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ORIGINAL PAPER
Abstract Turmeric has been in use since ancient times as a treated with curcumin. The study demonstrates the protective
condiment and due to its medicinal properties. Curcumin, the efficacy of curcumin in rat MCAO model.
yellow colouring principle in turmeric, is polyphenolic and
major active constituent. Besides anti-inflammatory, throm- Keywords Curcumin Middle cerebral artery occlusion
bolytic and anticarcinogenic activities, curcumin also Neuroprotection Oxidative stress
possesses strong antioxidant property. In view of the novel
combination of properties, neuroprotective efficacy of cur-
cumin was studied in rat middle cerebral artery occlusion Introduction
(MCAO) model. Rats were subjected to 2 h of focal ischemia
followed by 72 h of reperfusion. They were pre-treated with It is largely accepted that stroke is a leading cause of
curcumin (100 mg/kg, po) for 5 days prior to MCAO and for morbidity and poses serious health problems globally. The
another 3 days after MCAO. The parameters studied were affected persons often suffer from neurological deficits and
behavioural, biochemical and histological. Treatment with at times lead a crippled life [1]. Middle cerebral artery
curcumin could significantly improve neurobehavioral per- occlusion (MCAO) in rat is widely used to study experi-
formance compared to untreated ischemic rats as judged by its mental ischemic stroke and has provided invaluable
effect on rota-rod performance and grid walking. A significant understanding of the patho-physiology of focal cerebral
inhibition in lipid peroxidation and an increase in superoxide ischemia. Several mechanisms have been suggested to be
dismutase (SOD) activity in corpus striatum and cerebral involved in the etiology of stroke including NMDA
cortex was observed following treatment with curcumin in receptor activation leading to excitotoxicity, excessive
MCAO rats as compared to MCAO group. Intracellular cal- nitric oxide (NO) generation and free radical mediated
cium levels were decreased following treatment with oxidative stress [2–4]. Recently, role of intercellular
curcumin in MCAO rats. Histologically, a reduction in the adhesion molecule-1 (ICAM-1) protein has been suggested
infarct area from 33% to 24% was observed in MCAO rats in stroke since inhibition of ICAM-1 protein was found to
be neuroprotective in MCAO rats [5]. Several studies have
revealed that during ischemia there is excessive generation
P. K. Shukla V. K. Khanna (&) Mohd. M. Ali R. C. Srimal
Developmental Toxicology, Industrial Toxicology Research of free radicals and the antioxidant defence is impaired
Centre, PO Box 80, MG Marg, Lucknow 226 001, India causing more vulnerability and damage to the brain [6].
e-mail: vkkhanna1@gmail.com A number of agents, both synthetic and natural, have
been screened to evaluate their preventive and therapeutic
Present Address:
P. K. Shukla efficacy against ischemia [7–10]. Dietary supplementation
Department of Psychiatry and Behavioral Sciences, with blueberries, spinach and spirulina reduces ischemia/
Feinberg School of Medicine, Northwestern University, reperfusion induced apoptosis and cerebral infarction [6].
Chicago, IL 60611, USA
Turmeric (Curcuma longa rhizomes) has been extensively
Mohd. Y. Khan used as an effective therapeutic agent since ages [11–14].
Dr. B.R. Ambedkar University, Lucknow 226 014, India Turmeric as well as its constituent curcumin has been
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Neurochem Res (2008) 33:1036–1043 1037
shown to exhibit anti-inflammatory, anti-carcinogenic and artery of pentobarbitone anaesthetised (50 mg/kg, ip) rat
antioxidant activities, besides several other pharmacologi- was exposed through a midline incision in the neck under
cal properties [15–21]. Prophylactic/therapeutic effect of the operating microscope. A 4-0 nylon suture, the tip of
curcumin in cancer chemo-prevention, multiple sclerosis, which was rounded by heating over the flame, was intro-
myocardial infarction etc. has been reported [22]. Curcu- duced into the right external carotid artery and advanced
min has been found to be effective in the treatment of into the internal carotid artery for a length of 16 mm from
anterior uveitis and cystic fibrosis [23, 24]. More recently, the bifurcation. The tip of the suture was placed at the
neuroprotective efficacy of curcumin in attenuating 3-ni- origin of the anterior cerebral artery, thereby occluding the
tropropionic acid (a fungal toxin) and lead induced middle cerebral artery. The suture was left as such for 2 h.
neurotoxicity has been reported [25, 26]. Pari and Murugan The animal was allowed to recover from the anaesthesia
found that tetrahydrocurcumin prevented brain lipid per- after closure of the operation site and the suture was gently
oxidation in streptazotacin induced diabetic rats [27]. The removed 2 h after MCAO.
neuroprotective effect of curcumin was associated with its
anti-oxidant potential in these studies [27]. Curcumin has
been reported to cross the blood brain barrier [28] and Neurological score
based on the potential of curcumin to inhibit formation of
amyloid beta oligomers and fibrils in mice use of curcumin Neurological evaluation of rats was carried out after
has been recommended for the clinical trials to prevent or 30 min to verify successful MCAO and immediately before
treat Alzheimer’s disease [28] Effect of curcumin was they were sacrificed after 72 h. An eight point behavioural
studied in rats following intraperitoneal treatment, 30 min rating scale, modified from the scale as described by
after MCAO, indicating its neuroprotective potential in Rogers et al. [1] was used to score the neurological deficits.
ischemia. It has been suggested to be mediated through its 0 = no neurological deficit.
antioxidant activity [29] Our pilot studies conducted earlier 1 = failure to extend right forepaw fully.
suggested that oral treatment with curcumin is also neu- 2 = decreased grip of the right forelimb while tail gently
roprotective in ischemic rats [30]. Curcumin is recognised pulled.
as a promising compound with multiple pharmacological 3 = spontaneous movement in all direction, contralat-
properties and the present study was undertaken in rats eral circling only if pulled by the tail.
treated with oral curcumin before and after MCAO to 4 = circling or walking to the right.
evaluate its neuroprotective efficacy. 5 = walks only when stimulated.
6 = unresponsive to stimulation with a depressed level
Materials and methods of consciousness.
7 = dead.
Animals
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1038 Neurochem Res (2008) 33:1036–1043
received single baseline training on the rota-rod in was started by the addition of NADH followed by
which the speed was increased from 4 to 40 rpm over incubation at 37°C for 90 s. The reaction was stopped
a period of 5 min. At 24-h post occlusion, each rat by adding 1 ml of glacial acetic acid and the reaction
received another trial on the rota-rod and scoring was mixture was vigorously shaken with 4 ml of n-
carried out by a person blind to the condition [1]. butanol. The mixture was allowed to stand for
(ii) Grid walking: Rats were acclimatised for 1 min to an 10 min, centrifuged and butanol layer was separated.
elevated level of stainless steel grid with mesh size of The colour intensity of the chromogen in butanol was
30 mm before MCAO. At 24-h post-occlusion, they measured at 560 nm against butanol using a spectro-
were placed on the grid again for 1 min and the total photometer. A mixture without enzyme preparation
number of paired steps (placement of both fore limbs) was run in parallel to serve as control. The SOD
were counted. The scoring was carried out by a activity was expressed as units/mg protein. One unit
person blind to the condition. Foot-fault error (in of the enzyme was the amount required to inhibit the
which the animal made mistake in placing the rate of chromogen formation by 50%.
forelimbs or it fell from the grid) was monitored (iii) Intracellular calcium: The levels of intracellular
and the total number of errors in placing the forelimbs calcium were determined fluorometrically using
was recorded [1]. Quin-2AM as a fluorescent dye following the method
of Komulainen and Bondy [35]. Briefly, synapto-
somes containing 150–250 mg protein were incubated
in 3 ml Hepes buffer (25 mM Hepes, 12 mM NaCl,
Biochemical estimations
5 mM KCl, 1.2 mM MgSO4, 6 mM glucose, 6 mM
CaCl2, 5 mM NaHCO3, pH 7.4) with fluoremetric dye
Rats in all groups were sacrificed 72 h after MCAO by
Quin–2AM at a final concentration of 25 lM for
cervical decapitation and the brains were immediately
45 min in dark at 37°C. After the incubation was over,
removed. The brain regions, corpus striatum and cerebral
the assay mixture was centrifuged at 34,000g for
cortex, were dissected out following the standard procedure
15 min. To remove unbound Quin–2AM, the pellet
[32] and processed for biochemical assays within 45 min in
was carefully washed twice with assay buffer and
each case.
centrifuged at the same speed for same time. Finally,
(i) Lipid peroxidation: As a measure of lipid peroxida- pellet was suspended in 2 ml assay buffer. The emit-
tion, malonaldialdehyde (MDA) levels were estimated ted fluorescence of the sample was recorded on a
by measuring thiobarbituric acid reactive substances spectrophotofluorometer at excitation/emission 339/
(TBARS) following the standard protocol [33]. 492 nm respectively. Extracellular calcium was
Briefly, equal volumes (120 ll) of EDTA (10 mM), quenched by adding MnCl2 (40 lM) and the fluores-
ascorbate (10 mM) and mixture of EDTA (16.7 mM) cence R was measured. Fluorescence R minimum was
and FeSO4 (16.7 mM) were mixed and to this recorded after addition of sodium dodecyl sulphate
homogenate of different brain regions (0.6 ml) was (0.1%) and alkaline EGTA (5 mM) while R maximum
added. The reaction mixture was incubated at 37°C for was determined by addition of CaCl2 (7 mM) and
0 and 60 min. Immediately after incubation, the intracellular calcium levels were calculated using the
reaction was stopped by adding 1 ml of ice cold formula,
10% trichloro acetic acid (TCA). The deproteinised [Ca]i ¼ Kd (R - Rmin )/(Rmax - R)
homogenate was centrifuged at 2000g for 10 min and
supernatant was aspirated out. The supernatant was Kd = 115 nM is the dissociation constant of Quin-
mixed with an equal amount of 0.67% TBA and kept 2AM complex
in boiling water bath for 15–20 min. The intensity of
pink colour developed was read at 532 nm on a (iv) Protein estimation: Protein content was measured
spectrophotometer. following the method of Lowry et al. using bovine
(ii) Superoxide dismutase: Activity of superoxide dismu- serum albumin as a reference standard [36].
tase (SOD) was measured following the method of
Kakkar et al. [34] using NADH as a substrate.
Briefly, the assay mixture in a final volume of 3 ml
contained sodium pyrophosphate buffer (0.082 M, Histological studies
pH 8.3), phenazine methosulphate (186 lM), nitro
blue tetrazolium (300 lM), NADH (780 lM), Five coronal sections (2 mm thick) of the whole brain were
enzyme preparation and distilled water. The reaction taken from the region beginning 1 mm from the frontal pole
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Neurochem Res (2008) 33:1036–1043 1039
and ending just rostral to the cortico-cerebellar junction and Table 2 Protective effect of curcumin on rota-rod performance in
stained with 2% 2,3,5-triphenyl tetrazolium chloride [4]. The rats subjected to middle cerebral artery occlusion for 2 and 72 h after
ischemic reperfusion injury
damage following MCAO and any protection with curcumin
was assessed by an image analysis software. Group Time of fall (s)
Sham 215 ± 34
Statistical analysis Ischemic (MCAO) 77 ± 17*
Curcumin pre-treated ischemic 165 ± 15**
Data were analysed by comparing the mean ± SE of each Values are mean ± standard error of eight animals in each group
group and subjected to Student’s t test and P \ 0.05 was * Significantly differs from sham (P \ 0.05)
considered significant. ** Significantly differs from ischemic (MCAO) group (P \ 0.05)
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1040 Neurochem Res (2008) 33:1036–1043
40
35
30
% change
25
20
15
10
5
0
Sham MCAO MCAO+Curcumin
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Neurochem Res (2008) 33:1036–1043 1041
impaired co-ordination following MCAO for 2 h was also been used to investigate their protective and therapeutic
observed in the present study. Rota-rod performance was efficacy [9, 42]. Vitamin B3, Vitamin E, NMDA receptor
affected following MCAO in rats, which provided another antagonists, Na+ channel blockers and Nitric oxide syn-
evidence of impaired balance and muscle co-ordination due thase (NOS) inhibitors have been used and found effective
to ischemic-reperfusion injury. It has been reported that in the experimental model of MCAO [3, 10, 43]. Use of
rota-rod performance in the rats is significantly affected herbal products in the management of ischemia has also
following focal cerebral ischemia [37]. A linear relation- been advocated because of their high antioxidant activity
ship between the duration of ischemia and time during [9, 42]. Dietary supplementation with blueberries, spinach
which rats stay on the accelerating rod has been reported. and spirulina have been reported to reduce ischemia/
Significantly, treatment with curcumin in the MCAO rats reperfusion induced apoptosis and cerebral infarction [6]. It
caused an improvement in the grid walking and co-ordi- has been observed that agents that inhibit lipid peroxidation
nation as evident by the score of foot fault errors. The time or have strong antioxidant activity are useful in the treat-
of fall from the rotating rod was also significantly increased ment of this disease [9, 42, 44]. In an interesting study by
in these animals suggesting that curcumin treatment could Chabrier et al. BN 80933, a dual inhibitor of lipid perox-
significantly prevent impairment of sensorimotor functions. idation and NOS, significantly protected rats from ischemia
Further, a significant improvement in neurological score in different experimental models [3].
following curcumin treatment, observed in the present Curcumin, an important ingredient of turmeric, is a
study, is quite interesting and is consistent with the above cyclooxygenase inhibitor and possesses multiple pharma-
findings. cological properties including anti-inflammatory, anti-
A number of studies have observed that both cortex and carcinogenic and anti-thrombotic [18, 45]. These properties
corpus striatum are affected following stroke [38]. The rea- of curcumin might have also contributed to its anti-ischemic
son for including corpus striatum in the present study was efficacy but it is difficult to confirm them in the present study.
also due to the fact that motor functions are severely affected Free radical scavenging activity of curcumin and its pro-
following ischemia [1]. We have studied gross neuropro- tective effect against reactive species is well documented
tective effects of curcumin without going into details of the [46]. Curcumin is unique over other natural antioxidants
mechanisms at cellular or molecular levels. Enhanced oxi- since it possesses both the phenolic and diketonic groups
dative stress due to increased generation of free radicals has which help in the scavenging of free radicals. In contrast,
been reported during cerebral ischemia [9, 37, 39]. An other natural antioxidants possess either phenolic or dike-
increase in the levels of oxygen and hydroxyl radicals fol- tonic groups [47]. Curcumin has been found to be
lowing MCAO has also been shown. However, free radical neuroprotective against different neurotoxicants [48, 49].
generation is enhanced more during reperfusion [37]. One of the characteristic property of curcumin is that it does
Kuroda et al. suggested that generation of free radical species not affect the normal cells. In our earlier studies investigating
is an important contributor to brain damage [40]. An increase the neuroprotective efficacy of curcumin against lead
in lipid peroxidation and a decrease in superoxide dismutase neurotoxicity, treatment of rats only with curcumin (100 mg/
activity in corpus striatum and cortex, 72 h after MCAO kg, po) for 45 days had no significant effect on parameters
observed in the present study suggest a state of enhanced related with behaviour and oxidative stress [49].
oxidative stress. Protective effect of curcumin against cere- Treatment of ischemic rats with curcumin significantly
bral ischemia in rats has been studied by Thiyagarajan and inhibited lipid peroxidation both in corpus striatum and
Sharma [29]. They attributed the neuroprotective effect of cortex in the present study. Thiyagrajan and Sharma also
curcumin to its anti-oxidant property. However, a different observed inhibition in lipid peroxidation following intra-
route and schedule of curcumin administration was used in peritoneal treatment with curcumin [29]. Effect was more
these studies. We have used a more clinically relevant route marked at a higher dose (300 mg/kg) of curcumin.
of administration. Absorption of curcumin in the body may occur both by
A decrease in body weight following MCAO, observed gavage and intraperitoneal routes although bioavailability
in the present study, is consistent with the earlier reports of and pharmacokinetic properties are different [50]. Oral
post-ischemic loss in body weight [1, 37]. Garcia and Liu administration of curcumin has been reported to inhibit
reported that the body weight decrease was probably due to lipid peroxidation induced by carbon tetrachloride, parquat
infarction affecting feeding behaviour and injury to the and cyclophosphamide in brain, kidney, liver and lung in
anterior hypothalamus [41]. The decrease in body weight in mice [48]. It is, however, not clear whether inhibition in
ischemic rats in the present study could be due to decreased lipid peroxidation is due to scavenging of peroxides and
food intake of these rats. toxic free radical species generated during the reaction or
Since multi-factorial mechanisms are involved in neutralisation of free radicals [48]. As curcumin has xan-
ischemia, a number of synthetic and natural agents have thine oxidase inhibitory activity [51], it may prevent
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1042 Neurochem Res (2008) 33:1036–1043
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Neurochem Res (2008) 33:1036–1043 1043
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