Advances in Radiation Therapy Enhancement and Radio-Protection By Nano-Curcumins: A Systematic Review

Introduction/Objective: Nano-curcumins (Nano-CUR) improve solubility, bio-availability, and stability of the release of CUR into the body. In this systematic review, we aim to investigate different CUR nanoformulations' in targeting radiosensitizing path-ways and radioprotective mechanisms. Methods: We thoroughly searched electronic databases, including PubMed/MEDLINE, Web of Science, Scopus, Embase, and Cochrane Library to identify pertinent studies pub-lished before July 21, 2024. inclusion and exclusion criteria were set based on the study's purposes. Two reviewers independently performed data extraction to ensure precision and minimize bias. Subsequently, the data were extracted and analyzed. Results: A total of 24 articles were included. Nano-CURs by scavenging the levels of re-active oxygen species (ROS), decrease malondialdehyde (MDA), improve superoxide dismutase (SOD), prevent DNA methylation, reduce tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, IL-b and transforming growth factor-beta (TGF-β1), improve cell cycle, inhibit vascular endothelial growth factor (VEGF), attenuate cell cytotoxicity and modu-late cell apoptosis induce its radioprotective effects. In contrast, Nano-CUR induces oxida-tive stress and accumulation ROS, inhibits nuclear factor-κB (NF- κB), activates the ex-pression of TNF, TGF-β, phosphatidylinositol and FoxO, causing DNA damage, activat-ing proapoptotic pathways (boosted P53, P21 and BAX expressions), cell cycle arrest, re-ducing hypoxia-inducible factor (HIF-1α), revealed radiosensitizing effects. Conclusion: Nano-CURs improve CUR bioavailability and increase cancerous cells' sen-sitivity to radiation. They also protect healthy cells from ionizing radiation without signifi-cant side effects.