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Review ArticleReview Article
Open Access

Effect of gut microbiota on colorectal cancer progression and treatment

Glowi A. Alasiri
Saudi Medical Journal December 2022, 43 (12) 1289-1299; DOI: https://doi.org/10.15537/smj.2022.43.12.20220367
Glowi A. Alasiri
From the Department of Biochemistry, College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Kingdom of Saudi Arabia.
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    Figure 1

    - Imbalance of gut microbiota via diet, infections, nutrition, and xenobiotic.

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    Figure 2

    - Effects of gut microbiota on nutrition.

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    Table 1

    - Bacteria associated with colorectal cancer.

    BacteriaAssociation with colorectal cancer
    Fusobacterium nucleatum- Stages, recurrence, and patients’ low survival rates
    - Prevalence of a molecular feature such as mutation of BRAF, hypermutation with microsatellite instability and metastases
    - Serrated pathway manipulation
    - Binds to the E-cadherins’s extracellular domain and induces cancer cell proliferation
    - Promotes autophagy by upregulating CARD3
    - Regulates microRNA to induce chemotherapy resistance
    - Inhibits T-cell infiltration and stimulates myeloid-derived immunity
    Peptostreptococcus anaerobius- Induces TLR2/4 that causes ROS activation
    - Promotes cholesterol synthesis
    - Induces cell proliferation
    Peptostreptococcus stomatis- Induces hypoxia
    - Produces CMS-1
    Prevotella intermediaMutates P53 in pancreatic cancer
    Parvimonas micraInterrupts NOD2 that is involved in chemotherapy resistance and cancer progression
    Bacteroides fragilis- Regulates STAT3 and NF-kB that modulate pro-inflammatory molecules such as cytokine IL-17
    - Interrupts E-cadherin and DNA damage
    - Induces COX-2, causing upregulation of PGE2 and promotion of inflammation and cell proliferation
    Streptococcus gallolyticusInduces pro-inflammatory markers such as NF-κB and IL-8
    Escherichia coliInduces chromosomal appearance

    BRAF: B-Raf Proto-Oncogene, Serine/Threonine Kinase, CARD3: caspase activation and recruitment domain 3, TLR: toll-like receptor, ROS: reactive oxygen species, CMS-1: consensus molecular subtype-1, P53: tumor protein p53, NOD2: nucleotide-binding oligomerization domain 2, STAT3: Signal Transducer And Activator Of Transcription 3, NF-kB: nuclear factor kappa B, IL: interleukin, COX-2: cyclooxygenase-2, PGE2: prostaglandin E2

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      Table 2

      - Bacterial metabolites and colorectal cancer.

      Bacterial metabolitesExamplesEffect on CRC
      SCFAsButyrate, propionate, and acetate- Immunomodulation via regulation of AhR
      - Rebalance gut microbiota diversity and composition
      - Inhibit NF-kB and activate apoptosis
      - Antitumor effect via modulation of Tc17 cells and CTLs
      - Inhibit ERK1/2, causing tumor growth disruption
      - Induce ROS activity and decrease glucose oxidation
      - Induce HDAC
      Bile acidPrimary and secondary bile acids- Bind to FXR as CRC inhibitor
      - Promote cancer initiation by upregulating IL-8, ERK1/2, and inhibiting STAT3 phosphorylation
      - Activate MAPK pathway via upregulation of uPAR and calcium signaling
      Lactate- Creates an acidification environment
      - Stimulates angiogenic response to oxygen transfer, glucose delivery and nutrition delivery that promote CRC invasion, proliferation, and migration
      Succinate- Inhibits CRC proliferation and induces CRC metastasis via SUCNR1 signaling
      Protein-derived metabolitesHO-PAA, PAA, phenol (produced from tyrosine), acetaldehyde, H2S, and NOCs- Hydrogen sulfide inhibits the anti-inflammatory outcome in CRC cell lines by activating NF-kB pathway signaling
      - NOCs contribute to K-ras mutation, which drives CRC proliferation

      SCFAs: short-chain fatty acids, HO-PAA: 4-hydroxyphenylacetic acid, PAA: phenylacetic acid, H2S: hydrogen sulfide, NOCs: N-nitroso compounds, AhR: aryl hydrocarbon receptor, NF-kB: nuclear factor kappa B, Tc17: IL-17-secreting CD8 T cells), CTLs: cytotoxic T lymphocytes, ERK1/2: protein kinases 1 and 2, ROS: reactive oxygen species, HDAC: histone deacetylases, FXR: farnesoid X receptor, CRC: colorectal cancer, IL: interleukin, STAT3: Signal Transducer and Activator of Transcription 3, MAPK: mitogen-activated protein kinase, uPAR: urokinase plasminogen activator, SUCNR1: succinate receptor 1, K-ras: Kirsten rat sarcoma viral oncogene homolog

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      Effect of gut microbiota on colorectal cancer progression and treatment
      Glowi A. Alasiri
      Saudi Medical Journal Dec 2022, 43 (12) 1289-1299; DOI: 10.15537/smj.2022.43.12.20220367

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      Effect of gut microbiota on colorectal cancer progression and treatment
      Glowi A. Alasiri
      Saudi Medical Journal Dec 2022, 43 (12) 1289-1299; DOI: 10.15537/smj.2022.43.12.20220367
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      Keywords

      • gut microbiota
      • colorectal cancer
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      • treatment

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