肠道屏障功能障碍和微生物群失调在结直肠癌发生中的作用

The Role of Gut Barrier Dysfunction and Microbiome Dysbiosis in Colorectal Cancer Development.

作者信息

Genua Flavia, Raghunathan Vedhika, Jenab Mazda, Gallagher William M, Hughes David J

机构信息

Cancer Biology and Therapeutics Laboratory, Conway Institute, School of Biomedical and Biomolecular Sciences, University College Dublin, Dublin, Ireland.

College of Literature, Sciences, and the Arts, University of Michigan, Ann Arbor, MI, United States.

出版信息

Front Oncol. 2021 Apr 15;11:626349. doi: 10.3389/fonc.2021.626349. eCollection 2021.

Abstract

Accumulating evidence indicates that breakdown of the+ protective mucosal barrier of the gut plays a role in colorectal cancer (CRC) development. Inflammation and oxidative stress in the colonic epithelium are thought to be involved in colorectal carcinogenesis and the breakdown of the integrity of the colonic barrier may increase the exposure of colonocytes to toxins from the colonic milieu, enhancing inflammatory processes and release of Reactive Oxygen Species (ROS). The aetiological importance of the gut microbiome and its composition - influenced by consumption of processed meats, red meats and alcoholic drinks, smoking, physical inactivity, obesity - in CRC development is also increasingly being recognized. The gut microbiome has diverse roles, such as in nutrient metabolism and immune modulation. However, microbial encroachment towards the colonic epithelium may promote inflammation and oxidative stress and even translocation of species across the colonic lumen. Recent research suggests that factors that modify the above mechanisms, e.g., obesity and Western diet, also alter gut microbiota, degrade the integrity of the gut protective barrier, and expose colonocytes to toxins. However, it remains unclear how obesity, lifestyle and metabolic factors contribute to gut-barrier integrity, leading to metabolic disturbance, colonocyte damage, and potentially to CRC development. This review will discuss the interactive roles of gut-barrier dysfunction, microbiome dysbiosis, and exposure to endogenous toxins as another mechanism in CRC development, and how biomarkers of colonic mucosal barrier function may provide avenues for disease, prevention and detection.

摘要

越来越多的证据表明,肠道保护性黏膜屏障的破坏在结直肠癌(CRC)的发生发展中起作用。结肠上皮中的炎症和氧化应激被认为与结直肠癌的发生有关,结肠屏障完整性的破坏可能会增加结肠细胞暴露于结肠环境中的毒素,从而增强炎症过程和活性氧(ROS)的释放。肠道微生物群及其组成(受加工肉类、红肉和酒精饮料的摄入、吸烟、缺乏运动、肥胖等因素影响)在结直肠癌发生发展中的病因学重要性也越来越受到认可。肠道微生物群具有多种作用,如营养代谢和免疫调节。然而,微生物向结肠上皮的侵袭可能会促进炎症和氧化应激,甚至导致微生物穿过结肠腔移位。最近的研究表明,改变上述机制的因素,如肥胖和西方饮食,也会改变肠道微生物群,破坏肠道保护屏障的完整性,并使结肠细胞暴露于毒素中。然而,目前尚不清楚肥胖、生活方式和代谢因素如何影响肠道屏障的完整性,导致代谢紊乱、结肠细胞损伤,并可能导致结直肠癌的发生。本综述将讨论肠道屏障功能障碍、微生物群失调和内源性毒素暴露在结直肠癌发生发展中的相互作用,以及结肠黏膜屏障功能的生物标志物如何为疾病的预防和检测提供途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb1c/8082020/01f151f47dff/fonc-11-626349-g001.jpg

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