Does Watercress Intake Have an Impact on Cancer Patients Outcomes: a Longitudinal Trial
Słowa kluczowe
Abstrakcyjny
Opis
The relation between cancer and nutrition has been well established; cancer builds upon damage to cellular DNA resulting from carcinogenic environmental factors, in which nutrition plays a major role. Many diet and lifestyle factors can influence the development of cancer, a disease expected to affect worldwide more than 1 in 3 people. Population studies associate a higher intake of cruciferous vegetables with a reduced risk of cancers at several locations. In 1977, a study in laboratory animals showed the potential effect of phenylethyl isothiocyanate (PEITC) to inhibit carcinogenesis. Recent studies identified several active isothiocyanates in watercress extract that may have more significant anticarcinogenic activity than PEITC alone. Potential anticarcinogenic mechanisms include: preventing carcinogen activation by inhibiting phase I enzymes such as cytochrome P450s, by increasing cells' resistance through detoxification/antioxidant enzymes; e.g. phase II enzymes (quinone reductase, glutathione S-transferases, UDP glucuronosyltransferases);, by inhibiting cell cycle progression and/or by inducing apoptosis.
Several watercress components have antigenotoxic effects in vitro resulting in reduced DNA damage and have anti-proliferative effects. These components include flavonols such as quercetin, hydroxycinnamic acids such as ferulic acid and p-coumaric acid. In HT29 colon cancer cells, an extract of watercress juice was associated with inhibition of the three stages of carcinogenesis: initiation, proliferation and metastasis. In MDA-MB-23 human breast cancer cells, watercress extract inhibited metalloproteinase-9 activity, thus suppressing the invasive potential of cancer cells. In breast cancer, epidemiological studies suggest that cruciferous vegetables may reduce cancer incidence. In animal studies, a 9-week PEITC-NAC supplemented diet vs a non-supplemented diet was significantly associated with reduction in tumour size and weight.
A recognised mechanism by which PEITC inhibits the growth and survival of established cancer cells is through the inhibition of angiogenesis. A study explored the impact of PEITC on a specific pathway central to angiogenesis by exposing human MCF7 breast cancer cells to PEITC and measuring hypoxia inducible factor (HIF) signaling activity. PEITC was shown as an effective inhibitor of HIF activity which may contribute to its anti-angiogenic and anti-cancer properties. A follow up to this experiment demonstrated that, similar to PEITC, crude watercress extracts inhibited cancer cell growth and HIF activity in vitro. Furthermore 6 to 8 hours after a significant amount dietary intake of watercress by four healthy participants, peripheral blood cells demonstrated significantly reduced HIF signalling activity, suggesting that dietary intake of watercress may be sufficient to modulate this potential anti-cancer pathway.
Of further relevance, a blind, randomized crossover study was carried out in 60 healthy volunteers instructed to consume one pack (85g) of raw watercress daily for 8 weeks. Compared to the control phase, watercress supplementation increased lymphocytes' DNA resistance to free radicals, thus reducing DNA damage. The hypothesis set out was that watercress may reduce cancer risk via decreased damage to DNA and possible effects on antioxidant status by increasing levels of plasma carotenoids.
These findings are justifiably interesting for the primary care setting and cancer primary prevention. Yet, these cellular effects of watercress supplementation may further prove useful in the modulation of cancer progression and disease recurrence, a not yet explored area. Of note, that the role of nutrition intervention in medium and long term outcomes in cancer has been demonstrated. It is today acknowledged as grade A evidence that individualized nutritional counseling and education plays a central role in improving long-term outcomes in cancer, by prolonging survival, reducing late RT toxicity and improving QoL. The present clinical trial of nutritional supplementation in cancer, intends to further explore the effects of therapeutic diets supplemented with nutraceuticals via watercress that may prove useful in DNA damage modulation, as well as in the global disease prognosis.
Daktyle
Ostatnia weryfikacja: | 05/31/2015 |
Pierwsze przesłane: | 05/20/2015 |
Szacowana liczba przesłanych rejestracji: | 06/07/2015 |
Wysłany pierwszy: | 06/10/2015 |
Ostatnia aktualizacja przesłana: | 06/07/2015 |
Ostatnia opublikowana aktualizacja: | 06/10/2015 |
Rzeczywista data rozpoczęcia badania: | 02/28/2014 |
Szacowana data zakończenia podstawowej działalności: | 12/31/2018 |
Szacowana data zakończenia badania: | 12/31/2018 |
Stan lub choroba
Interwencja / leczenie
Dietary Supplement: Intervention group
Faza
Grupy ramion
Ramię | Interwencja / leczenie |
---|---|
Experimental: Intervention group Watercress will be tested in its natural form as a food item that will supplement the usual diet, via the prescription of watercress as whole food added daily to the usual diet. The intervention group will be asked to consume 100 grams of watercress per day, in addition to their usual diet for the total time of RT treatment. These 100 grams of watercress per day will allow the achievement of the daily "therapeutic" dose. | Dietary Supplement: Intervention group 100g of watercress daily during radiation therapy |
No Intervention: Control group The control group will receive the standard of care, thus will maintain their ad libitum diet. |
Kryteria kwalifikacji
Wiek kwalifikujący się do nauki | 18 Years Do 18 Years |
Płeć kwalifikująca się do nauki | Female |
Przyjmuje zdrowych wolontariuszy | tak |
Kryteria | Inclusion Criteria: - adult breast cancer female patients consecutively referred for primary radiotherapy with curative intent Exclusion Criteria: - pregnancy - cognitive impairment - uncooperative or - patients with any implantable electronic device (e.g. pacemaker) or internal metal material preventing BIA phase angle assessment |
Wynik
Podstawowe miary wyników
1. Cell phase angle [Change from baseline at up to 6 weeks]
2. body composition [Change from baseline at up to 6 weeks]
3. treatments' toxicity and symptoms [up to 6 weeks]
4. RT induced skin dermitis [up to 6weeks]
5. Quality of Life (QoL) [Change from baseline at up to 6 weeks]
6. DNA damage [Change from baseline at up to 6 weeks]
7. Metabolomic profile [Change from baseline at up to 6 weeks]
8. Nutritional status [Change from baseline at up to 6 weeks]
9. Dietary intake [Change from baseline at up to 6 weeks]
10. Carotenoids and flavonoids [Change from baseline at up to 6 weeks]
Miary wyników wtórnych
1. Cell phase angle 2 [change from 3 months at 3 years]
2. body composition 2 [change from 3 months at 3 years]
3. Quality of Life 2 (QoL2) [change from 3 months at 3 years]
4. Metabolomic profile 2 [change from 3 months at 3 years]
5. Nutritional status 2 [change from 3 months at 3 years]
6. Dietary intake 2 [change from 3 months at 3 years]