Yin Qiyan, Qin Fen, Gan Fangliu, Zhao Guangxi, Chen Ronghua, Wen Yue, Hua Xueyang, Zeng Fugui, Zhang Yuezheng, Xiao Yuliang, Xie Wenbing, Tao Yong
Center for Life Sciences, Yunnan Key Laboratory of Cell Metabolism and Diseases, School of Life Sciences, Yunnan University, Kunming 650504, China.
Hefei National Laboratory for Physical Sciences at the Microscale, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China.
Biology (Basel). 2025 Jul 3;14(7):805. doi: 10.3390/biology14070805.
Colorectal cancer (CRC) incidence increases markedly with age, yet chronological age is an inadequate proxy for the complex biological processes involved. Colon aging, the intrinsic biological aging of the colonic tissue, is emerging as a crucial, active driver of CRC development. This review comprehensively analyzes the interplay between colon aging and CRC pathogenesis by examining fundamental hallmarks of aging-such as altered tissue homeostasis, epigenetic dysregulation, and microenvironmental shifts including chronic inflammation (inflammaging), gut microbiome dysbiosis, and extracellular matrix remodeling-manifest specifically within the aging colon to synergistically foster a pro-tumorigenic environment. Key findings synthesized from the literature highlight the critical roles of impaired colonic stem cell function, epithelial barrier disruption ("leaky gut"), persistent low-grade inflammation, and altered microbial communities and their metabolites in promoting CRC initiation and progression. Translating this mechanistic understanding holds significant promise: insights from colon aging research can inform novel biomarkers for improved early detection and risk stratification, guide the development of personalized preventative strategies and therapeutic interventions targeting aging pathways, and underpin public health initiatives focused on healthy colon aging. Ultimately, recognizing colon aging as a modifiable contributor to CRC offers a powerful avenue to potentially reduce CRC incidence and enhance patient outcomes, particularly in the vulnerable aging population.
结直肠癌(CRC)的发病率随年龄显著增加,但实际年龄并不能充分代表所涉及的复杂生物学过程。结肠衰老,即结肠组织的内在生物学衰老,正成为CRC发展的关键、活跃驱动因素。本综述通过研究衰老的基本特征,如组织稳态改变、表观遗传失调以及包括慢性炎症(炎症衰老)、肠道微生物群失调和细胞外基质重塑在内的微环境变化,具体分析了结肠衰老与CRC发病机制之间的相互作用,这些变化在衰老结肠中协同促进肿瘤发生环境。从文献中综合得出的关键发现强调了结肠干细胞功能受损、上皮屏障破坏(“肠漏”)、持续性低度炎症以及微生物群落及其代谢产物改变在促进CRC起始和进展中的关键作用。将这种机制性认识转化为实际应用具有重大前景:结肠衰老研究的见解可为改进早期检测和风险分层提供新的生物标志物,指导针对衰老途径的个性化预防策略和治疗干预措施的开发,并为关注健康结肠衰老的公共卫生倡议提供支持。最终,认识到结肠衰老作为CRC的一个可改变因素,为潜在降低CRC发病率和改善患者预后提供了一条有力途径,特别是在脆弱的老年人群中。