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 |
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| 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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