Can supplementation of phytoestrogens/insoluble fibers help the management of duodenal polyps in familial adenomatous polyposis?

Autor: Fernando Rizzello, Antonio Strillacci, Nico Pagano, Gilberto Poggioli, Paolo Gionchetti, Carlo Calabrese, Enzo Spisni, Elena Cavazza, Luigia De Fazio, Maria Cristina Comelli, Maria Chiara Valerii, Massimo Campieri, A. Calafiore
Přispěvatelé: Calabrese, Carlo, Rizzello, Fernando, Gionchetti, Paolo, Calafiore, Andrea, Pagano, Nico, De Fazio, Luigia, Valerii, Maria Chiara, Cavazza, Elena, Strillacci, Antonio, Comelli, Maria Cristina, Poggioli, Gilberto, Campieri, Massimo, Spisni, Enzo
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Dietary Fiber
Colonic Pouche
Cancer Research
Colorectal cancer
medicine.medical_treatment
Administration
Oral

Anal Canal
Gastroenterology
Intestinal Polyp
0302 clinical medicine
Clinical endpoint
Medicine
Prospective Studies
Prospective cohort study
Colectomy
biology
medicine.diagnostic_test
Anastomosis
Surgical

Intestinal Polyps
General Medicine
Middle Aged
Treatment Outcome
Adenomatous Polyposis Coli
030220 oncology & carcinogenesis
Phytoestrogen
030211 gastroenterology & hepatology
Duodenal cancer
Human
Adult
medicine.medical_specialty
Adolescent
Adenomatous polyposis coli
Colonic Pouches
Phytoestrogens
Familial adenomatous polyposis
03 medical and health sciences
Young Adult
Internal medicine
Biopsy
Humans
neoplasms
Dietary Supplement
business.industry
medicine.disease
digestive system diseases
Prospective Studie
Gene Expression Regulation
Dietary Supplements
biology.protein
business
Popis: Familial adenomatous polyposis (FAP) is an autosomal dominant inherited disorder, and prophylactic colectomy has been shown to decrease the incidence of colorectal cancer (CRC). Duodenal cancer and desmoids are now the leading causes of death in FAP. We evaluate whether 3 months of oral supplementation with a patented blend of phytoestrogens and indigestible insoluble fibers (ADI) help the management of FAP patients with ileal pouch-anal anastomosis (IPAA). In a prospective open label study, we enrolled 15 FAP patients with IPAA and duodenal polyps who underwent upper gastrointestinal endoscopy at baseline and after 3 months of treatment. The primary endpoint was the change in gene expression in polyp mucosa, whereas the secondary endpoint was the reduction in polyp number and size. After 3 months of ADI treatment, all patients showed a reduction in the number and size of duodenal polyps (P = 0.021). Analysis of the expression of CRC promoting/inhibiting genes in duodenal polyps biopsies demonstrated that different CRC-promoting genes (PCNA, MUC1 and COX-2) were significantly downregulated, whereas CRC-inhibiting genes (ER-β and MUC2) were significantly upregulated after ADI treatment. In conclusion, ADI proved to be safe and effective, and its long-term effects on FAP patients need further investigation. Judging from the results we observed on COX-2 and miR-101 expression, the short-term effects of ADI treatment could be comparable with those obtained using COX-2 inhibitors, with the advantage of being much more tolerable in chronic therapies and void of adverse events.
Databáze: OpenAIRE
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