Curcumin restores reactive oxygen species (ROS)- and cigarette smoke extract (CSE)-impaired corticosteroid efficacy by inhibiting the pro-inflammatory cytokines in human monocytes. Phorbol-12-myristate-13-acetate (PMA)-differentiated U937 cells were stressed for 4 hours with CSE (1%), then left for a further 18 hours (A, C, and E), or with H2O2 (100 μM) followed by LPS (10 ng/ml) for 18 hours (B, D, F, and G). Immediately after ROS and CSE exposures, the cells were treated with increasing concentrations of curcumin alone (E and F) or in combination with corticosteroid; dexamethasone, 100 nM (C) or budesonide, 1 nM (D and G). As internal controls for C and D, dotted horizontal lines represent cytokine levels in naïve cells or LPS-treated naïve cells in the presence of budesonide (1 nM), respectively. ROS-stressed cells were also treated with a curcumin-budesonide combination in the presence of trichostatin A (TSA), 100 nM (G). TNF-α and IL-8 release was evaluated by enzyme-linked immunosorbent assay as described in Materials and Methods. The data are displayed as the mean ± SEM of at least three independent experiments, except for G, where the data represent the mean ± SEM for duplicate experiments. Where indicated the data is normalized against control; cells stimulated with CSE only (C and E) or cells treated with LPS only (D, F, and G). *P < 0.05, ***P < 0.001 versus control using ANOVA with Bonferroni post hoc analysis. Vehicle, DMSO.