Methylene blue but not indigo carmine causes DNA damage to colonocytes in vitro and in vivo at concentrations used in clinical chromoendoscopy

Davies, Jim; Burke, Dermot; Olliver, Joanna R; Hardie, L.J.; Wild, Christopher P.; Routledge, Michael N.

doi:10.1136/gut.2006.107300

Cited by 76 publications

(48 citation statements)

References 7 publications

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“…Two main stains are available: indigo carmine, a contrast dye which simply coats the colonic mucosal surface, highlighting subtle contour irregularities caused by lesions; and methylene blue, a dye which is absorbed readily by non-inflamed mucosa, but less well absorbed by active inflammation and neoplasia, creating a colour contrast. Concern has recently been raised about the safety of methylene blue: one study found in vitro evidence of DNA damage at the concentration used in the colon [32]. Whether this is of any clinical significance is unclear.…”

Section: Maximising Yield From Colonoscopymentioning

confidence: 97%

Surveillance programmes for neoplasia in colitis

Rutter

2010

J Gastroenterol

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Patients with longstanding extensive colitis, both ulcerative colitis and Crohn's colitis, have an increased risk of developing colorectal cancer. Because of this risk, colonoscopic surveillance for neoplasia is recommended by most authorities. Although there has been no randomised controlled trial to demonstrate surveillance effectiveness, there are several retrospective comparative studies, which suggest that surveillance reduces colorectal cancer mortality. Over the past decade there have been a number of developments in our understanding of colitis cancer. We have discovered that the severity of colorectal inflammation is an important risk factor, in addition to other known risk factors such as the extent and duration of colitis, primary sclerosing cholangitis and a family history of colorectal cancer. Endoscopic techniques have also improved and evidence now demonstrates that pancolonic chromoendoscopy yields significantly more intraepithelial neoplasia than random biopsies. Endoscopic resection of well-circumscribed lesions is now also recognised as being an appropriate strategy, potentially reducing the number of patients requiring colectomy. It is hoped that such developments will further improve the effectiveness of colitis surveillance.

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Section: Maximising Yield From Colonoscopymentioning

confidence: 97%

Surveillance programmes for neoplasia in colitis

Rutter

2010

J Gastroenterol

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“…The advantages of chromoendoscopy were recently confirmed in a multicenter study which detected more intraepithelial neoplasia as compared to conventional colonoscopy [59]. However, it should be kept in mind that methylene blue, which is frequently recommended for chromoendoscopy, may cause DNA damage and contribute to CRC risk [60,61,62]. Therefore, indigo carmine seems to be the better alternative for chromoendoscopy [55,60,63].…”

Section: How Should Surveillance Colonoscopies Be Performed?mentioning

confidence: 99%

“…However, it should be kept in mind that methylene blue, which is frequently recommended for chromoendoscopy, may cause DNA damage and contribute to CRC risk [60,61,62]. Therefore, indigo carmine seems to be the better alternative for chromoendoscopy [55,60,63]. The other techniques that have been investigated in recent years should not be used as stand-alone strategies.…”

Section: How Should Surveillance Colonoscopies Be Performed?mentioning

confidence: 99%

Inflammatory Bowel Disease Cancer Risk, Detection and Surveillance

Rogler

2012

Dig Dis

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Ulcerative colitis (UC) is a chronic and relapsing inflammation of the colonic mucosa with variable extension from the rectum towards the cecum. The aim of medical treatment is to induce and maintain clinical remission. If no remission can be achieved, continuous inflammation may repeatedly destroy the epithelial cells. This has to be compensated by epithelial increased proliferation which finally can lead to inflammation-associated colorectal cancer (CRC). The risk of colitis-associated CRC is increased after a long disease duration, especially in patients with chronic active disease. This risk may be lower if long-lasting mucosal healing can be achieved. To detect the development of dysplasia/intraepithelial neoplasia and colitis-associated CRC early, surveillance programs have been installed. However, the evidence of success for those surveillance programs is limited. This is partially due to problems of detecting precancerous lesions in the colonic mucosa during those surveillance programs. The specific problems of surveillance programs for the prevention of CRC and specific aspects of patient care in UC are reviewed in this article.

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“…Methylene blue, in contrast, is an absorptive dye that is actively taken up by normal epithelial cells in the colon and small intestine. Some reports suggested that methylene blue could cause oxidative DNA damage in cells exposed to white light during chromoendoscopy [5,6]. However, a recent study did not show that chromoendoscopy with methylene blue led to an increased number of cancers [7].…”

Section: Introductionmentioning

confidence: 96%

Optical Enhancements in Diagnosis and Surveillance of Colorectal Neoplasia

Sauk

Itzkowitz

2011

Curr Colorectal Cancer Rep

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The influx of new endoscopic technologies produces continuous evolution in diagnostic modalities, especially in colorectal cancer screening. New technologies seek not only to improve the detection of flat and difficult-tovisualize lesions, but also to more precisely differentiate between neoplastic and non-neoplastic lesions. The oldest technology, chromoendoscopy, has been shown to improve neoplasia detection in high-risk subjects, but it is not widely accepted due to its cumbersome nature. Newer technologies such as narrow-band imaging provide digital chromoendoscopy, yielding improved lesion detection and characterization with less inconvenience. Other technologies such as confocal endomicroscopy allow endoscopists to make in vivo histologic diagnoses of suspicious areas. Collectively, these emerging technologies may change the way that colonoscopy is performed.

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Methylene blue but not indigo carmine causes DNA damage to colonocytes in vitro and in vivo at concentrations used in clinical chromoendoscopy

Cited by 76 publications

References 7 publications

Surveillance programmes for neoplasia in colitis

Surveillance programmes for neoplasia in colitis

Inflammatory Bowel Disease Cancer Risk, Detection and Surveillance

Optical Enhancements in Diagnosis and Surveillance of Colorectal Neoplasia

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