Curcumin and quercetin greatly reduces size and number of colorecectal polyps

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Chemicals in curry and onions may help prevent colon cancer

A small but informative clinical trial by s Hopkins investigators

shows that a pill combining chemicals found in turmeric, a spice used

in curries, and onions reduces both the size and number of

precancerous lesions in the human intestinal tract.

In the study, published in the August issue of Clinical

Gastroenterology and Hepatology, five patients with an inherited form

of precancerous polyps in the lower bowel known as familial

adenomatous polyposis (FAP) were treated with regular doses of

curcumin (the chemical found in turmeric) and quercetin, an

antioxidant in onions, over an average of six months. The average

number of polyps dropped 60.4 percent, and the average size dropped by

50.9 percent, according to a team led by Francis M. Giardiello, M.D.,

at the Division of Gastroenterology, The s Hopkins University

School of Medicine, and Marcia Cruz-Correa, M.D., Ph.D., at s

Hopkins and the University of Puerto Rico School of Medicine.

" We believe this is the first proof of principle that these substances

have significant effects in patients with FAP, " says Giardiello.

Familial adenomatous polyposis is a disorder that runs in families and

is characterized by the development of hundreds of colorectal adenomas

(polyps) and eventual colon cancer. Recently, nonsteroidal

anti-inflammatory drugs (NSAIDs) have been used to treat some patients

with this condition, but these compounds often produce significant

side effects, including gastrointestinal ulcerations and bleeding,

according to Giardiello.

Previous observational studies in populations that consume large

amounts of curry, as well as laboratory research on rodents have

strongly suggested that curcumin -- a relatively innocuous yellow

pigment extracted from turmeric, the powdered root of the herb curcuma

longa and one of the main ingredients in Asian curries -- might be

effective in preventing and/or treating cancer in the lower intestine,

according to Cruz-Correa. She said curcumin has been given to cancer

patients, and previous studies have demonstrated that is well

tolerated at high doses.

Similarly, quercetin -- a member of a group of plant-derived

polyphenolic anti-oxidant substances known as flavanoids (found in a

variety of foods including onions, green tea and red wine) -- has been

shown to inhibit growth of colon cancer cell lines in humans and

abnormal colorectal cells in rodents.

Although these substances were administered together, due to relative

dose levels it is Giardiello's belief that curcumin is the key agent.

" The amount of quercetin we administered was similar to what many

people consume daily; however, the amount of curcumin is many times

what a person might ingest in a typical diet, since turmeric only

contains on average 3 percent to 5 percent curcumin by weight, " says

Giardiello. Because of this, he cautions that simply consuming curry

and onions may not have the same effect as was produced in this study.

In the trial, five patients were selected from the Cleveland Clinic in

Weston Fla. All patients had previously had their colons surgically

removed. Four of the five patients retained the rectums, whereas the

remaining patient had both colon and rectum removed and part of the

small intestine adapted to serve as colon and rectum. All patients had

five or more adenomas in their lower intestinal tract. None of the

patients had taken NSAIDS for more than one week during the three

months leading up to the study.

Participants were examined using a flexible sigmoidoscope before

treatment was initiated and at three month intervals (range three to

nine months) during treatment. Number and size of polyps were examined

at each visit.

Each patient received 480 milligrams of curcumin and 20 milligrams of

quercetin orally three times a day for six months and was told not to

use NSAIDs for the duration of the study. Three patients followed

treatment as prescribed. One patient did not follow the scheduled

treatment doses between months three and six and was continued on

therapy until the ninth month. A second patient dropped out of the

study after the third month.

A decrease in polyp number was observed in four of the five patients

at three months and four of the four patients at six months.

Side effects were minimal. One patient reported slight nausea and sour

taste within a couple of hours of taking the pill, which went away

within three days, and a second patient had mild diarrhea for five days.

" This study showed for the first time that curcumin treatment was

efficacious in decreasing the number of polyps in patients with FAP,

similarly to what has been seen with the use of synthetic NSAID

agents, but with minimal side effects. Furthermore, we saw that

adenomas found in the small intestine of our patients also responded

to curcumin, " says Cruz-Correa. She says a randomized clinical trial

will be conducted between s Hopkins and University of Puerto Rico

Comprehensive Cancer Center involving more patients. No date has been

set for this trial.

###

This study was supported by a grant from the National Institutes of

Health. Additional researchers who contributed to this study include

A. Shoskes, M.D.; , M.D.; Rhongua Zhao, M.D.,

Ph.D., and D. Wexner, M. D., of the Cleveland Clinic, Weston,

Fla.; and M. Hylind of The s Hopkins University School of

Medicine.

http://www.eurekalert.org/pub_releases/2006-08/jhmi-cic073106.php

Here is the abstract:

Volume 4, Issue 8, Pages 1035-1038 (August 2006)

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ABSTRACT

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Combination Treatment With Curcumin and Quercetin of Adenomas in

Familial Adenomatous Polyposis

Marcia Cruz–Correa & #8270;‡, A. Shoskes§, & #8270;, Rhongua

Zhao & #8270;, M. Hylind‡, D. Wexner & #8741;, Francis M.

Giardiello‡¶#Corresponding Author Informationemail address

published online 6 June 2006.

Background & Aims: Familialadenomatous polyposis (FAP) is an

autosomal-dominant disorder characterized by the development of

hundreds of colorectal adenomas and eventual colorectal cancer.

Regression of adenomas in this syndrome occurs with the administration

of nonsteroidal anti-inflammatory drugs and cyclooxygenase-2

inhibitors, but these compounds can have considerable side effects. We

evaluated the efficacy of the combination of diet-derived

nonprescription supplements curcumin and quercetin to regress adenomas

in patients with FAP. Methods: Five FAP patients with prior colectomy

(4 with retained rectum and 1 with an ileal anal pouch) received

curcumin 480 mg and quercetin 20 mg orally 3 times a day. The number

and size of polyps were assessed at baseline and after therapy. The

Wilcoxon signed-rank test was used to determine differences in the

number and size of polyps. Treatment side effects and medication

compliance also were evaluated. Results: All 5 patients had a

decreased polyp number and size from baseline after a mean of 6 months

of treatment with curcumin and quercetin. The mean percent decrease in

the number and size of polyps from baseline was 60.4% (P < .05) and

50.9% (P < .05), respectively. Minimal adverse side effects and no

laboratory abnormalities were noted. Conclusions: The combination of

curcumin and quercetin appears to reduce the number and size of ileal

and rectal adenomas in patients with FAP without appreciable toxicity.

Randomized controlled trials are needed to validate these findings.