welcome to oneFAPvoice- a positively charged Familial Adenomatous Polyposis community.
- join today!
Duodenal Mucosal Risk Markers in Patients with Familial Adenomatous Polyposis: Effects of Celecoxib/Ursodeoxycholic Acid Co-Treatment and Comparison with Patient Controls
source: Orphanet journal of rare diseases
authors: Bjorn W. H. van Heumen, Hennie M. J. Roelofs, René H. M. te Morsche, Fokko M. Nagengast, Wilbert H. M. Peterssummary/abstract:
BACKGROUND : Familial adenomatous polyposis (FAP) is a disease characterized by the development of hundreds to thousands of adenomatous polyps in the colorectum early in life. Virtually all patients with FAP will develop colorectal cancer before the age of 40 to 50 years, unless prophylactic colectomy is performed, which significantly improves their prognosis. The mortality pattern has changed and duodenal cancer now is one of the main cancer-related causes of death in these patients. Practically all patients with FAP develop premalignant duodenal adenomas, which may develop to duodenal cancer in approximately 3-7% of patients. Duodenal cancer in patients with FAP has a poor prognosis. The clinical challenge is to identify patients at high-risk for duodenal carcinoma. Chemoprevention would be desirable to avoid duodenectomy. The main goal of this study is to identify risk markers in normal duodenal mucosa of patients with FAP, that could help identify patients at increased risk for malignant transformation.
METHODS : Messenger RNA (mRNA) levels of glutathione S-transferase A1 (GSTA1), glutathione S-transferase P1 (GSTP1), KIAA1199, E-cadherin, peroxisome proliferative activated receptor δ (PPARδ), caspase-3, cyclin D1, β-catenin, and cyclooxygenase-2 (COX-2) were measured in duodenal mucosa, using the QuantiGene 2.0 Plex assay. Levels in normal appearing mucosa of patients with FAP (n = 37) were compared with levels in non-FAP patient controls (n = 16). In addition, levels before and after treatment with either celecoxib & ursodeoxycholic acid (UDCA, n = 14) or celecoxib & placebo (n = 13) were evaluated in patients with FAP.
RESULTS : mRNA levels of glutathione S-transferase A1 (28.16% vs. 38.24%, p = 0.008) and caspase-3 (3.30% vs. 5.31%, p = 0.001) were significantly lower in patients with FAP vs. non-FAP patient controls, respectively. COX-2 mRNA levels in normal duodenal mucosa of patients with FAP were found to be unexpectedly low. None of the potential risk markers was influenced by celecoxib or celecoxib & UDCA.
CONCLUSIONS : Protection against toxins and carcinogens (GSTA1) and apoptosis (caspase-3) is low in patients with FAP, which could contribute to increased susceptibility for malignant transformation of duodenal mucosa.
TRIAL REGISTRATION : http://ClinicalTrials.gov number NCT00808743.organization: Radboud University Nijmegen Medical Centre
read more full text source
expertly curated content related to this topic
papa’s got a brand new bagThe reason for this page is to give a un...
Adrenocortical Secreting Mass in a Patient with Gardner’s Syndrome: A Case ReportGardner's syndrome (GS) is a dysplasia c...
Familial Risk-Colorectal Cancer: ESMO Clinical Practice GuidelinesLynch syndrome is the most common heredi...
Special Concerns for People with J-PouchesAfter having an ileoanal reservoir proce...
Studies of the Foregut in Patients with Familial Adenomatous Polyposis (FAP): The Clinical Problem, Management, and ...Thirty-eight published papers, co-author...
Role of Ileostomy in Restorative ProctocolectomyRestorative proctocolectomy (RP) is the ...