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Spicy New Arthritis Treatment Moves to Clinical Trials

Posted November 27, 2015

Turmeric, a golden-hued spice native to Asia, has been used for centuries in the Indian-based healing practices of Ayurveda to treat many ailments, including arthritis, stomach problems, poor circulation and skin diseases. Although the spice has long been recognized for its anti-inflammatory benefits, the mysteries behind how it actually affects the human body largely have remained unsolved until now.

Dr. Janet Funk, a University of Arizona associate professor of medicine and nutritional sciences in the College of Medicine, has been working to crack the code behind turmeric’s medicinal potential for several years.

“When we first started researching turmeric, it had not yet been studied scientifically in order to discover whether it actually worked as an arthritis treatment,” said Funk, also a member of the UA’s BIO5 Institute and Cancer Center.

Funk and her research team decided to primarily focus on turmeric’s effects on rheumatoid arthritis, or RA. They were able to demonstrate that the chemicals in turmeric were highly effective in blocking the body’s inflammatory response — a helpful bit of medicinal knowledge not only for the treatment of arthritis, but also for other complications of inflammation, such as stroke. While these were excellent results, the next trick was to figure out which molecules were doing the real work and creating those desired effects, as well as which molecules might cause concerning toxicities.

Rheumatoid arthritis is a chronic autoimmune disease that causes the body’s defense system to attack itself. When RA flares, tissues around joints become inflamed, resulting in in swelling, pain, joint destruction and disability. RA disproportionately affects women, and there is no known cure.

While prescription medications such as Humira and Celebrex are used to treat RA, Funk was interested in finding out if turmeric could be equally as effective without as many corresponding side effects.

During its investigational studies, the UA team found that turmeric did, in fact, work just as well as commonly prescribed medications in blocking arthritic inflammation.

“In our experimental studies, we found out that turmeric inactivates a protein that is essentially the commander of a ‘fleet’ of inflammatory proteins made by the body,” Funk said. “When you block this protein, the fleet does not sail.

“Interestingly, the same protein is also a master regulator of bone breakdown, which is also a problem in RA, so turmeric’s blockade of this protein is sort of a two-for-the-price-of-one situation in RA.”

Now that they have identified turmeric’s biologically active spicy compounds and their intracellular targets in experimental models, Funk and her team are moving the project out of the laboratory and into the clinic in order to study turmeric’s effects in people.

The team successfully competed for funding from the National Institutes of Health, the agency that will oversee the clinical trial of 45 patients suffering from RA. The study will compare the effects of varying doses of turmeric dietary supplements alongside an inactive placebo over the course of a month, and is seeking to enroll individuals with RA whose symptoms are not well controlled on methotrexate, a common first-line treatment for the disease.

“We are calling it the CLaRA study, which is short for a title that includes turmeric’s botanical name (Curcuma longa L in Rheumatoid Arthritis),” Funk said. “We hope that this name will bring to mind both Clara Barton, a health care pioneer in an era when most medicines were plant-based, and claro, which means ‘clear’ in Spanish, since we believe this study will help to clarify exactly what role this botanical may play in modern-day arthritis treatment.”

The goal of this small study is to lay the groundwork for a larger and longer treatment trial that also would take place in Arizona.

Bringing to light the potential that natural remedies can play in modern medicine was the core catalyst to Funk’s turmeric study. Funk says that had it not been for NIH funding provided to the UA about a decade ago to create a large botanical research center, she would not have had the resources to conduct her study.

Barbara Timmerman, a Regents’ Professor and natural products chemist, was the driver behind that original grant and headed the botanical research center.

There have been many contributors to the turmeric study. Funk even mentioned a time when the turmeric root on which her team conducted tests was cultivated at the UA, in a greenhouse atop the roof of a parking garage.

“Ongoing research projects require teams of talented UA faculty, students, and staff with complementary areas of expertise, ranging all the way from biostatisticians to pharmacologists to clinicians,” Funk said. “It takes a village to move research all the way from the lab bench to the bedside. The UA is our village.”

With the RA clinical trial soon underway, Funk is also focused on expanding the impact turmeric may have to other diseases.

“One of the exciting things about studying ancient treatments using modern tools is that once you figure out how they work, you sometimes realize that they might also be useful for the treatment of entirely different diseases,” she said. “From learning how turmeric affects bone in our early arthritis work, we realized that turmeric might also be useful in blocking bone metastasis in women with advanced breast cancer.”

Funk is now testing this theory by starting to examine bone effects of turmeric in breast cancer. She also is collaborating with Thaddeus Pace, assistant professor in the UA College of Nursing, who is examining the ability of turmeric to reduce fatigue in women undergoing chemotherapy and radiation treatment for breast cancer in a small pilot study, with the goal of laying the groundwork for future trials in women with breast cancer.

Source: University of Arizona

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