Kang Ziran, Jiang Shanshan, Fang Jing-Yuan, Chen Huimin
Shanghai Institute of Digestive Disease, NHC Key Laboratory of Digestive Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China.
Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China.
Chin Med J (Engl). 2025 Jun 5;138(11):1266-1287. doi: 10.1097/CM9.0000000000003617. Epub 2025 May 19.
Colorectal cancer (CRC) is one of the leading causes of cancer-related morbidity and mortality worldwide, highlighting the urgent need for novel preventive and therapeutic strategies. Emerging research highlights the crucial role of the gut microbiota, including bacteria, fungi, viruses, and their metabolites, in the pathogenesis of CRC. Dysbiosis, characterized by an imbalance in microbial composition, contributes to tumorigenesis through immune modulation, metabolic reprogramming, and genotoxicity. Specific bacterial species, such as Fusobacterium nucleatum and enterotoxigenic Bacteroides fragilis , along with fungal agents like Candida species, have been implicated in CRC progression. Moreover, viral factors, including Epstein-Barr virus and human cytomegalovirus, are increasingly recognized for their roles in promoting inflammation and immune evasion. This review synthesizes the latest evidence on host-microbiome interactions in CRC, emphasizing microbial metabolites, such as short-chain fatty acids and bile acids, which may act as both risk factors and therapeutic agents. We further discuss the latest advances in microbiota-targeted clinical applications, including biomarker-assisted diagnosis, next-generation probiotics, and microbiome-based interventions. A deeper understanding of the role of gut microbiome in CRC pathogenesis could pave the way for diagnostic, preventive, and personalized therapeutic strategies.
结直肠癌(CRC)是全球癌症相关发病和死亡的主要原因之一,凸显了对新型预防和治疗策略的迫切需求。新兴研究强调了肠道微生物群(包括细菌、真菌、病毒及其代谢产物)在CRC发病机制中的关键作用。以微生物组成失衡为特征的生态失调通过免疫调节、代谢重编程和基因毒性促进肿瘤发生。特定的细菌种类,如具核梭杆菌和产肠毒素脆弱拟杆菌,以及念珠菌属等真菌病原体,都与CRC进展有关。此外,病毒因素,包括爱泼斯坦-巴尔病毒和人巨细胞病毒,在促进炎症和免疫逃逸方面的作用也越来越受到认可。本综述综合了关于CRC中宿主-微生物群相互作用的最新证据,强调了微生物代谢产物,如短链脂肪酸和胆汁酸,它们可能既是危险因素又是治疗剂。我们还讨论了以微生物群为靶点的临床应用的最新进展,包括生物标志物辅助诊断、下一代益生菌和基于微生物群的干预措施。更深入地了解肠道微生物群在CRC发病机制中的作用可为诊断、预防和个性化治疗策略铺平道路。
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