Department of Nuclear Medicine, The First Hospital of Jilin University, Changchun, China.
National Health Commission (NHC) Key laboratory of Radiobiology, School of Public Health, Jilin University, Changchun, China.
Front Immunol. 2023 Jan 31;14:1128774. doi: 10.3389/fimmu.2023.1128774. eCollection 2023.
Colorectal cancer (CRC) is one of the most common cancers, with a high mortality rate, and is a major burden on human health worldwide. Gut microbiota regulate human immunity and metabolism through producing numerous metabolites, which act as signaling molecules and substrates for metabolic reactions in various biological processes. The importance of host-gut microbiota interactions in immunometabolic mechanisms in CRC is increasingly recognized, and interest in modulating the microbiota to improve patient's response to therapy has been raising. However, the specific mechanisms by which gut microbiota interact with immunotherapy and radiotherapy remain incongruent. Here we review recent advances and discuss the feasibility of gut microbiota as a regulatory target to enhance the immunogenicity of CRC, improve the radiosensitivity of colorectal tumor cells and ameliorate complications such as radiotoxicity. Currently, great breakthroughs in the treatment of non-small cell lung cancer and others have been achieved by radioimmunotherapy, but radioimmunotherapy alone has not been effective in CRC patients. By summarizing the recent preclinical and clinical evidence and considering regulatory roles played by microflora in the gut, such as anti-tumor immunity, we discuss the potential of targeting gut microbiota to enhance the efficacy of radioimmunotherapy in CRC and expect this review can provide references and fresh ideas for the clinical application of this novel strategy.
结直肠癌（CRC）是最常见的癌症之一，死亡率高，是全球人类健康的主要负担。肠道微生物群通过产生大量代谢物来调节人体免疫和代谢，这些代谢物作为信号分子和代谢反应的底物，在各种生物过程中发挥作用。宿主-肠道微生物群相互作用在 CRC 中的免疫代谢机制中的重要性日益得到认可，人们对调节微生物群以改善患者对治疗的反应的兴趣也在不断提高。然而，肠道微生物群与免疫治疗和放射治疗相互作用的确切机制仍不一致。在这里，我们回顾了最近的进展，并讨论了将肠道微生物群作为调节靶点来增强 CRC 的免疫原性、提高结直肠肿瘤细胞的放射敏感性以及改善放射毒性等并发症的可行性。目前，放射免疫治疗在非小细胞肺癌等治疗方面取得了巨大突破，但单独的放射免疫治疗在 CRC 患者中并不有效。通过总结最近的临床前和临床证据，并考虑肠道微生物群在抗肿瘤免疫等方面的调节作用，我们讨论了靶向肠道微生物群以提高 CRC 放射免疫治疗疗效的潜力，并期望本综述能为该新策略的临床应用提供参考和新的思路。
