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Ulcerative colitis: From inflammation to cancer. Do estrogen receptors have a role?

World Journal of Gastroenterology 2014年第33期20卷 11496-11504页

作者： Mariabeatrice Principi Michele Barone Maria Pricci Nicola De Tullio Giuseppe Losurdo Enzo Ierardi Alfredo Di Leo Division of Gastroenterology Department of Emergency and Organ Transplantation University of Bari 70124 Bari Italy Division of Gastroenterology Department of Medical and Surgical Sciences University of Foggia 71100 Foggia Italy

Ulcerative colitis(UC) is a condition at increased risk for colorectal carcinoma(CRC) development. Nowadays, screening and follow-up programs are routinely performed worldwide to promote the early detection of CRCs in subjects with well known risk factors(extent, duration and severity of the disorder). The diffusion of these procedures is presumably the main reason for the marked reduction of cancer incidence and mortality in the course of UC. In addition, chemoprevention has been widely investigated and developed in many medical fields, and aspirin has shown a preventive effect against CRC, while mesalazine has been strongly invoked as a potential chemopreventive agent in UC. However, available studies show some limitations due to the obvious ethical implications of drug withdrawal in UC in order to design a control group. The estrogenreceptors(ER) alpha/beta balance seems to have a relevant influence on colorectal carcinogenesis and ER beta appears to parallel apoptosis, and hence an anticarcinogenic effect. Phytoestrogens are compounds acting as ER beta agonists and have shown a promising chemopreventive effect on sporadic as well as genetically inherited CRC. There is evidence suggesting a role for ERs in UC-related carcinogenesis. In this perspective, since these substances can be considered as dietary supplements and are completely free from side effects, phytoestrogens could be an interesting option for CRC prevention, even when the disease is a consequence of long-term chronic inflammation, as in the course of UC. Further studies of their effects are warranted in both the basic research and clinical fields.

关键词： Ulcerative colitis Epithelial dysplasia Colorectal cancer Estrogen receptors chemopreven-tion Phytoestrogens Dietary supplementation Inflam-matory bowel disease

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