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Int. J. Mol. Sci. 2018, 19(1), 166; https://doi.org/10.3390/ijms19010166

Could Aspirin and Diets High in Fiber Act Synergistically to Reduce the Risk of Colon Cancer in Humans?

1
Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA
2
Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
3
Department of Pathology, John Hopkins University, Baltimore, MD 21218, USA
4
Department of Pathology, The Ohio State University, Columbus, Ohio 43210, USA
5
Center for Biostatistics, The Ohio State University, Columbus, Ohio 43210, USA
6
Division of Hematology, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center and The James Cancer Hospital, The Ohio State University, Columbus, OH 43210, USA
7
Department of Surgery, The Ohio State University, Columbus, OH 43210, USA
*
Author to whom correspondence should be addressed.
Received: 11 December 2017 / Revised: 30 December 2017 / Accepted: 4 January 2018 / Published: 6 January 2018
View Full-Text   |   Download PDF [218 KB, uploaded 6 January 2018]   |  

Abstract

Early inhibition of inflammation suppresses the carcinogenic process. Aspirin is the most commonly used non-steroid anti-inflammatory drugs (NSAIDs), and it irreversibly inhibits cyclooxygenase-1 and -2 (COX1, COX2). Multiple randomized clinical trials have demonstrated that aspirin offers substantial protection from colon cancer mortality. The lower aspirin doses causing only minimal gastrointestinal disturbance, ideal for long-term use, can achieve only partial and transitory inhibition of COX2. Aspirin’s principal metabolite, salicylic acid, is also found in fruits and vegetables that inhibit COX2. Other phytochemicals such as curcumin, resveratrol, and anthocyanins also inhibit COX2. Such dietary components are good candidates for combination with aspirin because they have little or no toxicity. However, obstacles to using phytochemicals for chemoprevention, including bioavailability and translational potential, must be resolved. The bell/U-shaped dose–response curves seen with vitamin D and resveratrol might apply to other phytochemicals, shedding doubt on ‘more is better’. Solutions include: (1) using special delivery systems (e.g., nanoparticles) to retain phytochemicals; (2) developing robust pharmacodynamic biomarkers to determine efficacy in humans; and (3) selecting pharmacokinetic doses relevant to humans when performing preclinical experiments. The combination of aspirin and phytochemicals is an attractive low-cost and low-toxicity approach to colon cancer prevention that warrants testing, particularly in high-risk individuals. View Full-Text
Keywords: human clinical trials; aspirin; salicylic acid; cyclooxygenase 2; fruits and vegetables; phytochemicals; synergy; bell/U-shaped; cancer prevention human clinical trials; aspirin; salicylic acid; cyclooxygenase 2; fruits and vegetables; phytochemicals; synergy; bell/U-shaped; cancer prevention
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Pan, P.; Huang, Y.-W.; Oshima, K.; Yearsley, M.; Zhang, J.; Yu, J.; Arnold, M.; Wang, L.-S. Could Aspirin and Diets High in Fiber Act Synergistically to Reduce the Risk of Colon Cancer in Humans? Int. J. Mol. Sci. 2018, 19, 166.

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