Nutritional Agents with Anti-lnflammatory Properties in Chemoprevention of Colorectal Neoplasia
The strong link between inflammation and colorectal carcinogenesis provides the rationale for using anti-inflammatory agents for chemoprevention of colorectal cancer (CRC). Several naturally occurring substances with anti-inflammatory properties, used in a purified ‘nutraceutical’ form, including omega-3 polyunsaturated fatty acids (PUFAs) such as eicosapentaenoic acid (EPA) and polyphenols such as curcumin and resveratrol, have been demonstrated to have anti-CRC activity in preclinical models. As expected, these agents have an excellent safety and tolerability profile in Phase II clinical trials. Phase III randomized clinical trials of these naturally occurring substances are now beginning to be reported. The omega-3 polyunsaturated fatty acid EPA, in the free fatty acid (FFA) form, has been demonstrated to reduce adenomatous polyp number and size in patients with familial adenomatous polyposis (FAP), a finding which has prompted evaluation of this formulation of EPA for prevention of ‘sporadic’ colorectal neoplasia. Anti-inflammatory ‘nutraceuticals’ require further clinical evaluation in polyp prevention trials as they exhibit many of the characteristics of the ideal cancer chemoprevention agent, including safety, tolerability and patient acceptability.
KeywordsFamilial Adenomatous Polyposis Dextran Sodium Sulphate Colorectal Adenoma Aberrant Crypt Focus Familial Adenomatous Polyposis Patient
Work in the Hull laboratory is funded by the National Institute for Health Research Efficacy & Mechanism Evaluation Programme, Yorkshire Cancer Research and an unrestricted Scientific Grant from SLA Pharma (UK).
Conflict of Interest Statement
Mark Hull has received an unrestricted Scientific Grant and a travel grant for conference travel from SLA Pharma (UK), which produces the ω-3 PUFA EPA, in the free fatty acid form.
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