Effects of hydroalcoholic extract of Fumaria parviflora Lam on gene expression and serum levels of inflammatory and oxidative stress parameters in patients with type 2 diabetes: A randomized controlled clinical trial

Possible mechanisms of the actions of Fumaria parviflora in the management of diabetes. AP-1, Activator protein 1; ERKs, Extracellular signal-regulated kinases; IL‐1β, Interleukin‐1β; IL‐6, Interleukin 6; IRAK, Interleukin‐1 receptor‐associated kinase; IRF3, Interferon regulatory factor 3; MAPK, Mitogen‐activated protein kinases; MCP-1, Monocyte Chemoattractant Protein-1; MyD88, Myeloid differentiation primary response 88; NF-Κb; Nuclear factor-κB, Nrf‐2, Nuclear factor erythroid 2‐related factor 2; PI3K/AKT, Phosphatidylinositol 3‐kinase/protein kinase B; PPAR-γ, Peroxisome proliferator-activated receptor gamma; ROS, Reactive oxygen species; STAT3, Signal transducer and activator of transcription 3; TAK1;Transforming growth factor-β activated kinase 1; TLR4, Toll-like receptor 4; TNFα, Tumor necrosis factor‐α; TRAF6, Tumor necrosis factor receptor associated factor 6. • Expression levels of inflammatory parameters were lower in the Fumaria parviflora group compared to placebo. • Fumaria parviflora supplementation resulted in a significant increase in serum levels of antioxidant parameters. • Supplementation with Fumaria parviflora improved oxidative stress and inflammatory markers of diabetic patients. The present study examined the effects of hydroalcoholic extract of Fumaria parviflora (FP) on gene expression and serum levels of inflammatory and oxidative stress parameters in patients with type 2 diabetes. A total of 70 overweight or obese patients with diabetes were randomly assigned to either a FP (500 mg/day) or a placebo (cornstarch 500 mg/day) group for eight weeks. At the endpoint, mRNA expression levels of the B cell lymphoma-2 (BCL-2) and nuclear factor erythroid 2–related factor 2 (Nrf-2) were significantly higher in the FP group compared to placebo. In comparison, expression levels of the Bcl-2-associated protein x (BAX), nuclear factor kappa B (NF-κB), and monocyte chemoattractant protein-1 (MCP-1) were significantly lower in the FP group. FP supplementation resulted in a significant reduction in serum levels of intercellular adhesion molecule-1 (ICAM), interleukin-6, tumor necrosis factor-alpha, and malondialdehyde, as well as an increase in serum levels of antioxidant parameters. Trial registration: Iranian Registry of Clinical Trials (IRCT), IRCT20130610013612N11, https://irct.behdasht.gov.ir/trial/58544 .