Changes in Stem Cells of the Colon in Response to Increased Risk of Colorectal Cancer

NCT ID: NCT01075893

Last Updated: 2017-10-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

11 participants

Study Classification

OBSERVATIONAL

Study Start Date

2010-02-28

Study Completion Date

2012-10-31

Brief Summary

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Colorectal cancer is a common disease worldwide. Increasing evidence is demonstrating that colorectal cancers arise from 'cancer stem cells.' Stem cells in the colon reside at the bottom of thousands of microscopic crypts throughout the wall of the colon. They create all the cells lining the bowel wall. These cells are created in the base of the crypt and ascend to the top acquiring the characteristics of mature cells of the bowel wall as they ascend.

It is now thought that colorectal cancer cells arise from stem cells where the genetic material regulating growth and division of the stem cell has become defective. This leads to unregulated production of cells which in turn have defective genetic information and cancer formation.

Prior studies have demonstrated that the earliest changes before a cancer develops are changes in cellular proliferation. Now that reliable markers to identify stem cells have been found, the researchers aim to investigate stem cell numbers and changes in distribution in those at normal risk of colorectal cancer and those at higher risk. The researchers hypothesise that changes in cellular proliferation at the top of the crypt in individuals at higher risk of colorectal cancer are due to a change in the number of stem cells in the crypt base.

Detailed Description

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Conditions

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Colorectal Cancer

Keywords

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Colorectal cancer Stem cells Ulcerative colitis Polyps

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Adenomatous polyp

Patients who have begun the polyp-cancer sequence (ie. are in polyp surveillance after excision of a prior adenomatous polyp) will be used to test those patients at higher risk of colorectal.

No interventions assigned to this group

Patients at normal risk of cancer

Patients found to have endoscopically and histological normal mucosa.

No interventions assigned to this group

Ulcerative colitis

Patients who are under surveillance for known ulcerative colitis will be used to test those patients at higher risk of colorectal.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Referred for endoscopy at participating centre

Exclusion Criteria

* Age \<16 or \>85
* Familial polyposis syndrome
* Lynch syndrome
* Known colorectal tumour
* Previous colorectal resection
* Pregnancy
* Chemotherapy in last 6 months
* Therapy with aspirin/other nonsteroidal anti-inflammatory drug (NSAID)
* Other immunosuppressive medication
* Incomplete left sided examination
* Colorectal carcinoma found at endoscopy
* Iatrogenic perforation at endoscopy
* Colorectal cancer on histology
* Microscopic colitis on histology

For the colitis group

* Simple clinical colitis activity index (SCCAI) score \> 5
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Northumbria Healthcare NHS Foundation Trust

OTHER

Sponsor Role collaborator

Newcastle University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Iain JD McCallum, MBChB MRCS

Role: PRINCIPAL_INVESTIGATOR

Newcastle University, UK

John C Mathers, PhD

Role: STUDY_CHAIR

Newcastle University, UK

Seamus B Kelly, MD FRCS

Role: STUDY_DIRECTOR

Newcastle University, UK

Mike Bradburn, MD FRCS

Role: STUDY_DIRECTOR

Northumbria NHS foundation trust

Locations

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Wansbeck General Hospital

Ashington, Tyne & Wear, United Kingdom

Site Status

North Tyneside Hospital

North Shields, Tyne & Wear, United Kingdom

Site Status

Countries

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United Kingdom

References

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Dronamraju SS, Coxhead JM, Kelly SB, Burn J, Mathers JC. Cell kinetics and gene expression changes in colorectal cancer patients given resistant starch: a randomised controlled trial. Gut. 2009 Mar;58(3):413-20. doi: 10.1136/gut.2008.162933. Epub 2008 Oct 31.

Reference Type BACKGROUND
PMID: 18978177 (View on PubMed)

Barker N, van Es JH, Kuipers J, Kujala P, van den Born M, Cozijnsen M, Haegebarth A, Korving J, Begthel H, Peters PJ, Clevers H. Identification of stem cells in small intestine and colon by marker gene Lgr5. Nature. 2007 Oct 25;449(7165):1003-7. doi: 10.1038/nature06196. Epub 2007 Oct 14.

Reference Type BACKGROUND
PMID: 17934449 (View on PubMed)

Other Identifiers

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McCallum-001

Identifier Type: -

Identifier Source: org_study_id