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The role of curcumin as an inhibitor of oxidative stress caused by ischaemia re-perfusion injury in tetralogy of Fallot patients undergoing corrective surgery

Published online by Cambridge University Press:  28 April 2015

Rubiana Sukardi ,
Sudigdo Sastroasmoro ,
Nurjati C. Siregar ,
Mulyadi M. Djer ,
Fransciscus D. Suyatna ,
Mohammad Sadikin ,
Nurhadi Ibrahim ,
Sri E. Rahayuningsih  and
Arief B. Witarto
Rubiana Sukardi*
Affiliation:
Integrated Cardiovascular Service, Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Sudigdo Sastroasmoro
Affiliation:
Department of Child Health, Cardiology Division, Medical Faculty, University of Indonesia, Jakarta, Indonesia
Nurjati C. Siregar
Affiliation:
Department of Pathology Anatomy, Medical Faculty, University of Indonesia, Jakarta, Indonesia
Mulyadi M. Djer
Affiliation:
Department of Child Health, Cardiology Division, Medical Faculty, University of Indonesia, Jakarta, Indonesia
Fransciscus D. Suyatna
Affiliation:
Department of Pharmacology, Medical Faculty, University of Indonesia, Jakarta, Indonesia
Mohammad Sadikin
Affiliation:
Department of Biochemistry, Medical Faculty, University of Indonesia, Jakarta, Indonesia
Nurhadi Ibrahim
Affiliation:
Department of Physiology, Medical Faculty, University of Indonesia, Jakarta, Indonesia
Sri E. Rahayuningsih
Affiliation:
Department of Child Health, Cardiology Division, Medical Faculty, University of Padjajaran, Bandung, Indonesia
Arief B. Witarto
Affiliation:
Research and Development Laboratory, Dharmais Hospital National Cancer Center, Jakarta, Indonesia
*
Correspondence to: R. Sukardi, Cipto Mangunkusumo Hospital, Integrated Cardiovascular Center, Jalan Diponegoro 71, Jakarta 10430, Indonesia. Tel: +6 221 390 5839; E-mail: rubiana_sukardi@yahoo.com
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Abstract

Background

Cardiopulmonary bypass during tetralogy of Fallot corrective surgery is associated with oxidative stress, and contributes to peri-operative problems. Curcumin has been known as a potent scavenger of reactive oxygen species, which enhances the activity of antioxidants and suppresses phosphorylation of transcription factors involved in inflamation and apoptosis.

Objectives

To evaluate the effects of curcumin as an antioxidant by evaluating the concentrations of malondialdehyde and glutathione, activity of nuclear factor-kappa B, c-Jun N-terminal kinase, caspase-3, and post-operative clinical outcomes.

Methods

Tetralogy of Fallot patients for corrective surgery were randomised to receive curcumin (45 mg/day) or placebo orally for 14 days before surgery. Malondialdehyde and glutathione concentrations were evaluated during the pre-ischaemia, ischaemia, re-perfusion phases, and 6 hours after aortic clamping-off. Nuclear factor-kappa B, c-Jun N-terminal kinase, and caspase-3, taken from the infundibulum, were assessed during the pre-ischaemia, ischaemia, and re-perfusion phases. Haemodynamic parameters were monitored until day 5 after surgery.

Results

In all the observation phases, malondialdehyde and glutathione concentrations were similar between groups. There was no significant difference in nuclear factor-kappa B activity between the groups for three observations; however, in the curcumin group, c-Jun N-terminal kinase significantly decreased from the pre-ischaemia to the re-perfusion phases, and caspase-3 expression was lower in the ischaemia phase. Patients in the curcumin group had lower temperature and better ventricular functions, but no significant differences were found in mechanical ventilation day or length of hospital stay in the two groups.

Conclusion

Cardioprotective effects of curcumin may include inhibition of the c-Jun N-terminal kinase pathway and caspase-3 in cardiomyocytes, particularly in the ischaemia phase.

Keywords

Curcuminischaemia re-perfusion injuryapoptosis
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 3 , March 2016 , pp. 431 - 438
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Copyright
© Cambridge University Press 2015 

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