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Ardanareswari K, Lowisia W, Soedarini B, Liao JW, Chung YC. Jaboticaba (Myrciaria cauliflora) Fruit Extract Suppressed Aberrant Crypt Formation in 1,2-Dimetylhydrazine-Induced Rats. PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2023:10.1007/s11130-023-01051-z. [PMID: 36820999 DOI: 10.1007/s11130-023-01051-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
Early intervention can significantly improve the colorectal cancer survival rate. Foods rich in phenolic compounds, such as jaboticaba (Myrciaria cauliflora), may prevent tumorigenesis. We investigated the effectivity of jaboticaba whole fruit ethanolic extract (FEX) in suppressing aberrant crypt foci (ACF), the earliest lesion of colorectal cancer (CRC), in 1,2-dimethylhydrazine (DMH)-induced rats and the underlying mechanisms related to the gut microbiota composition and short chain fatty acid (SCFA). This study was approved by the Institutional Animal Care and Use Committee (IACUC) of Providence University (Trial Registration Number 20180419A01, registration date: 22 December 2018). The FEX contains gallic acid and an especially high ellagic acid concentration of 54.41 ± 1.80 and 209.79 ± 2.49 mg/100 g FEX. The highest total ACF number (150.00 ± 43.86) was recorded in the DMH control (D) group. After 56 days of oral FEX treatment, the total ACF number in the low FEX dosage (DL) group was significantly lower compared to the D group (p < 0.05). The large-sized ACF (> 5 foci), which has a higher probability of progressing to later stage, was significantly decreased in the high FEX dosage (DH) group. The 16s rDNA metagenomic sequencing of the cecal material revealed that the CRC biomarker Lachnoclostridium was significantly suppressed in the DH group (p < 0.05), whereas some SCFA-producing taxa and the cecal butyrate concentration were significantly elevated in the DL and DH groups (p < 0.05). This study demonstrated the potential of jaboticaba whole fruit in CRC prevention, especially in the initial stage, by shifting gut microbiota composition and improving cecal butyrate level.
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Affiliation(s)
- Katharina Ardanareswari
- Department of Food and Nutrition, Providence University, No. 200, Section 7, Taiwan Blvd, Shalu District, Taichung City, 43301, Republic of China (Taiwan)
- Department of Food Technology, Soegijapranata Catholic University, Semarang, Indonesia
| | - Webiana Lowisia
- Department of Food and Nutrition, Providence University, No. 200, Section 7, Taiwan Blvd, Shalu District, Taichung City, 43301, Republic of China (Taiwan)
- Department of Food Technology, Soegijapranata Catholic University, Semarang, Indonesia
| | - Bernadeta Soedarini
- Department of Food Technology, Soegijapranata Catholic University, Semarang, Indonesia
| | - Jiunn-Wang Liao
- Graduate Institute of Veterinary Pathobiology, National Chung-Hsing University, Taichung City, Republic of China (Taiwan)
| | - Yun-Chin Chung
- Department of Food and Nutrition, Providence University, No. 200, Section 7, Taiwan Blvd, Shalu District, Taichung City, 43301, Republic of China (Taiwan).
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Younes M, Aquilina G, Castle L, Engel K, Fowler P, Frutos Fernandez MJ, Fürst P, Gundert‐Remy U, Gürtler R, Husøy T, Manco M, Mennes W, Moldeus P, Passamonti S, Shah R, Waalkens‐Berendsen I, Wölfle D, Corsini E, Cubadda F, De Groot D, FitzGerald R, Gunnare S, Gutleb AC, Mast J, Mortensen A, Oomen A, Piersma A, Plichta V, Ulbrich B, Van Loveren H, Benford D, Bignami M, Bolognesi C, Crebelli R, Dusinska M, Marcon F, Nielsen E, Schlatter J, Vleminckx C, Barmaz S, Carfí M, Civitella C, Giarola A, Rincon AM, Serafimova R, Smeraldi C, Tarazona J, Tard A, Wright M. Safety assessment of titanium dioxide (E171) as a food additive. EFSA J 2021; 19:e06585. [PMID: 33976718 PMCID: PMC8101360 DOI: 10.2903/j.efsa.2021.6585] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The present opinion deals with an updated safety assessment of the food additive titanium dioxide (E 171) based on new relevant scientific evidence considered by the Panel to be reliable, including data obtained with TiO2 nanoparticles (NPs) and data from an extended one-generation reproductive toxicity (EOGRT) study. Less than 50% of constituent particles by number in E 171 have a minimum external dimension < 100 nm. In addition, the Panel noted that constituent particles < 30 nm amounted to less than 1% of particles by number. The Panel therefore considered that studies with TiO2 NPs < 30 nm were of limited relevance to the safety assessment of E 171. The Panel concluded that although gastrointestinal absorption of TiO2 particles is low, they may accumulate in the body. Studies on general and organ toxicity did not indicate adverse effects with either E 171 up to a dose of 1,000 mg/kg body weight (bw) per day or with TiO2 NPs (> 30 nm) up to the highest dose tested of 100 mg/kg bw per day. No effects on reproductive and developmental toxicity were observed up to a dose of 1,000 mg E 171/kg bw per day, the highest dose tested in the EOGRT study. However, observations of potential immunotoxicity and inflammation with E 171 and potential neurotoxicity with TiO2 NPs, together with the potential induction of aberrant crypt foci with E 171, may indicate adverse effects. With respect to genotoxicity, the Panel concluded that TiO2 particles have the potential to induce DNA strand breaks and chromosomal damage, but not gene mutations. No clear correlation was observed between the physico-chemical properties of TiO2 particles and the outcome of either in vitro or in vivo genotoxicity assays. A concern for genotoxicity of TiO2 particles that may be present in E 171 could therefore not be ruled out. Several modes of action for the genotoxicity may operate in parallel and the relative contributions of different molecular mechanisms elicited by TiO2 particles are not known. There was uncertainty as to whether a threshold mode of action could be assumed. In addition, a cut-off value for TiO2 particle size with respect to genotoxicity could not be identified. No appropriately designed study was available to investigate the potential carcinogenic effects of TiO2 NPs. Based on all the evidence available, a concern for genotoxicity could not be ruled out, and given the many uncertainties, the Panel concluded that E 171 can no longer be considered as safe when used as a food additive.
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Clapper ML, Chang WCL, Cooper HS. Dysplastic Aberrant Crypt Foci: Biomarkers of Early Colorectal Neoplasia and Response to Preventive Intervention. Cancer Prev Res (Phila) 2021; 13:229-240. [PMID: 32132117 DOI: 10.1158/1940-6207.capr-19-0316] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/04/2019] [Accepted: 10/25/2019] [Indexed: 12/15/2022]
Abstract
The discovery of aberrant crypt foci (ACF) more than three decades ago not only enhanced our understanding of how colorectal tumors form, but provided new opportunities to detect lesions prior to adenoma development and intervene in the colorectal carcinogenesis process even earlier. Because not all ACF progress to neoplasia, it is important to stratify these lesions based on the presence of dysplasia and establish early detection methods and interventions that specifically target dysplastic ACF (microadenomas). Significant progress has been made in characterizing the morphology and genetics of dysplastic ACF in both preclinical models and humans. Image-based methods have been established and new techniques that utilize bioactivatable probes and capture histologic abnormalities in vivo are emerging for lesion detection. Successful identification of agents that target dysplastic ACF holds great promise for intervening even earlier in the carcinogenesis process to maximize tumor inhibition. Future preclinical and clinical prevention studies should give significant attention to assessing the utility of dysplastic ACF as the earliest identifiable biomarker of colorectal neoplasia and response to therapy.See all articles in this Special Collection Honoring Paul F. Engstrom, MD, Champion of Cancer Prevention.
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Affiliation(s)
- Margie L Clapper
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
| | - Wen-Chi L Chang
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Harry S Cooper
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania.,Department of Pathology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
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Cap-Assisted Chromo-Colonoscopy: Are 2 Techniques Better Than None? Am J Gastroenterol 2020; 115:365-366. [PMID: 32142483 DOI: 10.14309/ajg.0000000000000543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cap-assisted and chromo-colonoscopy are 2 techniques which may increase adenoma detection; however, chromo-colonoscopy is limited by increased time requirement. In this edition of The American Journal of Gastroenterology, Kim et al. present data from a randomized controlled trial comparing standard colonoscopy with an arm using both techniques (CAP/CHROMO). The indigo carmine was applied using a simpler method than previous studies, resulting in shorter times. The CAP/CHROMO adenoma detection was higher than the controls (54.4% vs 44.9%; P < 0.001), but there was no difference for advanced neoplasia. If endoscopists find these data convincing, they should trial these techniques separately because each technique may have a different impact.
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Hong BY, Ideta T, Lemos BS, Igarashi Y, Tan Y, DiSiena M, Mo A, Birk JW, Forouhar F, Devers TJ, Weinstock GM, Rosenberg DW. Characterization of Mucosal Dysbiosis of Early Colonic Neoplasia. NPJ Precis Oncol 2019; 3:29. [PMID: 31754633 PMCID: PMC6856115 DOI: 10.1038/s41698-019-0101-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 09/18/2019] [Indexed: 12/19/2022] Open
Abstract
Aberrant crypt foci (ACF) are the earliest morphologically identifiable lesions in the colon that can be detected by high-definition chromoendoscopy with contrast dye spray. Although frequently associated with synchronous adenomas, their role in colorectal tumor development, particularly in the proximal colon, is still not clear. The goal of this study was to evaluate the profile of colon-adherent bacteria associated with proximal ACF and to investigate their relationship to the presence and subtype of synchronous polyps present throughout the colon. Forty-five subjects undergoing a screening or surveillance colonoscopy were included in this retrospective study. Bacterial cells adherent to the epithelia of ACF and normal mucosal biopsies were visualized by in situ hybridization within confocal tissue sections. ACF showed significantly greater heterogeneity in their bacterial microbiome profiles compared with normal mucosa. One of the bacterial community structures we characterized was strongly correlated with the presence of synchronous polyps. Finally, using DNA mass spectrometry to evaluate a panel of colorectal cancer hotspot mutations present in the ACF, we found that three APC gene mutations were positively associated with the presence of Instestinibacter sp., whereas KRAS mutations were positively correlated with Ruminococcus gnavus. This result indicates a potential relationship between specific colon-associated bacterial species and somatically acquired CRC-related mutations. Overall, our findings suggest that perturbations to the normal adherent mucosal flora may constitute a risk factor for early neoplasia, demonstrating the potential impact of mucosal dysbiosis on the tissue microenvironment and behavior of ACF that may facilitate their progression towards more advanced forms of neoplasia.
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Affiliation(s)
- Bo-Young Hong
- 1The Jackson Laboratory for Genomic Medicine, Farmington, CT USA
| | - Takayasu Ideta
- 2Department of Medicine, University of Connecticut Health, Farmington, CT USA
| | - Bruno S Lemos
- 2Department of Medicine, University of Connecticut Health, Farmington, CT USA
| | - Yuichi Igarashi
- 2Department of Medicine, University of Connecticut Health, Farmington, CT USA
| | - Yuliana Tan
- 2Department of Medicine, University of Connecticut Health, Farmington, CT USA
| | - Michael DiSiena
- 3Department of Gastroenterology and Hepatology, University of Connecticut Health, Farmington, CT USA
| | - Allen Mo
- 2Department of Medicine, University of Connecticut Health, Farmington, CT USA
| | - John W Birk
- 3Department of Gastroenterology and Hepatology, University of Connecticut Health, Farmington, CT USA
| | - Faripour Forouhar
- 4Department of Pathology, University of Connecticut Health, Farmington, CT USA
| | - Thomas J Devers
- 2Department of Medicine, University of Connecticut Health, Farmington, CT USA
| | | | - Daniel W Rosenberg
- 2Department of Medicine, University of Connecticut Health, Farmington, CT USA
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Sinicrope FA, Velamala PR, Song LMWK, Viggiano TR, Bruining DH, Rajan E, Gostout CJ, Kraichely RE, Buttar NS, Schroeder KW, Kisiel JB, Larson MV, Sweetser SR, Sedlack RR, Sinicrope SN, Richmond E, Umar A, Della'Zanna G, Noaeill JS, Meyers JP, Foster NR. Efficacy of Difluoromethylornithine and Aspirin for Treatment of Adenomas and Aberrant Crypt Foci in Patients with Prior Advanced Colorectal Neoplasms. Cancer Prev Res (Phila) 2019; 12:821-830. [PMID: 31484660 DOI: 10.1158/1940-6207.capr-19-0167] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/27/2019] [Accepted: 08/27/2019] [Indexed: 11/16/2022]
Abstract
Difluoromethylornithine (DFMO), an inhibitor of polyamine synthesis, was shown to act synergistically with a NSAID for chemoprevention of colorectal neoplasia. We determined the efficacy and safety of DFMO plus aspirin for prevention of colorectal adenomas and regression of rectal aberrant crypt foci (ACF) in patients with prior advanced adenomas or cancer. A double-blinded, placebo-controlled trial was performed in 104 subjects (age 46-83) randomized (1:1) to receive daily DFMO (500 mg orally) plus aspirin (325 mg) or matched placebos for one year. All polyps were removed at baseline. Adenoma number (primary endpoint) and rectal ACF (index cluster and total) were evaluated at a one year colonoscopy. ACF were identified by chromoendoscopy. Toxicity was monitored, including audiometry. Eighty-seven subjects were evaluable for adenomas or ACF modulation (n = 62). At one year of treatment, adenomas were detected in 16 (38.1%) subjects in the DFMO plus aspirin arm (n = 42) versus 18 (40.9%) in the placebo arm (n = 44; P = 0.790); advanced adenomas were similar (n = 3/arm). DFMO plus aspirin was associated with a statistically significant reduction in the median number of rectal ACF compared with placebo (P = 0.036). Total rectal ACF burden was also reduced in the treatment versus the placebo arm relative to baseline (74% vs. 45%, P = 0.020). No increase in adverse events, including ototoxicity, was observed in the treatment versus placebo arms. While adenoma recurrence was not significantly reduced by one year of DFMO plus aspirin, the drug combination significantly reduced rectal ACF number consistent with a chemopreventive effect.
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Affiliation(s)
- Frank A Sinicrope
- Divisions of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota.
| | - Pruthvi R Velamala
- Divisions of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota
| | | | - Thomas R Viggiano
- Divisions of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota
| | - David H Bruining
- Divisions of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Elizabeth Rajan
- Divisions of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota
| | | | - Robert E Kraichely
- Divisions of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Navtej S Buttar
- Divisions of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Kenneth W Schroeder
- Divisions of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota
| | - John B Kisiel
- Divisions of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Mark V Larson
- Divisions of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Seth R Sweetser
- Divisions of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Robert R Sedlack
- Divisions of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Stephen N Sinicrope
- Divisions of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Ellen Richmond
- Biomedical Statistics & Informatics, Mayo Clinic, Rochester, Minnesota
| | - Asad Umar
- Biomedical Statistics & Informatics, Mayo Clinic, Rochester, Minnesota
| | - Gary Della'Zanna
- Biomedical Statistics & Informatics, Mayo Clinic, Rochester, Minnesota
| | - Joni S Noaeill
- Divisions of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Jeffrey P Meyers
- Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | - Nathan R Foster
- Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
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Quintanilla I, López-Cerón M, Jimeno M, Cuatrecasas M, Zabalza M, Moreira L, Alonso V, Rodríguez de Miguel C, Muñoz J, Castellvi-Bel S, Llach J, Castells A, Balaguer F, Camps J, Pellisé M. Rectal Aberrant Crypt Foci in Humans Are Not Surrogate Markers for Colorectal Cancer Risk. Clin Transl Gastroenterol 2019; 10:e00047. [PMID: 31136360 PMCID: PMC6613864 DOI: 10.14309/ctg.0000000000000047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 02/22/2019] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Over the past 20 years, aberrant crypt foci (ACF) have emerged as potential precursors and biomarkers for colorectal cancer (CRC). However, data regarding their molecular pathogenesis, as well as their endoscopic and histological identification, remain inconsistent. METHODS A wide cohort of ACF from 100 control subjects and 100 case patients, including patients with adenoma and CRC, were characterized for endoscopic, morphologic, and molecular features. RESULTS We observed that among all the endoscopic features evaluated, only the number of large ACF correlated with CRC risk (P = 0.003), whereas the histological classification, as assessed by 2 different pathologists, was inconsistent and did not differ between control and case patients. Moreover, only a few APC and BRAF mutations and no microsatellite instability were detected in our samples. KRAS mutations were detected in 16.3% of ACF samples, which also exhibited increased MGMT hypermethylation. However, none of those events were found to be predictive of CRC risk. DISCUSSION Although ACF might be preneoplastic lesions of the colon, they are not suitable biomarkers for assessing CRC progression.
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Affiliation(s)
- Isabel Quintanilla
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - María López-Cerón
- Gastroenterology Department, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)
| | - Mireya Jimeno
- Pathology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic and Banc de Tumors-Biobanc Clinic-IDIBAPS-XBTC, Barcelona, Catalonia, Spain
| | - Miriam Cuatrecasas
- Pathology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic and Banc de Tumors-Biobanc Clinic-IDIBAPS-XBTC, Barcelona, Catalonia, Spain
| | - Michel Zabalza
- Gastroenterology Department, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)
| | - Leticia Moreira
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Virginia Alonso
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Cristina Rodríguez de Miguel
- Gastroenterology Department, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)
| | - Jennifer Muñoz
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Sergi Castellvi-Bel
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Josep Llach
- Gastroenterology Department, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)
| | - Antoni Castells
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, (IDIBAPS), University of Barcelona, Barcelona, Spain
- Gastroenterology Department, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)
| | - Francesc Balaguer
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, (IDIBAPS), University of Barcelona, Barcelona, Spain
- Gastroenterology Department, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)
| | - Jordi Camps
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Maria Pellisé
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, (IDIBAPS), University of Barcelona, Barcelona, Spain
- Gastroenterology Department, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)
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Abstract
Colorectal cancer (CRC) is one of the most common malignant tumors in the digestive tract, with high incidence and mortality. Most of CRC cases are diagnosed at the late stage, and the treatment effect is therefore poor. Thus, the prevention of CRC is particularly important. There have been many studies on the prevention of CRC in recent years. This paper will summarize the latest research on the primary prevention of CRC.
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Affiliation(s)
- Yan Chu
- Department of Gastroenterology, Shanghai Fifth People's Hospital Affiliated to Fudan University, Shanghai 200240, China
| | - Feng-Yuan Chen
- Department of Gastroenterology, Shanghai Fifth People's Hospital Affiliated to Fudan University, Shanghai 200240, China
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Drew DA, Mo A, Grady JJ, Stevens RG, Levine JB, Brenner BM, Anderson JC, Forouhar F, O'Brien MJ, Devers TJ, Rosenberg DW. Proximal Aberrant Crypt Foci Associate with Synchronous Neoplasia and Are Primed for Neoplastic Progression. Mol Cancer Res 2017; 16:486-495. [PMID: 29222172 DOI: 10.1158/1541-7786.mcr-17-0380] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 10/11/2017] [Accepted: 11/08/2017] [Indexed: 12/27/2022]
Abstract
Aberrant crypt foci (ACF) are the earliest morphologically identifiable lesion found within the human colon. Despite their relatively high frequency in the distal colon, few studies have examined the molecular characteristics of ACF within the proximal colon. In the following study, clinical participants (n = 184) were screened for ACF using high-definition chromoendoscopy with contrast dye-spray. Following pathologic confirmation, ACF biopsies were subjected to laser capture microdissection (LCM), and epithelial cells were evaluated for somatic mutations with a customized colorectal cancer mutation panel using DNA-mass spectrometry. Samples were further characterized for microsatellite instability (MSI). Logistic models were used to associate proximal ACF with synchronous (detected during the same procedure) neoplasia. Thirty-nine percent of participants had at least one histologically confirmed proximal ACF. Individuals with a proximal ACF were significantly more likely to present with a synchronous neoplasm (P = 0.001), and specifically, a proximal, tubular, or tubulovillous adenoma (multivariable OR = 2.69; 95% confidence interval, 1.12-6.47; P = 0.027). Proximal ACF were more likely to be dysplastic (52%) compared with distal ACF (13%; P < 0.0001). Somatic mutations to APC, BRAF, KRAS, NRAS, and ERBB2 were detected in 37% of proximal ACF. Hyperplastic ACF were more often MSI-high, but there were no differences in MSI status observed by colonic location. In summary, ACF are identified in the proximal colons of approximately 40% of individuals undergoing chromoendoscopy and more often in patients with synchronous proximal adenomas.Implications: This study provides the most complete set of data, to date, that ACF represent the earliest step in the adenoma-carcinoma sequence but remain below the detection limit of conventional endoscopy.Visual Overview: http//mcr.accrjournals.org/content/molcanres/16/3/486/F1.large.jpg Mol Cancer Res; 16(3); 486-95. ©2017 AACR.
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Affiliation(s)
- David A Drew
- Center for Molecular Medicine, University of Connecticut Health, Farmington, Connecticut
| | - Allen Mo
- Center for Molecular Medicine, University of Connecticut Health, Farmington, Connecticut
| | - James J Grady
- Connecticut Institute for Clinical and Translational Science, University of Connecticut Health, Farmington, Connecticut
| | - Richard G Stevens
- Division of Epidemiology and Biostatistics, University of Connecticut Health, Farmington, Connecticut.,Department of Community Medicine and Health Care
| | - Joel B Levine
- Colon Cancer Prevention Program, University of Connecticut Health, Farmington, Connecticut
| | - Bruce M Brenner
- Division of Gastroenterology, University of Connecticut Health, Farmington, Connecticut
| | - Joseph C Anderson
- Division of Gastroenterology, University of Connecticut Health, Farmington, Connecticut
| | - Faripour Forouhar
- Department of Anatomic Pathology, School of Medicine, University of Connecticut Health, Farmington, Connecticut
| | - Michael J O'Brien
- Department of Pathology, School of Medicine, Boston University, Boston, Massachusetts
| | - Thomas J Devers
- Division of Gastroenterology, University of Connecticut Health, Farmington, Connecticut
| | - Daniel W Rosenberg
- Center for Molecular Medicine, University of Connecticut Health, Farmington, Connecticut. .,Colon Cancer Prevention Program, University of Connecticut Health, Farmington, Connecticut
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10
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Kumarasamy V, Kuppusamy UR, Jayalakshmi P, Samudi C, Ragavan ND, Kumar S. Exacerbation of colon carcinogenesis by Blastocystis sp. PLoS One 2017; 12:e0183097. [PMID: 28859095 PMCID: PMC5578604 DOI: 10.1371/journal.pone.0183097] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 07/28/2017] [Indexed: 01/14/2023] Open
Abstract
Colorectal cancer (CRC) is one the most commonly diagnosed cancers worldwide and the number is increasing every year. Despite advances in screening programs, CRC remains as the second leading cause of cancer deaths in the United States. Oxidative stress plays an important role in the molecular mechanisms of colorectal cancer (CRC) and has been shown to be associated with Blastocystis sp., a common intestinal microorganism. In the present study, we aimed to identify a role for Blastocystis sp. in exacerbating carcinogenesis using in vivo rat model. Methylene blue staining was used to identify colonic aberrant crypt foci (ACF) and adenomas formation in infected rats whilst elevation of oxidative stress biomarker levels in the urine and serum samples were evaluated using biochemical assays. Histological changes of the intestinal mucosa were observed and a significant number of ACF was found in Blastocystis sp. infected AOM-rats compared to the AOM-controls. High levels of urinary oxidative indices including advanced oxidative protein products (AOPP) and hydrogen peroxide were observed in Blastocystis sp. infected AOM-rats compared to the uninfected AOM-rats. Our study provides evidence that Blastocystis sp. has a significant role in enhancing AOM-induced carcinogenesis by resulting damage to the intestinal epithelium and promoting oxidative damage in Blastocystis sp. infected rats.
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Affiliation(s)
- Vinoth Kumarasamy
- Department of Microbiology, Faculty of Medicine, MAHSA University, Bandar Saujana Putra, Shah Alam, Malaysia
| | - Umah Rani Kuppusamy
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Pailoor Jayalakshmi
- Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chandramathi Samudi
- Department of Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nanthiney Devi Ragavan
- Department of Biomedical Science, Faculty of Medicine, Mahsa University, Bandar Saujana Putra, Shah Alam, Malaysia
| | - Suresh Kumar
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail:
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Bettini S, Boutet-Robinet E, Cartier C, Coméra C, Gaultier E, Dupuy J, Naud N, Taché S, Grysan P, Reguer S, Thieriet N, Réfrégiers M, Thiaudière D, Cravedi JP, Carrière M, Audinot JN, Pierre FH, Guzylack-Piriou L, Houdeau E. Food-grade TiO 2 impairs intestinal and systemic immune homeostasis, initiates preneoplastic lesions and promotes aberrant crypt development in the rat colon. Sci Rep 2017; 7:40373. [PMID: 28106049 PMCID: PMC5247795 DOI: 10.1038/srep40373] [Citation(s) in RCA: 235] [Impact Index Per Article: 33.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 12/06/2016] [Indexed: 02/06/2023] Open
Abstract
Food-grade titanium dioxide (TiO2) containing a nanoscale particle fraction (TiO2-NPs) is approved as a white pigment (E171 in Europe) in common foodstuffs, including confectionary. There are growing concerns that daily oral TiO2-NP intake is associated with an increased risk of chronic intestinal inflammation and carcinogenesis. In rats orally exposed for one week to E171 at human relevant levels, titanium was detected in the immune cells of Peyer’s patches (PP) as observed with the TiO2-NP model NM-105. Dendritic cell frequency increased in PP regardless of the TiO2 treatment, while regulatory T cells involved in dampening inflammatory responses decreased with E171 only, an effect still observed after 100 days of treatment. In all TiO2-treated rats, stimulation of immune cells isolated from PP showed a decrease in Thelper (Th)-1 IFN-γ secretion, while splenic Th1/Th17 inflammatory responses sharply increased. E171 or NM-105 for one week did not initiate intestinal inflammation, while a 100-day E171 treatment promoted colon microinflammation and initiated preneoplastic lesions while also fostering the growth of aberrant crypt foci in a chemically induced carcinogenesis model. These data should be considered for risk assessments of the susceptibility to Th17-driven autoimmune diseases and to colorectal cancer in humans exposed to TiO2 from dietary sources.
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Affiliation(s)
- Sarah Bettini
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Elisa Boutet-Robinet
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Christel Cartier
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Christine Coméra
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Eric Gaultier
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Jacques Dupuy
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Nathalie Naud
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Sylviane Taché
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Patrick Grysan
- Luxembourg Institute of Science and Technology (LIST), Materials Research and Technology (MRT), Advanced Instrumentation for Ion Nano-Analytics (IANA), L-4362 Esch-sur-Alzette, Luxembourg
| | | | - Nathalie Thieriet
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), F-94701 Maisons-Alfort, France
| | | | | | - Jean-Pierre Cravedi
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Marie Carrière
- Université Grenoble-Alpes, INAC-LCIB, Laboratoire Lésions des Acides Nucléiques, 17 rue des Martyrs, F-38000 Grenoble, France.,CEA, INAC-SCIB, Laboratoire Lésions des Acides Nucléiques, 17 rue des Martyrs, F-38000 Grenoble, France
| | - Jean-Nicolas Audinot
- Luxembourg Institute of Science and Technology (LIST), Materials Research and Technology (MRT), Advanced Instrumentation for Ion Nano-Analytics (IANA), L-4362 Esch-sur-Alzette, Luxembourg
| | - Fabrice H Pierre
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Laurence Guzylack-Piriou
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Eric Houdeau
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, Toulouse, France
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12
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Yang K, Fard S, Furrer R, Archer MC, Bruce WR, Lip H, Mehta R, O'Brien PJ, Giacca A, Ward WE, Femia AP, Caderni G, Medline A, Banks K. Risk factors for colorectal cancer in man induce aberrant crypt foci in rats: Preliminary findings. Nutr Cancer 2015; 68:94-104. [PMID: 26709971 PMCID: PMC4784512 DOI: 10.1080/01635581.2016.1115098] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Epidemiological studies have demonstrated clear associations between specific dietary and environmental risk factors and incidence of colorectal cancer, but the mechanisms responsible for these associations are not known. An animal model could facilitate such an understanding. Both genotoxic and nongenotoxic carcinogens induce aberrant crypt foci (ACF) in the colons of F344 rats. F344 rats were provided with diets that contained putative risk factors for CRC: low calcium and low vitamin D, high iron, high fructose, and decreased light (UV) exposure or a control diet for 14 wk. The rats were then assessed with biochemical measures and by topological examination for evidence of colon abnormalities. Circulating ionized calcium was decreased from 2.85 to 1.69 mmol/L, and ACF were increased from 0.7 to 13.6 lesions/colon (both P < 0.001). Rats exposed to the multiple environmental conditions associated with colon cancer, developed ACF similar to the heterogeneous or ill-defined ACF in the human colon. Heterogeneous ACF are the most frequently seen in humans and are also seen in rats shortly after exposure to the non-genotoxic colon carcinogen, dextransulfate sodium. The rodent model could be used to assess the pathways from diet and environment to colon cancer and to provide guidance for clinical studies.
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Affiliation(s)
- Kai Yang
- a Faculty of Medicine, University of Toronto , Toronto , Canada
| | - Sara Fard
- b Department of Nutritional Sciences , Faculty of Medicine, University of Toronto , Toronto , Canada
| | - Rudolf Furrer
- b Department of Nutritional Sciences , Faculty of Medicine, University of Toronto , Toronto , Canada
| | - Michael C Archer
- b Department of Nutritional Sciences , Faculty of Medicine, University of Toronto , Toronto , Canada
| | - W Robert Bruce
- b Department of Nutritional Sciences , Faculty of Medicine, University of Toronto , Toronto , Canada
| | - HoYin Lip
- c Department of Pharmaceutical Science , Faculty of Pharmacy, University of Toronto , Toronto , Canada
| | - Rhea Mehta
- c Department of Pharmaceutical Science , Faculty of Pharmacy, University of Toronto , Toronto , Canada
| | - Peter J O'Brien
- c Department of Pharmaceutical Science , Faculty of Pharmacy, University of Toronto , Toronto , Canada
| | - Adria Giacca
- d Department of Physiology , Faculty of Medicine, University of Toronto , Toronto , Canada
| | - Wendy E Ward
- e Centre for Bone and Muscle Health, Brock University , St. Catharines , Canada
| | - A Pietro Femia
- f NEUROFARBA Department , Section of Pharmacology and Toxicology, University of Florence , Florence , Italy
| | - Giovanna Caderni
- f NEUROFARBA Department , Section of Pharmacology and Toxicology, University of Florence , Florence , Italy
| | - Alan Medline
- g Department of Pathology , Humber River Hospital , Toronto , Canada
| | - Kate Banks
- h Division of Comparative Medicine and Department of Physiology, Faculty of Medicine, University of Toronto , Toronto , Canada
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13
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Drew DA, Goh G, Mo A, Grady JJ, Forouhar F, Egan G, Swede H, Rosenberg DW, Stevens RG, Devers TJ. Colorectal polyp prevention by daily aspirin use is abrogated among active smokers. Cancer Causes Control 2015; 27:93-103. [DOI: 10.1007/s10552-015-0686-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 10/17/2015] [Indexed: 01/03/2023]
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14
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Ito M, Kanno S, Nosho K, Sukawa Y, Mitsuhashi K, Kurihara H, Igarashi H, Takahashi T, Tachibana M, Takahashi H, Yoshii S, Takenouchi T, Hasegawa T, Okita K, Hirata K, Maruyama R, Suzuki H, Imai K, Yamamoto H, Shinomura Y. Association ofFusobacterium nucleatumwith clinical and molecular features in colorectal serrated pathway. Int J Cancer 2015; 137:1258-68. [DOI: 10.1002/ijc.29488] [Citation(s) in RCA: 208] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 02/12/2015] [Indexed: 02/06/2023]
Affiliation(s)
- Miki Ito
- Department of Gastroenterology; Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine; Sapporo Japan
| | - Shinichi Kanno
- Department of Gastroenterology; Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine; Sapporo Japan
| | - Katsuhiko Nosho
- Department of Gastroenterology; Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine; Sapporo Japan
| | - Yasutaka Sukawa
- Department of Medical Oncology; Dana-Farber Cancer Institute and Harvard Medical School; Boston MA
| | - Kei Mitsuhashi
- Department of Gastroenterology; Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine; Sapporo Japan
| | - Hiroyoshi Kurihara
- Department of Gastroenterology; Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine; Sapporo Japan
| | - Hisayoshi Igarashi
- Department of Gastroenterology; Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine; Sapporo Japan
| | - Taiga Takahashi
- Department of Gastroenterology; Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine; Sapporo Japan
| | - Mami Tachibana
- Department of Gastroenterology; Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine; Sapporo Japan
| | - Hiroaki Takahashi
- Department of Gastroenterology; Keiyukai Sapporo Hospital; Sapporo Japan
| | - Shinji Yoshii
- Department of Gastroenterology; NTT East Sapporo Hospital; Sapporo Japan
| | | | - Tadashi Hasegawa
- Department of Surgical Pathology; Sapporo Medical University School of Medicine; Sapporo Japan
| | - Kenji Okita
- Department of Surgery; Surgical Oncology and Science, Sapporo Medical University School of Medicine; Sapporo Japan
| | - Koichi Hirata
- Department of Surgery; Surgical Oncology and Science, Sapporo Medical University School of Medicine; Sapporo Japan
| | - Reo Maruyama
- Department of Molecular Biology; Sapporo Medical University School of Medicine; Sapporo Japan
| | - Hiromu Suzuki
- Department of Molecular Biology; Sapporo Medical University School of Medicine; Sapporo Japan
| | - Kohzoh Imai
- The Institute of Medical Science, The University of Tokyo; Tokyo Japan
| | - Hiroyuki Yamamoto
- Division of Gastroenterology and Hepatology; St. Marianna University School of Medicine; Kawasaki Japan
| | - Yasuhisa Shinomura
- Department of Gastroenterology; Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine; Sapporo Japan
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15
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Bortniker E, Anderson JC. Do recent epidemiologic observations impact who and how we should screen for CRC? Dig Dis Sci 2015; 60:781-94. [PMID: 25492505 DOI: 10.1007/s10620-014-3467-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 11/26/2014] [Indexed: 12/18/2022]
Abstract
Colorectal cancer (CRC) screening is recommended to begin at age 50 for those patients with no significant family history of CRC. However, even within this group of average-risk patients, there is data to suggest that there may be variation in CRC risk. These observations suggest that perhaps CRC screening should be tailored to target those patients at higher risk for earlier or more invasive screening as compared to those individuals at lower risk. The strategy of how to identify those higher-risk patients may not be straightforward. One method might be to use single risk factors such as smoking or elevated BMI as has been suggested in the recent American College of Gastroenterology CRC screening guidelines. Another paradigm involves the use of models which incorporate several risk factors to stratify patients by risk. This article will highlight recent large studies that examine recognized CRC risk factors as well as review recently developed CRC risk models. There will also be a discussion of the application of these factors and models in an effort to make CRC screening more efficient.
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Affiliation(s)
- Ethan Bortniker
- Division of Gastroenterology and Hepatology, University of Connecticut School of Medicine, Farmington, CT, 06030, USA
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16
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Anderson JC. Pathogenesis and management of serrated polyps: current status and future directions. Gut Liver 2014; 8:582-9. [PMID: 25368744 PMCID: PMC4215442 DOI: 10.5009/gnl14248] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 08/20/2014] [Indexed: 12/28/2022] Open
Abstract
Hyperplastic or serrated polyps were once believed to have little to no clinical significance. A subset of these polyps are now considered to be precursors to colorectal cancers (CRC) in the serrated pathway that may account for at least 15% of all tumors. The serrated pathway is distinct from the two other CRC pathways and involves an epigenetic hypermethylation mechanism of CpG islands within promoter regions of tumor suppressor genes. This process results in the formation of CpG island methylator phenotype tumors. Serrated polyps are divided into hyperplastic polyps, sessile serrated adenomas/polyps (SSA/Ps), and traditional serrated adenomas (TSAs). The SSA/P and the TSA have the potential for dysplasia and subsequent malignant transformation. The SSA/Ps are more common and are more likely to be flat than TSAs. Their flat morphology may make them difficult to detect and thus explain the variation in detection rates among endoscopists. Challenges for endoscopists also include the difficulty in pathological interpretation as well surveillance of these lesions. Furthermore, serrated polyps may be inadequately resected by endoscopists. Thus, it is not surprising that the serrated pathway has been linked with interval cancers. This review will provide the physician or clinician with the knowledge to manage patients with serrated polyps.
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Affiliation(s)
- Joseph C Anderson
- Department of Veterans Affairs Medical Center, White River Junction, VT, and The Geisel School of Medicine at Dartmouth Medical, Hanover, NH, USA
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17
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Freire P, Figueiredo P, Cardoso R, Manuel Donato M, Ferreira M, Mendes S, Silva MR, Cipriano MA, Ferreira AM, Vasconcelos H, Portela F, Sofia C. Predictive value of rectal aberrant crypt foci for intraepithelial neoplasia in ulcerative colitis - a cross-sectional study. Scand J Gastroenterol 2014; 49:1219-29. [PMID: 25157637 DOI: 10.3109/00365521.2014.951390] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Ulcerative colitis (UC) is associated with an increased risk of colorectal cancer (CRC). Aberrant crypt foci (ACF) are important biomarkers of sporadic CRC risk. Their correlation with the risk of intraepithelial neoplasia (IN) in UC remains unclear. AIMS To assess whether ACF are a risk factor for IN in long-standing UC and to investigate any correlation between the clinico-epidemiological characteristics and prevalence/number of ACF in these patients. METHODS Seventy-six patients with long-standing UC were prospectively screened by colonoscopy with chromoendoscopy-guided endomicroscopy. ACF were sought in the lower rectum. RESULTS Eight INs were detected in seven (9.2%) patients. The ACF prevalence and mean number were 60.5% and 2.4 ± 2.8, respectively. The number of ACF was independently associated with the risk of having IN (odds ratio = 1.338; 95% confidence interval 1.030-1.738). ACF number revealed a good calibration (area under the receiver operating characteristic curve = 0.829) and discriminative ability (p = 0.205, Hosmer-Lemeshow test) for the prediction of synchronous IN. Patients with ≥3 ACF have a significantly higher prevalence of IN than patients with <3 ACF (22.6% vs. 0%, p = 0.001). Using this cut-off value, the performance of ACF in predicting the presence of IN was as follows: sensitivity = 100%, specificity = 65.2%, positive predictive value = 22.6%, and negative predictive value = 100%. Age >40 years, family history of CRC, and increased body mass index (BMI) were associated with a significantly higher number of ACF. CONCLUSION Long-standing UC patients with ≥3 ACF have a significantly higher likelihood of having IN. Age >40 years, family history of CRC, and increased BMI have significant positive associations with the number of ACF.
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Affiliation(s)
- Paulo Freire
- Department of Gastroenterology , Centro Hospitalar e Universitário de Coimbra , Coimbra , Portugal
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18
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Drew DA, Devers TJ, O'Brien MJ, Horelik NA, Levine J, Rosenberg DW. HD chromoendoscopy coupled with DNA mass spectrometry profiling identifies somatic mutations in microdissected human proximal aberrant crypt foci. Mol Cancer Res 2014; 12:823-9. [PMID: 24651453 DOI: 10.1158/1541-7786.mcr-13-0624] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
UNLABELLED Despite increased implementation of screening colonoscopy, interval cancers in the proximal colon remain a major public health concern. This fact underscores the limitations of current screening paradigms and the need for developing advanced endoscopic techniques. The density of aberrant crypt foci (ACF), the earliest identifiable mucosal abnormality, may serve as a surrogate marker for colon cancer risk, but has rarely been studied in the proximal colon. To this end, high-definition (HD) chromoendoscopy was conducted to define the relevance of ACF in the proximal colon. In addition, due to limited ACF size, the development of a combinatorial approach was required to maximize data acquisition obtained from individual biopsy samples. Proximal and distal ACF samples were characterized for a total of 105 mutations across 22 known tumor suppressor and proto-oncogenes using high-throughput Sequenom MassARRAY analysis. From this profiling, a discrete number of somatic mutations were identified, including APC(R876*) and FLT3(I836M), as well as a deletion within the EGFR gene. Combined, these data highlight the significance of ACF within the context of colon cancer pathogenesis, particularly in the proximal colon. IMPLICATIONS The identification of cancer-related mutations in commonly overlooked mucosal lesions underscores the preventive benefit of implementing advanced endoscopic screening to larger patient populations, particularly in the proximal colon. Visual Overview: http://mcr.aacrjournals.org/content/early/2014/05/22/1541-7786.MCR-13-0624/F1.large.jpg. Mol Cancer Res; 12(6); 823-9. ©2014 AACR.
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Affiliation(s)
- David A Drew
- Authors' Affiliations: Center for Molecular Medicine; Colon Cancer Prevention Program, Neag Comprehensive Cancer Center, School of Medicine, University of Connecticut Health Center, Farmington, Connecticut; and
| | - Thomas J Devers
- Division of Gastroenterology; Colon Cancer Prevention Program, Neag Comprehensive Cancer Center, School of Medicine, University of Connecticut Health Center, Farmington, Connecticut; and
| | - Michael J O'Brien
- Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston, Massachusetts
| | - Nicole A Horelik
- Authors' Affiliations: Center for Molecular Medicine; Colon Cancer Prevention Program, Neag Comprehensive Cancer Center, School of Medicine, University of Connecticut Health Center, Farmington, Connecticut; and
| | - Joel Levine
- Division of Gastroenterology; Colon Cancer Prevention Program, Neag Comprehensive Cancer Center, School of Medicine, University of Connecticut Health Center, Farmington, Connecticut; and
| | - Daniel W Rosenberg
- Authors' Affiliations: Center for Molecular Medicine; Colon Cancer Prevention Program, Neag Comprehensive Cancer Center, School of Medicine, University of Connecticut Health Center, Farmington, Connecticut; and
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19
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Tadros M, Anderson JC. Serrated polyps: clinical implications and future directions. Curr Gastroenterol Rep 2014; 15:342. [PMID: 23934652 DOI: 10.1007/s11894-013-0342-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Serrated polyps were once thought to have no clinical implications with regards to the development of colorectal cancer (CRC). Over the past several years, published data have enabled clinicians to develop a better understanding of these lesions. The serrated pathway associated with these lesions involves an epigenetic mechanism characterized by abnormal hypermethylation of CpG islands located in the promoter regions of tumor suppressor genes. It is often associated with BRAF mutations and may account for 15-35% of all CRC. This pathway may also play a major role in proximal neoplasia and missed cancer. There are three distinct subtypes of serrated neoplasia; hyperplastic (70% of all serrated polyps), sessile serrated adenoma/polyp (SSA/P) (25%) and traditional serrated adenoma (<2%). The last two forms are considered to be precursors for CRC. SSA/P are associated with synchronous CRC especially if the polyps are large (≥1 cm), multiple, or if they are in the proximal colon. Lesions containing serrated neoplasia are usually flat or sessile, may be large, and occasionally have a mucous cap. Serrated lesions provide many challenges for the clinician and may be difficult to detect and completely remove. Furthermore, pathologists may misclassify SSA/P as HP. For the first time, the Multi-Society Task Force guidelines for colorectal polyp surveillance have included the management of serrated lesions in their published recommendations. In addition, an expert panel has also recently issued recommendations regarding serrated neoplasia. In this article, we provide the reader with a summary as well as the latest developments regarding serrated colonic lesions.
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Affiliation(s)
- Michael Tadros
- Gastroenterology-Hepatology, University of Connecticut School of Medicine, Farmington, CT 06030, USA
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20
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Abstract
The age-related epithelial cancers of the breast, colorectum and prostate are the most prevalent and are increasing in our aging populations. Epithelial cells turnover rapidly and mutations naturally accumulate throughout life. Most epithelial cancers arise from this normal mutation rate. All elderly individuals will harbour many cells with the requisite mutations and most will develop occult neoplastic lesions. Although essential for initiation, these mutations are not sufficient for the progression of cancer to a life-threatening disease. This progression appears to be dependent on context: the tissue ecosystem within individuals and lifestyle exposures across populations of individuals. Together, this implies that the seeds may be plentiful but they only germinate in the right soil. The incidence of these cancers is much lower in Eastern countries but is increasing with Westernisation and increases more acutely in migrants to the West. A Western lifestyle is strongly associated with perturbed metabolism, as evidenced by the epidemics of obesity and diabetes: this may also provide the setting enabling the progression of epithelial cancers. Epidemiology has indicated that metabolic biomarkers are prospectively associated with cancer incidence and prognosis. Furthermore, within cancer research, there has been a rediscovery that a switch in cell metabolism is critical for cancer progression but this is set within the metabolic status of the host. The seed may only germinate if the soil is fertile. This perspective brings together the different avenues of investigation implicating the role that metabolism may play within the context of post-genomic concepts of cancer.
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Affiliation(s)
- Jeff M P Holly
- School of Clinical Science, Faculty of Medicine, University of Bristol, Learning and Research Building, Southmead Hospital, Bristol, BS10 5NB, UK,
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21
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Abstract
Chromocolonoscopy is the process of endoscopically examining the colon mucosa after it has been stained with dye. The goal is to allow the endoscopist to identify subtle features in the mucosa, such as morphologically flat polyps or crypt patterns. Studies examining the efficacy of chromocolonoscopy to identify adenomas missed by conventional colonoscopy have shown that although chromocolonoscopy increases polyp yield, most additional lesions are small in size. Staining can also help in differentiating neoplastic from non-neoplastic polyps. Perhaps the most useful aspect of chromocolonoscopy is increasing the yield for dysplasia in patients undergoing colonoscopy for inflammatory bowel disease surveillance.
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Affiliation(s)
- Deepika Devuni
- University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA
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22
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Drew DA, Devers T, Horelik N, Yang S, O'Brien M, Wu R, Rosenberg DW. Nanoproteomic analysis of extracellular receptor kinase-1/2 post-translational activation in microdissected human hyperplastic colon lesions. Proteomics 2013; 13:1428-36. [PMID: 23467982 DOI: 10.1002/pmic.201200430] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 01/04/2013] [Accepted: 02/07/2013] [Indexed: 12/21/2022]
Abstract
Oncogenic activation resulting in hyperproliferative lesions within the colonic mucosa has been identified in putative precancerous lesions, aberrant crypt foci (ACF). KRAS and BRAF mutation status was determined in 172 ACF identified in the colorectum of screening subjects by in situ high-definition, magnifying chromoendoscopy. Lesions were stratified according to histology (serrated vs. distended). Due to their limiting size, however, it was not technically feasible to examine downstream signaling consequences of these oncogenic mutations. We have combined ultraviolet-infrared (UV/IR) microdissection with an ultrasensitive nanofluidic proteomic immunoassay (NIA) to enable accurate quantification of posttranslational modifications to mitogen-activated protein kinase (MAPK) in total protein lysates isolated from hyperproliferative crypts and adjacent normal mucosa. Using this approach, levels of singly and dually (activated) phosphorylated isoforms of extracellular receptor kinase(ERK)-1 and ERK-2 were quantified in samples containing as little as 16 ng of total protein recovered from <200 cells. ERK activation is responsible for observed hyperplasia found in these early lesions, but is not directly dependent on KRAS and/or BRAF mutation status. This study describes the novel use of a sensitive nanofluidic platform to measure oncogene-driven proteomic changes in diminutive lesions and highlights the advantage of this approach over classical immunohistochemistry-based analyses.
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Affiliation(s)
- David A Drew
- Center for Molecular Medicine, University of Connecticut Health Center, Farmington, Connecticut 06030-3101, USA
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23
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Takahashi H, Yamada E, Ohkubo H, Sakai E, Higurashi T, Uchiyama T, Hosono K, Endo H, Nakajima A. Relationship of human rectal aberrant crypt foci and formation of colorectal polyp: One-year following up after polypectomy. World J Gastrointest Endosc 2012; 4:561-4. [PMID: 23293726 PMCID: PMC3536853 DOI: 10.4253/wjge.v4.i12.561] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 10/20/2012] [Accepted: 12/01/2012] [Indexed: 02/05/2023] Open
Abstract
AIM: To clarify the relationship of human rectal aberrant crypt foci and formation of colorectal polyp.
METHODS: Eighty-nine subjects were recruited from the population of Japanese individuals who underwent polypectomy at Yokohama City University Hospital. All patients had baseline adenomas removed at year 0 colonoscopy. Aberrant crypt foci (ACF) were defined as lesions in which the crypts were more darkly stained with methylene blue than normal crypts and had larger diameters, often with oval or slit-like lumens and a thicker epithelial lining.
RESULTS: A total of 366 ACFs were identified in 89 patients; all had baseline adenomas removed at the first examination (year 0) colonoscopy and returned for the second (year 1). ACF in the lower rectum were assessed at year 0 and study group were divided into two groups depend on ACF numbers, 0-3 or over 3. All participants were examined in the number and maximum size of adenoma. There was no statistical difference in number and maximum size of ACF at year 0, however, maximum size of adenoma was larger in over 3 group than 0-3 group at year 1.
CONCLUSION: The number of ACF may be a predictive factor of relatively large adenoma incidence in the pilot phase study.
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Affiliation(s)
- Hirokazu Takahashi
- Hirokazu Takahashi, Eiji Yamada, Hidenori Ohkubo, Eiji Sakai, Takuma Higurashi, Takashi Uchiyama, Kunihiro Hosono, Hiroki Endo, Atsushi Nakajima, Gastroenterology Division, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
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Wall RA, Barton JK. Fluorescence-based surface magnifying chromoendoscopy and optical coherence tomography endoscope. JOURNAL OF BIOMEDICAL OPTICS 2012; 17:086003. [PMID: 23224190 PMCID: PMC3411934 DOI: 10.1117/1.jbo.17.8.086003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 07/06/2012] [Accepted: 07/12/2012] [Indexed: 05/20/2023]
Abstract
A side-viewing, 2.3-mm diameter, surface magnifying chromoendoscopy-optical coherence tomography (SMC-OCT) endoscope has been designed for simultaneous, nondestructive surface fluorescence visualization and cross-sectional imaging. We apply this endoscope to in vivo examination of the mouse colon. A 30,000 element fiber bundle is combined with single mode fibers, for SMC and OCT imaging, respectively. The distal optics consist of a gradient-index lens and spacer to provide a 1× magnification at a working distance of 1.58 mm in air, necessary to image the sample through a 0.23-mm thick outer glass envelope, and an aluminized right-angle prism fixed to the distal end of the gradient-index lens assembly. The resulting 1∶1 imaging system is capable of 3.9-µm lateral and 2.3-µm axial resolution in the OCT channel, and 125-lp/mm resolution across a 0.70-mm field of view in the SMC channel. The endoscope can perform high contrast crypt visualization, molecular imaging, and cross-sectional imaging of colon microstructure.
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Affiliation(s)
- R. Andrew Wall
- The University of Arizona, College of Optical Sciences, 1630 E. University Boulevard, Tucson, Arizona 85721
| | - Jennifer K. Barton
- The University of Arizona, College of Optical Sciences, 1630 E. University Boulevard, Tucson, Arizona 85721
- The University of Arizona, Department of Biomedical Engineering, 1127 E. James E. Rogers Way, Tucson, Arizona 85721
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