SIGNIFICANCE OF ANGIOTENSIN SYSTEM IN PROGRESSION OF COLORECTAL CANCER

Abstract

Colorectal cancer (CRC) cells possess an angiotensin activation mechanism provided by the expression of renin and chymase. Renin expression is induced by hyperglycemic condition. Since angiotensinogen is produced in the liver, CRC cells with angiotensin-activating machinery possess an advantage to metastasize to the liver. In human CRC cases, the diabetes complicated patients show higher concentrations of renin, angiotensin-Ⅱ in the primary tumors, and more progressed disease stage, especially, liver metastasis in an association with HbA1c levels than those in the patients without diabetes. Concurrent treatment with anti-angiotensin and hypoglycemic agents shows a synergic effect of decrease of liver metastasis and improvement of the survival of diabetic mice of CRC liver metastasis model. The effect of anti-angiotensin treatment and blood sugar control as a baseline management of the colon cancer patients with the diabetic condition is needed to be examined in clinical situation for prevention of liver metastasis.