doi:10.1111/j.1365-2036.2007.03429.xengLanas, AOrtego, JSopeña, FAlcedo, JBarrio, EBujanda, LCosme, ABajador, EParra-Blanco, AFerrandez, APiazuelo, EQuintero, EPique, JMEffects of long-term cyclo-oxygenase 2 selective and acid inhibition on Barrett's oesophagusART-2007-81188Background: 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.2007http://zaguan.unizar.es/record/16842610.1111/j.1365-2036.2007.03429.xhttp://zaguan.unizar.es/record/168426oai:zaguan.unizar.es:168426ALIMENTARY PHARMACOLOGY & THERAPEUTICS 26, 6 (2007), 913-923All rights reservedhttp://www.europeana.eu/rights/rr-f/info:eu-repo/semantics/closedAccess