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
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Abstract
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 antiinflammatory 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. Antiinflammatory ‘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.
M. A. Hull (&) Section of Molecular Gastroenterology, Leeds Institute of Molecular Medicine, St James’s University Hospital, Beckett Street Leeds, West Yorkshire LS9 7TF, UK e-mail: [email protected]
A. T. Chan and E. Detering (eds.), Prospects for Chemoprevention of Colorectal Neoplasia, Recent Results in Cancer Research 191, DOI: 10.1007/978-3-642-30331-9_8, Ó Springer-Verlag Berlin Heidelberg 2013
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Contents 1 Naturally Occurring Substances Used as Pharmaceutical Preparations—‘Nutraceuticals’............................................................................................ 2 Anti-inflammatory Agents for Prevention and Treatment of CRC................................... 3 Anti-inflammatory Nutraceuticals with Evidence of Anti-CRC Activity ......................... 3.1 Omega-3 PUFAs......................................................................................................... 3.2 Curcumin .................................................................................................................... 3.3 Resveratrol .................................................................................................................. 3.4 Other Dietary Polyphenols ......................................................................................... 3.5 Other Natural Anti-inflammatory Agents with CRC Chemopreventative Efficacy ...................................................................................... 4 Summary .............................................................................................................................. References..................................................................................................................................
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