Pharmacological and dietary prevention for colorectal cancer

Abstract

BackgroundColorectal cancer (CRC) is a leading cause of cancer morbidity and mortality. People at higher risk are those individuals with a family history of CRC and familial adenomatous polyposis. Prevention and screening are two milestones for this disease. The aim of this study is to evaluate the chemopreventive role of non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin and cyclooxygenase 2 inhibitors, some micronutrients (folic acid, calcium, selenium, antioxidants) and probiotics.DiscussionThe studies on aspiring reported promising results, but it is debatable whether aspirin should be used as chemoprevention, because of its side effects and because of poor efficacy evident in subjects at high risk. Similar results were reported for other non-aspirin NSAIDs, such as sulindac and celecoxib, which the potential adverse effects limit their use. Selenium role in prevention of various types of cancer as well as in colon adenomas are often inconclusive or controversial. Several studies suggested that calcium may have a possible chemopreventive effect on colon adenomas and CRC, although contrasting results are reported for the latter. A recent meta-analysis including 13 randomized trial suggested that folic acid supplementation had not a chemiopreventive action on CRC. Several studies investigated the association between antioxidants, administered alone or in combination, and CRC risk, both among general and at risk population, but only few of them supported statistically significant results.ConclusionThe results of this literature review showed an unclear role in CRC prevention of both pharmacological and dietary intervention. Despite several options are available to prevent colon cancer, it is challenging to identify a correct strategy to prevent CRC through pharmacological and dietary intervention due to the long latency of cancer promotion and development. Since some of the drugs investigated may have uncertain individual effects, it can be suggested to potentiate such effects by adding them together.

In Vitro Influence of Extracts from Snail Helix aspersa Müller on the Colon Cancer Cell Line Caco-2

“…Se content in lyophilised snail tissues was a little bit lower than in dry matter of beef [ 18 ] and edible parts of oysters [ 37 ]. In the work of Nolfo et al, the potential prevention of colorectal cancer by Se was attributed to its functions in acceleration of DNA repair, reduction of DNA damage and decrease in mutations contributing to carcinogenesis [ 63 ]. Another mechanism could be related to induction of apoptosis, by the activation of Caspase-3 and modulation of glutathione and functions of mitochondria.…”

β-Catenin Regulation in Sporadic Colorectal Carcinogenesis: Not as Simple as APC

“…COX-2 expression and its downstream by-product, prostaglandin E 2 (PGE 2 ), are upregulated in sporadic CRC and IBD [ 6 ]. Moreover, COX-2 inhibitors have been shown to reduce carcinogenesis in both animal and human studies [ 7 ].…”

Supplementation with Brazil nuts and green tea extract regulates targeted biomarkers related to colorectal cancer risk in humans

“…There is a lot of interest in naturally occurring substances found in food for CRC prevention (3) ; two such agents of interest are Se, an essential trace micronutrient, and green tea, the second most widely consumed beverage in the world next to water (4) . Epidemiological and observational studies have identified the association between Se and/or green tea supplementation with risk of CRC (5)(6)(7)(8) . Although preclinical studies have shown promising results in this regard, a few studies on Se or green tea have demonstrated their effectiveness as cancer preventive agents in human clinical trials (7,9) .…”

“…Dietary agents generally have a favourable safety profile, with good accessibility, low costs and strong biological plausibility, although they often have less potency compared with pharmaceutical compounds (14) . There is a growing interest for improving efficacy of cancer prevention by combination of dietary agents with complementary mechanisms (5) . The Linxian Chinese Cancer Prevention Trial (targeting 29 584 adults) showed that a combination of β-carotene, vitamin E and Se Abbreviations: Ac-H3, acetylated histone H3; CRC, colorectal cancer; DNMT, DNA methyltransferase; EGCG, (-)-epigallocatechin-3-gallate; GTE, green tea extract; SePP, selenoprotein P.…”