Sulindac reversal of 15-PGDH-mediated resistance to colon tumor chemoprevention with NSAIDs.

Abstract:

:Non-steroidal anti-inflammatory drugs prevent colorectal cancer by inhibiting cyclooxygenase (COX) enzymes that synthesize tumor-promoting prostaglandins. 15-hydroxyprostaglandin dehydrogenase (15-PGDH) is a tumor suppressor that degrades tumor-promoting prostaglandins. Murine knockout of 15-PGDH increases susceptibility to azoxymethane-induced colon tumors. It also renders these mice resistant to celecoxib, a selective inhibitor of inducible COX-2 during colon neoplasia. Similarly, humans with low colonic 15-PGDH are also resistant to colon adenoma prevention with celecoxib. Here, we used aspirin and sulindac, which inhibit both COX-1 and COX-2, in order to determine if these broader COX inhibitors can prevent colon tumors in 15-PGDH knockout (KO) mice. Unlike celecoxib, sulindac proved highly effective in colon tumor prevention of 15-PGDH KO mice. Significantly, however, aspirin demonstrated no effect on colon tumor incidence in either 15-PGDH wild-type or KO mice, despite a comparable reduction in colonic mucosal Prostaglandin E₂ (PGE₂) levels by both sulindac and aspirin. Notably, colon tumor prevention activity by sulindac was accompanied by a marked induction of lymphoid aggregates and proximal colonic inflammatory mass lesions, a side effect seen to a lesser degree with celecoxib, but not with aspirin. These findings suggest that sulindac may be the most effective agent for colon cancer prevention in humans with low 15-PGDH, but its use may also be associated with inflammatory lesions in the colon.

journal_name

Carcinogenesis

journal_title

Carcinogenesis

authors

Fink SP,Dawson DM,Zhang Y,Kresak A,Lawrence EG,Yang P,Chen Y,Barnholtz-Sloan JS,Willis JE,Kopelovich L,Markowitz SD

doi

10.1093/carcin/bgu241

subject

Has Abstract

pub_date

2015-02-01 00:00:00

pages

291-8

issue

2

eissn

0143-3334

issn

1460-2180

pii

bgu241

journal_volume

36

pub_type

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