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Can resistant starch and/or aspirin prevent the development of coloi neoplasia? The Concerted Action Polyp Prevention (CAPP) 1 Study

Lookup NU author(s): Professor John Mathers, Dr Ian Mickleburgh, Professor Sir John Burn

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Abstract

Loss of function of the adenomatous polyposis coli (APC) tumour suppressor gene through truncating mutations or other means is an early event in most colo-rectal cancer (CRC). The AFC gene encodes a large multifunctional protein that plays key roles in several cellular processes, including the wnt signalling pathway where an intact APC protein is essential for down regulation of β-catenin. The APC protein also plays a role in regulation of cell proliferation, differentiation, apoptosis, cell-cell adhesion, cell migration and chromosomal stability during mitosis. Acquisition of a non-functional APC gene can occur by inheritance (in the disease familial adenomatous polyposis (FAP)) or by a sporadic event in a somatic cell. Whilst there is strong epidemiological evidence that variation in diet is a major determinant of variation in CRC incidence, conventional adenoma recurrence trials in sporadic cases of the disease have been relatively unsuccessful in identifying potentially protective food components. Since the genetic basis of CRC in FAP and in sporadic CRC is similar, intervention trials in FAP gene carriers provide an attractive strategy for investigation of potential chemo-preventive agents, since smaller numbers of subjects and shorter time frames are needed. The Concerted Action Polyp Prevention (CAPP) 1 Study is using a 2×2 factorial design to test the efficacy of resistant starch (30 g raw potato starch-Hylon VII (1:1, w/w)/d) and aspirin (600 mg/d) in suppressing colo-rectal adenoma formation in young subjects with FAP. Biopsies of macroscopically-normal rectal mucosa are also being collected for assay of putative biomarkers of CRC risk.


Publication metadata

Author(s): Mathers JC, Mickleburgh I, Chapman PC, Bishop DT, Burn J

Publication type: Article

Publication status: Published

Journal: Proceedings of the Nutrition Society

Year: 2003

Volume: 62

Issue: 1

Pages: 51-72

Print publication date: 01/02/2003

Online publication date: 05/03/2007

ISSN (print): 0029-6651

ISSN (electronic): 1475-2719

Publisher: Cambridge University Press

URL: http://dx.doi.org/10.1079/PNS2002236

DOI: 10.1079/PNS2002236


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