Clinical Study of Ursodeoxycholic Acid in Barrett's Esophagus Patients

Banerjee, Bhaskar; Shaheen, Nicholas J.; Martinez, Jessica A.; Hsu, Chiu-Hsieh; Trowers, Eugene; Gibson, Blake A.; Della’Zanna, Gary; Richmond, Ellen; Chow, H‐H. Sherry

doi:10.1158/1940-6207.capr-15-0276

Cited by 21 publications

(32 citation statements)

References 29 publications

(32 reference statements)

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“…Banerjee et al. [155] found a significant increase in UDCA content (from 18 to 93% of the total BA content) in gastric fluid over the 6‐month treatment period with 13–15 mg/kg of UDCA daily and a decrease in the content of other generally toxic BAs (CDCA, DCA, CA, LCA). These findings were also confirmed by Bozikas et al.…”

Section: Biological Samplesmentioning

confidence: 99%

Analysis of bile acids in human biological samples by microcolumn separation techniques: A review

2020

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Bile acids are a group of compounds essential for lipid digestion and absorption with a steroid skeleton and a carboxylate side chain usually conjugated to glycine or taurine. Bile acids are regulatory molecules for a number of metabolic processes and can be used as biomarkers of various disorders. Since the middle of the twentieth century, the detection of bile acids has evolved from simple qualitative analysis to accurate quantification in complicated mixtures. Advanced methods are required to characterize and quantify individual bile acids in these mixtures. This article overviews the literature from the last two decades (2000-2020) and focuses on bile acid analysis in various human biological samples. The methods for sample preparation, including the sample treatment of conventional (blood plasma, blood serum, and urine) and unconventional samples (bile, saliva, duodenal/gastric juice, feces, etc.) are shortly discussed. Eventually, the focus is on novel analytical approaches and methods for each particular biological sample, providing an overview of the microcolumn separation techniques, such as high-performance liquid chromatography, gas chromatography, and capillary electrophoresis, used in their analysis. This is followed by a discussion on selected clinical applications.

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Section: Biological Samplesmentioning

confidence: 99%

Analysis of bile acids in human biological samples by microcolumn separation techniques: A review

2020

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“…Unfortunately, in 29 patients who took oral UDCA, markers of oxidative DNA damage, cell proliferation, and apoptosis (as assessed by immunohistochemical staining) did not change. 91 Gastric acid represents a genotoxic stress as it induces double-strand DNA breaks in BE cells and patient tissues. 92 Gastric acid can activate oncogenic signaling pathways, such as ERK and p38MAPK, and silence tumor suppressor genes, such as p16.…”

Section: Chemopreventive Effects Of Ppis In Barrett's Esophagusmentioning

confidence: 99%

Gastrointestinal pharmacology: practical tips for the esophagologist

Scarpignato

Sloan²,

Wang

et al. 2020

Annals of the New York Academy of Sciences

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Gastroesophageal reflux disease (GERD) is primarily a motor disorder, and its pathogenesis is multifactorial. As a consequence, treatment should be able to address the underlying pathophysiology. Proton pump inhibitors (PPIs) are the mainstay of medical therapy for GERD, but these drugs only provide the control of symptoms and lesions without curing the disease. However, continuous acid suppression with PPIs is recommended for patients with Barrett's esophagus because of their potential chemopreventive effects. In addition to the antisecretory activity, these compounds display several pharmacological properties, often overlooked in clinical practice. PPIs can indeed affect gastric motility, exert a mucosal protective effect, and an antioxidant, anti‐inflammatory, and antineoplastic activity, also protecting cancer cells from developing chemo‐ or radiotherapeutic resistance. Even in the third millennium, current pharmacologic approaches to address GERD are limited. Reflux inhibitors represent a promise unfulfilled, effective and safe prokinetics are lacking, and antidepressants, despite being effective in selected patients, give rise to adverse events in a large proportion of them. While waiting for new drug classes (like potassium‐competitive acid blockers), reassessing old drugs (namely alginate‐containing formulations), and paving the new avenue of esophageal mucosal protection are, at the present time, the only reliable alternatives to acid suppression.

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“…Ursodeoxycholic-acid supplementation has been hypothesized to alter the acid and bile composition of gastroesophageal refluxate and its use in preclinical studies has shown reduced rates of EAC in a rat model of BE [ 72 ]. However, a non-randomized pilot study of 29 patients with BE showed altered bile-acid composition after 6 months of ursodeoxycholic-acid supplementation but no change in the primary study endpoint of altered tissue biomarkers indicative of oxidative damage and apoptosis [ 73 ].…”

Section: Candidate Chemoprevention Therapies For Esophageal Adenocarcmentioning

confidence: 99%

Chemoprevention of esophageal adenocarcinoma

Snider

Kaz

Inadomi

et al. 2020

Gastroenterology Report

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Esophageal adenocarcinoma (EAC) is a major cause of cancer-related death, particularly in Western populations, and is rapidly rising in Asian populations at this time. Virtually all EACs develop from the precursor lesion Barrett’s esophagus (BE), which is the most significant risk factor for EAC. However, the rates of progression from BE to EAC are low and patients with BE are asymptomatic. Thus, any strategy for EAC prevention must carry a low risk of harm in order to be clinically useful. Since current EAC-screening and BE-surveillance methods carry some procedural risk and are burdensome, there is an opportunity for chemoprevention, i.e. medications or dietary factors that may prevent BE from progressing to EAC. A variety of candidate chemoprevention therapies have been assessed to date. Proton-pump inhibitors (PPIs) are the best studied and have modest EAC-chemoprevention efficacy in BE patients, with a recent randomized trial showing that high-dose PPI may be more effective than low-dose PPI. Aspirin and other non-steroidal anti-inflammatory drugs have moderate quality observational and randomized-trial evidence for preventing progression of BE to EAC, but their risks for harm have precluded their routine clinical use. Other therapies (statins, metformin, female sex hormones) generally do not have strong evidence to support their use in EAC chemoprevention. Although progress has been made in this field, there is still a need for more effective and safe chemoprevention therapies for EAC.

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Clinical Study of Ursodeoxycholic Acid in Barrett's Esophagus Patients

Cited by 21 publications

References 29 publications

Analysis of bile acids in human biological samples by microcolumn separation techniques: A review

Analysis of bile acids in human biological samples by microcolumn separation techniques: A review

Gastrointestinal pharmacology: practical tips for the esophagologist

Chemoprevention of esophageal adenocarcinoma

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