BACKGROUND:Sulindac regresses colorectal adenomas in patients with familial adenomatous polyposis (FAP), although the mechanism of polyp regression is unclear. AIMS: To determine whether differences occur in alteration of rectal epithelial apoptotic index and expression of apoptosis related proteins in FAP patients treated withsulindac compared with placebo. PATIENTS: Twenty one FAP patients; 12 had not undergone colectomy. METHODS:Patients with FAP were treated with sulindac 150 mg orally twice a day for three months (n=10) or placebo (n=11). Colorectal polyp number was determined and biopsies of the normal rectal mucosa were performed before and after three months of treatment. Response to treatment and alteration of the apoptotic ratio (index in base of crypt divided by index in surface epithelium) were evaluated. Bcl-2, bax, p21/WAF-1, and p53 proteins were assessed semiquantitatively by immunohistochemistry. RESULTS: Significant decreases in polyp number and in the apoptotic ratio were seen in patients treated with sulindac compared with controls. The mean percentage change in polyp number from baseline was -46% in the sulindac group and +13% in the placebo group (p=0.005). Mean percentage change in the apoptotic ratio was -8% and +25% in the sulindac and placebo treated patients, respectively (p=0.004). No differences in expression or compartmentalisation of apoptosis related proteins were noted between treatment groups. CONCLUSIONS:Sulindac regression of colorectal adenomas is accompanied by alteration of the rectal epithelial apoptotic ratio with relative increase in apoptosis in surface cells compared with the deeper crypt. The utility of the apoptotic ratio as an intermediate biomarker for colorectal tumorigenesis deserves further study.
RCT Entities:
BACKGROUND:Sulindac regresses colorectal adenomas in patients with familial adenomatous polyposis (FAP), although the mechanism of polyp regression is unclear. AIMS: To determine whether differences occur in alteration of rectal epithelial apoptotic index and expression of apoptosis related proteins in FAPpatients treated with sulindac compared with placebo. PATIENTS: Twenty one FAPpatients; 12 had not undergone colectomy. METHODS:Patients with FAP were treated with sulindac 150 mg orally twice a day for three months (n=10) or placebo (n=11). Colorectal polyp number was determined and biopsies of the normal rectal mucosa were performed before and after three months of treatment. Response to treatment and alteration of the apoptotic ratio (index in base of crypt divided by index in surface epithelium) were evaluated. Bcl-2, bax, p21/WAF-1, and p53 proteins were assessed semiquantitatively by immunohistochemistry. RESULTS: Significant decreases in polyp number and in the apoptotic ratio were seen in patients treated with sulindac compared with controls. The mean percentage change in polyp number from baseline was -46% in the sulindac group and +13% in the placebo group (p=0.005). Mean percentage change in the apoptotic ratio was -8% and +25% in the sulindac and placebo treated patients, respectively (p=0.004). No differences in expression or compartmentalisation of apoptosis related proteins were noted between treatment groups. CONCLUSIONS:Sulindac regression of colorectal adenomas is accompanied by alteration of the rectal epithelial apoptotic ratio with relative increase in apoptosis in surface cells compared with the deeper crypt. The utility of the apoptotic ratio as an intermediate biomarker for colorectal tumorigenesis deserves further study.
Authors: V Korinek; N Barker; P J Morin; D van Wichen; R de Weger; K W Kinzler; B Vogelstein; H Clevers Journal: Science Date: 1997-03-21 Impact factor: 47.728
Authors: A Bedi; P J Pasricha; A J Akhtar; J P Barber; G C Bedi; F M Giardiello; B A Zehnbauer; S R Hamilton; R J Jones Journal: Cancer Res Date: 1995-05-01 Impact factor: 12.701
Authors: G A Piazza; A L Rahm; M Krutzsch; G Sperl; N S Paranka; P H Gross; K Brendel; R W Burt; D S Alberts; R Pamukcu Journal: Cancer Res Date: 1995-07-15 Impact factor: 12.701
Authors: Jurriaan B Tuynman; Christianne J Buskens; Kristel Kemper; Fiebo J W ten Kate; G Johan A Offerhaus; Dirk J Richel; J Jan B van Lanschot Journal: Ann Surg Date: 2005-12 Impact factor: 12.969
Authors: Temitope O Keku; Ahmad Amin; Joseph Galanko; Christopher Martin; Barbara Schliebe; Robert S Sandler Journal: Cancer Epidemiol Biomarkers Prev Date: 2008-02 Impact factor: 4.254
Authors: Bini Mathew; Judith Varady Hobrath; Larry Ross; Michele C Connelly; Hava Lofton; Malini Rajagopalan; R Kiplin Guy; Robert C Reynolds Journal: PLoS One Date: 2016-10-21 Impact factor: 3.240
Authors: P Friederich; B W H van Heumen; I D Nagtegaal; M Berkhout; J H J M van Krieken; W H M Peters; F M Nagengast Journal: Virchows Arch Date: 2007-07-05 Impact factor: 4.064
Authors: E M J Boon; J J Keller; T A M Wormhoudt; F M Giardiello; G J A Offerhaus; R van der Neut; S T Pals Journal: Br J Cancer Date: 2004-01-12 Impact factor: 7.640