Potencial terapêutico do curcumin nanoparticulado como adjuvante no tratamento e reparo da periodontite
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Data
2020-04-01
Autores
Perez-Pacheco, Cindy Grace
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Curcumin é o principal composto biologicamente ativo extraído do rizoma da espécie Curcuma longa. Diversos estudos relatam efeitos biológicos do curcumin que são de interesse em diferentes condições clínicas, como doenças inflamatórias intestinais, artrite reumatóide, câncer, diabetes, obesidade, depressāo, líquen plano e periodontite. Estudos pré-clínicos em modelos de periodontite experimental consistentemente demonstram efeito anti-inflamatório com a redução da reabsorção óssea. No entanto, existem poucas informações sobre o efeito biológico do curcumin no reparo dos tecidos periodontais, uma vez que na maioria dos estudos pré-clínicos a administração do curcumin é feita como único tratamento e de forma concomitante à indução da doença. Estudos clínicos do uso do curcumin como adjuvante do tratamento periodontal mecânico relatam, em geral, efeitos benéficos; porém há necessidade de avaliação sistemática dos resultados e da validade interna e externa dos trabalhos clínicos. Este trabalho tem o objetivo geral de investigar o potencial do curcumin aplicado localmente como adjuvante do tratamento periodontal mecânico no reparo dos tecidos periodontais. A hipótese é que a aplicação local de curcumin potencializa seus efeitos biológicos favorecendo o reparo tecidual ao evitar as dificuldades associadas às pobres propriedades farmacocinéticas da administração oral. O trabalho está organizado em três estudos: (i) estudo pré-clínico em modelo de periodontite experimental com aplicação local de curcumin como adjuvante da terapia mecânica e durante a fase de reparo; (ii) estudo clínico randomizado controlado com aplicação única do curcumin como adjuvante do tratamento mecânico; e (iii) revisão sistemática de estudos clínicos avaliando a aplicação local de curcumin como adjuvante do tratamento periodontal mecânico. Os resultados indicam que a aplicação local de curcumin promoveu o reparo periodontal no estudo pré-clínico; porém o estudo clínico não indicou benefício significativo clínico, microbiológico ou imunológico. A revisão sistemática e meta-análise indicou benefícios clínicos significativos (redução de sangramento e profundidade de sondagem, ganho de inserção) com o uso local de curcumin. A conclusão geral é que a aplicação local de curcumin tem potencial de favorecer o reparo periodontal, porém são necessários estudos adicionais para otimização do veículo, dosagem e posologia de aplicação.
Curcumin is the main biologically active compound extracted from the rhizome of the Curcuma longa. Several studies report biological effects of curcumin that are of interest in different clinical conditions, such as inflammatory bowel diseases, rheumatoid arthritis, cancer, diabetes, obesity, depression, lichen planus and periodontitis. Pre-clinical studies in experimental periodontitis models consistently demonstrate an anti-inflammatory effect by reducing bone resorption. However, there is limited information on the biological effect of curcumin in repairing periodontal tissues, since in most preclinical studies curcumin is administered as the sole treatment and concurrently with the induction of the disease. Clinical studies using curcumin as an adjunct to mechanical periodontal treatment report, in general, beneficial effects; however, there is a need for systematic evaluation of the results and the internal and external validity of clinical studies. This work aims to investigate the potential of locally-delivered curcumin as an adjunct to mechanical periodontal treatment in the repair of periodontal tissues. The hypothesis is that local application of curcumin enhances its biological effects, favoring tissue repair by avoiding issues associated with the poor pharmacokinetic properties of oral administration. The work is organized in three studies: (i) pre-clinical study in an experimental periodontitis model with local application of curcumin as an adjunct to mechanical therapy and during the repair phase; (ii) randomized controlled clinical study with a single application of curcumin as an adjunct to mechanical treatment; and (iii) systematic review of clinical studies assessing the local application of curcumin as an adjunct to mechanical periodontal treatment. The results indicate that the local application of curcumin promoted periodontal repair in the preclinical study; however, the clinical study did not indicate a significant clinical, microbiological or immunological benefit. The systematic review and meta-analysis indicated significant clinical benefits (reduced bleeding and probing pocket depth, and gain of clinical attachment) with the local use of curcumin. In conclusion, local application of curcumin has potential to favor periodontal repair, however, additional studies are needed to optimize the vehicle, dosage and application dosage.
Curcumin is the main biologically active compound extracted from the rhizome of the Curcuma longa. Several studies report biological effects of curcumin that are of interest in different clinical conditions, such as inflammatory bowel diseases, rheumatoid arthritis, cancer, diabetes, obesity, depression, lichen planus and periodontitis. Pre-clinical studies in experimental periodontitis models consistently demonstrate an anti-inflammatory effect by reducing bone resorption. However, there is limited information on the biological effect of curcumin in repairing periodontal tissues, since in most preclinical studies curcumin is administered as the sole treatment and concurrently with the induction of the disease. Clinical studies using curcumin as an adjunct to mechanical periodontal treatment report, in general, beneficial effects; however, there is a need for systematic evaluation of the results and the internal and external validity of clinical studies. This work aims to investigate the potential of locally-delivered curcumin as an adjunct to mechanical periodontal treatment in the repair of periodontal tissues. The hypothesis is that local application of curcumin enhances its biological effects, favoring tissue repair by avoiding issues associated with the poor pharmacokinetic properties of oral administration. The work is organized in three studies: (i) pre-clinical study in an experimental periodontitis model with local application of curcumin as an adjunct to mechanical therapy and during the repair phase; (ii) randomized controlled clinical study with a single application of curcumin as an adjunct to mechanical treatment; and (iii) systematic review of clinical studies assessing the local application of curcumin as an adjunct to mechanical periodontal treatment. The results indicate that the local application of curcumin promoted periodontal repair in the preclinical study; however, the clinical study did not indicate a significant clinical, microbiological or immunological benefit. The systematic review and meta-analysis indicated significant clinical benefits (reduced bleeding and probing pocket depth, and gain of clinical attachment) with the local use of curcumin. In conclusion, local application of curcumin has potential to favor periodontal repair, however, additional studies are needed to optimize the vehicle, dosage and application dosage.
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Palavras-chave
Curcumin, Periodontite, Nanopartículas, Ensaio clínico, Ratos, Curcumin, Periodontitis, Nanoparticles, Clinical Trial, Rats