Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, China.
The First Clinical Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, China.
World J Gastroenterol. 2024 Oct 14;30(38):4175-4193. doi: 10.3748/wjg.v30.i38.4175.
As a research hotspot in the field of molecular biology, N6-methyladenosine (m6A) modification has made progress in the treatment of colorectal cancer (CRC), leukemia and other cancers. Numerous studies have demonstrated that the tumour microenvironment (TME) regulates the level of m6A modification in the host and activates a series of complex epigenetic signalling pathways through interactions with CRC cells, thus affecting the progression and prognosis of CRC. However, with the diversity in the composition of TME factors, this action is reciprocal and complex. Encouragingly, some studies have experimentally revealed that the intestinal flora can alter CRC cell proliferation by directly acting on m6A and thereby altering CRC cell proliferation. This review summarizes the data, supporting the idea that the intestinal flora can influence host m6A levels through pathways such as methyl donor metabolism and thus affect the progression of CRC. We also review the role of m6A modification in the diagnosis, treatment, and prognostic assessment of CRC and discuss the current status, limitations, and potential clinical value of m6A modification in this field. We propose that additional in-depth research on m6A alterations in CRC patients and their TME-related targeted therapeutic issues will lead to better therapeutic outcomes for CRC patients.
作为分子生物学领域的研究热点，N6-甲基腺苷（m6A）修饰在结直肠癌（CRC）、白血病等癌症的治疗方面取得了进展。大量研究表明，肿瘤微环境（TME）通过与 CRC 细胞相互作用调节宿主中 m6A 修饰的水平，并激活一系列复杂的表观遗传信号通路，从而影响 CRC 的进展和预后。然而，由于 TME 因素的组成多样性，这种作用是相互的且复杂的。令人鼓舞的是，一些研究通过实验表明，肠道菌群可以通过直接作用于 m6A 来改变 CRC 细胞的增殖，从而改变 CRC 细胞的增殖。本综述总结了相关数据，支持肠道菌群可以通过甲基供体代谢等途径影响宿主 m6A 水平，从而影响 CRC 进展的观点。我们还综述了 m6A 修饰在 CRC 诊断、治疗和预后评估中的作用，并讨论了该领域 m6A 修饰的现状、局限性和潜在的临床价值。我们提出，对 CRC 患者及其 TME 相关靶向治疗问题的 m6A 改变进行更多深入研究，将为 CRC 患者带来更好的治疗效果。
