A Presurgical Study of Curcumin Combined with Anthocyanin Supplements in Patients with Colorectal Adenomatous Polyps.

Irene Maria Briata,Mariangela Rutigliani,Mauro Dalla Libera,Paola Romagnoli,Andrea Decensi,Massimo Oppezzi,Giacomo Siri,Karen Brown,Matteo Puntoni,Laura Paleari,Raj Singh,Lynne Howells,Marilena Petrera,Silvia Caviglia,Matteo Lazzeroni

doi:10.3390/ijms222011024

Abstract

Adenomatous polyps are precancerous lesions associated with a higher risk of colorectal cancer (CRC). Curcumin and anthocyanins have shown promising CRC-preventive activity in preclinical and epidemiological studies. The objective of this window-of-opportunity, proof-of principle trial was to evaluate the effect of curcumin combined with anthocyanin supplements on tissue biomarkers of colorectal adenomatous polyps. Eligible patients received either anthocyanin and curcumin supplementation or related matching placebo for 4–6 weeks before polyp removal. Adenomatous polyps and adjacent tissue biopsies were collected at baseline and after supplementation for immunohistochemical assessment of β-catenin, NF-kappa B (NF-κB), Ki-67, P53, and dysplasia. No differences were observed in baseline biomarker expression between normal and dysplastic tissues. The combination of anthocyanins and curcumin resulted in a significant borderline reduction of NF-κB immunohistochemistry (IHC) expression in adenoma tissue (geometric mean ratio (GMR): 0.72; 95% confidence interval (CI): 0.51–1.00; p-value: 0.05) and a trend to a reduction of Ki-67 (GMR: 0.73; 95% CI: 0.50–1.08; p-value: 0.11). No significant modulation of biomarkers in normal adjacent mucosa was observed. We concluded that the combined supplementation of anthocyanins and curcumin seems to lead to a potentially favorable modulation of tissue biomarkers of inflammation and proliferation in colon adenomas.

Highlights

Colorectal cancer (CRC) is the second most commonly diagnosed malignancy and one of the main causes of cancer death in both men and women [1]
We investigated the effect of the combination of anthocyanins with curcumin phospholipids formulation on the modulation of tissue biomarkers in patients with the precancerous lesion of the colorectal tract
We found that the combined concomitant supplementation resulted in a possibly favorable modulation of NF-κB and Ki-67 in colorectal adenomas, suggesting that both inflammation and proliferation are moderately inhibited by the combination

Summary

Introduction

Colorectal cancer (CRC) is the second most commonly diagnosed malignancy and one of the main causes of cancer death in both men and women [1]. The main risk factors are age, family history, the presence of adenomatous polyps (APs), diffuse polyps, and the presence of hereditary conditions such as Lynch syndrome or familial adenomatous polyp (FAP) syndromes. APs are present in approximately one-half to two-thirds of patients diagnosed with colorectal polyps. APs are precancerous lesions associated with a higher risk of CRC, the advanced ones (≥1 cm in diameter, villous histology, or high-grade dysplasia) with or without multiplicity (>3 adenomas) [2]. The adenoma–carcinoma progression happens over approximately 10 years; APs are considered a reliable intermediate marker (surrogate) of risk and efficacy for chemoprevention studies [3]

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