Effects of long-term cyclo-oxygenase 2 selective and acid inhibition on Barrett's oesophagus

Lanas, A (Universidad de Zaragoza) ; Ortego, J (Universidad de Zaragoza) ; Sopeña, F (Universidad de Zaragoza) ; Alcedo, J ; Barrio, E ; Bujanda, L ; Cosme, A ; Bajador, E (Universidad de Zaragoza) ; Parra-Blanco, A ; Ferrandez, A ; Piazuelo, E ; Quintero, E ; Pique, JM

Resumen: Background: There is an overexpression of cyclo-oxygenase 2 (COX-2) in Barrett’s oesophagus (BO). Aim To determine the long-term effect of a COX-2 inhibitor on cellular mechanisms involved in BO.
Methods: A randomized controlled trial was conducted in BO patients allocated to continue the usual proton pump inhibitor (PPI) alone treatment, or PPI combined with rofecoxib (25 mg/ day) for 6 months. Cell proliferation index and COX-2 expression in BO glands was determined in biopsy specimens at baseline and after treatment. Cell apoptosis, cyclin D1, p53 and vascular endothelial growth factor (VEGF) expression was also explored in a subset of patients. Student-t test and the U-Mann–Whitney test were used for quantitative and ordinal variables.
Results: Of 62 patients, 58 completed the study. A higher proportion of patients on rofecoxib + PPI exhibited a decrease in COX-2 expression compared to those treated with PPI alone, but cell proliferation index was not affected. Unlike PPI alone, rofecoxib + PPI was associated with an increase in the apoptotic cell index, a decrease in p53 cell staining and VEGF expression in mucosal vessels. No effect on low-grade dysplasia or cyclin D1 was observed.
Conclusions: The addition of rofecoxib to PPI therapy does not affect cell proliferation index in BO cells after 6 months of therapy, but does reduce COX-2 and VEGF expression and increases cell apoptosis.

Idioma: Inglés

DOI: 10.1111/j.1365-2036.2007.03429.x

Año: 2007

Publicado en: ALIMENTARY PHARMACOLOGY & THERAPEUTICS 26, 6 (2007), 913-923
ISSN: 0269-2813

Factor impacto JCR: 3.201 (2007)

Categ. JCR: PHARMACOLOGY & PHARMACY rank: 55 / 203 = 0.271 (2007) - Q2 - T1
Categ. JCR: GASTROENTEROLOGY & HEPATOLOGY rank: 16 / 50 = 0.32 (2007) - Q2 - T1

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
Área (Departamento): Area Anatomía Patológica (Dpto. Anat.Pat.Med.Leg.For.To.)