Curcumin as a multi-hepatoprotective agent-mechanism, clinical and preclinical studies-A narrative review
DOI:
https://doi.org/10.70066/jahm.v14i6.2837Keywords:
Curcumin, fatty liver, liver disease, inflammation, narrative review, oxidative stressAbstract
Introduction: Non-alcoholic fatty liver disease‚ alcoholic liver disease‚ viral hepatitis and cirrhosis are the major liver diseases․ Oxidative stress‚ chronic inflammation and dyslipidemias are the primary pathophysiological mechanisms leading to damage to hepatic cells and the progression of liver diseases․ Curcumin‚ a polyphenol derived from Curcuma longa (turmeric)‚ is one of the most analyzed bioactive compounds for its antioxidant‚ anti-inflammatory and hepatoprotective effects․ In this narrative review‚ we summarize the molecular mechanisms of curcumin's liver-protective effects and its potential as a treatment for liver disease․ Methods: Databases such as PubMed‚ Scopus‚ and Web of Science were searched for articles published in English over the previous 15 years and containing the keywords "curcumin"‚ "Curcuma longa"‚ "hepatoprotection"‚ "liver injury"‚ and "antioxidant"․ The preclinical and clinical studies were analyzed and data regarding the study design‚ dose‚ therapeutic effects‚ and mechanism of action were extracted and qualitatively discussed․ Results: Curcumin prevents liver injury by inhibiting the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling pathway and decreasing levels of pro-inflammatory cytokines such as tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6)․ Additionally‚ curcumin reduces oxidative stress by scavenging free radicals and activating the nuclear factor (erythroid-derived 2)-like 2 (Nrf2) pathway that increases the activity of endogenous antioxidant enzymes․ Curcumin regulates lipid metabolism by activating AMPK and PPAR-α and by inhibiting SREBP-1c‚ which is associated with less hepatic steatosis․ In animal models‚ curcumin consistently improved serum liver function and fibrosis markers․ Clinical trials showed positive results with lowering of liver fat‚ inflammatory markers‚ and serum transaminases․ Conclusion: Curcumin is a potential hepatoprotective agent with multi-targeting effects despite its bioavailability issues․ further modified preparations and large-scale studies should allow for effective hepatoprotective drugs for chronic liver disease to be developed․
References
Zhao J, Zhang X, Li Y, Yu J, Chen Z, Niu Y, Ran S, Wang S, Ye W, Luo Z, Li X. Interorgan communication with the liver: novel mechanisms and therapeutic targets. Frontiers in immunology. 2023 Dec 12;14:1314123. https://doi.org/10.3389/fimmu.2023.1314123
Mohajan HK. A study on functions of liver to sustain a healthy liver. Innov Sci Technol. 2025;4(1):77-87. https://doi.org/10.56397/IST.2025.01.08
Pawar A, Middha AK. Tinospora Cordifolia: A Comprehensive Review of Its Liver Detoxifying Mechanism. International Journal of Research in Pharmacy and Allied Science. 2025 Sep 30;4(9):1-7. https://doi.org/10.71431/IJRPAS.2025.4901
Barton MH. Liver Metabolism and Function. Veterinary Clinics: Equine Practice. 2026 May 28. https://doi.org/10.1016/j.cveq.2026.04.008
Kocaadam B, Şanlier N. Curcumin, an active component of turmeric (Curcuma longa), and its effects on health. Critical reviews in food science and nutrition. 2017 Sep 2;57(13):2889-95. https://doi.org/10.1080/10408398.2015.1077195
Sharifi-Rad J, Rayess YE, Rizk AA, Sadaka C, Zgheib R, Zam W, Sestito S, Rapposelli S, Neffe-Skocińska K, Zielińska D, Salehi B. Turmeric and its major compound curcumin on health: bioactive effects and safety profiles for food, pharmaceutical, biotechnological and medicinal applications. Frontiers in pharmacology. 2020 Sep 15;11:550909. https://doi.org/10.3389/fphar.2020.01021
Mari M, Carrozza D, Malavasi G, Venturi E, Avino G, Capponi PC, Iori M, Rubagotti S, Belluti S, Asti M, Ferrari E. Curcumin-based β-diketo ligands for Ga3+: thermodynamic investigation of potential metal-based drugs. Pharmaceuticals. 2022 Jul 12;15(7):854. https://doi.org/10.3390/ph15070854
Tian WW, Liu L, Chen P, Yu DM, Li QM, Hua H, Zhao JN. Curcuma Longa (turmeric): from traditional applications to modern plant medicine research hotspots. Chinese Medicine. 2025 May 28;20(1):76. https://doi.org/10.1186/s13020-025-01115-z
Devarbhavi H, Asrani SK, Arab JP, Nartey YA, Pose E, Kamath PS. Global burden of liver disease: 2023 update. Journal of hepatology. 2023 Aug 1;79(2):516-37. https://doi.org/10.1016/j.jhep.2023.03.017
Vento S, Cainelli F. Chronic liver diseases must be reduced worldwide: it is time to act. The Lancet Global Health. 2022 Apr 1;10(4):e471-2. https://doi.org/10.1016/S2214-109X(22)00047-X
Cheemerla S, Balakrishnan M. Global epidemiology of chronic liver disease. Clinical liver disease. 2021 May 1;17(5):365-70. https://doi.org/10.1002/cld.1061
Younossi ZM, Wong G, Anstee QM, Henry L. The global burden of liver disease. Clinical Gastroenterology and Hepatology. 2023 Jul 1;21(8):1978-91. https://doi.org/10.1016/j.cgh.2023.04.015
Chou AH, Lee HC, Liao CC, Yu HP, Liu FC. ERK/NF-kB/COX-2 signaling pathway plays a key role in curcumin protection against acetaminophen-induced liver injury. Life. 2023 Oct 31;13(11):2150. https://doi.org/10.3390/life13112150
Saadati S, Sadeghi A, Mansour A, Yari Z, Poustchi H, Hedayati M, Hatami B, Hekmatdoost A. Curcumin and inflammation in non-alcoholic fatty liver disease: a randomized, placebo controlled clinical trial. BMC gastroenterology. 2019 Jul 25;19(1):133. https://doi.org/10.1186/s12876-019-1055-4
Mahjoubin-Tehran M, Hasan A, Eid AH, Almahmeed W, Kesharwani P, Butler AE, Jamialahmadi T, Sahebkar A. Effects of dietary curcumin on gene expression: an analysis of transcriptomic data in mice. Pathology-Research and Practice. 2024 Nov 1;263:155653. https://doi.org/10.1016/j.prp.2024.155653
Li Y, Deng X, Tan X, Li Q, Yu Z, Wu W, Ma X, Zeng J, Wang X. Protective role of curcumin in disease progression from non-alcoholic fatty liver disease to hepatocellular carcinoma: a meta-analysis. Frontiers in Pharmacology. 2024 Jan 19;15:1343193. https://doi.org/10.3389/fphar.2024.1343193
Panahi Y, Kianpour P, Mohtashami R, Jafari R, Simental-Mendía LE, Sahebkar A. Efficacy and safety of phytosomal curcumin in non-alcoholic fatty liver disease: a randomized controlled trial. Drug research. 2017 Apr;67(04):244-51. https://doi.org/10.1055/s-0043-100019 .
Farzaei MH, Zobeiri M, Parvizi F, El-Senduny FF, Marmouzi I, Coy-Barrera E, Naseri R, Nabavi SM, Rahimi R, Abdollahi M. Curcumin in liver diseases: a systematic review of the cellular mechanisms of oxidative stress and clinical perspective. Nutrients. 2018 Jul 1;10(7):855. https://doi.org/10.3390/nu10070855
Soliman MM, Nassan MA, Ismail TA. Immunohistochemical and molecular study on the protective effect of curcumin against hepatic toxicity induced by paracetamol in Wistar rats. BMC complementary and alternative medicine. 2014 Nov 29;14(1):457. https://doi.org/10.1186/1472-6882-14-457
Bahrami A, Sathyapalan T, Moallem SA, Sahebkar A. Counteracting arsenic toxicity: curcumin to the rescue?. Journal of hazardous materials. 2020 Dec 5; 400:123160. https://doi.org/10.1016/j.jhazmat.2020.123160
Tan L, Hu C, Guo J, Du Y. Curcumin: structure, pharmacokinetics, extraction-purification, and multi-target cardioprotection against myocardial ischemia-reperfusion injury. International Journal of Food Properties. 2026 Dec 31;29(1):2628372. https://doi.org/10.1080/10942912.2026.2628372
Beji RS, Mansour RB, Rebey IB, Wannes WA, Jameleddine S, Hammami M, Megdiche W, Ksouri R. Does Curcuma longa root powder have an effect against CCl4-induced hepatotoxicity in rats: a protective and curative approach. Food Science and Biotechnology. 2018 Aug 19;28(1):181. https://doi.org/10.1007/s10068-018-0449-3
Muhammad I, Wang H, Sun X, Wang X, Han M, Lu Z, Cheng P, Hussain MA, Zhang X. Dual role of dietary curcumin through attenuating AFB1-induced oxidative stress and liver injury via modulating liver phase-I and phase-II enzymes involved in AFB1 bioactivation and detoxification. Frontiers in Pharmacology. 2018 May 25;9:554. https://doi.org/10.3389/fphar.2018.00554
Huang BH, Guo ZW, Lv BH, Zhao X, Li YB, Lv WL. A role for curcumin in preventing liver fibrosis in animals: A systematic review and meta-analysis. Frontiers in Pharmacology. 2024 May 24; 15:1396834. https://doi.org/10.3389/fphar.2024.1396834
Voncik KS, de Mattos RH, da Silva WC, de Freitas GB, Cavazzatto TG, da Rocha JB, Khalil NM, Bonini JS. Evaluation of curcumin toxicity in rats through biochemical and hematological parameters. African Journal of Pharmacy and Pharmacology. 2015 Aug 8;9(29):711-6. https://doi.org/10.5897/AJPP2015.4359
Lee HY, Lee GH, Kim SW, Kang CG, Jo JH, Chung MJ, Min K, Chae HJ. Turmeric extract (Curcuma longa L.) regulates hepatic toxicity in a single ethanol binge rat model. Heliyon. 2022 Sep 1;8(9). https://doi.org/10.1016/j.heliyon.2022.e10737
Abdallah S, Islam T, Moustaid-Moussa N, Scoggin S, Zu Y. Protective Effects of Curcumin in Metabolic Dysfunction-Associated Steatotic Liver Disease. Current Developments in Nutrition. 2024 Jul 1;8. https://doi.org/10.1016/j.cdnut.2024.103524
Um MY, Hwang KH, Ahn J, Ha TY. Curcumin attenuates diet‐induced hepatic steatosis by activating AMP‐activated protein kinase. Basic & clinical pharmacology & toxicology. 2013 Sep;113(3):152-7. https://doi.org/10.1111/bcpt.12076
Zhao NJ, Liao MJ, Wu JJ, Chu KX. Curcumin suppresses Notch-1 signaling: improvements in fatty liver and insulin resistance in rats. Molecular Medicine Reports. 2018 Jan;17(1):819-26. https://doi.org/10.3892/mmr.2017.7980
Niu Y, He J, Ahmad H, Wang C, Zhong X, Zhang L, Cui T, Zhang J, Wang T. Curcumin attenuates insulin resistance and hepatic lipid accumulation in a rat model of intra-uterine growth restriction through insulin signalling pathway and sterol regulatory element binding proteins. British Journal of Nutrition. 2019 Sep;122(6):616-24. https://doi.org/10.1017/S0007114519001508
Esmaeli M, Dehabadi MD, Ghanbari A. Molecular targets and therapeutic implications of curcumin in hepatocellular carcinoma: a comprehensive literature review. Cancer Cell International. 2025 Oct 3;25(1):335. https://doi.org/10.1186/s12935-025-03988-4
Elnawasany S, Haggag YA, Shalaby SM, Soliman NA, El Saadany AA, Ibrahim MA, Badria F. Anti-cancer effect of nano-encapsulated boswellic acids, curcumin and naringenin against HepG-2 cell line. BMC Complementary Medicine and Therapies. 2023 Jul 29;23(1):270. https://doi.org/10.1186/s12906-023-04096-4
Atia MM, Abdel-Tawab HS, Mostafa AM, Mobarak SA. Nanocurcumin and curcumin prevent N, N'-methylenebisacrylamide-induced liver damage and promotion of hepatic cancer cell growth. Scientific Reports. 2022 May 18;12(1):8319. https://doi.org/10.1038/s41598-022-12406-y
Shu Y, He Y, Ye G, Liu X, Huang J, Zhang Q, Tian D, Wang T, Shu J. Curcumin inhibits the activity and induces apoptosis of activated hepatic stellate cell by suppressing autophagy. Journal of Cellular Biochemistry. 2023 Nov;124(11):1764-78. https://doi.org/10.1002/jcb.30487
Hu P, Su L, Wang Y, Chen Y, Tian X, Qian Y. Targeting Liver Fibrosis with Nanoparticle Technology: The Dual-Drug Strategy for Hepatic Stellate Cell Activation Inhibition. ACS Applied Materials & Interfaces. 2025 Apr 16;17(17):25071-82. https://doi.org/10.1021/acsami.5c02796
Sedky RA, Taha NM, Mandour AE, Lebda MA, Hashem AE. Potential Protective Effect of Curcumin on Paracetamol Model of Liver Injury in Rats. Alexandria Journal of Veterinary Sciences. 2019 Oct 1;63(1). https://doi.org/10.5455/ajvs.63350
Ishfaq Muhammad IM, Wang He WH, Sun XiaoQi SX, Wang XingHe WX, Han MeiYu HM, Lu ZiYin LZ, Cheng Ping CP, Hussain MA, Zhang XiuYing ZX. Dual role of dietary curcumin through attenuating AFB1-induced oxidative stress and liver injury via modulating liver phase-I and phase-II enzymes involved in AFB1 bioactivation and detoxification. https://doi.org/10.3389/fphar.2018.00554
Zhang NY, Qi M, Zhao L, Zhu MK, Guo J, Liu J, Gu CQ, Rajput SA, Krumm CS, Qi DS, Sun LH. Curcumin prevents aflatoxin B1 hepatoxicity by inhibition of cytochrome P450 isozymes in chick liver. Toxins. 2016 Nov 10;8(11):327. https://doi.org/10.3390/toxins8110327
Mashayekhi-Sardoo H, Mashayekhi-Sardoo A, Roufogalis BD, Jamialahmadi T, Sahebkar A. Impact of curcumin on microsomal enzyme activities: drug interaction and chemopreventive studies. Current medicinal chemistry. 2021 Oct 1;28(34):7122-40. https://doi.org/10.2174/0929867328666210329123449
El-Saadony MT, Yang T, Korma SA, Sitohy M, Abd El-Mageed TA, Selim S, Al Jaouni SK, Salem HM, Mahmmod Y, Soliman SM, Mo’men SA. Impacts of turmeric and its principal bioactive curcumin on human health: Pharmaceutical, medicinal, and food applications: A comprehensive review. Frontiers in Nutrition. 2023 Jan 10;9:1040259. https://doi.org/10.3389/fnut.2022.1040259
Peng Y, Ao M, Dong B, Jiang Y, Yu L, Chen Z, Hu C, Xu R. Anti-inflammatory effects of curcumin in the inflammatory diseases: status, limitations and countermeasures. Drug design, development and therapy. 2021 Nov 2:4503-25. https://doi.org/10.2147/DDDT.S327378
Sanuelly A, De M, Orlando R, Oliveira F, Oliveira M, Moura F. Curcumin in inflammatory bowel diseases: Cellular targets and molecular mechanisms. Biocell. 2023;47(11):2547. https://doi.org/10.32604/biocell.2023.043253
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 M K Srinivasan, Gundeti Tharun Reddy
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors retain the copyright of their work and grant the Journal of Ayurveda and Holistic Medicine (JAHM) the right of first publication. All published articles are licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) license, which permits non-commercial sharing, use, distribution, and adaptation with proper attribution and the same license terms.
JAHM ensures free, irrevocable, worldwide access to its content. Users may copy, distribute, display, and share published works for non-commercial purposes with appropriate credit to the author(s) and the journal. Limited printed copies for personal, non-commercial use are allowed under the same license.
If a submission is not accepted for publication, the author(s) will be notified.
By submitting, authors confirm that the work is original, that all listed authors have contributed and approved it, and that it does not infringe any third-party rights or duplicate work submitted elsewhere.
