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Chevalier E, Benamouzig R. Chemoprevention in hereditary digestive neoplasia: A comprehensive review. Therap Adv Gastroenterol 2023; 16:17562848231215585. [PMID: 38050626 PMCID: PMC10693784 DOI: 10.1177/17562848231215585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/23/2023] [Indexed: 12/06/2023] Open
Abstract
Hereditary syndromes, such as familial adenomatous polyposis (FAP), MUTYH polyposis or Lynch syndrome, are particularly predisposing to the development of colorectal cancer. These situations have necessitated the development of adapted prevention strategies based largely on reinforced endoscopic surveillance and the search for complementary prevention strategies. This is the case for chemoprevention, which is the long-term administration of chemical agents limiting carcinogenesis, used as primary or secondary prophylaxis. The aim of this review is to present the available literature and the latest advances in chemoprevention in patients with FAP or MUTYH and other polyposis as well as in patients with Lynch syndrome. The main conclusions of the few available guidelines in these situations are also discussed.
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Affiliation(s)
- Eugénie Chevalier
- Department of Gastroenterology and Digestive Oncology, Avicenne Hospital, Bobigny, France
| | - Robert Benamouzig
- Department of Gastroenterology and Digestive Oncology, Avicenne Hospital, AP-HP, Paris Nord la Sorbonne University, 125 Rue de Stalingrad, Bobigny 93000, France
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Khoonkari M, Liang D, Kamperman M, Kruyt FAE, van Rijn P. Physics of Brain Cancer: Multiscale Alterations of Glioblastoma Cells under Extracellular Matrix Stiffening. Pharmaceutics 2022; 14:pharmaceutics14051031. [PMID: 35631616 PMCID: PMC9145282 DOI: 10.3390/pharmaceutics14051031] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/27/2022] [Accepted: 05/06/2022] [Indexed: 12/12/2022] Open
Abstract
The biology and physics underlying glioblastoma is not yet completely understood, resulting in the limited efficacy of current clinical therapy. Recent studies have indicated the importance of mechanical stress on the development and malignancy of cancer. Various types of mechanical stress activate adaptive tumor cell responses that include alterations in the extracellular matrix (ECM) which have an impact on tumor malignancy. In this review, we describe and discuss the current knowledge of the effects of ECM alterations and mechanical stress on GBM aggressiveness. Gradual changes in the brain ECM have been connected to the biological and physical alterations of GBM cells. For example, increased expression of several ECM components such as glycosaminoglycans (GAGs), hyaluronic acid (HA), proteoglycans and fibrous proteins result in stiffening of the brain ECM, which alters inter- and intracellular signaling activity. Several mechanosensing signaling pathways have been identified that orchestrate adaptive responses, such as Hippo/YAP, CD44, and actin skeleton signaling, which remodel the cytoskeleton and affect cellular properties such as cell–cell/ECM interactions, growth, and migration/invasion of GBM cells. In vitro, hydrogels are used as a model to mimic the stiffening of the brain ECM and reconstruct its mechanics, which we also discuss. Overall, we provide an overview of the tumor microenvironmental landscape of GBM with a focus on ECM stiffening and its associated adaptive cellular signaling pathways and their possible therapeutic exploitation.
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Affiliation(s)
- Mohammad Khoonkari
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (M.K.); (D.L.)
- Polymer Science, Zernike Institute for Advanced Materials, University of Groningen, Nijenborgh 4, 9747 AG Groningen, The Netherlands;
| | - Dong Liang
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (M.K.); (D.L.)
| | - Marleen Kamperman
- Polymer Science, Zernike Institute for Advanced Materials, University of Groningen, Nijenborgh 4, 9747 AG Groningen, The Netherlands;
| | - Frank A. E. Kruyt
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (M.K.); (D.L.)
- Correspondence: (F.A.E.K.); (P.v.R.)
| | - Patrick van Rijn
- Department of Biomedical Engineering-FB40, University of Groningen, University Medical Center Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands
- W.J. Kolff Institute for Biomedical Engineering and Materials Science-FB41, University of Groningen, University Medical Center Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands
- Correspondence: (F.A.E.K.); (P.v.R.)
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ERβ and Inflammation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1390:213-225. [DOI: 10.1007/978-3-031-11836-4_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Hases L, Indukuri R, Birgersson M, Nguyen-Vu T, Lozano R, Saxena A, Hartman J, Frasor J, Gustafsson JÅ, Katajisto P, Archer A, Williams C. Intestinal estrogen receptor beta suppresses colon inflammation and tumorigenesis in both sexes. Cancer Lett 2020; 492:54-62. [PMID: 32711097 DOI: 10.1016/j.canlet.2020.06.021] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/16/2020] [Accepted: 06/26/2020] [Indexed: 02/07/2023]
Abstract
Estrogen hormones protect against colorectal cancer (CRC) and a preventative role of estrogen receptor beta (ERβ) on CRC has been supported using full knockout animals. However, it is unclear through which cells or organ ERβ mediates this effect. To investigate the functional role of intestinal ERβ during colitis-associated CRC we used intestine-specific ERβ knockout mice treated with azoxymethane and dextran sodium sulfate, followed by ex vivo organoid culture to corroborate intrinsic effects. We explored genome-wide impact on TNFα signaling using human CRC cell lines and chromatin immunoprecipitation assay to mechanistically characterize the regulation of ERβ. Increased tumor formation in males and tumor size in females was noted upon intestine-specific ERβ knockout, accompanied by enhanced local expression of TNFα, deregulation of key NFκB targets, and increased colon ulceration. Unexpectedly, we noted especially strong effects in males. We corroborated that intestinal ERβ protects against TNFα-induced damage intrinsically, and characterized an underlying genome-wide signaling mechanism in CRC cell lines whereby ERβ binds to cis-regulatory chromatin areas of key NFκB regulators. Our results support a protective role of intestinal ERβ against colitis-associated CRC, proposing new therapeutic strategies.
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Affiliation(s)
- Linnea Hases
- Science for Life Laboratory, Department of Protein Science, KTH Royal Institute of Technology, 171 21, Solna, Sweden; Department of Biosciences and Nutrition, Karolinska Institutet, 141 83, Huddinge, Sweden
| | - Rajitha Indukuri
- Science for Life Laboratory, Department of Protein Science, KTH Royal Institute of Technology, 171 21, Solna, Sweden; Department of Biosciences and Nutrition, Karolinska Institutet, 141 83, Huddinge, Sweden
| | - Madeleine Birgersson
- Science for Life Laboratory, Department of Protein Science, KTH Royal Institute of Technology, 171 21, Solna, Sweden; Department of Biosciences and Nutrition, Karolinska Institutet, 141 83, Huddinge, Sweden
| | - Trang Nguyen-Vu
- Center for Nuclear Receptors and Cell Signaling, Department of Biology and Biochemistry, University of Houston, Houston, TX, 77204, USA
| | - Rodrigo Lozano
- Department of Biosciences and Nutrition, Karolinska Institutet, 141 83, Huddinge, Sweden
| | - Ashish Saxena
- Center for Nuclear Receptors and Cell Signaling, Department of Biology and Biochemistry, University of Houston, Houston, TX, 77204, USA
| | - Johan Hartman
- Department of Oncology and Pathology, Karolinska Institutet, 171 76, Stockholm, Sweden; Department of Clinical Pathology and Cytology, Karolinska University Laboratory, Södersjukhuset, 118 83, Stockholm, Sweden
| | - Jonna Frasor
- Department of Physiology and Biophysics, University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Jan-Åke Gustafsson
- Department of Biosciences and Nutrition, Karolinska Institutet, 141 83, Huddinge, Sweden; Center for Nuclear Receptors and Cell Signaling, Department of Biology and Biochemistry, University of Houston, Houston, TX, 77204, USA
| | - Pekka Katajisto
- Department of Biosciences and Nutrition, Karolinska Institutet, 141 83, Huddinge, Sweden
| | - Amena Archer
- Science for Life Laboratory, Department of Protein Science, KTH Royal Institute of Technology, 171 21, Solna, Sweden; Department of Biosciences and Nutrition, Karolinska Institutet, 141 83, Huddinge, Sweden
| | - Cecilia Williams
- Science for Life Laboratory, Department of Protein Science, KTH Royal Institute of Technology, 171 21, Solna, Sweden; Department of Biosciences and Nutrition, Karolinska Institutet, 141 83, Huddinge, Sweden.
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Stevanato Filho PR, Aguiar Júnior S, Begnami MD, Kuasne H, Spencer RM, Nakagawa WT, Bezerra TS, Kupper BC, Takahashi RM, Barros Filho M, Rogatto SR, Lopes A. Oestrogen receptor beta isoform expression in sporadic colorectal cancer, familial adenomatous polyposis and progressive stages of colorectal cancer. BMC Cancer 2017; 17:754. [PMID: 29132333 PMCID: PMC5683223 DOI: 10.1186/s12885-017-3688-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 10/15/2017] [Indexed: 02/08/2023] Open
Abstract
Background Among the sex hormones, oestrogen may play a role in colorectal cancer, particularly in conjunction with oestrogen receptor-β (ERβ). The expression of ERβ isoform variants and their correlations with familial adenomatous polyposis (FAP) syndrome and sporadic colorectal carcinomas are poorly described. Methods This study aimed to investigate the expression levels of the ERβ1, ERβ2, ERβ4 and ERβ5 isoform variants using quantitative RT-PCR (921 analyses) in FAP, normal mucosa, adenomatous polyps and sporadic colorectal carcinomas. Results Decreased expression of ERβ isoforms was identified in sporadic polyps and in sporadic colorectal cancer as well as in polyps from FAP syndrome patients compared with normal tissues (p < 0.001). In FAP patients, ERβ1 and ERβ5 isoforms showed significant down-expression in polyps (p < 0.001) compared with matched normal tissues. However, no differences were observed when sporadic colorectal carcinomas were compared to normal mucosa tissues. These findings suggest an association of the ERβ isoform variants in individuals affected by germline mutations of the APC gene. Progressively decreased expression of ERβ was found in polyps at early stages of low-grade dysplasia, followed by T1-T2 and T3-T4 tumours (p < 0.05). In sporadic colorectal cancer, the loss of expression was an independent predictor of recurrence, and ERβ1 and ERβ5 expression levels were associated with better disease-free survival (p = 0.002). Conclusion These findings may provide a better understanding of oestrogens and their potential preventive and therapeutic effects on sporadic colorectal cancer and cancers associated with FAP syndrome. Electronic supplementary material The online version of this article (10.1186/s12885-017-3688-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Paulo Roberto Stevanato Filho
- Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil. .,Colorectal Tumor Nucleus of the A.C. Camargo Cancer Center, R. Professor Antônio Prudente, 211 Liberdade, São Paulo, São Paulo, SP, CEP 01509-010, Brazil.
| | - Samuel Aguiar Júnior
- Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil
| | | | - Hellen Kuasne
- CIPE - International Center for Research, A. C. Camargo Cancer Center, São Paulo, Brazil.,Department of Clinical Genetics, Vejle Sygehus, Vejle and Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Ranyell Matheus Spencer
- Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil
| | - Wilson Toshihiko Nakagawa
- Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil
| | - Tiago Santoro Bezerra
- Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil
| | - Bruna Catin Kupper
- Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil
| | - Renata Maymi Takahashi
- Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil
| | - Mateus Barros Filho
- CIPE - International Center for Research, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Silvia Regina Rogatto
- CIPE - International Center for Research, A. C. Camargo Cancer Center, São Paulo, Brazil.,Department of Clinical Genetics, Vejle Sygehus, Vejle and Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Ademar Lopes
- Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil
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Stevanato Filho PR, Aguiar Júnior S, Begnami MD, Ferreira FDO, Nakagawa WT, Spencer RMSB, Bezerra TS, Boggiss PE, Lopes A. Estrogen Receptor β as a Prognostic Marker of Tumor Progression in Colorectal Cancer with Familial Adenomatous Polyposis and Sporadic Polyps. Pathol Oncol Res 2017; 24:533-540. [PMID: 28681123 DOI: 10.1007/s12253-017-0268-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 06/22/2017] [Indexed: 02/06/2023]
Abstract
The incidence of colorectal cancer (CRC) is lower in women than in men, and sex steroids can be considered contributing factors because oral contraception usage and estrogen replacement therapy are associated with decreased risk. Conversely, colorectal polyp development in familial adenomatous polyposis (FAP) begins during puberty. The objectives were to evaluate the relationship between the expression of these hormone receptors and adenoma-carcinoma progression, CRC stage and overall survival. We studied 120 A.C. Camargo Cancer Center patients diagnosed with either FAP-associated or spontaneous adenomatous polyps or CRC to determine the immunohistochemical expression levels of estrogen receptor (ER)-α, ER-β and the progesterone and androgen receptors (480 analyses). The ER-β expression levels differed between the groups: the group with FAP polyps had lower ER-β expression than that of the sporadic polyp group. With transformation of the sporadic polyps to cancer, there was a considerable decrease in ER-β expression (from 90% with strong expression to 80% with absent or weak expression) (p < 0.001). The ER-β expression was lower in T3/T4 tumors than in T1/T2 tumors (p = 0.015). The 5-year overall survival of CRC patients positively expressing ER-β exceeded that of patients without detectable expression levels (74.8% vs. 44.3%, respectively; p = 0.035). There was no significant expression of the androgen or progesterone receptor or ER-α among the groups. Differences in ER-β expression represent a potential mechanism through which estrogen might alter the susceptibility to colon cancer, thereby confirming the possibility of a protective role of estrogen against colorectal carcinogenesis.
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Affiliation(s)
- Paulo Roberto Stevanato Filho
- Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, R. Professor Antônio Prudente, 211 Liberdade, São Paulo CEP, São Paulo, SP, 01509-010, Brazil.
| | - Samuel Aguiar Júnior
- Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, R. Professor Antônio Prudente, 211 Liberdade, São Paulo CEP, São Paulo, SP, 01509-010, Brazil
| | | | - Fábio de Oliveira Ferreira
- Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, R. Professor Antônio Prudente, 211 Liberdade, São Paulo CEP, São Paulo, SP, 01509-010, Brazil
| | - Wilson Toshihiko Nakagawa
- Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, R. Professor Antônio Prudente, 211 Liberdade, São Paulo CEP, São Paulo, SP, 01509-010, Brazil
| | - Ranyell Matheus Sobreira Batista Spencer
- Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, R. Professor Antônio Prudente, 211 Liberdade, São Paulo CEP, São Paulo, SP, 01509-010, Brazil
| | - Tiago Santoro Bezerra
- Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, R. Professor Antônio Prudente, 211 Liberdade, São Paulo CEP, São Paulo, SP, 01509-010, Brazil
| | - Philip Edward Boggiss
- Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, R. Professor Antônio Prudente, 211 Liberdade, São Paulo CEP, São Paulo, SP, 01509-010, Brazil
| | - Ademar Lopes
- Colorectal Tumor Nucleus of the Pelvic Surgery Department, A.C. Camargo Cancer Center, R. Professor Antônio Prudente, 211 Liberdade, São Paulo CEP, São Paulo, SP, 01509-010, Brazil
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Davidson BA, Moorman PG. Risk-benefit assessment of the combined oral contraceptive pill in women with a family history of female cancer. Expert Opin Drug Saf 2014; 13:1375-82. [PMID: 25146351 DOI: 10.1517/14740338.2014.951327] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Oral contraceptive pills (OCPs) are the most frequently used form of effective, reversible contraception among women of childbearing potential. In the average risk population, OCPs may offer a protective benefit against ovarian, endometrial and colorectal malignancies. In women at high risk for breast, ovarian, endometrial or colorectal malignancies, the risk-benefit profile is less well studied. AREAS COVERED In this article, we review pertinent literature on the use of OCPs in patients with genetic susceptibilities due to mutations in BRCA1, BRCA2 or mismatch repair genes implicated in hereditary nonpolyposis colorectal cancer as well as those with a strong family history of malignancies associated with these syndromes. EXPERT OPINION For women at high risk for ovarian, endometrial and/or colorectal malignancies due to genetic susceptibilities or a strong family history, the possibility of chemoprevention with OCPs may be an attractive option; however, the potential increase in breast cancer, although small, must be considered in clinical decision-making. The ultimate decision to use OCPs in a high-risk woman should be based on a consideration of her specific genetic risk, her age, her reproductive plans and her willingness to consider surgical prophylaxis options.
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Affiliation(s)
- Brittany Anne Davidson
- Duke University Medical Center, Division of Gynecologic Oncology , DUMC 3079, Durham, NC 27710 , USA
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Sereno M, Aguayo C, Guillén Ponce C, Gómez-Raposo C, Zambrana F, Gómez-López M, Casado E. Gastric tumours in hereditary cancer syndromes: clinical features, molecular biology and strategies for prevention. Clin Transl Oncol 2012; 13:599-610. [PMID: 21865131 DOI: 10.1007/s12094-011-0705-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Gastric cancer is the major cause of cancer-related deaths worldwide. The majority of them are classified as sporadic, whereas the remaining 10% exhibit familial clustering. Hereditary diffuse gastric cancer (HDGC) syndrome is the most important condition that leads to hereditary gastric cancer. However, other hereditary cancer syndromes, such as hereditary non-polyposis colorectal cancer, familial adenomatous polyposis, Peutz-Jeghers syndrome, Li-Fraumeni syndrome and hereditary breast and ovarian cancer, entail a higher risk compared to the general population for developing this kind of neoplasia. In this review, we describe briefly the most important aspects related to clinical features, molecular biology and strategies for prevention in hereditary gastric associated to different cancer syndromes.
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Affiliation(s)
- María Sereno
- Medical Oncology Department, Infanta Sofía University Hospital, San Sebastián de los Reyes, Madrid, Spain.
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Heijmans J, Muncan V, Jacobs RJ, de Jonge-Muller ESM, Graven L, Biemond I, Ederveen AG, Groothuis PG, Mosselman S, Hardwick JC, Hommes DW, van den Brink GR. Intestinal tumorigenesis is not affected by progesterone signaling in rodent models. PLoS One 2011; 6:e22620. [PMID: 21818351 PMCID: PMC3144908 DOI: 10.1371/journal.pone.0022620] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Accepted: 06/26/2011] [Indexed: 01/06/2023] Open
Abstract
Clinical data suggest that progestins have chemopreventive properties in the development of colorectal cancer. We set out to examine a potential protective effect of progestins and progesterone signaling on colon cancer development. In normal and neoplastic intestinal tissue, we found that the progesterone receptor (PR) is not expressed. Expression was confined to sporadic mesenchymal cells. To analyze the influence of systemic progesterone receptor signaling, we crossed mice that lacked the progesterone receptor (PRKO) to the ApcMin/+ mouse, a model for spontaneous intestinal polyposis. PRKO-ApcMin/+mice exhibited no change in polyp number, size or localization compared to ApcMin/+. To examine effects of progestins on the intestinal epithelium that are independent of the PR, we treated mice with MPA. We found no effects of either progesterone or MPA on gross intestinal morphology or epithelial proliferation. Also, in rats treated with MPA, injection with the carcinogen azoxymethane did not result in a difference in the number or size of aberrant crypt foci, a surrogate end-point for adenoma development. We conclude that expression of the progesterone receptor is limited to cells in the intestinal mesenchyme. We did not observe any effect of progesterone receptor signaling or of progestin treatment in rodent models of intestinal tumorigenesis.
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Affiliation(s)
- Jarom Heijmans
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
- Tytgat Institute for Liver and Intestinal Research, Academic Medical Center, Amsterdam, The Netherlands
- * E-mail: (JH); (GRvdB)
| | - Vanesa Muncan
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
- Tytgat Institute for Liver and Intestinal Research, Academic Medical Center, Amsterdam, The Netherlands
| | - Rutger J. Jacobs
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Laura Graven
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Izak Biemond
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Antwan G. Ederveen
- Merck, Sharpe and Dohme, Women's Health Department, Oss, The Netherlands
| | | | - Sietse Mosselman
- Merck, Sharpe and Dohme, Women's Health Department, Oss, The Netherlands
| | - James C. Hardwick
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Daniel W. Hommes
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Gijs R. van den Brink
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
- Tytgat Institute for Liver and Intestinal Research, Academic Medical Center, Amsterdam, The Netherlands
- Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
- * E-mail: (JH); (GRvdB)
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Power DG, Gloglowski E, Lipkin SM. Clinical genetics of hereditary colorectal cancer. Hematol Oncol Clin North Am 2011; 24:837-59. [PMID: 20816577 DOI: 10.1016/j.hoc.2010.06.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Colorectal cancer (CRC) is a common disease, and approximately 25% of patients have a familial component. High-penetrance singlegene germline mutations conferring a true hereditary susceptibility account for around 5% to 6% of all cases. Lynch syndrome is the most common hereditary form of colorectal cancer. Much of the hereditary component in the remaining familial cases of CRC is likely polygenic, and many of the genetic changes involved are as yet unidentified. This article addresses the most clinically important CRC genetic syndromes.
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Affiliation(s)
- Derek G Power
- Clinical Genetics, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
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Half E, Bercovich D, Rozen P. Familial adenomatous polyposis. Orphanet J Rare Dis 2009; 4:22. [PMID: 19822006 PMCID: PMC2772987 DOI: 10.1186/1750-1172-4-22] [Citation(s) in RCA: 336] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2009] [Accepted: 10/12/2009] [Indexed: 02/06/2023] Open
Abstract
Familial adenomatous polyposis (FAP) is characterized by the development of many tens to thousands of adenomas in the rectum and colon during the second decade of life. FAP has an incidence at birth of about 1/8,300, it manifests equally in both sexes, and accounts for less than 1% of colorectal cancer (CRC) cases. In the European Union, prevalence has been estimated at 1/11,300-37,600. Most patients are asymptomatic for years until the adenomas are large and numerous, and cause rectal bleeding or even anemia, or cancer develops. Generally, cancers start to develop a decade after the appearance of the polyps. Nonspecific symptoms may include constipation or diarrhea, abdominal pain, palpable abdominal masses and weight loss. FAP may present with some extraintestinal manifestations such as osteomas, dental abnormalities (unerupted teeth, congenital absence of one or more teeth, supernumerary teeth, dentigerous cysts and odontomas), congenital hypertrophy of the retinal pigment epithelium (CHRPE), desmoid tumors, and extracolonic cancers (thyroid, liver, bile ducts and central nervous system). A less aggressive variant of FAP, attenuated FAP (AFAP), is characterized by fewer colorectal adenomatous polyps (usually 10 to 100), later age of adenoma appearance and a lower cancer risk. Some lesions (skull and mandible osteomas, dental abnormalities, and fibromas on the scalp, shoulders, arms and back) are indicative of the Gardner variant of FAP. Classic FAP is inherited in an autosomal dominant manner and results from a germline mutation in the adenomatous polyposis (APC) gene. Most patients (~70%) have a family history of colorectal polyps and cancer. In a subset of individuals, a MUTYH mutation causes a recessively inherited polyposis condition, MUTYH-associated polyposis (MAP), which is characterized by a slightly increased risk of developing CRC and polyps/adenomas in both the upper and lower gastrointestinal tract. Diagnosis is based on a suggestive family history, clinical findings, and large bowel endoscopy or full colonoscopy. Whenever possible, the clinical diagnosis should be confirmed by genetic testing. When the APC mutation in the family has been identified, genetic testing of all first-degree relatives should be performed. Presymptomatic and prenatal (amniocentesis and chorionic villous sampling), and even preimplantation genetic testing is possible. Referral to a geneticist or genetic counselor is mandatory. Differential diagnoses include other disorders causing multiple polyps (such as Peutz-Jeghers syndrome, familial juvenile polyps or hyperplastic polyposis, hereditary mixed polyposis syndromes, and Lynch syndrome). Cancer prevention and maintaining a good quality of life are the main goals of management and regular and systematic follow-up and supportive care should be offered to all patients. By the late teens or early twenties, colorectal cancer prophylactic surgery is advocated. The recommended alternatives are total proctocolectomy and ileoanal pouch or ileorectal anastomosis for AFAP. Duodenal cancer and desmoids are the two main causes of mortality after total colectomy, they need to be identified early and treated. Upper endoscopy is necessary for surveillance to reduce the risk of ampullary and duodenal cancer. Patients with progressive tumors and unresectable disease may respond or stabilize with a combination of cytotoxic chemotherapy and surgery (when possible to perform). Adjunctive therapy with celecoxib has been approved by the US Food and Drug Administration and the European Medicines Agency in patients with FAP. Individuals with FAP carry a 100% risk of CRC; however, this risk is reduced significantly when patients enter a screening-treatment program.
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Affiliation(s)
- Elizabeth Half
- Familial Cancer Clinic, Gastroenterology Dept, Meir Hospital, Kfar Saba, Israel.
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Bosetti C, Bravi F, Negri E, La Vecchia C. Oral contraceptives and colorectal cancer risk: a systematic review and meta-analysis. Hum Reprod Update 2009; 15:489-98. [DOI: 10.1093/humupd/dmp017] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Di Leo A, Barone M, Maiorano E, Tanzi S, Piscitelli D, Marangi S, Lofano K, Ierardi E, Principi M, Francavilla A. ER-beta expression in large bowel adenomas: implications in colon carcinogenesis. Dig Liver Dis 2008; 40:260-6. [PMID: 18093886 DOI: 10.1016/j.dld.2007.10.018] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2007] [Revised: 10/27/2007] [Accepted: 10/29/2007] [Indexed: 02/07/2023]
Abstract
BACKGROUND A pivotal role of oestrogen receptor-beta has been suggested in colon carcinogenesis in humans. However, few data are available on oestrogen receptor-beta in colorectal pre-cancerous lesions. AIM In the present study, we evaluated oestrogen receptor-beta expression and its possible correlation with proliferative activity and apoptosis in colorectal adenomas and normal colon tissue. PATIENTS/METHODS Adenomatous tissue from 25 patients with colonic polyps, and normal tissue from 25 controls were used. Oestrogen receptor-beta expression, colonocyte proliferation (expressed as PCNA positivity) and apoptosis were evaluated. RESULTS In adenomatous tissue, a significant reduction of oestrogen receptor-beta was observed compared to normal mucosa (10.1+/-5.5% vs. 44.2+/-13.7; p<0.03), while the expression of oestrogen receptor-alpha remained unvaried. Cell proliferative activity significantly increased in adenomatous tissue compared to normal mucosa (59.3+/-7.1 vs. 18.5+/-8.8; p<0.0001), doubling the PCNA/apoptosis ratio. An inverse correlation was found between oestrogen receptor-beta and PCNA expression in adenomas (r=-0.81), a datum confirmed by confocal microscopy evaluation. CONCLUSIONS Our data demonstrate, for the first time, a significant reduction of oestrogen receptor-beta expression already in the pre-cancerous phase of colon carcinogenesis. This suggests a role of selective oestrogen receptor-beta agonists in the prevention of colorectal cancer.
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Affiliation(s)
- A Di Leo
- Section of Gastroenterology, Department of Emergency and Organ Transplantation (D.E.T.O.), Bari, Italy.
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Barone M, Tanzi S, Lofano K, Scavo MP, Guido R, Demarinis L, Principi MB, Bucci A, Di Leo A. Estrogens, phytoestrogens and colorectal neoproliferative lesions. GENES & NUTRITION 2008; 3:7-13. [PMID: 18850193 PMCID: PMC2311500 DOI: 10.1007/s12263-008-0081-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Epidemiological and experimental studies suggest a protective role of estrogens against colorectal cancer. This effect seems to be mediated by their binding to estrogen receptor beta (ER-beta), one of the two estrogen receptors with high affinity for these hormones. Very recently, the demonstration of an involvement of ER-beta in the development of adenomatous polyps of the colon has also been documented, suggesting the use of selective ER-beta agonists in primary colorectal cancer prevention. Phytoestrogens are plant-derived compounds that structurally and functionally act as estrogen-agonists in mammals. They are characterized by a higher binding affinity to ER-beta as compared to estrogen receptor alpha (ER-alpha), the other estrogen receptor subtype. These biological characteristics explain why the administration of phytoestrogens does not produce the classical side effects associated to estrogen administration (cerebro- and cardio-vascular accidents, higher incidence of endometrial and breast cancer) and makes these substances ideal candidates for the prevention of colorectal cancer.
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Affiliation(s)
- Michele Barone
- Facolta’ di Medicina e Chirurgia, Universita’ di Bari, Bari, Italy
| | - Sabina Tanzi
- Facolta’ di Medicina e Chirurgia, Universita’ di Bari, Bari, Italy
| | - Katia Lofano
- Facolta’ di Medicina e Chirurgia, Universita’ di Bari, Bari, Italy
| | | | - Raffaella Guido
- Facolta’ di Medicina e Chirurgia, Universita’ di Bari, Bari, Italy
| | - Lucia Demarinis
- Facolta’ di Medicina e Chirurgia, Universita’ di Bari, Bari, Italy
| | | | | | - Alfredo Di Leo
- Facolta’ di Medicina e Chirurgia, Universita’ di Bari, Bari, Italy
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Berkhout M, Roelofs HMJ, te Morsche RHM, Dekker E, van Krieken JHJM, Nagengast FM, Peters WHM. Detoxification enzyme polymorphisms are not involved in duodenal adenomatosis in familial adenomatous polyposis. Br J Surg 2007; 95:499-505. [DOI: 10.1002/bjs.6027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Background
Patients with familial adenomatous polyposis (FAP) are at high risk of developing duodenal adenomas and carcinomas. Besides germline mutations in the adenomatous polyposis coli (APC) gene, additional factors may influence the age of onset and number of duodenal adenomas. This study compared the genotype distributions of duodenal detoxification enzyme isoforms in patients with FAP and controls.
Methods
The study included 85 patients with FAP and 218 healthy age- and sex-matched controls. Genotyping of all participants using polymerase chain reaction was performed to detect polymorphisms in isoforms of uridine 5′-diphosphate glucuronosyltransferases (UGTs) and glutathione S-transferases (GSTs): UGT1A1, UGT1A3, UGT1A4, UGT1A6, UGT1A10, UGT2B4, UGT2B7, UGT2B15, GSTA1, GSTP1, GSTM1 and GSTT1.
Results
The variant genotypes of UGT1A3 were less common in patients with FAP than in controls (odds ratio 0·39 (95 per cent confidence interval 0·22 to 0·67)). There were no associations between FAP and the other polymorphic genes. The polymorphisms investigated had no predictive value for the severity of duodenal adenomatosis in patients with FAP.
Conclusion
Although the variant genotypes of UGT1A3 were less common in patients with FAP than in those without, this did not modulate the severity of duodenal adenomatosis.
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Affiliation(s)
- M Berkhout
- Department of Gastroenterology, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - H M J Roelofs
- Department of Gastroenterology, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - R H M te Morsche
- Department of Gastroenterology, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - E Dekker
- Department of Gastroenterology, Academic Medical Centre, Amsterdam, The Netherlands
| | - J H J M van Krieken
- Department of Pathology, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - F M Nagengast
- Department of Gastroenterology, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - W H M Peters
- Department of Gastroenterology, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands
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