Could aspirin and diets high in fiber act synergistically to reduce the risk of colon cancer in humans?

Pan Pan, Yi Wen Huang, Kiyoko Oshima, Martha Yearsley, Jianying Zhang, Jianhua Yu, Mark Arnold, Li Shu Wang

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish (US)
Article number166
JournalInternational journal of molecular sciences
Volume19
Issue number1
DOIs
StatePublished - Jan 6 2018

Keywords

  • Aspirin
  • Bell/U-shaped
  • Cancer prevention
  • Cyclooxygenase 2
  • Fruits and vegetables
  • Human clinical trials
  • Phytochemicals
  • Salicylic acid
  • Synergy

ASJC Scopus subject areas

  • Catalysis
  • Molecular Biology
  • Spectroscopy
  • Computer Science Applications
  • Physical and Theoretical Chemistry
  • Organic Chemistry
  • Inorganic Chemistry

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