Dmitriy A. Lukichev

This review presents current data on the pharmacokinetics, side effects, dosage forms and interactions of curcumin. Curcumin, the major bioactive component of turmeric, has low bioavailability due to its low water solubility, rapid metabolism in the liver and rapid excretion from the body. The main pathways of curcumin metabolism are described, including its reduction and subsequent conjugation with glucuronic acid and sulphates. Side effects of curcumin such as hyperoxaluria, iron deficiency anaemia, hepatotoxicity, arrhythmias, allergic reactions and potential carcinogenic properties are discussed. Various dosage forms of curcumin developed to enhance its bioavailability are discussed, including liposomes, nanoparticles, hydrogels and phytosomes. Particular attention is given to the drug interactions of curcumin with chemotherapeutic agents such as 5-fluorouracil, vincristine, gemcitabine, adriamycin and cisplatin, as well as with hypolipidaemic agents, antiaggregants and anticoagulants. These data highlight the need for further studies to optimise the therapeutic use of curcumin and minimise its side effects.

This paper details the impact of inflammatory bowel disease (IBD) on patients’ quality of life. In order to assess patients’ quality of life, a number of specific and general tools have been developed to assess quality of life in patients with IBS. According to the data obtained in a number of clinical studies, IBS significantly reduces the quality of life of patients compared to healthy people. Moreover, the quality of life is directly related to the form and degree of ICD activity. Thus, worse quality of life is associated with Crohn’s disease and active stage of the disease. However, in the remission stage, the quality of life in patients with Crohn’s disease (CD) and ulcerative colitis (UC) do not have statistically significant differences. In addition, diet and lifestyle are of great importance for the QOL of patients with UC. Conservative therapy is an extremely important link that allows to significantly improve the life quality of patients, in which targeting pre-drugs play an important role. The latter significantly improve the QOL of patients with ICD, contributing to the transition of ICD from the active form to remission.

Curcumin, an active ingredient derived from turmeric root (Curcuma longa), has significant pharmacological properties including anti-inflammatory, antioxidant, antimicrobial, anticancer and analgesic activities. Studies show that curcumin affects the expression of various microRNAs and long non-coding RNAs to regulate cell proliferation and apoptosis in various types of malignant tumours. In addition, curcumin modulates signalling pathways such as PI3K/Akt/mTOR, MAPK/ERK and AMPK, activating autophagy and inhibiting tumour angiogenesis. It also inhibits metastasis and invasion of tumour cells by affecting epithelial-mesenchymal transition and expression of matrix metalloproteinases. Curcumin exhibits antibacterial and antiviral activity by disrupting bacterial cell membranes and inhibiting viral replication. The antioxidant properties of curcumin are due to its ability to neutralise reactive oxygen species and stimulate antioxidant enzymes. Curcumin also promotes wound healing by modulating inflammatory processes and stimulating angiogenesis. The analgesic effect of curcumin is due to its ability to stimulate the release of endogenous opioid peptides and modulate the activity of GABA receptors and ASIC and TRPV ion channels. Curcumin has an effect on lipid and carbohydrate metabolism, which makes it a promising agent for the treatment of dyslipidaemia and insulin resistance. The effect of curcumin on haemostasis is manifested in its ability to inhibit platelet aggregation and blood clotting, which may be useful for the prevention of cardiovascular diseases.

This review examines modern approaches to the diagnosis and treatment of irritable bowel syndrome (IBS) in children, one of the most common functional disorders of the gastrointestinal tract. IBS is characterized by chronic abdominal pain, intestinal motility disorders and stool changes, which significantly reduces the quality of life of patients. The article analyzes in detail the pathogenetic mechanisms of IBS, including the role of the gut–brain axis, gut microbiota and neuroendocrine factors. Special attention is paid to the pharmacotherapy of IBS in children, including the use of antidepressants, probiotics and herbal components, as well as the role of correctors of the motor activity of the digestive tract in relieving symptoms. Modern recommendations on the use of various classes of antidepressants are considered, taking into account their pharmacokinetic and pharmacodynamic characteristics. The prospects of using probiotics and herbal preparations in the complex therapy of IBS are also analyzed. The data obtained confirm the need for a personalized approach to the treatment of IBS, taking into account the genetic and physiological characteristics of patients.