Microbiome modulation in the prevention and management of colorectal cancer: a systematic review of clinical interventions

Abstract

Introduction. The role of probiotics/prebiotics in modulating the procarcinogenic effects of microbiota have been studied with inconclusive results. This systematic review aimed to identify the role of several studied interventions on the gut microbiota modulation in humans for the prevention and management of colorectal cancer (CRC).
 Methods. We conducted a systematic search using PubMed and Cochrane Central electronic databases, identifying clinical studies published within the last 20 years. We performed a qualitative analysis of eligible studies included in our review on each of the 4 investigated topics: CRC potential biomarkers, dietary interventions, probiotic administration in non-surgical and surgical patients, respectively.
 Results. A total of 54 studies involving healthy volunteers, in addition to colorectal adenoma and CRC patients were included in our qualitative synthesis. We were able to identify bacterial signatures of CRC including Fusobacterium nucleatum and Clostridium butyricum. Moreover, dietary supplementation with oligosaccharides or fibers increased short chain fatty acid-producing bacteria levels, thus inhibiting tumorigenesis. Furthermore, we have confirmed that Lactobacilli and Bifidobacterium intake modulates gut microbiota towards tumor suppression. We have also showed that probiotic intake around colectomy significantly reduces complications.
 Conclusions. Bacterial metabolism is strongly linked with colonic carcinogenesis and influenced by diet. Probiotics and prebiotics can act as microbiota modulators, suppressing epithelial proliferation and reversing DNA toxicity. As adjuvants to surgery or chemotherapy, Lactobacilli and Bifidobacteria decrease complications. Improved outcomes in CRC patients can possibly be achieved through future research directed towards the benefits of bacterial agents as tumor suppressors or as treatment of oncological therapy resistance.

Gut Microbiota and Colorectal Cancer: An Umbrella Review of Methodological Trends and Clinical Correlations

“…Out of the 96 reports that were selected for full-text review, 22 of them were not obtainable. We assessed the eligibility of all 74 articles and identified only 20 systematic reviews and meta-analyses that met our inclusion criteria for the final synthesis [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Figure 1 represents the PRISMA flow diagram with a detailed search and selection process overview.…”

“…FIGURE 2: Matrix heatmap of included reviewsAlhhazmi et al[12]; Amitay et al[13]; Anandakumar et al[14]; Aprile et al[15]; Borges-Canha et al[16]; Costa et al[17]; Eastmond et al[18]; Fratila et al[19]; Gethings-Behncke et al[20]; Hussan et al[21]; Karimi et al[22]; Mohammad et al[23]; Negrut et al[24]; Peng et al[25]; Ranjbar et al[26]; Tabowei et al[27]; Valciukiene et al[28]; Vorstenbosch et al[29]; Yu et al[30]; Zwezerijnen-Jiwa et al[31] …”

Potential therapeutic target for polysaccharide inhibition of colon cancer progression

“…In CRC treatment, prebiotics and probiotics, as microbiota modulators, play a significant role. They are capable of inhibiting epithelial cell proliferation, reversing DNA damage, and reducing complications from surgery or chemotherapy ( 95 ). A systematic review involving 23 randomized controlled trials (RCTs) showed that supplementing CRC patients with probiotics, including Bifidobacteria and Lactobacilli, improves quality of life, reduces postoperative infections, inhibits the production of pro-inflammatory cytokines, and alleviates chemotherapy side effects, thereby improving surgical outcomes and reducing mortality risk ( 96 ).…”

The influence of gut microbiota on immunotherapy for Colorectal Cancer

“…Specific postbiotics, such as SCFAs and the p40 protein produced by Lactobacillus rhamnosus, have been identified as crucial in preventing CRC development. [121,122] SCFAs regulate gene expression, induce apoptosis in cancer cell lines, and contribute to mucosal protection, while the p40 protein aids in reducing intestinal epithelial inflammation and increasing IgA production. [121,122] Although the use of postbiotics shows promise in CRC prevention, further research is also required to confirm their potential.…”