title: Pilot translational study of dietary vitamin C supplementation in Barrett's esophagus.
abstract: The transcription factor Nuclear factor kappa B (NF-kappaB) is central to the regulation of genes encoding for mediators of inflammation and carcinogenesis. In the esophagus, NF-kappaB is progressively activated from inflammation to Barrett's metaplasia and adenocarcinoma. Vitamin C, an antioxidant, can inhibit NF-kappaB in in vitro models, and the aim of this study was to prospectively assess the effect of supplemental vitamin C on NF-kappaB and associated cytokines in patients with Barrett's esophagus. Twenty-five patients with long-segment Barrett's and specialized intestinal metaplasia received dietary vitamin C (1000 mg/day) orally for four weeks, and had pre- and post-vitamin C endoscopic biopsies. NF-kappaB activity (activated p50 and p65 subunits) of nuclear extracts was assessed using the Active Motif NF-kappaB assay, and cytokines and growth factors were measured using the Evidence Investigator biochip array. NF-kappaB and related pro-inflammatory cytokines and growth factors (IL-8, VEGF, IL-10) were activated in all Barrett's tissue pre-treatment. Down-regulation in activated NF-kappaB and cytokines was observed in 8/25 (35%) patients. Dietary vitamin C supplementation may down-regulate pro-inflammatory markers in a subset of Barrett's patients. Further studies with larger numbers of endpoints will be needed to further evaluate this effect.
authors.affiliation: Department of Clinical Surgery, Trinity Centre for Health Sciences, St. James's Hospital, Dublin, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Babar
authors.forename: M M M
authors.initials: MM
authors.lastname: Abdel-Latif
authors.forename: N
authors.initials: N
authors.lastname: Ravi
authors.forename: A
authors.initials: A
authors.lastname: Murphy
authors.forename: P J
authors.initials: PJ
authors.lastname: Byrne
authors.forename: D
authors.initials: D
authors.lastname: Kelleher
authors.forename: J V
authors.initials: JV
authors.lastname: Reynolds
mesh_terms: D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use*; D001471:Barrett Esophagus / Q000378:metabolism* / Q000473:pathology / Q000628:therapy*; D015331:Cohort Studies; D016207:Cytokines / Q000378:metabolism; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016328:NF-kappa B / Q000378:metabolism*; D010865:Pilot Projects
chemical_list: D000975:Antioxidants; D016207:Cytokines; D016328:NF-kappa B; D001205:Ascorbic Acid