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

Proc Nutr Soc

Human Nutrition Research Centre, School of Clinical Medical Sciences, University of Newcastle, Newcastle upon Tyne NE1 7RU, UK.

Published: February 2003

AI Article Synopsis

  • Loss of function in the APC tumor suppressor gene is a critical early step in the development of most colorectal cancers (CRC) and impacts various cellular processes, particularly the regulation of the Wnt signaling pathway and beta-catenin.
  • APC gene mutations can occur through inheritance, as seen in familial adenomatous polyposis (FAP), or as random mutations in somatic cells.
  • The CAPP 1 Study is exploring potential chemo-preventive agents, specifically resistant starch and aspirin, in reducing colorectal adenoma formation among young FAP carriers, while also analyzing rectal mucosa biopsies for CRC risk biomarkers.

Article 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 APC 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 beta-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 x 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.

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http://dx.doi.org/10.1079/PNS2002236DOI Listing

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