Helieh S. Oz
UK Medical Center
Title: Colorectal neoplasia predispositions, basic, translational to bedside approaches
Biography
Biography: Helieh S. Oz
Abstract
Colorectal malignancy, the 3rd most important malignant complications with a high tendency for metastasis, is caused by risk factors such as lifestyle, dietary, race, and aging or due to the underlying genetic predispositions (e.g. familial adenomatous polyposis). It is mainly common in patients with chronic idiopathic inflammatory bowel disease (IBD), as there is no cure for IBD. IBD patients are predestined to have a colostomy or to develop colorectal malignancy; suggesting a profound relationship between the chronic inflammation and susceptibility to acquiring colorectal neoplasia. Dysplasia is mainly originated from intestinal epithelial cells lining (IEC-cells) in the colon or rectum with altered apoptosis as a result of a mutation in the Wnt signaling pathway with increase signaling and activity in the intestinal crypt stem cell. Further, local microbial dysbiosis is predicted to contribute to functional changes at the cancerous sites. Various animals serve as models for dysplasia and carcinoma including chemical exposure or genetically altered animals. IL-10-deficient mice when exposed to normal gut flora develop severe enterocolitis followed by the rectal prolapse. Yet, when these animals are kept in our germfree environment eventually develop dysplasia and colorectal neoplasia. Surgery is the elective approach for colorectal malignancy, yet the morbidity rate following colorectal resection remains as high as 24%-43%. The postsurgical complications include tissue adhesions at the site of surgery, infection, anastomotic leakage, impaired bowel movement and malfunction as a transient or prolonged impediment which delay recovery and increase the length of hospitalization followed by acquired infections, sepsis, and possible death. Postoperative infections seriously affect the prognosis of cancer patients, while probiotics have been increasingly used to prevent postoperative infection in clinical practice. This presentation will review colorectal malignancies and explore the mechanism of actions for ongoing and prospective protective effects of interventions and possible adverse effects and safety issues.