Anticancer Potential of the Principal Constituent of Piper nigrum, Piperine: A Comprehensive Review.

Black pepper's main component, piperine, is a phytochemical that gives the spice its distinctively pungent flavor, which has made it a staple in human diets for decades and a widely used food item. In addition to its use as a culinary component and preservation agent, it is also employed in traditional medicine for a diverse range of objectives, a practice that has been substantiated by existing scientific investigations on its physiological impacts in the majority of instances. Piperine contains various bioactive effects, such as antibacterial activity, in addition to several physiological benefits that could help overall human health, such as immunomodulatory, hepatoprotective, antioxidant, antimetastatic, anticancer, and many more properties that have been established. Clinical trials revealed that this phytochemical has exceptional antioxidant, anticancer, and drug availability-enhancing properties, as well as immunomodulatory potential. The different components of evidence indicate the therapeutic potential of piperine and underscore the importance of incorporating it into both broad health-promoting interventions and supplementary treatment pharmaceutical formulations. This inclusion can enhance the bioavailability of other therapeutic medications, including those used in chemotherapy.

Enhancing oral bioavailability of andrographolide using solubilizing agents and bioenhancer: comparative pharmacokinetics of Andrographis paniculata formulations in beagle dogs.

CONTEXT: The therapeutic potential of andrographolide is hindered by its poor oral bioavailability and unpredictable pharmacokinetics, primarily due to its limited water solubility. OBJECTIVE: This work aimed to enhance the solubility and pharmacokinetics of andrographolide, a bioactive compound in Andrographis paniculata (Burm. f.) Nees (Acanthaceae), using solubilizing agents and a bioenhancer. MATERIALS AND METHODS: Four groups of beagles were compared: (1) A. paniculata powder alone (control), (2) A. paniculata powder with 50% weight/weight (w/w) ß-cyclodextrin solubilizer, (3) A. paniculata powder with 1% w/w sodium dodecyl sulfate (SDS) solubilizer, and (4) A. paniculata powder co-administered with 1% w/w SDS solubilizer and 10% piperine bioenhancer. All groups received a consistent oral dose of 3 mg/kg of andrographolide, administered both as a single dose and multiple doses over seven consecutive days. RESULTS: Thirteen chemical compounds were identified in A. paniculata powder, including 7 diterpenoids, 5 flavonoids, and 1 phenolic compound. A. paniculata co-administration with either 50% w/w ß-cyclodextrin or 1% w/w SDS, alone or in combination with 10% w/w piperine, significantly increased systemic andrographolide exposure by enhancing bioavailability (131.01% to 196.05%) following single and multiple oral co-administration. Glucuronidation is one possible biotransformation pathway for andrographolide, as evidenced by the excretion of glucuronide conjugates in urine and feces. CONCLUSION: The combination of solubilizing agents and a bioenhancer improved the oral bioavailability and pharmacokinetics of andrographolide, indicating potential implications for A. paniculata formulations and clinical therapeutic benefits. Further investigation in clinical studies is warranted.

[Intestinal absorption components and absorption characteristics of Wuwei Qingzhuo San by everted intestinal sac models].

This study investigated the absorption profile of Wuwei Qingzhuo San in different intestinal segments and the absorption characteristics of its alkaloids(piperine, piperanine, piperlonguminine, and dihydropiperlonguminine). The everted gut sac model was established, and the chemical components of Wuwei Qingzhuo San in different intestinal segments were detected by UPLC-Q-TOF-MS. The content of piperine, piperanine, piperlonguminine, and dihydropiperlonguminine in intestinal absorption fluid was determined by UPLC-Q-TRAP-MS and the absorption parameters were calculated. The absorption characteristics in different intestinal segments at different time were analyzed. As a result, 27, 27, 8, and 6 absorbent components from Wuwei Qingzhuo San were detected in the intestinal cyst fluid of jejunum, ileum, duodenum, and colon by UPLC-Q-TOF-MS technology, respectively. It was also found that piperine, piperanine, piperlonguminine, and dihydropiperlonguminine from Wuwei Qingzhuo San showed linear absorption in various intestinal segments, with r values exceeding 0.9. In terms of absorption content, the components were ranked as piperine>piperanine>dihydropiperlonguminine>piperlonguminine in various intestinal segments, but the absorption rate and mechanism of each component varied. The results demonstrate that the absorption of the components of Wuwei Qingzhuo San in different intestinal segments is selective and is not a simple semi-permeable membrane permeation process.

Randomised Clinical Trial Study: The Combination of Vitamin D and Curcumin Piperine Attenuates Disease Activity and Pro-inflammatory Cytokines Levels Insystemic Lupus Erythematosus Patients.

BACKGROUND: Curcumin-piperine might synergise with vitamin D to induce clinical remission in patients with systemic lupus erythematosus (SLE). OBJECTIVE: To observe the improvement of patients with SLE clinically and the levels of inflammatory cytokines after receiving supplements of curcumin-piperine and cholecalciferol (Vitamin D3). METHODS: Forty-five female SLE patients were included in a three-month double-blind, randomized controlled trial. Participants were classified into: Group I (400 IU cholecalciferol + placebo three times daily, n = 15), Group II (600 mg curcumin + 15,800 m piperine once daily and three times daily placebo, n = 15), and Group III (cholecalciferol 400 IU three times and 600 mg curcumin + 15,800 mg piperine once a day, n = 15). Mexican SLE disease activity score (Mex- SLEDAI), fatigue severity scale (FSS), TGF-ß, and IL-6 levels were measured from all patients before and after the treatments. RESULTS: Mex-SLEDAI, FSS, and IL-6 were reduced significantly, while TGF-ß serum levels were increased in all groups after the treatments (p <0.05). Changes in Mex-SLEDAI score (p = 0.003 and p = 0.008), FSS (p = 0.001 and p <0.001), and TGF-ß (p = 0.003 and p = 0.004) serum levels were significantly higher in group III compared to the group I or group II. On the other hand, changes in Mex-SLEDAI, FSS, IL-6, and TGF-ß serum levels were similar between groups I and II. CONCLUSION: Although vitamin D or curcumin-piperine alone could improve the clinical outcome and cytokines levels in SLE, curcumin-piperine combined with vitamin D had the best outcome in improving the disease activity and cytokines levels among patients with SLE. (ClinicalTrials.gov number, NCT05430087).

Investigation of alternative two-phase solvent systems for purification of natural products by centrifugal partition chromatography.

INTRODUCTION: Centrifugal partition chromatography (CPC) is a liquid-liquid chromatography characterised by its solvent flexibility. The compounds undergoing separation are subjected to a continuous partition process between two immiscible phases in a column space free of solid support. In the context of green chemistry, it is important to substitute halogenated and petroleum-based solvents commonly used in purification processes. OBJECTIVES: The main goal of the current study was to replace classical solvents used in CPC (e.g., hexane and methanol) by green and renewable alternatives. METHODS: Solvents were first selected based on literature. Their commercial availability, price, recyclability, toxicity and ability to form two phases were particularly sought after. KEY FINDINGS: The new two-phase solvent systems were evaluated for the purification of two compounds of interest: piperine and cannabidiol. Using these alternative two-phase solvent systems allows us to isolate natural products with a high purity level (> 95%). CONCLUSION: Substituting petroleum-based solvents with bio-sourced, renewable alternatives reduces the environmental impact of CPC. Herein, new biphasic solvent systems were built using hexamethyldisiloxane, ethyl isobutyrate and 2-methyl tetrahydrofuran in combination with ethanol and water. Furthermore, this research provides a scientific basis for developing new and sustainable solvent systems in CPC.

Piperine promotes PI3K/AKT/mTOR-mediated gut-brain autophagy to degrade α-Synuclein in Parkinson's disease rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Piper longum L., a medicinal and food homologous herb, has a traditional history of use in treating gastrointestinal and neurological disorders. Piperine (PIP) the main alkaloid of P. longum, exists neuroprotective effects on various animal models of Parkinson's disease (PD). Nevertheless, the underlying mechanism, particularly the role of PIP in promoting gut-brain autophagy for α-Synuclein (α-Syn) degradation in PD, remains incompletely understood. AIM OF THE STUDY: To explore the role of PIP in regulating the gut-brain autophagy signaling pathway to reduce α-Syn levels in both the colon and substantia nigra (SN) of PD model rats. MATERIALS AND METHODS: Behavioral experiments were conducted to assess the impact of PIP on 6-hydroxydopamine (6-OHDA)-induced PD rats. The intestinal microbiome composition and intestinal metabolites were analyzed by metagenomics and GC-MS/MS. The auto-phagosomes were visualized by transmission electron microscopy. Immunohistochemistry, immunofluorescence, and western blotting were performed to assess the levels of tyrosine hydroxylase (TH), α-Syn, LC3II/LC3I, p62, and the PI3K/AKT/mTOR pathway in both the SN and colon of the rats. The pathway-related inhibitor and agonist were used to verify the autophagy mechanism in the SH-SY5Y cells overexpressing A53T mutant α-Syn (A53T-α-Syn). RESULTS: PIP improved autonomic movement and gastrointestinal dysfunctions, reduced α-Syn aggregation and attenuated the loss of dopaminergic neurons in 6-OHDA-induced PD rats. After oral administration of PIP, the radio of LC3II/LC3I increased and the expression of p62 was degraded, as well as the phosphorylation levels of PI3K, AKT and mTOR decreased in the SN and colon of rats. The effect of PIP on reducing A53T-α-Syn through the activation of the PI3K/AKT/mTOR-mediated autophagy pathway was further confirmed in A53T-α-Syn transgenic SH-SY5Y cells. This effect could be inhibited by the autophagy inhibitor bafilomycin A1 and the PI3K agonist 740 Y-P. CONCLUSIONS: Our findings suggested that PIP could protect neurons by activating autophagy to degrade α-Syn in the SN and colon, which were related to the suppression of PIP on the activation of PI3K/AKT/mTOR signaling pathway.

First report on evaluation of commercial eugenol and piperine against Aedes aegypti L (Diptera: Culicidae) larvae: Mortality, detoxifying enzyme, and histopathological changes in the midgut.

Dengue fever is a worldwide public health problem, and efforts to eradicate it have focused on controlling the dengue vector, Aedes aegypti. This study aims to assess the toxicity and effect of commercial eugenol and piperine on Ae. aegypti larvae through enzyme detoxification and histopathological changes in the midgut. Laboratory-reared Ae. aegypti larvae were treated with various concentrations of commercial eugenol and piperine and observed after 24, 48, and 72 h. Biochemical methods were used to assess detoxification enzyme activity for acetylcholinesterase, glutathione S-transferase, and oxidase, and changes in the midgut were examined using routine histological examination. In terms of larvicidal activity, piperine exceeded eugenol. Piperine and eugenol had LC50 and LC90 values of 3.057 and 5.543 µM, respectively, and 6.421 and 44.722 µM at 24 h. Piperine and eugenol reduced oxidase activity significantly (p < 0.05), but increased acetylcholinesterase and glutathione S-transferase activity significantly (p < 0.05). After being exposed to piperine and eugenol, the food bolus and peritrophic membrane ruptured, the epithelial layer was interrupted and irregular, the epithelial cells shrank and formed irregularly, and the microvilli became irregular in shape. Commercial piperine and eugenol behave as potential larvicides, with processes involving altered detoxifying enzymes, specifically decreased oxidase function and increased GST activity, as well as midgut histological abnormalities.

Anti-diarrheal effect of piperine possibly through the interaction with inflammation inducing enzymes: In vivo and in silico studies.

Piperine is a natural alkaloid that possesses a variety of therapeutic properties, including anti-inflammatory, antioxidant, antibacterial, and anticarcinogenic activities. The present study aims to assess the medicinal benefits of piperine as an anti-diarrheal agent in a chick model by utilizing in vivo and in silico techniques. For this, castor oil was administered orally to 2-day-old chicks to cause diarrhea. Bismuth subsalicylate (10 mg/kg), loperamide (3 mg/kg), and nifedipine (2.5 mg/kg) were used as positive controls, while the vehicle was utilized as a negative control. Two different doses (25 and 50 mg/kg b.w.) of the test sample (piperine) were administered orally, and the highest dose was tested with standards to investigate the synergistic activity of the test sample. In our findings, piperine prolonged the latent period while reducing the number of diarrheal feces in the experimental chicks during the monitoring period (4 h). At higher doses, piperine appears to reduce diarrheal secretion while increasing latency in chicks. Throughout the combined pharmacotherapy, piperine outperformed bismuth subsalicylate and nifedipine in terms of anti-diarrheal effects with loperamide. In molecular docking, piperine exhibited higher binding affinities towards different inflammatory enzymes such as cyclooxygenase 1 (-7.9 kcal/mol), cyclooxygenase 2 (-8.4 kcal/mol), nitric oxide synthases (-8.9 kcal/mol), and L-type calcium channel (-8.8 kcal/mol), indicating better interaction of PP with these proteins. In conclusion, piperine showed a potent anti-diarrheal effect in castor oil-induced diarrheal chicks by suppressing the inflammation and calcium ion influx induced by castor oil.

The effects of curcumin-piperine supplementation on inflammatory, oxidative stress and metabolic indices in patients with ischemic stroke in the rehabilitation phase: a randomized controlled trial.

BACKGROUND: Stroke is a leading cause of death worldwide, which is associated with a heavy economic and social burden. The purpose of this study was to investigate the effects of supplementation with curcumin-piperine combination in patients with ischemic stroke in the rehabilitation stage. METHODS: In this randomized controlled trial, 66 patients with stroke were randomized into two groups receiving curcumin-piperine tablets (500 mg curcumin + 5 mg piperine) and matched placebo tablets for 12 weeks. High-sensitivity C-reactive protein (hs-CRP), carotid intima-media thickness (CIMT), thrombosis, total antioxidant capacity (TAC), lipid profile, anthropometric indices, blood pressure, and quality of life were assessed before and after the intervention. Statistical data analysis was done using SPSS22 software. RESULTS: A total of 56 patients with a mean age of 59.80 ± 4.25 years completed the trial. Based on ANCOVA test, adjusted for baseline values, curcumin-piperine supplementation for 12 weeks resulted in significant reductions in serum levels of hs-CRP (p = 0.026), total cholesterol (TC) (p = 0.009), triglycerides (TG) (p = 0.001), CIMT (p = 0.002), weight (P = 0.001), waist circumference (p = 0.024), and systolic and diastolic blood pressure (p < 0.001), and a significant increase in TAC (p < 0.001) in comparison to the placebo. Pain score significantly increased in both groups; however, its increase was significantly higher in the placebo group compared with the intervention group (p = 0.007). No significant changes were observed between the two groups in terms of serum fibrinogen, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and quality of life indices. CONCLUSION: Curcumin-piperine supplementation had beneficial effects on CIMT, serum hs-CRP, TC, TG, TAC, and systolic and diastolic blood pressure in patients with ischemic stroke in the rehabilitation stage.

Non-therapeutic plasma levels in individuals utilizing curcumin supplements in daily life.

Introduction: The spice curcumin and its metabolites are widely used by cancer patients but have not shown proven health benefits in clinical studies, likely due to low plasma concentrations after oral intake. However, public interest in curcumin continues to grow, and companies claim enhanced absorption in their formulations. This study aims to determine if daily oral intake of curcumin leads to sufficient plasma concentrations for health effects. The study was registered in the Dutch Clinical Trial Register with ID NL5931. Methods: We used a validated HPLC-MS/MS method to measure curcumin and its metabolites in 47 individuals using their own curcumin formulations. Questionnaires assessed other supplement and medication use. Plasma samples were collected before and 1.5 h after intake, analyzing curcumin and metabolite levels with and without ß-glucuronidase pretreatment to measure conjugated and unconjugated forms. Results: Plasma concentrations of curcumin, demethoxycurcumin, bisdemethoxycurcumin and tetrahydrocurcumin, ranged between 1.0 and 18.6 ng/mL. Adding ß-glucuronidase resulted in an increase of unconjugated curcumin plasma levels to 25.4 ng/mL; however still significantly below (1000-fold) a plasma concentration that is expected to have a beneficial health effect. The use of adjuvants like piperine did not result in higher curcumin plasma concentrations. Discussion: Our study shows that using oral curcumin supplements still does not result in therapeutic plasma levels. Health care practitioners need to be critical toward the claimed beneficial systemic health effects of current curcumin supplement use by their patients. Clinical Trial Registration: https://onderzoekmetmensen.nl/en/trial/25480, NL5931.

The Promise of Piperine in Cancer Chemoprevention.

Cancer, characterized by the unregulated growth and dissemination of malignantly transformed cells, presents a significant global health challenge. The multistage process of cancer development involves intricate biochemical and genetic alterations within target cells. Cancer chemoprevention has emerged as a vital strategy to address this complex issue to mitigate cancer's impact on healthcare systems. This approach leverages pharmacologically active agents to block, suppress, prevent, or reverse invasive cancer development. Among these agents, piperine, an active alkaloid with a wide range of therapeutic properties, including antioxidant, anti-inflammatory, and immunomodulatory effects, has garnered attention for its potential in cancer prevention and treatment. This comprehensive review explores piperine's multifaceted role in inhibiting the molecular events and signaling pathways associated with various stages of cancer development, shedding light on its promising prospects as a versatile tool in cancer chemoprevention. Furthermore, the review will also delve into how piperine enhances the effectiveness of conventional treatments such as UV-phototherapy and TRAIL-based therapy, potentially synergizing with existing therapeutic modalities to provide more robust cancer management strategies. Finally, a crucial perspective of the long-term safety and potential side effects of piperine-based therapies and the need for clinical trials is also discussed.

Piper retrofractum ameliorates imiquimod-induced skin inflammation via modulation of TLR4 axis and suppression of NF-κB activity.

Chronic inflammation is a significant concern due to its association with various pathological conditions. As a result, extensive research has been conducted to identify new natural products that can effectively treat acute inflammation, which has the potential to inhibit the chronic inflammation. In our study, we aimed to identify Indonesian medicinal plants with the ability to inhibit proinflammatory agents, specifically targeting NF-κB, a crucial regulator of gene transcription involved in the production of proinflammatory proteins/cytokines. Through a series of identification processes, we found that Piper retrofractum (Javanese chili) extract demonstrated promising inhibitory effects on NF-κB and proinflammatory molecules. Further investigation was conducted using a variety of assays, including reporter assay, viability test, ELISA, and Western blotting. The results revealed that the extract significantly reduced LPS, NO, COX-2, IL-6, IL-1, and NF-κB through the TLR4 axis. Notably, Piper retrofractum extract was found to enhance the survival of human keratinocytes by protecting them from cell death induced by TRAIL, a member of the TNF superfamily. Moreover, immunohistochemistry analysis in an Imiquimod-induced skin inflammation mice model showed downregulation of COX-2 and IL-1ß expression upon treatment with the extract. In conclusion, our findings suggest that Piper retrofractum extract possesses anti-inflammatory properties by reducing proinflammatory cytokine production through inhibition of NF-κB signaling pathway. These promising results highlight the potential of Piper retrofractum extract as a candidate for future drug development in the clinical treatment of inflammation-related conditions, offering hope for the advancement of therapeutic interventions.

Significant Advancement in Various Synthetic Strategies and Pharmacotherapy of Piperine Derivatives: A Review.

BACKGROUND: Piperine is a natural compound found in black pepper that has been traditionally used for various therapeutic purposes. In the ayurvedic system of medication there is a lot of evidence which shows that the piperine is widely used for different therapeutic purpose. In recent years, there has been an increasing interest in the pharmacological and therapeutic potential of piperine and its derivatives in modern medicine. In order to increase the bioavailability and therapeutic effectiveness of piperine and its analogs, researchers have been looking at various extraction methods and synthesis approaches. Many studies have been conducted in this area because of the promise of piperine as a natural substitute for synthetic medications. OBJECTIVES: The objective of this review article is to provide an up-to-date analysis of the literature on the synthesis of piperine analogs, including their extraction techniques and various biological activities such as antihypertensive, antidiabetic, insecticidal, antimicrobial, and antibiotic effects. Additionally, the review aims to discuss the potential of piperine in modern medicine, given its traditional use in various medicinal systems such as Ayurveda, Siddha, and Unani. The article also provides a comprehensive analysis of the plant from which piperine is derived. CONCLUSION: This review article provides a thorough examination of piperine and the source plant. The best extraction technique for the extraction of piperine and the synthesis of its analogs with various biological activities, including antihypertensive, antidiabetic, insecticidal, antibacterial, and antibiotic properties, are covered in the article. This review aims to provide an updated analysis of the literature on the synthesis of piperine analogs.

Piperine modulates IR/Akt/GLUT4 pathways to mitigate insulin resistance: Evidence from animal and computational studies.

The global prevalence of diabetes mellitus is rising, especially in India. Medicinal herbs, whether used alone or in combination with conventional medicines, have shown promise in managing diabetes and improving overall well-being. Piperine (PIP), a major bioactive compound found in pepper, is gaining attention for its beneficial properties. This study aimed to assess whether PIP could alleviate diabetes by targeting insulin pathway-related molecules in the adipose tissue of rats on a high-fat diet (HFD). After 60 days on the HFD, rats received PIP at a dose of 40 mg/kg body weight for one month. The results showed that PIP significantly improved metabolic indicators, antioxidant enzymes, and carbohydrate metabolic enzymes. It also regulated the mRNA and protein expression of insulin signaling, which had been disrupted by the diet and sucrose intake. Molecular docking analysis also revealed strong binding of PIP to key diabetes-related regulatory proteins, including Akt (-6.2 kcal/mol), IR (-7.02 kcal/mol), IRS-1 (-6.86 kcal/mol), GLUT4 (-6.24 kcal/mol), AS160 (-6.28 kcal/mol), and ß-arrestin (-6.01 kcal/mol). Hence, PIP may influence the regulation of glucose metabolism through effective interactions with these proteins, thereby controlling blood sugar levels due to its potent antilipidemic and antioxidant properties. In conclusion, our study provides in vivo experimental evidence against the HFD-induced T2DM model for the first time, making PIP a potential natural remedy to enhance the quality of life for diabetic patients and aid in their management.

Piperine as a Potential Nutraceutical Agent for Managing Diabetes and Its Complications: A Literature Review.

The global prevalence of diabetes and its related complications has increased drastically and is currently a worldwide health challenge. There is still an urgent need for safe and effective natural products and supplements as alternative and/or adjunctive therapeutic interventions. Nowadays, people pay more and more attention to the nutritional and medicinal value of food ingredients. As one of the most widely employed spices in cooking, pepper also has novel medicinal values attributed to its main component, piperine (Pip). Pip is an amide alkaloid with pleiotropic properties such as anti-inflammatory, antioxidant, anti-cancer, and other related activities. Recently, Pip has received increasing scientific attention due to its antidiabetic and related complication properties. However, the values of existing studies are limited due to being scattered and unsystematic. The present study reviewed the therapeutic potential and possible mechanisms of Pip in diabetes and related complications, with the aim of providing promising candidates for the development of novel and effective alternative and/or adjunctive nutraceutical agents for the management of diabetes.

Effects of dietary piperine supplementation on innate immunity, growth performance, feed utilization and intestinal morphology of olive flounder (Paralichthys olivaceus).

Piperine, the main bioactive component of black pepper (Piper nigrum) or long pepper (Piper longum), has anti-inflammatory, antifungal, and antibacterial properties. This study was carried out to evaluate the supplemental effects of piperine in olive flounder (Paralichthys olivaceus) diets. Six isonitrogenous and isolipidic diets were formulated to contain different levels of piperine at 0.00, 0.25, 0.50, 0.75, 1.00, and 2.00 g/kg (Con, P25, P50, P75, P100, and P200, respectively). Diets were randomly allocated to triplicate groups of fish (initial weight 27.6 ± 0.4 g, 30 fish/tank) and fed three times daily for 8 weeks. Results showed that dietary piperine significantly improved fish growth and feed utilization efficiency. The highest growth, including the highest Igf-1 mRNA expression, was observed in the P50 group, while P50 and P75 groups showed the highest protein efficiency ratio. Compared to the Con group piperine supplemented groups had significantly higher lysozyme activity, immunoglobulin level, and phagocytosis activities. Plasma cholesterol was significantly lower in fish fed P200 diet. Dry matter and protein digestibility were higher in P25, P50, and P75 groups than in Con group. Dietary piperine increased the intestinal villi length and goblet cell counts. In the challenge test against Edwardsiella tarda, all the groups supplemented with piperine showed higher cumulative survival compared to Con group. Therefore, these findings indicate that dietary piperine supplementation can improve growth performance, innate immunity, disease resistance, diet digestibility, and intestinal morphology of olive flounder. The optimum dietary piperine level seems to be approximately 0.5 g/kg for the fish.

The Use of Herbal Medicine in Sudden Sensorineural Hearing Loss in Diabetic Patients.

Introduction: This study was conducted to evaluate the effect of Doluperine® capsule (curcumin, piperine, and gingerol) on hearing recovery in diabetic patients with Sudden Sensorineural Hearing Loss (SSNHL). Materials and Methods: Fifty-one diabetic patients with SSNHL were randomized to receive two placebo capsules (group 1), a Doluperine® plus one placebo capsule (group 2), or two Doluperine® capsules (group 3). Moreover, all patients had an injection of dexamethasone in the middle ear. Results: The proportion of significant positive changes in PTA, SDS, and SRT was 45.4%, 45.4%, and 36.37% in group1, 84.6%, 84.6%, and 76.92% in group 2, and 70%, 50.0%, and 80.0% in group 3, respectively. Many patients in group 3 did not respond to treatment in the first month, while they recovered at the end of the second month. The chance of recovery reduced with increased time between the onset of symptoms and treatment (delayed visitation) in group 1; however, this finding was not seen in groups 2 and 3. Conclusion: Doluperine® is recommended as a complementary medicine along with steroid therapy for hearing loss improvement in diabetic patients; moreover, this herbal medicine seems to play an important role in recovery in patients with delayed visitation.

Evaluation of Curcumin-Piperine Supplementation in COVID-19 Patients Admitted to the Intensive Care: A Double-Blind, Randomized Controlled Trial.

BACKGROUND: Curcumin is a traditional remedy for diseases associated with hyper-inflammatory responses and immune system impairment. Piperine, a bioactive compound in black pepper, has the potential to enhance curcumin bioavailability. 0This study aims to examine the effect of the curcumin-piperine co-supplementation in patients infected with SARS-CoV-2 and admitted to the intensive care unit (ICU). MATERIAL AND METHODS: In this parallel randomized, double-blind, placebo-controlled trial, 40 patients with COVID-19 admitted to ICU were randomized to receive three capsules of curcumin (500 mg)-piperine (5 mg) or placebo for 7 days. RESULTS: After 1 week of the intervention, serum aspartate aminotransferase (AST) (p = 0.02) and C-reactive protein (CRP) (p = 0.03) were significantly decreased, and hemoglobin was increased (p = 0.03) in the curcumin-piperine compared to the placebo group. However, compared with the placebo, curcumin-piperine had no significant effects on the other biochemical, hematological, and arterial blood gas and 28-day mortality rate was three patients in each group (p = 0.99). CONCLUSION: The study results showed that short-term curcumin-piperine supplementation significantly decreased CRP, AST, and increased hemoglobin in COVID-19 patients admitted to the ICU. Based on these promising findings, curcumin appears to be a complementary treatment option for COVID-19 patients, although some parameters were not affected by the intervention.

In-silico, in-vitro and ex-vivo evidence of combining silymarin phytopharmaceutical with piperine, and fulvic acid for enhancing its solubility and permeability.

Non-alcoholic fatty liver disease is one of the leading causes of death worldwide. Even if with such a high mortality there is no definite treatment approved. Thus, there is a need to develop a formulation which can have multiple pharmacological activities. Herbal drugs are among the most promising compounds that act by different pharmacological actions. For increasing the bio-activity of Silymarin we had isolated five active biomarker molecules from silymarin extract (as a Phytopharmaceutical) in our previous work. It possesses lower bioavailability due to poor solubility, lesser permeability and first pass metabolism effect. Therefore, from the literature we had screened two bioavailability enhancers i.e. piperine and fulvic acid for overcoming the drawbacks associated with silymarin. Hence, in this study we had first explored the ADME-T parameters and then evaluated their in-silico activity for different enzymes involved in inflammation and fibrosis. Interestingly, it was found that besides the bioavailability enhancing property, piperine and fulvic acid also shown anti-inflammatory and anti-fibrotic action, particularly more activity was demonstrated by fulvic acid than piperine. Furthermore, the concentration of the bioavailability enhancers i.e. 20% FA and 10% PIP were optimized by QbD assisted solubility studies. Moreover, the percentage release and apparent permeability coefficient of the optimized formulation was found to be 95% and 90%, respectively as compared to 6.54*106 and 1.63*106 respectively by SM suspension alone. Furthermore, it was found that plain rhodamine solution penetrated only up to 10 um whereas, formulation penetrated up to 30 um. Thus, combining these three, can not only increase the bioavailability of silymarin, but might also, increase the physiological action synergistically.

Evaluation of piperine analogs against prostate cancer targeting AKT1 kinase domain through network pharmacological analysis.

Prostate cancer is the second most fatal malignancy in men after lung cancer, and the fifth leading cause of death. Piperine has been utilized for its therapeutic effects since the time of Ayurveda. According to traditional Chinese medicine, piperine has a wide variety of pharmacological effects, including anti-inflammatory, anti-cancer, and immune-regulating properties. Based on the previous study, Akt1 (protein kinase B) is one of the targets of piperine, it belongs to the group of oncogenes and the mechanism of the Akt1 is an interesting approach for anticancer drug design. From the peer-reviewed literature, five piperine analogs were identified altogether, and a combinatorial collection was formed. However, may not be entirely clear how piperine analogs work to prevent prostate cancer. In the present study, serine-threonine kinase domain Akt1 receptor was employed to analyze the efficacy of piperine analogs against standards using in silico methodologies. Additionally, their drug-likeness was evaluated utilizing online servers like Molinspiration and preADMET. Using AutoDock Vina, the interactions of five piperine analogs and two standards with Akt1 receptor was investigated. Our study reveals that piperine analog-2 (pip2) shows highest binding affinity (- 6.0 kcal/mol) by forming 6 hydrogen bonds with more hydrophobic interactions compared to other four analogs and standards. In conclusion, the piperine analog pip2, which shows strong inhibition affect in Akt1-cancer pathway, may be employed as chemotherapeutic drugs.