Changes in Stem Cells of the Colon in Response to Increased Risk of Colorectal Cancer
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.
Study Overview
Status
Status
Conditions
Conditions
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
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-
Tyne & Wear
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Ashington, Tyne & Wear, United Kingdom, NE63 9JJ
- Wansbeck General Hospital
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North Shields, Tyne & Wear, United Kingdom, NE29 8NH
- North Tyneside Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
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
Study Plan
How is the study designed?
Design Details
- Observational Models: Case-Control
- Time Perspectives: Prospective
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
|---|
|
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.
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Patients at normal risk of cancer
Patients found to have endoscopically and histological normal mucosa.
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Ulcerative colitis
Patients who are under surveillance for known ulcerative colitis will be used to test those patients at higher risk of colorectal.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Number of stem cells in the colonic crypt
Time Frame: On day of endoscopy
|
On day of endoscopy
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Stem cell position in colonic crypt
Time Frame: On day of endoscopy
|
On day of endoscopy
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Iain JD McCallum, MBChB MRCS, Newcastle University, UK
- Study Chair: John C Mathers, PhD, Newcastle University, UK
- Study Director: Seamus B Kelly, MD FRCS, Newcastle University, UK
- Study Director: Mike Bradburn, MD FRCS, Northumbria NHS Foundation Trust
Publications and helpful links
General Publications
- 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.
- 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.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- McCallum-001
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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