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To the Editor: Dr Erlinger and colleagues¹ reported that C-reactive protein (CRP) levels were associated with risk of colon cancer. We have suggested that CRP is not merely a nonspecific marker of inflammation but has several important proinflammatory effects.^2-3 In particular, CRP may activate endothelial cells, monocytes and smooth muscle cells, induce expression of adhesion molecules,² chemoactractants,³ tissue factor, and activate the NF-B pathway.⁴ Although we are not aware of any studies on the effect of CRP on cancer cells or on epithelial cells of the gastrointestinal tract, expression of adhesion molecules is important for cancer invasion and activation of the NF-B pathway may have important oncogenic effects.⁵

Thus, it is possible that direct effects of CRP may contribute to its association with colon cancer. Statins, used as cholesterol-lowering drugs, may also reduce CRP and it would be interesting to know whether these drugs can reduce the incidence . . . [Full Text of this Article]

Vincenzo Pasceri, MD, PhD
vpasceri@hotmail.com
Department of Cardiovascular Science
San Filippo Neri Hospital

Giovanni Cammarota, MD
Department of Gastroenterology
Catholic University
Rome, Italy

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