Abstract
Malaria remains a global health burden, with 219 million cases worldwide in 2017, resulting in 435,000 deaths. The main obstacle in malaria treatment is resistance to antimalarial drugs, rendering patients at risk of complications. Consequently, traditional herbs have been widely developed and studied as adjuvant therapies for malaria. Curcumin, an active compound of turmeric has been known to possess antimalarial effects against various Plasmodium species. It has a beneficial impact on both parasite removal and endothelial protection and may promote the immune response against Plasmodium via increasing the reactive oxygen species production, activating PPARγ/Nrf2 and upregulating CD36 expression in monocytes or macrophages to phagocytose parasite-infected erythrocytes. It can also downregulate the proinflammatory cytokine response and the expression of various adhesion molecules in endothelial cells and may bind to the heterodimer interface of the α/β-tubulin, causing the depolarisation of microtubules in the mitosis phase during cell division. Curcumin also has a role as an antiplasmodial agent via targeting PfATP6, the parasite orthologue of mammalian SERCA (sarcoplasmic-endoplasmic reticulum Ca2+-ATPase). Furthermore, it inhibits the formation of β-hematin and glycogen synthase kinase-3β (GSK3β), a protein kinase that mediates an anti-inflammatory response through NF-ƘB activation. Moreover, it is a histone acetyltransferase (HAT) inhibitor that is involved in parasite chromatin modifications. In summary, curcumin has a potency to be used as an adjuvant therapy for malaria.
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