Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: Drs Pasceri and Cammarota raise the
possibility that CRP may have a direct role in the pathogenesis of colon cancer
due to its direct proinflammatory effects. We agree that CRP appears to have
direct proinflammatory effects and could be more than a marker of inflammation.
However, as they point out, data are sparse in relation to direct effects
of CRP on cancer cells, in contrast to a growing literature suggesting direct
effects of IL-6 on cancer cells. Further studies are needed to clarify this
issue. We also agree that studies of anti-inflammatory agents should be examined
for effect modification in relation to any associations with CRP and cancer
outcomes. For cardiovascular disease, use of aspirin appears to strongly modify
the associations between CRP and cardiovascular outcomes.1 Similar
analyses with cancer would be of great interest, as would analyses of potential
effect modification by use of female hormones.
Erlinger TP, Platz E, Helzlsouer KJ, Rifai N. C-Reactive Protein and Risk of Colon Cancer—Reply. JAMA. 2004;291(23):2818-2819. doi:10.1001/jama.291.23.2819-b