Antagonistic effects of aspirin and folic acid on inflammation markers and subsequent risk of recurrent colorectal adenomas

Gloria Y F Ho, Xiaonan (Nan) Xue, Mary Cushman, Gail McKeown-Eyssen, Robert S. Sandler, Dennis J. Ahnen, Elizabeth L. Barry, Fred Saibil, Robert S. Bresalier, Thomas E. Rohan, John A. Baron

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

The Aspirin/Folate Polyp Prevention Trial found that aspirin, but not folic acid, reduced recurrence of colorectal adenomas. This study examined whether treatment effects on inflammation markers explained the trial results. The trial had a factorial design with three aspirin (placebo, 81, and 325 mg/d) and two folic acid (placebo and 1 mg/d) groups. There were 884 subjects who had colonoscopic evaluation for adenomas at year 3 and plasma levels of C-reactive protein (CRP), interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), soluble TNF receptor type II (sTNF-R2), and IL-1 receptor antagonist (IL-1Ra) measured at baseline and year 3. Among individuals not receiving folic acid, there was a 4% decrease (mean ratio of year 3 to baseline levels = 0.96, 95% confidence interval [CI] = 0.82 to 1.14) in CRP for a period of 3 years in the 325 mg of aspirin group vs a 20% increase (mean ratio = 1.20, 95% CI = 1.03 to 1.41) in the placebo group (P =. 027). By contrast, the reverse was observed among individuals who also received folic acid (Pinteraction =. 013). Changes in inflammation markers were not associated with adenoma recurrence. Low-dose aspirin (325 mg/d) is beneficial in stabilizing CRP levels, which may be abrogated by folate. Nevertheless, inflammation markers do not mediate the chemopreventive effect of aspirin on colorectal adenomas.

Original languageEnglish (US)
Pages (from-to)1650-1654
Number of pages5
JournalJournal of the National Cancer Institute
Volume101
Issue number23
DOIs
StatePublished - Dec 2009

Fingerprint

Folic Acid
Adenoma
Aspirin
Inflammation
C-Reactive Protein
Placebos
Confidence Intervals
Recurrence
Interleukin-1 Receptors
Tumor Necrosis Factor Receptors
Polyps
Interleukin-6
Tumor Necrosis Factor-alpha

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Antagonistic effects of aspirin and folic acid on inflammation markers and subsequent risk of recurrent colorectal adenomas. / Ho, Gloria Y F; Xue, Xiaonan (Nan); Cushman, Mary; McKeown-Eyssen, Gail; Sandler, Robert S.; Ahnen, Dennis J.; Barry, Elizabeth L.; Saibil, Fred; Bresalier, Robert S.; Rohan, Thomas E.; Baron, John A.

In: Journal of the National Cancer Institute, Vol. 101, No. 23, 12.2009, p. 1650-1654.

Research output: Contribution to journalArticle

Ho, GYF, Xue, XN, Cushman, M, McKeown-Eyssen, G, Sandler, RS, Ahnen, DJ, Barry, EL, Saibil, F, Bresalier, RS, Rohan, TE & Baron, JA 2009, 'Antagonistic effects of aspirin and folic acid on inflammation markers and subsequent risk of recurrent colorectal adenomas', Journal of the National Cancer Institute, vol. 101, no. 23, pp. 1650-1654. https://doi.org/10.1093/jnci/djp346
Ho, Gloria Y F ; Xue, Xiaonan (Nan) ; Cushman, Mary ; McKeown-Eyssen, Gail ; Sandler, Robert S. ; Ahnen, Dennis J. ; Barry, Elizabeth L. ; Saibil, Fred ; Bresalier, Robert S. ; Rohan, Thomas E. ; Baron, John A. / Antagonistic effects of aspirin and folic acid on inflammation markers and subsequent risk of recurrent colorectal adenomas. In: Journal of the National Cancer Institute. 2009 ; Vol. 101, No. 23. pp. 1650-1654.
@article{ce5a8414e2644aaba515741f547996be,
title = "Antagonistic effects of aspirin and folic acid on inflammation markers and subsequent risk of recurrent colorectal adenomas",
abstract = "The Aspirin/Folate Polyp Prevention Trial found that aspirin, but not folic acid, reduced recurrence of colorectal adenomas. This study examined whether treatment effects on inflammation markers explained the trial results. The trial had a factorial design with three aspirin (placebo, 81, and 325 mg/d) and two folic acid (placebo and 1 mg/d) groups. There were 884 subjects who had colonoscopic evaluation for adenomas at year 3 and plasma levels of C-reactive protein (CRP), interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), soluble TNF receptor type II (sTNF-R2), and IL-1 receptor antagonist (IL-1Ra) measured at baseline and year 3. Among individuals not receiving folic acid, there was a 4{\%} decrease (mean ratio of year 3 to baseline levels = 0.96, 95{\%} confidence interval [CI] = 0.82 to 1.14) in CRP for a period of 3 years in the 325 mg of aspirin group vs a 20{\%} increase (mean ratio = 1.20, 95{\%} CI = 1.03 to 1.41) in the placebo group (P =. 027). By contrast, the reverse was observed among individuals who also received folic acid (Pinteraction =. 013). Changes in inflammation markers were not associated with adenoma recurrence. Low-dose aspirin (325 mg/d) is beneficial in stabilizing CRP levels, which may be abrogated by folate. Nevertheless, inflammation markers do not mediate the chemopreventive effect of aspirin on colorectal adenomas.",
author = "Ho, {Gloria Y F} and Xue, {Xiaonan (Nan)} and Mary Cushman and Gail McKeown-Eyssen and Sandler, {Robert S.} and Ahnen, {Dennis J.} and Barry, {Elizabeth L.} and Fred Saibil and Bresalier, {Robert S.} and Rohan, {Thomas E.} and Baron, {John A.}",
year = "2009",
month = "12",
doi = "10.1093/jnci/djp346",
language = "English (US)",
volume = "101",
pages = "1650--1654",
journal = "Journal of the National Cancer Institute",
issn = "0027-8874",
publisher = "Oxford University Press",
number = "23",

}

TY - JOUR

T1 - Antagonistic effects of aspirin and folic acid on inflammation markers and subsequent risk of recurrent colorectal adenomas

AU - Ho, Gloria Y F

AU - Xue, Xiaonan (Nan)

AU - Cushman, Mary

AU - McKeown-Eyssen, Gail

AU - Sandler, Robert S.

AU - Ahnen, Dennis J.

AU - Barry, Elizabeth L.

AU - Saibil, Fred

AU - Bresalier, Robert S.

AU - Rohan, Thomas E.

AU - Baron, John A.

PY - 2009/12

Y1 - 2009/12

N2 - The Aspirin/Folate Polyp Prevention Trial found that aspirin, but not folic acid, reduced recurrence of colorectal adenomas. This study examined whether treatment effects on inflammation markers explained the trial results. The trial had a factorial design with three aspirin (placebo, 81, and 325 mg/d) and two folic acid (placebo and 1 mg/d) groups. There were 884 subjects who had colonoscopic evaluation for adenomas at year 3 and plasma levels of C-reactive protein (CRP), interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), soluble TNF receptor type II (sTNF-R2), and IL-1 receptor antagonist (IL-1Ra) measured at baseline and year 3. Among individuals not receiving folic acid, there was a 4% decrease (mean ratio of year 3 to baseline levels = 0.96, 95% confidence interval [CI] = 0.82 to 1.14) in CRP for a period of 3 years in the 325 mg of aspirin group vs a 20% increase (mean ratio = 1.20, 95% CI = 1.03 to 1.41) in the placebo group (P =. 027). By contrast, the reverse was observed among individuals who also received folic acid (Pinteraction =. 013). Changes in inflammation markers were not associated with adenoma recurrence. Low-dose aspirin (325 mg/d) is beneficial in stabilizing CRP levels, which may be abrogated by folate. Nevertheless, inflammation markers do not mediate the chemopreventive effect of aspirin on colorectal adenomas.

AB - The Aspirin/Folate Polyp Prevention Trial found that aspirin, but not folic acid, reduced recurrence of colorectal adenomas. This study examined whether treatment effects on inflammation markers explained the trial results. The trial had a factorial design with three aspirin (placebo, 81, and 325 mg/d) and two folic acid (placebo and 1 mg/d) groups. There were 884 subjects who had colonoscopic evaluation for adenomas at year 3 and plasma levels of C-reactive protein (CRP), interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), soluble TNF receptor type II (sTNF-R2), and IL-1 receptor antagonist (IL-1Ra) measured at baseline and year 3. Among individuals not receiving folic acid, there was a 4% decrease (mean ratio of year 3 to baseline levels = 0.96, 95% confidence interval [CI] = 0.82 to 1.14) in CRP for a period of 3 years in the 325 mg of aspirin group vs a 20% increase (mean ratio = 1.20, 95% CI = 1.03 to 1.41) in the placebo group (P =. 027). By contrast, the reverse was observed among individuals who also received folic acid (Pinteraction =. 013). Changes in inflammation markers were not associated with adenoma recurrence. Low-dose aspirin (325 mg/d) is beneficial in stabilizing CRP levels, which may be abrogated by folate. Nevertheless, inflammation markers do not mediate the chemopreventive effect of aspirin on colorectal adenomas.

UR - http://www.scopus.com/inward/record.url?scp=71549138845&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=71549138845&partnerID=8YFLogxK

U2 - 10.1093/jnci/djp346

DO - 10.1093/jnci/djp346

M3 - Article

VL - 101

SP - 1650

EP - 1654

JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

SN - 0027-8874

IS - 23

ER -