{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:35:29Z","timestamp":1787243729951,"version":"build-2736575974"},"reference-count":42,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Federal Medical Biological Agency (FMBA) of Russia","award":["125052706442-0"],"award-info":[{"award-number":["125052706442-0"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"abstract":"<jats:p>Background: Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system and is the leading cause of neurological disability. Currently, the main strategy for MS therapy is the use of disease-modifying therapies (DMTs). If low-efficacy DMTs are ineffective, patients are transferred to high-efficacy DMTs, which possess more severe side effects associated with immunosuppression. Therefore, the search for new add-on therapies for MS that can enhance the effect of low-efficacy DMTs is relevant. Curcumin, being a natural polyphenol, has immunoregulatory properties and a favorable safety profile. In addition, micellar forms of curcumin can increase its bioavailability. We studied the effect of micellar curcumin on clinical and laboratory parameters in patients with MS receiving low-efficacy DMTs (IFN-\u03b2). Methods: Sixty patients with MS and a suboptimal response to IFN-\u03b2 were randomized (1:1) into two groups: the IFN-CUR group, which received add-on therapy with micellar curcumin (containing curcumin and Tween 80 as a solubilizer) for 6 months, and a control group (IFN group), which received IFN-\u03b2 alone. The 6-month treatment period was followed by a subsequent 6-month follow-up off curcumin treatment (DMTs only). Results: The proportion of patients without relapses in the curcumin add-on group increased significantly after 6 months (from 57% to 90%, p = 0.007), and the risk of exacerbation was significantly lower compared to the control group (HR = 0.2; p = 0.03). The treatment was associated with EDSS score stabilization, a positive effect on depression (p = 0.05), and a reduction in plasma IFN-\u03b3 levels (p = 0.02). A decreasing trend in MRI lesion activity and reductions in specific microbiota-related markers, including the Eggerthella lenta-associated marker (i16a), were also observed. In ex vivo cultures, curcumin significantly inhibited IL-6 production in macrophages derived from patients with multiple sclerosis (MS) and healthy donors. Conclusions: Add-on therapy with micellar curcumin may enhance the efficacy of IFN-\u03b2, improving clinical outcomes and modulating inflammatory and microbial parameters in MS patients with a suboptimal response to IFN-\u03b2 treatment.<\/jats:p>","DOI":"10.3390\/pharmaceutics18050519","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T11:40:12Z","timestamp":1777981212000},"page":"519","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Anti-Inflammatory Properties of Curcumin as Add-On Therapy in Patients with MS\u2014Prospective, Comparative, Randomized, Pilot Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9964-8103","authenticated-orcid":false,"given":"Anna","family":"Kukushkina","sequence":"first","affiliation":[{"name":"Department of Neuroimmunology, Institute of Clinical Neurology, Federal Center of Brain Research and Neurotechnologies of the Federal Medical Biological Agency, 117513 Moscow, Russia"},{"name":"Zhadkevich Moscow City Clinical Hospital, 121374 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Rogovskii","sequence":"additional","affiliation":[{"name":"Department of Neuroimmunology, Institute of Clinical Neurology, Federal Center of Brain Research and Neurotechnologies of the Federal Medical Biological Agency, 117513 Moscow, Russia"},{"name":"Department of molecular pharmacology, N.I. Pirogov Russian National Research Medical University, 117513 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Zhilenkova","sequence":"additional","affiliation":[{"name":"G.N. Gabrichevsky Research Institute for Epidemiology and Microbiology, 125212 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5337-0054","authenticated-orcid":false,"given":"Timur","family":"Sadekov","sequence":"additional","affiliation":[{"name":"G.N. Gabrichevsky Research Institute for Epidemiology and Microbiology, 125212 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikhail","family":"Melnikov","sequence":"additional","affiliation":[{"name":"Department of Neuroimmunology, Institute of Clinical Neurology, Federal Center of Brain Research and Neurotechnologies of the Federal Medical Biological Agency, 117513 Moscow, Russia"},{"name":"Department of Neurology, Neurosurgery and Medical Genetics, N.I. Pirogov Russian National Research Medical University, 117513 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexey","family":"Boyko","sequence":"additional","affiliation":[{"name":"Department of Neuroimmunology, Institute of Clinical Neurology, Federal Center of Brain Research and Neurotechnologies of the Federal Medical Biological Agency, 117513 Moscow, Russia"},{"name":"Department of Neurology, Neurosurgery and Medical Genetics, N.I. Pirogov Russian National Research Medical University, 117513 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/S0140-6736(23)01473-3","article-title":"Multiple sclerosis","volume":"403","author":"Jakimovski","year":"2024","journal-title":"Lancet"},{"key":"ref_2","first-page":"105","article-title":"Mechanism and adverse effects of multiple sclerosis drugs: A review article. Part 2","volume":"11","author":"Ghadimi","year":"2019","journal-title":"Int. J. Physiol. Pathophysiol. Pharmacol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e597","DOI":"10.1212\/NXI.0000000000000597","article-title":"Cholecalciferol in relapsing-remitting MS: A randomized clinical trial (CHOLINE)","volume":"6","author":"Camu","year":"2019","journal-title":"Neurol. Neuroimmunol. 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