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Review
. 2023 Jan-Dec;15(1):2236364.
doi: 10.1080/19490976.2023.2236364.

Colorectal cancer and gut microbiota studies in China

Zikai Wang  1   2 , Wanyue Dan  1   3 , Nana Zhang  1 , Jingyuan Fang  4 , Yunsheng Yang  1   2
Affiliations
Review

Colorectal cancer and gut microbiota studies in China

Zikai Wang et al. Gut Microbes. 2023 Jan-Dec.

Abstract

Colorectal cancer (CRC) is the third most common malignant tumor worldwide. The incidence and mortality rates of CRC have been increasing in China, possibly due to economic development, lifestyle, and dietary changes. Evidence suggests that gut microbiota plays an essential role in the tumorigenesis of CRC. Gut dysbiosis, specific pathogenic microbes, metabolites, virulence factors, and microbial carcinogenic mechanisms contribute to the initiation and progression of CRC. Gut microbiota biomarkers have potential translational applications in CRC screening and early diagnosis. Gut microbiota-related interventions could improve anti-tumor therapy's efficacy and severe intestinal toxic effects. Chinese researchers have made many achievements in the relationship between gut microbiota and CRC, although some challenges remain. This review summarizes the current evidence from China on the role of gut microbiota in CRC, mainly including the gut microbiota characteristics, especially Fusobacterium nucleatum and Parvimonas micra, which have been identified to be enriched in CRC patients; microbial pathogens such as F. nucleatum and enterotoxigenic Bacteroides fragilis, and P. micra, which Chinese scientists have extensively studied; diagnostic biomarkers especially F. nucleatum; therapeutic effects, including microecological agents represented by certain Lactobacillus strains, fecal microbiota transplantation, and traditional Chinese medicines such as Berberine and Curcumin. More efforts should be focused on exploring the underlying mechanisms of microbial pathogenesis of CRC and providing novel gut microbiota-related therapeutic and preventive strategies.

Keywords: Gut microbiota; anti-tumor therapy; colorectal cancer; microbial biomarkers; microbial carcinogenesis; microbiota interventions.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Schematic representation of gut microbiota and their metabolites involved in colorectal carcinogenesis at the cellular and molecular levels. Gut bacteria such as Fusobacterium nucleatum, enterotoxigenic Bacteroides fragilis, Peptostreptococcus anaerobius, pks+ Escherichia coli, and Parvimonas micra, and their virulence factors FadA, B. fragilis toxin, and colibactin contribute to the colorectal cancer (CRC) development by activating different pathways that trigger DNA damage, intestinal inflammation, macrophage polarization, and apoptosis.
Figure 2.
Figure 2.
Overview of candidates for gut microbiota modulation for the prevention and treatment of colorectal cancer, including diet modulations, microecological agents, fecal microbiota transplantation, antibiotics, and traditional Chinese medicine.
See this image and copyright information in PMC

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