The effects of fluorouracil, epirubicin, and cyclophosphamide (FEC60) on the intestinal barrier function and gut peptides in breast cancer patients: an observational study
<p>Abstract</p> <p>Background</p> <p>Several GI peptides linked to intestinal barrier function could be involved in the modification of intestinal permeability and the onset of diarrhea during adjuvant chemotherapy. The aim of the study was to evaluate the circulating l...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2013-02-01
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| Series: | BMC Cancer |
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| Online Access: | http://www.biomedcentral.com/1471-2407/13/56 |
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| author | Russo Francesco Linsalata Michele Clemente Caterina D’Attoma Benedetta Orlando Antonella Campanella Giovanna Giotta Francesco Riezzo Giuseppe |
| author_facet | Russo Francesco Linsalata Michele Clemente Caterina D’Attoma Benedetta Orlando Antonella Campanella Giovanna Giotta Francesco Riezzo Giuseppe |
| author_sort | Russo Francesco |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Several GI peptides linked to intestinal barrier function could be involved in the modification of intestinal permeability and the onset of diarrhea during adjuvant chemotherapy. The aim of the study was to evaluate the circulating levels of zonulin, glucagon-like peptide-2 (GLP-2), epidermal growth factor (EGF) and ghrelin and their relationship with intestinal permeability and chemotherapy induced diarrhea (CTD).</p> <p>Methods</p> <p>Sixty breast cancer patients undergoing an FEC60 regimen were enrolled, 37 patients completed the study. CTD(+) patients were discriminated by appropriate questionnaire and criteria. During chemotherapy, intestinal permeability was assessed by lactulose/mannitol urinary test on day 0 and day 14. Zonulin, GLP-2, EGF and ghrelin circulating levels were evaluated by ELISA tests at five time-points (days 0, 3, 10, 14, and 21).</p> <p>Results</p> <p>During FEC60 administration, the lactulose/mannitol ratio was significantly higher on day 14 than at baseline. Zonulin levels were not affected by chemotherapy, whereas GLP-2 and EGF levels decreased significantly. GLP-2 levels on day 14 were significantly lower than those on day 0 and day 3, while EGF values were significantly lower on day 10 than at the baseline. In contrast, the total concentrations of ghrelin increased significantly at day 3 compared to days 0 and 21, respectively. Ten patients (27%) suffered from diarrhea. On day 14 of chemotherapy, a significant increase of the La/Ma ratio occurred in CTD(+) patients compared to CTD(−) patients. With regards to circulating gut peptides, the AUCg of GLP-2 and ghrelin were significantly lower and higher in CTD(+) patients than CTD(−) ones, respectively. Finally in CTD(+) patients a significant and inverse correlation between GLP-2 and La/Ma ratio was found on day 14.</p> <p>Conclusions</p> <p>Breast cancer patients undergoing FEC60 showed alterations in the intestinal permeability, which was associated with modifications in the levels of GLP-2, ghrelin and EGF. In CTD(+) patients, a different GI peptide profile and increased intestinal permeability was found in comparison to CTD(−) patients. This evidence deserves further studies for investigating the potentially different intestinal luminal and microbiota conditions.</p> <p>Trial registration</p> <p>Clinical trial NCT01382667</p> |
| first_indexed | 2024-04-12T14:26:55Z |
| format | Article |
| id | doaj.art-d2174e262b8a4499882b6ef428a794a2 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-12T14:26:55Z |
| publishDate | 2013-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-d2174e262b8a4499882b6ef428a794a22022-12-22T03:29:25ZengBMCBMC Cancer1471-24072013-02-011315610.1186/1471-2407-13-56The effects of fluorouracil, epirubicin, and cyclophosphamide (FEC60) on the intestinal barrier function and gut peptides in breast cancer patients: an observational studyRusso FrancescoLinsalata MicheleClemente CaterinaD’Attoma BenedettaOrlando AntonellaCampanella GiovannaGiotta FrancescoRiezzo Giuseppe<p>Abstract</p> <p>Background</p> <p>Several GI peptides linked to intestinal barrier function could be involved in the modification of intestinal permeability and the onset of diarrhea during adjuvant chemotherapy. The aim of the study was to evaluate the circulating levels of zonulin, glucagon-like peptide-2 (GLP-2), epidermal growth factor (EGF) and ghrelin and their relationship with intestinal permeability and chemotherapy induced diarrhea (CTD).</p> <p>Methods</p> <p>Sixty breast cancer patients undergoing an FEC60 regimen were enrolled, 37 patients completed the study. CTD(+) patients were discriminated by appropriate questionnaire and criteria. During chemotherapy, intestinal permeability was assessed by lactulose/mannitol urinary test on day 0 and day 14. Zonulin, GLP-2, EGF and ghrelin circulating levels were evaluated by ELISA tests at five time-points (days 0, 3, 10, 14, and 21).</p> <p>Results</p> <p>During FEC60 administration, the lactulose/mannitol ratio was significantly higher on day 14 than at baseline. Zonulin levels were not affected by chemotherapy, whereas GLP-2 and EGF levels decreased significantly. GLP-2 levels on day 14 were significantly lower than those on day 0 and day 3, while EGF values were significantly lower on day 10 than at the baseline. In contrast, the total concentrations of ghrelin increased significantly at day 3 compared to days 0 and 21, respectively. Ten patients (27%) suffered from diarrhea. On day 14 of chemotherapy, a significant increase of the La/Ma ratio occurred in CTD(+) patients compared to CTD(−) patients. With regards to circulating gut peptides, the AUCg of GLP-2 and ghrelin were significantly lower and higher in CTD(+) patients than CTD(−) ones, respectively. Finally in CTD(+) patients a significant and inverse correlation between GLP-2 and La/Ma ratio was found on day 14.</p> <p>Conclusions</p> <p>Breast cancer patients undergoing FEC60 showed alterations in the intestinal permeability, which was associated with modifications in the levels of GLP-2, ghrelin and EGF. In CTD(+) patients, a different GI peptide profile and increased intestinal permeability was found in comparison to CTD(−) patients. This evidence deserves further studies for investigating the potentially different intestinal luminal and microbiota conditions.</p> <p>Trial registration</p> <p>Clinical trial NCT01382667</p>http://www.biomedcentral.com/1471-2407/13/56Breast cancerChemotherapy-induced diarrheaEpidermal growth factorIntestinal permeabilityGhrelinGlucagon-like peptide 2Gut peptidesZonulin |
| spellingShingle | Russo Francesco Linsalata Michele Clemente Caterina D’Attoma Benedetta Orlando Antonella Campanella Giovanna Giotta Francesco Riezzo Giuseppe The effects of fluorouracil, epirubicin, and cyclophosphamide (FEC60) on the intestinal barrier function and gut peptides in breast cancer patients: an observational study BMC Cancer Breast cancer Chemotherapy-induced diarrhea Epidermal growth factor Intestinal permeability Ghrelin Glucagon-like peptide 2 Gut peptides Zonulin |
| title | The effects of fluorouracil, epirubicin, and cyclophosphamide (FEC60) on the intestinal barrier function and gut peptides in breast cancer patients: an observational study |
| title_full | The effects of fluorouracil, epirubicin, and cyclophosphamide (FEC60) on the intestinal barrier function and gut peptides in breast cancer patients: an observational study |
| title_fullStr | The effects of fluorouracil, epirubicin, and cyclophosphamide (FEC60) on the intestinal barrier function and gut peptides in breast cancer patients: an observational study |
| title_full_unstemmed | The effects of fluorouracil, epirubicin, and cyclophosphamide (FEC60) on the intestinal barrier function and gut peptides in breast cancer patients: an observational study |
| title_short | The effects of fluorouracil, epirubicin, and cyclophosphamide (FEC60) on the intestinal barrier function and gut peptides in breast cancer patients: an observational study |
| title_sort | effects of fluorouracil epirubicin and cyclophosphamide fec60 on the intestinal barrier function and gut peptides in breast cancer patients an observational study |
| topic | Breast cancer Chemotherapy-induced diarrhea Epidermal growth factor Intestinal permeability Ghrelin Glucagon-like peptide 2 Gut peptides Zonulin |
| url | http://www.biomedcentral.com/1471-2407/13/56 |
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