title: Ulcerative colitis: from inflammation to cancer. Do estrogen receptors have a role?
abstract: Ulcerative colitis (UC) is a condition at increased risk for colorectal carcinoma (CRC) development. Nowadays, screening and follow-up programs are routinely performed worldwide to promote the early detection of CRCs in subjects with well known risk factors (extent, duration and severity of the disorder). The diffusion of these procedures is presumably the main reason for the marked reduction of cancer incidence and mortality in the course of UC. In addition, chemoprevention has been widely investigated and developed in many medical fields, and aspirin has shown a preventive effect against CRC, while mesalazine has been strongly invoked as a potential chemopreventive agent in UC. However, available studies show some limitations due to the obvious ethical implications of drug withdrawal in UC in order to design a control group. The estrogen receptors (ER) alpha/beta balance seems to have a relevant influence on colorectal carcinogenesis and ER beta appears to parallel apoptosis, and hence an anti-carcinogenic effect. Phytoestrogens are compounds acting as ER beta agonists and have shown a promising chemopreventive effect on sporadic as well as genetically inherited CRC. There is evidence suggesting a role for ERs in UC-related carcinogenesis. In this perspective, since these substances can be considered as dietary supplements and are completely free from side effects, phytoestrogens could be an interesting option for CRC prevention, even when the disease is a consequence of long-term chronic inflammation, as in the course of UC. Further studies of their effects are warranted in both the basic research and clinical fields.
authors.affiliation: Mariabeatrice Principi, Maria Pricci, Nicola De Tullio, Giuseppe Losurdo, Enzo Ierardi, Alfredo Di Leo, Division of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy.
authors.forename: Mariabeatrice
authors.initials: M
authors.lastname: Principi
authors.affiliation: Mariabeatrice Principi, Maria Pricci, Nicola De Tullio, Giuseppe Losurdo, Enzo Ierardi, Alfredo Di Leo, Division of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Barone
authors.affiliation: Mariabeatrice Principi, Maria Pricci, Nicola De Tullio, Giuseppe Losurdo, Enzo Ierardi, Alfredo Di Leo, Division of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Pricci
authors.affiliation: Mariabeatrice Principi, Maria Pricci, Nicola De Tullio, Giuseppe Losurdo, Enzo Ierardi, Alfredo Di Leo, Division of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: De Tullio
authors.affiliation: Mariabeatrice Principi, Maria Pricci, Nicola De Tullio, Giuseppe Losurdo, Enzo Ierardi, Alfredo Di Leo, Division of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Losurdo
authors.affiliation: Mariabeatrice Principi, Maria Pricci, Nicola De Tullio, Giuseppe Losurdo, Enzo Ierardi, Alfredo Di Leo, Division of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy.
authors.forename: Enzo
authors.initials: E
authors.lastname: Ierardi
authors.affiliation: Mariabeatrice Principi, Maria Pricci, Nicola De Tullio, Giuseppe Losurdo, Enzo Ierardi, Alfredo Di Leo, Division of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Di Leo
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D016588:Anticarcinogenic Agents / Q000627:therapeutic use; D002471:Cell Transformation, Neoplastic / Q000378:metabolism*; D003093:Colitis, Ulcerative / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000209:etiology* / Q000378:metabolism / Q000517:prevention & control; D047629:Estrogen Receptor beta / Q000819:agonists / Q000378:metabolism; D006801:Humans; D048789:Phytoestrogens / Q000627:therapeutic use; D065840:Protective Factors; D011960:Receptors, Estrogen / Q000187:drug effects / Q000378:metabolism*; D012307:Risk Factors; D015398:Signal Transduction / Q000187:drug effects
chemical_list: D000893:Anti-Inflammatory Agents; D016588:Anticarcinogenic Agents; D047629:Estrogen Receptor beta; D048789:Phytoestrogens; D011960:Receptors, Estrogen
keywords: Chemoprevention; Colorectal cancer; Dietary supplementation; Epithelial dysplasia; Estrogen receptors; Inflammatory bowel disease; Phytoestrogens; Ulcerative colitis