Ionescu Vlad Alexandru, Diaconu Camelia Cristina, Gheorghe Gina, Mihai Mara-Madalina, Diaconu Carmen Cristina, Bostan Marinela, Bleotu Coralia
Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania.
Internal Medicine Department, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania.
Int J Mol Sci. 2025 Apr 15;26(8):3733. doi: 10.3390/ijms26083733.
The gut microbiome, a complex community of microorganisms residing in the intestinal tract, plays a dual role in colorectal cancer (CRC) development, acting both as a contributing risk factor and as a protective element. This review explores the mechanisms by which gut microbiota contribute to CRC, emphasizing inflammation, oxidative stress, immune evasion, and the production of genotoxins and microbial metabolites. , (pks+), and promote tumorigenesis by inducing chronic inflammation, generating reactive oxygen species, and producing virulence factors that damage host DNA. These microorganisms can also evade the antitumor immune response by suppressing cytotoxic T cell activity and increasing regulatory T cell populations. Additionally, microbial-derived metabolites such as secondary bile acids and trimethylamine-N-oxide (TMAO) have been linked to carcinogenic processes. Conversely, protective microbiota, including , , and , contribute to intestinal homeostasis by producing short-chain fatty acids (SCFAs) like butyrate, which exhibit anti-inflammatory and anti-carcinogenic properties. These beneficial microbes enhance gut barrier integrity, modulate immune responses, and inhibit tumor cell proliferation. Understanding the dynamic interplay between pathogenic and protective microbiota is essential for developing microbiome-based interventions, such as probiotics, prebiotics, and fecal microbiota transplantation, to prevent or treat CRC. Future research should focus on identifying microbial biomarkers for early CRC detection and exploring personalized microbiome-targeted therapies. A deeper understanding of host-microbiota interactions may lead to innovative strategies for CRC management and improved patient outcomes.
肠道微生物群是存在于肠道中的一个复杂微生物群落,在结直肠癌(CRC)的发展中起着双重作用,既是一个促成风险因素,也是一个保护因素。这篇综述探讨了肠道微生物群促成结直肠癌的机制,重点关注炎症、氧化应激、免疫逃逸以及基因毒素和微生物代谢产物的产生。某些微生物,如具核梭杆菌(Fusobacterium nucleatum)、产肠毒素脆弱拟杆菌(Bacteroides fragilis toxin,pks+),通过诱导慢性炎症、产生活性氧以及产生损害宿主DNA的毒力因子来促进肿瘤发生。这些微生物还可以通过抑制细胞毒性T细胞活性和增加调节性T细胞数量来逃避抗肿瘤免疫反应。此外,微生物衍生的代谢产物,如次级胆汁酸和氧化三甲胺(TMAO),也与致癌过程有关。相反,包括普拉梭菌(Faecalibacterium prausnitzii)、双歧杆菌(Bifidobacterium)和嗜酸乳杆菌(Lactobacillus acidophilus)在内的保护性微生物群,通过产生丁酸等短链脂肪酸(SCFA)来促进肠道稳态,这些短链脂肪酸具有抗炎和抗癌特性。这些有益微生物增强肠道屏障完整性,调节免疫反应,并抑制肿瘤细胞增殖。了解致病微生物群和保护性微生物群之间的动态相互作用对于开发基于微生物群的干预措施(如益生菌、益生元和粪便微生物群移植)以预防或治疗结直肠癌至关重要。未来的研究应专注于识别用于早期结直肠癌检测的微生物生物标志物,并探索针对个体微生物群的个性化疗法。对宿主-微生物群相互作用的更深入理解可能会带来结直肠癌管理的创新策略,并改善患者预后。
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