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Nonsteroidal anti-inflammatory drugs, apoptosis, and colorectal adenomas

Christopher Martin1, Alexandra Connelly, Temitope O Keku

  • 1Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, 27599, USA.

Gastroenterology
|November 28, 2002
PubMed
Abstract

Insights

Regular nonsteroidal anti-inflammatory drug (NSAID) use and increased apoptosis in rectal mucosa are linked to a lower risk of adenomas. These factors appear to independently reduce adenoma prevalence, suggesting a broad protective effect.

Area of Science:

  • Gastroenterology
  • Molecular Biology
  • Oncology

Background:

  • Observational studies suggest nonsteroidal anti-inflammatory drugs (NSAIDs) decrease colorectal neoplasia risk.
  • The underlying mechanism may involve modulation of apoptotic activity in colonic mucosa.

Purpose of the Study:

  • To investigate the association between NSAID use, adenomatous polyps, and apoptosis in normal rectal mucosa.
  • To assess if NSAID use and apoptosis are independent risk factors for adenomas.

Main Methods:

  • Colonoscopy patients (n=719) with adenomas (n=226) and controls (n=493) were analyzed.
  • Biopsy specimens of rectal mucosa were assessed for apoptosis and proliferation.
  • Regression analyses were used to determine odds ratios (ORs) for adenoma risk.

Main Results:

  • Regular NSAID users had a significantly lower likelihood of adenomas (OR 0.4).
  • Higher rectal mucosal apoptosis was strongly associated with reduced adenoma prevalence (OR 0.12).
  • NSAID use and apoptotic activity were not correlated; proliferation was unrelated to adenomas or NSAID use.

Conclusions:

  • NSAID use and elevated mucosal apoptosis are independently associated with lower adenoma prevalence.
  • The findings suggest a significant field effect for apoptosis in the colon.

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