Familial adenomatous polyposis (FAP) is an autosomal-dominant hereditary condition associated with germline mutations in the adenomatous polyposis coli gene. Patient management involves prophylactic surgery and intensive life-long endoscopic surveillance. Diet is a major concern for patients with FAP, who are generally free of symptoms before surgery but tend to have issues related to bowel function postoperatively. We hypothesized that a low-inflammatory diet based on the principles and recipes of the Mediterranean diet would reduce markers of local and systemic inflammation. Twenty-eight patients with FAP over 18 years of age who underwent rectum-sparing prophylactic colectomy and were included in our surveillance program participated in a pilot dietary intervention study. Blood and stool samples at baseline (T0), at the end of the dietary intervention (T1, three months), and at the end of the study (T2, six months after T0) were collected. Gastrointestinal inflammation markers including fecal calprotectin, cyclooxygenase-2, and 15-hydroxyprostaglandin dehydrogenase were evaluated. Serum calprotectin, insulin, insulin-like growth factor-1, C-reactive protein, and glycated hemoglobin were also assessed. Significant changes in serum calprotectin, insulin, and insulin-like growth factor-1 levels occurred over time. Borderline significant changes were observed in the neutrophil–lymphocyte ratio. These changes were noticeable immediately at the end of the 3-month active dietary intervention (T1). A significant increase in 15-hydroxyprostaglandin dehydrogenase expression in the normal crypts of matched samples was also observed between T0 and T2. This pilot study supports the hypothesis that a low-inflammatory diet can modulate gastrointestinal markers of inflammation in individuals with FAP. Prevention Relevance: Cancer is known to be related to inflammatory conditions. This study suggests that anti-inflammatory dietary intervention may potentially prevent adenomas and cancer in FAP patients by reducing systemic and tissue inflammatory indices.

中文翻译：

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预防性抗炎饮食以减少家族性腺瘤性息肉病患者的胃肠道炎症：一项前瞻性试验研究

家族性腺瘤性息肉病 (FAP) 是一种常染色体显性遗传病，与大肠杆菌腺瘤性息肉病基因的种系突变相关。患者管理涉及预防性手术和密集的终生内窥镜监测。饮食是 FAP 患者的一个主要问题，他们在手术前通常没有症状，但术后往往会出现与肠道功能相关的问题。我们假设基于地中海饮食原则和食谱的低炎症饮食会减少局部和全身炎症的标志物。28 名 18 岁以上的 FAP 患者接受了保留直肠的预防性结肠切除术并被纳入我们的监测计划，参与了一项试点饮食干预研究。基线（T0）的血液和粪便样本，在饮食干预结束时（T1，三个月）和研究结束时（T2，T0 后六个月）收集数据。评估了包括粪便钙卫蛋白、环氧合酶 2 和 15-羟基前列腺素脱氢酶在内的胃肠道炎症标志物。还评估了血清钙卫蛋白、胰岛素、胰岛素样生长因子 1、C 反应蛋白和糖化血红蛋白。随着时间的推移，血清钙卫蛋白、胰岛素和胰岛素样生长因子-1 水平发生显着变化。在中性粒细胞 - 淋巴细胞比率中观察到临界显着变化。这些变化在 3 个月的积极饮食干预（T1）结束时立即显着。在 T0 和 T2 之间也观察到匹配样品的正常隐窝中 15-羟基前列腺素脱氢酶表达的显着增加。这项初步研究支持低炎症饮食可以调节 FAP 患者胃肠道炎症标志物的假设。预防相关性：已知癌症与炎症有关。该研究表明，抗炎饮食干预可能通过降低全身和组织炎症指数来预防 FAP 患者的腺瘤和癌症。