Effects of Ginger Supplementation on Cell-Cycle Biomarkers in the Normal-Appearing Colonic Mucosa of Patients at Increased Risk for Colorectal Cancer: Results from a Pilot, Randomized, and Controlled Trial

Cancer Prevention Research
Q1
Jan 2013
Citations:88
Influential Citations:4
Interventional (Human) Studies
65
COI
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Methods
Pilot, randomized, double-blind, placebo-controlled trial; 20 adults at increased risk for colorectal cancer; mean age 51 years; 35% male; 75% White; increased CRC risk defined by a first-degree relative with CRC diagnosed before age 60 or prior adenomatous polyp; two flexible sigmoidoscopies with mucosal biopsies at baseline and day 28.
Intervention
2.0 g/day ginger extract powder; four 250 mg capsules taken twice daily (total 8 capsules/day) for 28 days; capsules standardized to 5% gingerols.
Results
Ginger supplementation (2.0 g/day for 28 days) reduced a marker of cellular proliferation in normal-appearing colorectal crypts, with significant decreases in hTERT expression in whole crypts (−41.2%, P=0.05) and in the differentiation zone (−47.9%, P=0.04). MIB-1 (Ki-67) decreased across compartments but changes were not statistically significant. Bax and Bcl-2 changes were inconsistent; p21 decreased non-significantly. The p21/hTERT ratio increased, and overall directions suggest reduced proliferation and increased differentiation/apoptosis relative to proliferation, particularly in the differentiation zone. These preliminary results support a larger, longer trial to confirm health relevance for colorectal cancer risk reduction.
Limitations
Small pilot study (n≈20); short duration (28 days); endpoints are intermediate biomarkers rather than cancer outcomes; some biomarker changes were not statistically significant; limited statistical power; results may not generalize beyond adults at increased CRC risk; multiple biomarker tests raise the possibility of chance findings; replication is needed in larger, longer trials.

Abstract

To estimate the effects of ginger on apoptosis, proliferation, and differentiation in the normal-appearing colonic mucosa, we randomized 20 people at increased risk for colorectal cancer to 2.0 g of ginger or placebo daily for 28 days in a pilot tria...