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Los antiinflamatorios no esteroideos y la carcinogénesis molecular de los carcinomas colorrectales
G Huls1, J J Koornstra, J H Kleibeuker
1Department of Internal Medicine, University Hospital Groningen, Groningen, Netherlands. g.huls@int.azg.nl <g.huls@int.azg.nl>
Lancet (London, England)
|July 30, 2003
Resumen
Los antiinflamatorios no esteroideos (AINE), incluida la aspirina, muestran efectos quimiopreventivos moderados contra el cáncer colorrectal en individuos con riesgo intermedio. Se necesita más investigación para comprender los mecanismos moleculares, como el papel de p21, en la prevención del cáncer mediada por AINE.
Área de la Ciencia:
- Oncología Oncología.
- Gastroenterología y Gastroenterología.
- Farmacología Farmacología.
Sus antecedentes:
- El cáncer colorrectal es una de las principales causas de mortalidad por cáncer, lo que requiere estrategias efectivas de prevención.
- Los antiinflamatorios no esteroideos (AINE) demuestran propiedades quimiopreventivas contra el cáncer colorrectal.
- Estudios previos muestran que los AINE como el sulindac y el celecoxib son efectivos en pacientes con poliposis adenomatosa familiar.
Objetivo del estudio:
- Evaluar los efectos quimiopreventivos de la aspirina en poblaciones con riesgo intermedio de cáncer colorrectal.
- Explorar los posibles mecanismos moleculares subyacentes a la quimioprevención del cáncer colorrectal mediada por AINE.
Principales métodos:
- Análisis de dos ensayos aleatorizados controlados con placebo que investigaban el efecto de la aspirina en la recurrencia del adenoma colorrectal.
- Revisión de estudios in vitro, animales, epidemiológicos y de intervención sobre los mecanismos de los AINE.
Principales resultados:
- La aspirina (325 mg al día) redujo el riesgo de adenoma recurrente en un 35% en pacientes con cáncer colorrectal previo.
- Las dosis más bajas de aspirina (81 mg) también mostraron una tendencia hacia una menor incidencia de adenoma en comparación con el placebo.
- Los AINE pueden inducir la apoptosis en las células neoplásicas y potencialmente involucrar al regulador del ciclo celular p21.
Conclusiones:
- La aspirina exhibe un efecto quimiopreventivo moderado en poblaciones con riesgo intermedio de cáncer colorrectal.
- La proteína reguladora del ciclo celular p21 puede ser un mediador molecular clave de los efectos quimiopreventivos de los AINE.
- La comprensión de estos mecanismos podría conducir a mejores estrategias de prevención del cáncer colorrectal.
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