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Meriva^®
Bioavailable curcumin

Meriva^® is a patented complex of curcumin, a dietary phenolic, with soy phosphatidyl choline⁽¹⁾. The two compounds form a non-covalent adduct in a 1:2 weight ratio, and two parts of microcrystalline cellulose are then added to improve formulation, with an overall contents of curcumin of 20%.
Turmeric has a long history of medicinal use, especially to treat inflammation⁽²⁾,  and many of its traditional uses have been mechanistically validated in cellular systems as well as in animal models of disease. Indeed, with almost 3000 pre-clinical investigations, curcumin is one of the best investigated products of the whole biomedical literature⁽²⁾. These studies have demonstrated that curcumin acts as a master switch of inflammation by acting at level of enzymes (COXs and LOs) and transcription factors (NF-kB) level, as well as at their genomic expression⁽³⁾. However, little clinical evidence of efficacy has so far been reported, and most of the beneficial effects of curcumin are suggested by epidemiological studies, supported by studies in animal models, extrapolated from studies in vitro, but not validated clinically⁽²⁾. This paradoxical situation is mainly due to the poor druggability of curcumin with a dismally low oral absorption, characterized by plasma concentrations that are barely overcome 50 ng/mL after administration of dosages as high as 12 g/die⁽⁴⁾. 

Curcumin, just like most dietary phenolics, is sparingly soluble both in water and in oily solvents, but shows polar groups (two phenolic hydroxyl and one enolic hydroxyl) that can interact via hydrogen bondings and polar interactions with complementary group, like the polar heads of phospholipids. Thus, phosphatidylcholine has a highly polarized head, with the negative charge of a phosphate group and the positive charge of the choline ammonium group, and can complex a variety of poorly soluble phenolics, including curcumin⁽¹⁾. Phenolics shows a high affinity for biological membranes, and, once complexed with phospholipids, are embedded into a lipidic matrix that by capitalizing on the rapid exchange of phospholipids between biological membranes and the extracellular fluids, can lead to an increased cellular capitation. 

A 2007 study published in the journal Cancer Chemotherapy and Pharmacology⁽⁵⁾ demonstrated Meriva^®'s superior bioavailability compared to a standardized curcumin extract in rats. Meriva^® improved plasma Cmax and AUC of curcuminoids by 20-fold and levels of curcumin in the liver increased by much more then a 20 folds. This improved in bioavailability did not translate to increased toxicity levels. 

In a recent registry study⁽⁶⁾, 50 patients with osteoarthritis (OA) divided into two groups were treated with Meriva^®:
Group A was managed using the “best available treatment as defined by patient’s GP and by specialist
Group B was managed using the best treatment as above in association with Meriva administered as a food supplement at a dosage of 200mg curcumin/die, a dosage much lower than those used in previous and ongoing clinical studies, that can reach 8g/die.
Both objective and subjective end-points were evaluated: mobility was studied by walking performance (treadmill), and the inflammatory status was assessed by measurements of C-reactive protein (CRP) plasma concentration. OA signs/symptoms were evaluated by the WOMAC scores.
After three months of treatment, the global WOMAC score (used to evaluate OA signs/symptoms) decreased by 58% (p < 0.05), walking distance in the treadmill test was prolonged from 76 m to 332 m (p < 0.05), and CRP levels decreased from 168 ± 18 to 11.3 ±. 4.1 mg/L in the subpopulation with high CRP. In comparison, the control group experienced only a modest improvement in these parameters (2% in the WOMAC score, from 82 m to 129 m in the treadmill test, and from 175 ± 12.3 to 112 ± 22.2 mg/L in the CRP plasma concentration), while the treatment costs (use of anti-inflammatory drugs, treatment and hospitalization) were reduced significantly in the treatment group.

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