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Report for Clinical Trial NCT01105169

Developed by Shray Alag, 2020.
SNP Clinical Trial Gene

Investigational Nutrigenetic Studies for Cancer Prevention

Colorectal cancer is the fourth most common incident cancer and the second most common cause of cancer death in the United States, with approximately 150,000 new cases and 57,000 deaths per year. High calcium intake and magnesium may protect against colorectal cancer and adenoma, however, results have been inconsistent. We found that genetic makeup, associated with magnesium absorption and re-absorption, significantly interacted with the calcium and magnesium ratio in relation to the both adenomatous and hyperplastic polyps. Participants who carried at least one 1482Ile allele (G->A)of TRPM7 and who consumed diets with a high calcium/magnesium ratio were at a higher risk of adenoma and hyperplastic polyps than were participants who did not carry the polymorphism. We hypothesize that the reduction in the dietary Ca/Mg ratio may change the markers directly related to tumorigenesis. The primary aims of this study are to conduct a randomized placebo-controlled intervention trial to test whether reducing the Ca/mg intake ratio through magnesium supplementation has effects on the related biomarkers. We will also examine whether the effect of modulating Ca/Mg intake ratio may be more pronounced among those who carry the 1482Ile allele compared those who don't carry the 1482Ile allele. Results from our study will help to identify people at a high risk of colorectal adenoma and to develop personalized strategies to prevent occurrence of colorectal adenoma, and thus, colorectal cancer through dietary change or nutritional fortification.

NCT01105169 Colorectal Cancer
MeSH: Colorectal Neoplasms
HPO: Neoplasm of the large intestine

2 Interventions

Name: Magnesium glycinate

Description: Oral administration of magnesium glycinate daily for 12 weeks

Type: Dietary Supplement

GA/AA genotype and magnesium treatment GG genotype and magnesium treatment

Name: Placebo

Description: Oral administration of identical-appearing placebo daily for 12 weeks

Type: Dietary Supplement

GA/AA genotype and Placebo GG genotype and placebo


Primary Outcomes

Description: TRPM7 and MLKL have been detected using immunohistochemical (IHC) techniques.

Measure: The protein expression levels of TRPM7, MLKL in colorectal mucosa

Time: 12 week (rectal biopsies will be collected at the baseline and the end of the intervention)

Description: Ki67:BAX and Ki67:TUNEL have been analyzed using immunohistochemical (IHC) techniques.

Measure: Ratios of Ki67:BAX, Ki67:TUNEL in rectal epithelial

Time: 12 week (rectal biopsies will be collected at the baseline and the end of the intervention)

Description: Cox2 has been analyzed using immunohistochemical (IHC)

Measure: Expression of Cox2 in rectal epithelia

Time: 12 week (rectal biopsies will be collected at the baseline and the end of the intervention)

Secondary Outcomes

Description: Serum magnesium concentration was determined using 7D70 Magnesium Reagent Kit from Abbot Laboratories (Abbott Park, IL) the assay was conducted at the Vanderbilt Pathology Laboratory Services.

Measure: Serum magnesium

Time: 12 week

Description: Body magnesium status obtained using magnesium tolerance test (MTT)

Measure: Post treatment body magnesium status

Time: 12 week after treatment

Measure: Circulation 25-Hydroxyvitamin D

Time: 12 week

Description: Assays of CRP for 180 participants were performed using immuno turbidimetric immunoassay based commercial assay kits (Pointe Scientific, Inc, Canton, MI) at Vanderbilt Lipid Laboratory

Measure: Serum C-reactive protein concentration

Time: 12 week

Description: Urinary PGE-M level was measured using a liquid chromatography/tandem mass spectrometric method at the Integrated Health Sciences Facility Core of the Vanderbilt Center in Molecular Toxicology.

Measure: Urine excretion of prostaglandin E2 metabolite (PGE-M)

Time: 12 week

Purpose: Prevention

Allocation: Randomized

Factorial Assignment


There is one SNP

SNPs


1 T1482I

- Participants from the TCPS (IRB # 090235), the TIARS (IRB # 090235), from Vanderbilt University Hospital or from other resources - Consent to be contacted for future studies in TCPS (IRB # 020462), TIARS (IRB#090235) - Participants with a calcium intake ≥ 700 mg/day measuring with 24 hour dietary recalls - Participants with a calcium intake < 2000 mg/day measuring with 24 hour dietary recalls - Participants with a calcium/magnesium intake ratio > 2.6 - Participants with known genotype for Thr1482Ile polymorphism in TRPM7 - Will live in Nashville or surrounding area in the next 6 months Exclusion Criteria: - Intolerance to magnesium glycinate or microcrystalline cellulose (placebo) - Chronic renal diseases and hepatic cirrhosis - Chronic ischemic heart disease with unstable angina, chronic heart failure at class III or IV and acute myocardial infarction in the last 6 months - Chronic diarrhea - Current breastfeeding - Current or planned pregnancy - Type I diabetes mellitus - Pituitary dwarfism - Use of digoxin and licorice - Current use of blood anticoagulant drugs such as Dicumarol(Warfarin), Clopidogrel (Plavix), Prasugrel HCl (Efficent), Ticlopidine (Ticlid), Lovenox (Enoxaparin), Fragmin (Dalteparin), Innohep (Tinzaparin), Eptifibatide (Integrilin), Tyrofiban (Aggrastat), and Abciximab (Reopro) - Current use of lithium carbonate therapy (Eskalith, Lithobid, Lithonate, Lithotabs, Apo-Lithium carbonate, Apo-Lithium carbonate SR, Carbolth, Duralith, PMS-Lithium carbonate, PMS-Lithium citrate) - Individuals with a history of colon resection or colectomy due to any reason - Individuals with any history of cancer other than non-melanoma skin cancer - Individual with history of any organ transplantation - Individual with a history of gastric bypass due to any reason - Individuals with Inflammatory bowel disease - Individuals if creatinine clearance is < 50 - Currently institutionalized - Homeless individual (address, telephone etc.) - Unable to provide informed consent - Any condition that in the opinion of the investigator raises concerns about protocol compliance Inclusion Criteria: - Hyperplastic polyp or/and Adenoma cases - Polyps free participants with any of the following high risk of colorectal polyps or cancer: (1) family history of colorectal cancer or polyps; (2) current cigarette smoker; (3) obesity (BMI≥30 kg/m2); (4) low intake of fiber (lowest fiber intake quartile: daily intake <16.6g); (5) high intake of red meat and well-done or processed meat (mutageneity index ≥5852). --- Thr1482Ile ---

- Participants from the TCPS (IRB # 090235), the TIARS (IRB # 090235), from Vanderbilt University Hospital or from other resources - Consent to be contacted for future studies in TCPS (IRB # 020462), TIARS (IRB#090235) - Participants with a calcium intake ≥ 700 mg/day measuring with 24 hour dietary recalls - Participants with a calcium intake < 2000 mg/day measuring with 24 hour dietary recalls - Participants with a calcium/magnesium intake ratio > 2.6 - Participants with known genotype for Thr1482Ile polymorphism in TRPM7 - Will live in Nashville or surrounding area in the next 6 months Exclusion Criteria: - Intolerance to magnesium glycinate or microcrystalline cellulose (placebo) - Chronic renal diseases and hepatic cirrhosis - Chronic ischemic heart disease with unstable angina, chronic heart failure at class III or IV and acute myocardial infarction in the last 6 months - Chronic diarrhea - Current breastfeeding - Current or planned pregnancy - Type I diabetes mellitus - Pituitary dwarfism - Use of digoxin and licorice - Current use of blood anticoagulant drugs such as Dicumarol(Warfarin), Clopidogrel (Plavix), Prasugrel HCl (Efficent), Ticlopidine (Ticlid), Lovenox (Enoxaparin), Fragmin (Dalteparin), Innohep (Tinzaparin), Eptifibatide (Integrilin), Tyrofiban (Aggrastat), and Abciximab (Reopro) - Current use of lithium carbonate therapy (Eskalith, Lithobid, Lithonate, Lithotabs, Apo-Lithium carbonate, Apo-Lithium carbonate SR, Carbolth, Duralith, PMS-Lithium carbonate, PMS-Lithium citrate) - Individuals with a history of colon resection or colectomy due to any reason - Individuals with any history of cancer other than non-melanoma skin cancer - Individual with history of any organ transplantation - Individual with a history of gastric bypass due to any reason - Individuals with Inflammatory bowel disease - Individuals if creatinine clearance is < 50 - Currently institutionalized - Homeless individual (address, telephone etc.) - Unable to provide informed consent - Any condition that in the opinion of the investigator raises concerns about protocol compliance Colorectal Cancer Colorectal Neoplasms null --- Thr1482Ile ---



HPO Nodes


HPO:
Neoplasm of the large intestine
Genes 120
FLCN SDHC MLH1 PMS2 APC EPCAM SDHC PALLD SRC BUB1 APC GREM1 NTHL1 PMS1 PTEN SDHB MSH6 APC KIT SDHD KRAS BMPR1A FAN1 CTNNB1 MSH3 POLD1 KRAS RNF43 KEAP1 DICER1 DLC1 BMPR1A MSH2 MSH6 PIK3CA CDKN2A FGFR3 BMPR1A MUTYH PIK3CA BMPR1A EP300 FOXE1 ENG SMAD7 AXIN2 CHEK2 MLH1 RPS20 BRCA1 RPS19 PRKAR1A APC GPR35 MLH1 AKT1 POLE SMAD4 KIT TP53 TRIP13 COL14A1 MDM2 SMAD4 POLE BRCA2 AKT1 MSH6 HABP2 NRAS MUTYH BUB1B DOCK8 TGFBR2 STK11 AXIN2 EPCAM BUB3 DCC AXIN2 TCF4 KLLN MSH2 APC TP53 SEC23B PTEN TGFBR2 SEMA4A POLD1 PIK3CA PDGFRA MINPP1 APC SH3KBP1 BMPR1A TP53 BUB1 AAGAB SMAD4 BMPR1A MST1 MLH3 MSH2 PALB2 FLCN SDHA PMS2 SDHB BUB1B MSH2 MLH1 CEP57 MLH3 TP53 PTPRJ PMS1 APC CDKN2A APC