleviate the Adverse Effects of Cancer Treatment

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 21: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 22: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 23: Curcumin in Chronic pain

Pubmed 18112015 2367 publications

Curcumin anti-oxidant power is 10 time higher than Vit E - Direct activity on ROS - Induction of NRF2 - Induce mitocondrial biogenesis

Curcumin is a powerful anti-oxidant

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 24: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 25: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Inflammatory targets modulated by curcumin

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 26: Curcumin in Chronic pain

Epigenetic activity of Curcumin

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 27: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Epigenetic activity of curcumin

Molecular targets Activity Epigenetic and anti-cancer activity under evaluation

DNA methylation HAT activities Histone acetylation (Acetil transferasehistone deacetilase HDAC isoenzymes (HDAC 13458)

miRNArsquos

miRNArsquos target genes

Decrease Decrease Rebalance Reduce expression Modulation Regulation

Anti-oxidant anti-angiogenic antiproliferative pro-apoptotic

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 28: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Bioavailability of Curcumin is very poor

Poor absorption Max conc 180 minutes Liver cleverage Cit P450

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 29: Curcumin in Chronic pain

Curcuma polvere

Curcumina principio attivo (1)

Fitosoma (1)

Oli (1)

Ciclodestrina (1)

Forma micellare o Solubilizzata (2)

X 95 ndash 511

X 577

X 335

X 1350

X 73

Source bull (1) Jaumlger et al Nutrition Journal 2014 1311 comparative absorption of curcumin formulations bull (2) Schiborr et al Mol Nutr Food Res 2014 58 516-527

X 1

Biodisponibilitagrave vs Curcuma

Bioavailability of IMPROVED Curcumins

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 30: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

bull Curcuma longa is GRASS in the USA

Turmeric tolerability

bull Curcumin is not carcinogenic bull No concerns of genotoxicity bull ADI of 3 mgkg bwday based on the NOAEL of 250-320

mgkg bwday bull Intake of curcumin from the normal diet amounts to less than

7 of the ADI of 3 mgkg bwday bull Possible weak interference with anti-coagulant that normally

do not require dosage adjustments

ADI = Accettable daily Intake

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 31: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Synergistic activity with

bull Nsaidrsquos

bull Steroids

bull Omega 3

bull Boswellia

Inflammation anc chronic pain

bull Omega3

bull Vit B complex

bull Ginko biloba

bull Anti-oxidants

Peripheral

Neuropatic pain and neurodegeneration

bull Glutammine

bull Probiotics

bull Prebiotics

bull Anti-oxidants

Gastrointestinal health

bull Glucosammine

bull Chondroitine

bull MSM

bull Boswellia

Joints Health

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 32: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

Ongoing clinical trials with curcumin

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 33: Curcumin in Chronic pain

For in

ternal u

se on

ly ndash Q1 2015

DAI Medicina Interna Medicina Specialistica UO Medicina Interna Universitaria ldquoCesare Frugonirdquo

Centro di Assistenza e Ricerca Sovraziendale per le Malattie Rare

Universitagrave Degli Studi ldquoALDO MOROrdquo di Bari

Direttore Prof Carlo Sabbagrave

REGIONE PUGLIA

AZIENDA OSPEDALIERA OSPEDALE POLICLINICO CONSORZIALE

Piazza Giulio Cesare 11 ndash 70124 BARI

Testing 3 ldquolevelsrdquo of curcumin activity

ANALYSYS OF GENIC EXPRESSION OF MONONUCLEATE BLOOD CELLS OF PATIENTS WITH METABOLIC SYNDROME AND OSTEOARTHROSIS POTENZIAL APPLICATIONS IN DIAGNOSIS MONITORING AND TREATMENT AFTER 3 MONTHS OF SUPPLEMENTATION WITH CURCUDYN (MSCPBMCCURCUMIN15)

First Level GENE EXPRESSION

bull Quantitative analysis of (mRNA) PCR Quantitative Real Time (RT-qPCR) RT-qPCR Primer

bull SNPrsquos Genotyping on DNA

Second Level INFLAMMATIONrsquos MARKERS

bull C Reactive Protein bull TNF alfa bull IL 6 IL 10

Third Level SYMPTOMS AND LIFE QUALITY

bull Chronic pain (Forms) bull Mobility bull Quality of Life (Form ILMA)

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 34: Curcumin in Chronic pain

Take home messages

Curcumin is effective on chronic pain and inflammation as NSAIDrsquos laquoEnhanced raquo curcumins have better bioavailability Curcumin is safe can be used with all patients

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS

Page 35: Curcumin in Chronic pain

Contatti msal37gmailcom +39 3663461468

Social httpswwwlinkedincominmauriziosalamone

httpmauriziosalamoneblogspotit

httpwwwslidesharenetMaurizio37

httpswwwfacebookcommauriziosalamone

Maurizio Salamone biologist Science Manager Metagenics Italia srl DISCLAIMER MSALAMONE IS AN EMPLOYEE OF METAGENICS A GLOBAL COMPANY THAT MARKETS NUTRACEUTICALS