Zinc may prevent Barret's esophageal cancer
Zinc may prevent Barrett’s esophagus-related esophageal cancer, human study shows
Patients with BE, the esophageal condition caused by long-term gastrointestinal reflux disease, have a significantly higher risk of developing cancer of the esophagus than the general population. Moreover, esophageal cancer has one of the lowest five-year survival rates of any cancer: less than 20 percent.
“Finding a way to effectively treat BE and stop its progression to cancer has been paramount among those in the gastroenterology community,” noted Gary Newman, MD, a gastroenterologist at Lankenau Medical Center and one of the new study’s authors.
Preclinical studies in rodents done at Thomas Jefferson University School of Medicine and elsewhere suggested that zinc deficiency was associated with higher rates of chemically induced esophageal cancer (squamous cell carcinoma). Could the same be true regarding esophageal adenocarcinoma in humans diagnosed with BE?
“We wanted to determine if the chemopreventive action reported for zinc’s inhibition of esophageal cancer in rodents extends to the Barrett’s-driven esophageal adenocarcinoma in humans,” noted James Mullin, PhD, LIMR professor and one of the study’s authors. “Our pilot study in humans offers promising data that this may be true.”
The researchers conducted a small pilot study involving over 100 BE patients from 2012 to 2019. Study participants were randomized into two study arms. One group took two zinc gluconate lozenges each morning and evening for 14 days. Dosage was 13.2 mg of zinc per lozenge for a daily intake of 52.8 mg. The other group took a sodium gluconate placebo.
After 14 days, biopsies of study participants’ esophageal tissue were taken for RNA and protein analyses. The researchers found an intriguing pattern in the nature of the molecular changes observed. Among the notable findings they discovered an uptick in genes that have been shown in previous studies to suppress tumors, and a down regulation in genes known to promote tumor growth.
“Overall, this study suggests that daily zinc prophylaxis could be a significant proactive step that a Barrett’s esophagus patient could take to reduce the lifetime risk of esophageal adenocarcinoma,” wrote the study’s authors, which included those at LIMR; the divisions of Gastroenterology and Pathology at Lankenau Medical Center; the Wistar Institute; Thomas Jefferson University; and Saint Joseph’s University.
The authors concluded that these promising results from a small sampling of BE patients suggests the imperative of conducting a larger prospective clinical trial that would study the therapeutic value of zinc in more patients, specifically targeting the issue of whether zinc prophylaxis reduces the risk of Barrett’s patients acquiring esophageal adenocarcinoma.
The manuscript “Zinc gluconate induces potentially cancer chemopreventive activity in Barrett’s esophagus: a phase 1 pilot study” was published in the journal Digestive Diseases and Sciences. The full manuscript is available at here..
The current manuscript follows an earlier publication from LIMR and Lankenau’s Gastroenterology group describing drug delivery of zinc to Barrett’s tissue.
The current study was supported by funding from the Sharpe-Strumia Research Foundation and internal funding from LIMR. The pilot study provided research training to — and benefited from the assistance of — more than a dozen gastroenterology fellows at Lankenau Medical Center during its seven years of patient recruitment.
About Main Line Health
Main Line Health® is a not-for-profit health system serving the greater Philadelphia region. The System comprises five hospitals, seven health centers, more than 160 outpatient and physician practice locations, over 14,500 employees and more than 2,200 employed and independent physicians and advanced practice providers.
Founded in 1985, Main Line Health includes four of the region’s most respected acute care hospitals — Lankenau Medical Center, Bryn Mawr Hospital, Paoli Hospital and Riddle Hospital — as well as Bryn Mawr Rehab Hospital, one of the nation’s premier facilities for rehabilitative medicine. The System also includes Mirmont Treatment Center, which provides treatment and support for substance use disorders; Main Line Health HomeCare & Hospice; Main Line HealthCare, its employed multispecialty physician network; Lankenau Institute for Medical Research, a leading biomedical research organization; and Main Line Health Centers offering primary and specialty care, lab, radiology and other outpatient services in Broomall, Collegeville, Concordville, Devon, Exton, King of Prussia and Newtown Square.
Main Line Health brings together physicians, advanced practice providers, nurses, researchers and other healthcare professionals across a broad network of inpatient, outpatient, home-based and community-based services. Through this integrated approach, the System delivers high-quality, comprehensive care across the continuum — from primary care and preventive services to complex specialty, surgical, trauma, emergency, rehabilitative, behavioral health, home care and hospice services — with a focus on making care accessible in the communities where people live and work.
Main Line Health also collaborates with leading clinical partners to expand access to specialized care. Through its affiliation with Children's Hospital of Philadelphia, pediatric care is provided at select Main Line Health locations, including neonatal intensive care units at its acute care hospitals and Bryn Mawr Hospital’s Inpatient Pediatric Unit and Emergency Department. Jefferson Health neurosurgeons and neurointerventionalists also provide 24/7 specialized care, including neurointervention and lifesaving stroke care.
About Lankenau Institute for Medical Research
Lankenau Institute for Medical Research (LIMR), part of Main Line Health, is a nonprofit biomedical research institute on the campus of Lankenau Medical Center celebrating its landmark 100th anniversary of scientific accomplishment in Fall 1927. LIMR's mission is to improve human health and well-being. Through its ACAPRENEURIAL™ organizational model, which integrates academic and entrepreneurial approaches, LIMR faculty and staff advance innovative strategies to address formidable medical challenges including cancer, cardiovascular disease, tissue regeneration, gastrointestinal disorders and autoimmune diseases such as rheumatoid arthritis. LIMR's principal investigators conduct basic, preclinical and clinical research, using their findings to improve disease detection, diagnosis, treatment and prevention. They are committed to extending the boundaries of human health through technology transfer and training the next generation of scientists and physicians.