Promising Probiotics Potentials in CRC Treatment
Explore the exciting prospects of using probiotics in CRC treatment. Learn how these beneficial bacteria can make a difference.
Introduction
In the vast universe of human health, the gut stands as a pivotal player, orchestrating a myriad of processes essential to our well-being.
A growing body of research is highlighting the significance of the gut microbiota, the complex community of microorganisms that call our intestines home, in influencing various diseases, including colorectal cancer (CRC).
Probiotics, defined as "live microorganisms that confer health benefits to the host when administered in adequate amounts," have emerged as a promising avenue in the prevention and treatment of CRC.
These beneficial bacteria not only contribute to maintaining gut balance but may also play a pivotal role in halting the progression of CRC.
This article delves into the burgeoning research on the potential of probiotics in CRC treatment, exploring their mechanisms of action, benefits, and challenges in clinical application.
Key Points
- Microbiota Modulation Strategies for CRC: Modulation of the intestinal microbiota is seen as a new strategy for preventing and treating colorectal cancer (CRC) due to its significant influence on the disease.
- Dietary Intervention: Dietary patterns can impact the composition of the intestinal microbiota. Adopting a healthier dietary pattern, especially one rich in fiber, can potentially reduce the risk of CRC.
- Role of Probiotics: Probiotics can aid in CRC prevention and treatment by various mechanisms, such as inactivating carcinogens, modulating immunity, and improving gut barrier function. Several studies have shown the protective effects of probiotics against CRC.
- Importance of Prebiotics and Synbiotics: Prebiotics nourish beneficial bacteria in the gut, while synbiotics are a combination of probiotics and prebiotics. Clinical trials have noted benefits from synbiotics in CRC patients.
- Potential of Fecal Microbiota Transplantation (FMT): FMT involves transplanting fecal material from a healthy donor to a patient, which can help restore a balanced microbiome. It shows promise in treating various gastrointestinal disorders, and there's potential for its application in CRC treatment.
- Challenges and Controversies: Despite the potential of these strategies, there are challenges. For instance, short-term dietary changes might not be sufficient for CRC prevention, and the safety and efficacy of probiotics need further study.
- Clinical Value of Microbiota and Biomarkers for CRC: The study of the microbiota aids in selecting useful biomarkers for CRC. These biomarkers may be helpful for screening and prognosis in CRC treatment.
- Technical Challenges: There is a high variability in intestinal microbiota across different populations, and there are challenges related to sample collection, storage, and analysis, which need to be standardized for better clinical translation.
In This Article:
The Role of Gut Bacteria in CRC Treatment And Prevention
Our gut is home to billions of bacteria, both good and bad.
The balance of these bacteria can play a big role in our health, including in conditions like colorectal cancer (CRC).
How Our Diet Affects CRC
Dietary Impact on Gut Bacteria: Your diet can change the types of bacteria in your gut.
Eating a lot of fruits, vegetables, whole grains, fish, and lean meats can help reduce the risk of CRC Trusted Sourced Yusof AS, Md Isa Z, Shah SA. Dietary patterns and risk of colorectal cancer: Asystematic review of cohort studies (2000-2011). Asian Pac J Cancer Prev (2012) 13(9):4713–7. doi: 10.7314/APJCP.2012.13.9.4713On the other hand, diets high in fats and low in fiber, like some Western diets, might increase CRC risk.
When we change our diet, our gut bacteria change too, but if we go back to old eating habits, the bacteria return to their old patterns Trusted Sourced Xu Z, Knight R. Dietary effects on human gut microbiome diversity. Br J Nutr (2014) 113(S1):S1–5. doi: 10.1017/s0007114514004127Obesity and CRC: Being overweight is also linked with a higher risk of getting CRC.
So, cutting down on fatty foods might help prevent it.
The Good Bacteria: Probiotics and Prebiotics
Probiotics: The Helpful Bacteria Probiotics are living bacteria that can be good for our health.
They can help prevent CRC by fighting bad substances in our gut and boosting our body's defenses Trusted Sourced Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, et al. Expert consensus document: The international scientific association for probiotics and prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol (2014) 11(8):506–14. doi: 10.1038/nrgastro.2014.66 Some examples include Faecalibacterium prausnitziiTrusted Sourced Quévrain E, Maubert MA, Michon C, Chain F, Marquant R, Tailhades J, et al. Identification of an anti-inflammatory protein from Faecalibacterium prausnitzii, a commensal bacterium deficient in Crohn’s disease. Gut (2016) 65(3):415–25. doi: 10.1136/gutjnl-2014-307649 and Lactobacillus caseiTrusted Sourced Ishikawa H, Akedo I, Otani T, Suzuki T, Nakamura T, Takeyama I, et al. Randomized trial of dietary fiber and Lactobacillus casei administration for prevention of colorectal tumors. Int J Cancer (2005) 116(5):762–7. doi: 10.1002/ijc.21115Prebiotics: Prebiotics are special ingredients in our food that feed the good bacteria in our gut.
When we combine probiotics and prebiotics, we get something called "synbiotics".
These have been shown to help patients with CRC in various ways Trusted Sourced Sommacal HM, Bersch VP, Vitola SP, Osvaldt AB. Perioperative synbiotics decrease postoperative complications in periampullary neoplasms: a randomized, double-blind clinical trial. Nutr Cancer (2015) 67(3):457–62. doi: 10.1080/01635581.2015.1004734 Trusted Sourced Flesch AT, Tonial ST, Contu PC, Damin DC. Perioperative synbiotics administration decreases postoperative infections in patients with colorectal cancer: a randomized, double-blind clinical trial. Rev Col Bras Cir (2017) 44(6):567–73. doi: 10.1590/0100-69912017006004Benefits of Probiotics in Treatment
Probiotics can also help with the side effects of cancer treatments.
For instance, they can reduce problems like diarrhea and stomach pain in patients undergoing chemotherapy Trusted Sourced Osterlund P, Ruotsalainen T, Korpela R, Saxelin M, Ollus A, Valta P, et al. Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study. Br J Cancer (2007) 97(8):1028–34. doi: 10.1038/sj.bjc.6603990 Some probiotics might even help fix damage caused by radiation treatments Trusted Sourced Packey CD, Ciorba MA. Microbial influences on the small intestinal response to radiation injury. Curr Opin Gastroenterol (2010) 26(2):88–94. doi: 10.1097/MOG.0b013e3283361927
Fecal Microbiota Transplantation (FMT): A Powerful Technique
FMT is a process where stool from a healthy person is transferred to someone with an unhealthy gut.
This can help restore a healthy balance of bacteria.
It's been very successful in treating some diseases Trusted Sourced Quraishi MN, Widlak M, Bhala N, Moore D, Price M, Sharma N, et al. Systematic review with meta-analysis: the efficacy of faecal microbiota transplantation for the treatment of recurrent and refractory Clostridium difficile infection. Aliment Pharmacol Ther (2017) 46(5):479–93. doi: 10.1111/apt.14201 and shows promise for CRC treatment, though more research is needed Trusted Sourced Rosshart SP, Vassallo BG, Angeletti D, Hutchinson DS, Morgan AP, Takeda K, et al. Wild Mouse Gut Microbiota Promotes Host Fitness and Improves Disease Resistance. Cell (2017) 171(5):1015–1028 e1013. doi: 10.1016/j.cell.2017.09.016Challenges and Future Directions
While these strategies are promising, there are still questions and challenges.
For example:
The best diet to prevent CRC is still being studied Trusted Sourced Song M, Chan AT, Sun J. Influence of the Gut Microbiome, Diet, and Environment on Risk of Colorectal Cancer. Gastroenterology (2020) 158(2):322–40. doi: 10.1053/j.gastro.2019.06.048 Not all probiotics work the same way, and we need to know more about safe doses and how long to use them Trusted Sourced Drago L. Probiotics and Colon Cancer. Microorganisms (2019) 7(3). doi: 10.3390/microorganisms7030066 Even though FMT has potential, there are still concerns about its long-term safety and other risks Trusted Sourced Wang JW, Kuo CH, Kuo FC, Wang YK, Hsu WH, Yu FJ, et al. Fecal microbiota transplantation: Review and update. J Formos Med Assoc (2019) 118 Suppl 1:S23–31. doi: 10.1016/j.jfma.2018.08.011Moving Forward
As we learn more, it's important to make sure these treatments are safe and effective.
Future research will help us better understand our gut bacteria and how to use them to fight CRC.
HIGHLIGHT
Gut bacteria play a crucial role in colorectal cancer prevention and treatment. Diet, probiotics, and fecal transplants can influence these bacteria, offering potential strategies against the disease.
Unlocking the Secrets of Gut Bacteria in Cancer
The Connection Between Microbiota and Colorectal Cancer (CRC)
Many researchers are exploring the links between gut bacteria and CRC.
By understanding the tiny life forms inside our intestines, we might find better ways to detect and treat this type of cancer.
Some in-depth studies give more insights, but for those wanting a brief overview, there are other articles you can check out Trusted Sourced Wong SH, Yu J. Gut microbiota in colorectal cancer: mechanisms of action and clinical applications. Nat Rev Gastroenterol Hepatol (2019) 16(11):690–704. doi: 10.1038/s41575-019-0209-8 Trusted Sourced Fong W, Li Q, Yu J. Gut microbiota modulation: a novel strategy for prevention and treatment of colorectal cancer. Oncogene (2020) 39(26):4925–43. doi: 10.1038/s41388-020-1341-1Why Biomarkers are Game-Changers
Biomarkers, molecules, or genes we can measure, could be the future of early cancer detection.
They can show us who's at risk and might need treatment Trusted Sourced Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin (2019) 69(1):7–34. doi: 10.3322/caac.21551Finding Early Warning Signs
Imagine catching cancer before it becomes dangerous.
Some studies show that changes in our gut bacteria can signal if we're heading towards CRC.
Catching CRC early can make a huge difference: people found early have a 90% chance of living for at least another five years Trusted Sourced Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin (2019) 69(1):7–34. doi: 10.3322/caac.21551Existing Screening Tools: Pros and Cons
There are tests, like the fecal immunohistochemical testing (FIT), that detect CRC by checking for blood in the stool.
They're useful but not perfect.
For instance, FIT misses out on detecting CRC 21% of the time and is even less accurate for spotting early-stage growths Trusted Sourced Hundt S, Haug U, Brenner H. Comparative evaluation of immunochemical fecal occult blood tests for colorectal adenoma detection. Ann Intern Med (2009) 150(3):162–9. doi: 10.7326/0003-4819-150-3-200902030-00005 Trusted Sourced Lee JK, Liles EG, Bent S, Levin TR, Corley DA. Accuracy of fecal immunochemical tests for colorectal cancer: systematic review and meta-analysis. Ann Intern Med (2014) 160(3):171–1. doi: 10.7326/M13-1484The Power of Combining Techniques
By pairing FIT with tests that look for specific gut bacteria, we could boost its accuracy Trusted Sourced Baxter NT, Ruffin MTT, Rogers MAM, Schloss PD. Microbiota-based model improves the sensitivity of fecal immunochemical test for detecting colonic lesions. Genome Med (2016) 8(1):37–7. doi: 10.1186/s13073-016-0290-3 Trusted Sourced Suehiro Y, Zhang Y, Hashimoto S, Takami T, Higaki S, Shindo Y, et al. Highly sensitive faecal DNA testing of TWIST1 methylation in combination with faecal immunochemical test for haemoglobin is a promising marker for detection of colorectal neoplasia. Ann Clin Biochem (2018) 55(1):59–68. doi: 10.1177/0004563217691064 ne bacterium, F. nucleatum, looks particularly promising Trusted Sourced Eklöf V, Löfgren-Burström A, Zingmark C, Edin S, Larsson P, Karling P, et al. Cancer-associated fecal microbial markers in colorectal cancer detection. Int J Cancer (2017) 141(12):2528–36. doi: 10.1002/ijc.31011 Trusted Sourced Guo S, Li L, Xu B, Li M, Zeng Q, Xiao H, et al. A Simple and Novel Fecal Biomarker for Colorectal Cancer: Ratio of Fusobacterium Nucleatum to Probiotics Populations, Based on Their Antagonistic Effect. Clin Chem (2018) 64(9):1327–37. doi: 10.1373/clinchem.2018.289728 Trusted Sourced Wong SH, Kwong TNY, Chow TC, Luk AKC, Dai RZW, Nakatsu G, et al. Quantitation of faecal Fusobacterium improves faecal immunochemical test in detecting advanced colorectal neoplasia. Gut (2017) 66(8):1441–8. doi: 10.1136/gutjnl-2016-312766 Some researchers are also looking at mouth bacteria or "oral biomarkers" as potential signals for CRC Trusted Sourced Flemer B, Warren RD, Barrett MP, Cisek K, Das A, Jeffery IB, et al. The oral microbiota in colorectal cancer is distinctive and predictive. Gut (2018) 67(8):1454–63. doi: 10.1136/gutjnl-2017-314814Decoding Stool Samples for CRC Clues
Checking stools for certain chemicals could be another non-invasive way to find CRC Trusted Sourced Villéger R, Lopès A, Veziant J, Gagnière J, Barnich N, Billard E, et al. Microbial markers in colorectal cancer detection and/or prognosis. World J Gastroenterol (2018) 24(22):2327–47. doi: 10.3748/wjg.v24.i22.2327It's like each person's gut bacteria has its own "chemical fingerprint," and some fingerprints might point to cancer.
Bacteria as Predictors of CRC Outcomes
Certain bacteria levels might also help doctors predict how CRC will progress.
For instance, more F. nucleatum in CRC tissues could hint at a tougher battle ahead Trusted Sourced Mima K, Nishihara R, Qian ZR, Cao Y, Sukawa Y, Nowak JA, et al. Fusobacterium nucleatum in colorectal carcinoma tissue and patient prognosis. Gut (2016) 65(12):1973–80. doi: 10.1136/gutjnl-2015-310101Challenges in Making Bacteria-Based Tests a Reality
Our gut bacteria are influenced by many things, from our diet and age to where we live.
This makes finding a one-size-fits-all bacterial marker for CRC tricky.
Also, we need consistent ways to collect and analyze samples.
But, with continued research and innovation, we're hopeful for the future.
What's Ahead in CRC Research
We need to standardize our methods and maybe find common markers that work across diverse groups of people.
By working together, scientists hope to make these bacterial tests a reliable tool in the fight against CRC.
HIGHLIGHT
Researchers are exploring gut bacteria's role in detecting and treating colorectal cancer (CRC). Biomarkers, especially from gut microbiota, show promise in early detection, though challenges remain in standardization and variability.
Discussion
The role of the intestinal microbiota in human health, particularly in colorectal cancer (CRC), has gained significant attention in recent years.
The strategies mentioned above, from dietary interventions to the application of probiotics, prebiotics, and FMT, all aim to harness the potential of microbiota modulation for CRC prevention and treatment.
However, while the potential is evident, there are several challenges to overcome.
Dietary interventions, though promising, may have temporary effects on the microbiota composition.
This brings into question the long-term effectiveness of such interventions for CRC prevention.
Additionally, while probiotics have shown protective effects against CRC in animal models, their safety, efficacy, and dosing requirements in humans remain a topic of investigation.
The success of FMT in treating conditions like C. difficile infection provides hope for its application in CRC, but its use in human CRC treatment remains largely unexplored.
Furthermore, while the exploration of the CRC microbiota aims to better CRC prevention and treatment, technical challenges abound.
The high variability of intestinal microbiota across different individuals due to various factors complicates the identification of universal microbial markers for CRC detection.
Conclusion
The microbiota, particularly that of the gut, plays a pivotal role in CRC, offering avenues for new treatment and prevention strategies.
Although promising results have emerged, particularly in the realm of dietary interventions, probiotics, prebiotics, and FMT, significant challenges remain.
For these strategies to transition from the realm of research into practical, clinical applications, further investigations are crucial.
Moreover, for biomarker-based approaches to gain traction, standardization and validation across diverse populations are essential.
The future of CRC prevention and treatment may well lie in the intricate world of our gut microbiota, and continuous research in this domain is paramount.
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