Bidirectional Effects of Intestinal Microbiota and Antibiotics: a New Strategy for Colorectal Cancer Treatment and Prevention

Overview

Journal J Cancer Res Clin Oncol

Specialty Oncology

Date 2022 Jun 6

PMID 35661254

Authors

Wenjie Zhang

Jie Zhang

Tian Liu

Juan Xing

Huan Zhang

Daorong Wang

Dong Tang

Affiliations

Soon will be listed here.

Abstract

Purpose: Colorectal cancer (CRC) is the third most common cancer worldwide, and its incidence and mortality rates are increasing every year. The intestinal microbiota has been called the "neglected organ" and there is growing evidence that the intestinal microbiota and its metabolites can be used in combination with immunotherapy, radiotherapy and chemotherapy to greatly enhance the treatment of colorectal cancer and to address some of the side effects and adverse effects of these therapies. Antibiotics have great potential to eliminate harmful microbiota, control infection, and reduce colorectal cancer side effects. However, the use of antibiotics has been a highly controversial issue, and numerous retrospective studies have shown that the use of antibiotics affects the effectiveness of treatment (especially immunotherapy). Understanding the bi-directional role of the gut microbiota and antibiotics will further enhance our research into the diagnosis and treatment of cancer.

Methods: We searched the "PubMed" database and selected the following keywords "intestinal microbiota, antibiotics, treatment, prevention, colorectal cancer". In this review, we discuss the role of the intestinal microbiota in immunotherapy, radiotherapy, chemotherapy, diagnosis, and prevention of CRC. We also conclude that the intestinal microbiota and antibiotics work together to promote the treatment of CRC through a bidirectional effect.

Results: We found that the intestinal microbiota plays a key role in promoting immunotherapy, chemotherapy, radiotherapy, diagnosis and prevention of CRC. In addition, gut microbiota and antibiotic interactions could be a new strategy for CRC treatment.

Conclusion: The bi-directional role of the intestinal microbiota and antibiotics plays a key role in the prevention, diagnosis, and treatment of colorectal cancer.

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References

Abdulamir A, Hafidh R, Mahdi L, Al-jeboori T, Abubaker F . Investigation into the controversial association of Streptococcus gallolyticus with colorectal cancer and adenoma. BMC Cancer. 2009; 9:403. PMC: 2785837. DOI: 10.1186/1471-2407-9-403. View

Ahmed J, Kumar A, Parikh K, Anwar A, Knoll B, Puccio C . Use of broad-spectrum antibiotics impacts outcome in patients treated with immune checkpoint inhibitors. Oncoimmunology. 2018; 7(11):e1507670. PMC: 6205076. DOI: 10.1080/2162402X.2018.1507670. View

Akbari M, Shomali N, Faraji A, Shanehbandi D, Asadi M, Mokhtarzadeh A . CD133: An emerging prognostic factor and therapeutic target in colorectal cancer. Cell Biol Int. 2019; 44(2):368-380. DOI: 10.1002/cbin.11243. View

Aneke-Nash C, Yoon G, Du M, Liang P . Antibiotic use and colorectal neoplasia: a systematic review and meta-analysis. BMJ Open Gastroenterol. 2021; 8(1). PMC: 8174505. DOI: 10.1136/bmjgast-2021-000601. View

Aparicio C, Belver M, Enriquez L, Espeso F, Nunez L, Sanchez A . Cell Therapy for Colorectal Cancer: The Promise of Chimeric Antigen Receptor (CAR)-T Cells. Int J Mol Sci. 2021; 22(21). PMC: 8583883. DOI: 10.3390/ijms222111781. View

Arnold M, Sierra M, Laversanne M, Soerjomataram I, Jemal A, Bray F . Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2016; 66(4):683-691. DOI: 10.1136/gutjnl-2015-310912. View

Avril M, DePaolo R . "Driver-passenger" bacteria and their metabolites in the pathogenesis of colorectal cancer. Gut Microbes. 2021; 13(1):1941710. PMC: 8265790. DOI: 10.1080/19490976.2021.1941710. View

Barclay J, Creswell J, Leon J . Cancer immunotherapy and the PD-1/PD-L1 checkpoint pathway. Arch Esp Urol. 2018; 71(4):393-399. View

Barker H, Paget J, Khan A, Harrington K . The tumour microenvironment after radiotherapy: mechanisms of resistance and recurrence. Nat Rev Cancer. 2015; 15(7):409-25. PMC: 4896389. DOI: 10.1038/nrc3958. View

10.

Becattini S, Taur Y, Pamer E . Antibiotic-Induced Changes in the Intestinal Microbiota and Disease. Trends Mol Med. 2016; 22(6):458-478. PMC: 4885777. DOI: 10.1016/j.molmed.2016.04.003. View

11.

Bezabeh T, Somorjai R, Dolenko B, Bryskina N, Levin B, Bernstein C . Detecting colorectal cancer by 1H magnetic resonance spectroscopy of fecal extracts. NMR Biomed. 2009; 22(6):593-600. DOI: 10.1002/nbm.1372. View

12.

Borgo C, Ruzzene M . Role of protein kinase CK2 in antitumor drug resistance. J Exp Clin Cancer Res. 2019; 38(1):287. PMC: 6612148. DOI: 10.1186/s13046-019-1292-y. View

13.

Bray F, Ferlay J, Soerjomataram I, Siegel R, Torre L, Jemal A . Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68(6):394-424. DOI: 10.3322/caac.21492. View

14.

Bullman S, Pedamallu C, Sicinska E, Clancy T, Zhang X, Cai D . Analysis of persistence and antibiotic response in colorectal cancer. Science. 2017; 358(6369):1443-1448. PMC: 5823247. DOI: 10.1126/science.aal5240. View

15.

Campbell C, McKenney P, Konstantinovsky D, Isaeva O, Schizas M, Verter J . Bacterial metabolism of bile acids promotes generation of peripheral regulatory T cells. Nature. 2020; 581(7809):475-479. PMC: 7540721. DOI: 10.1038/s41586-020-2193-0. View

16.

Campbell C, Marchildon F, Michaels A, Takemoto N, van der Veeken J, Schizas M . FXR mediates T cell-intrinsic responses to reduced feeding during infection. Proc Natl Acad Sci U S A. 2020; 117(52):33446-33454. PMC: 7776647. DOI: 10.1073/pnas.2020619117. View

17.

Cekic C, Linden J . Adenosine A2A receptors intrinsically regulate CD8+ T cells in the tumor microenvironment. Cancer Res. 2014; 74(24):7239-49. PMC: 4459794. DOI: 10.1158/0008-5472.CAN-13-3581. View

18.

Chang C, Pan T . Anticancer and Antimigration Effects of a Combinatorial Treatment of 5-Fluorouracil and Lactobacillus paracasei subsp. paracasei NTU 101 Fermented Skim Milk Extracts on Colorectal Cancer Cells. J Agric Food Chem. 2018; 66(22):5549-5555. DOI: 10.1021/acs.jafc.8b01445. View

19.

Chen W, Liu F, Ling Z, Tong X, Xiang C . Human intestinal lumen and mucosa-associated microbiota in patients with colorectal cancer. PLoS One. 2012; 7(6):e39743. PMC: 3386193. DOI: 10.1371/journal.pone.0039743. View

20.

Chen C, Lin W, Kong M, Shi H, Walker W, Lin C . Oral inoculation of probiotics Lactobacillus acidophilus NCFM suppresses tumour growth both in segmental orthotopic colon cancer and extra-intestinal tissue. Br J Nutr. 2011; 107(11):1623-34. DOI: 10.1017/S0007114511004934. View