Curcumin Benefits in Children with Active Lupus Nephritis via NLRP3 Inflammasome Inhibition- A Randomized Controlled Trial

Abstract

Lupus nephritis is a serious complication of childhood systemic lupus erythematous (cSLE). Nucleotide-binding domain, leucine-rich–containing family, pyrin domain–containing-3 (NLRP3) inflammasome activation is one of the pathogenic pathways leading to deterioration of kidney functions in cSLE causing end stage kidney diseases (ESKD). Curcumin as a potent anti-oxidant, anti-inflammatory and nephroprotective drug has proved experimentally its benefits on murine lupus via inhibiting NLRP3 inflammasome. This study aimed to investigate the effects of curcumin supplementation in pediatric patients with active lupus nephritis. In this randomized controlled trial, 44 patients with lupus nephritis are randomized to receive either curcumin tablets (1000 mg curcumin) added to their standard immunotherapy for 12 weeks, or their standard immunotherapy alone. Serum NLRP3 inflammasome, complement component 3 (C3), 24-h urine protein and erythrocytes sedimentation rate (ESR) are measured at baseline and after 12 weeks. A total of 44 patients with a mean age of 13.3 ± 4.7 years completed the trial. Curcumin- supplementation for 12 weeks resulted in significant reduction in serum NLRP3 inflammasome and improved complement component 3 (C<inf>3</inf>) with p-values (0.0399) and (<0.0001) respectively, compared to patients on the standard immunotherapy alone. Curcumin is an effective add-on anti-inflammatory agent in childhood lupus nephritis.