Department of Nutrition and Dietetics, Hamidiye Faculty of Health Sciences, University of Health Sciences, 34668, Istanbul, Türkiye.
Curr Nutr Rep. 2024 Jun;13(2):126-151. doi: 10.1007/s13668-024-00525-z. Epub 2024 Mar 14.
Colorectal cancer is the second deadliest cancer in the world, and its prevalence has been increasing alarmingly in recent years. After researchers discovered the existence of dysbiosis in colorectal cancer, they considered the use of probiotics in the treatment of colorectal cancer. However, for various reasons, including the low safety profile of probiotics in susceptible and immunocompromised patient5s, and the risk of developing antibiotic resistance, researchers have shifted their focus to non-living cells, their components, and metabolites. This review aims to comprehensively evaluate the literature on the effects of diet, microbiota, and postbiotics on colorectal cancer and the future of postbiotics.
The link between diet, gut microbiota, and colorectal cancer has been established primarily as a relationship rather than a cause-effect relationship. The gut microbiota can convert gastrointestinal tract and dietary factors into either onco-metabolites or tumor suppressor metabolites. There is serious dysbiosis in the microbiota in colorectal cancer. Postbiotics appear to be promising agents in the prevention and treatment of colorectal cancer. It has been shown that various postbiotics can selectively induce apoptosis in CRC, inhibit cell proliferation, growth, invasion, and migration, modulate the immune system, suppress carcinogenic signaling pathways, maintain intestinal epithelial integrity, and have a synergistic effect with chemotherapy drugs. However, it is also reported that some postbiotics are ineffective and may be risky in terms of safety profile in some patients. Many issues need to be researched about postbiotics. Large-scale, randomized, double-blind clinical studies are needed.
结直肠癌是全球第二大致命癌症，近年来其发病率呈惊人上升趋势。在研究人员发现结直肠癌存在肠道菌群失调后，他们开始考虑使用益生菌治疗结直肠癌。然而，由于各种原因，包括益生菌在易感和免疫功能低下患者中的安全性低，以及产生抗生素耐药性的风险，研究人员将注意力转向了非活细胞、其成分和代谢物。本综述旨在全面评估饮食、微生物组和后生元对结直肠癌的影响以及后生元的未来。
饮食、肠道微生物组和结直肠癌之间的联系主要是一种关联，而不是因果关系。肠道微生物组可以将胃肠道和饮食因素转化为致癌代谢物或肿瘤抑制代谢物。结直肠癌中存在严重的肠道菌群失调。后生元似乎是预防和治疗结直肠癌的有前途的药物。已经表明，各种后生元可以选择性地诱导 CRC 细胞凋亡，抑制细胞增殖、生长、侵袭和迁移，调节免疫系统，抑制致癌信号通路，维持肠道上皮完整性，并与化疗药物具有协同作用。然而，也有报道称，一些后生元在某些患者中无效，且在安全性方面存在风险。后生元有许多问题需要研究。需要进行大规模、随机、双盲的临床研究。
