Lactobacillus rhamnosus GG: An Overview to Explore the Rationale of Its Use in Cancer

Abstract

Cancer is the second leading cause of death in the western world. In the era of precision medicine, a significant number of cancer patients can be cured with several anti-cancer therapeutic regimens. However, therapy failure may be caused by treatment side effects, such as diarrhea, especially occurring in patients with gastrointestinal or pelvic malignancies. In particular, diarrhea is one of the most frequent gastrointestinal toxicity during cancer treatment and it can result from nearly bot chemo- and radio-therapeutic strategies currently used. Diarrhea has a serious impact on patients’ quality of life and treatment dosing and schedule modification due to its severity can negatively influence treatment outcomes. In this context, probiotics may play an interesting role in several human diseases with an inflammatory bowel involvement and, among these, Lactobacillus rhamnosus GG (LGG) is one of the most characterized and utilized. In particular, LGG is able to reverse intestinal dysbiosis and moderate diarrhea. Moreover, preclinical studies have documented its effects in reducing chronic inflammation associated with cancer development. This review summarizes the preclinical results of LGG on cancer cells proliferation and tumor invasion as well as the potential role of LGG use in cancer patients for the prevention and management of diarrhea associated with cancer treatment. Overall, these encouraging data support further investigation on the use of LGG in stratified patients undergoing specific therapeutic protocols, including chemotherapy and pelvic radiotherapy, in order to reduce the development of severe diarrhea and thus improve the adherence to the therapy and patients’ quality of life.

Association of oral dysbiosis with oral cancer development (Review)

“…In this respect, the use of probiotics that in appropriate amounts give a health benefit to the host, including anti-tumoral effects, could be useful to promote cancer therapies representing a new step of the evolution of anticancer pharmacological treatments (190,204). Although in vitro and in vivo experiments demonstrated the beneficial effects probiotics (7)(8)(9), few data are available about the efficacy of probiotics in oral cancer. It is reasonable to hypothesize that the beneficial effects exert by probiotics in intestinal and colorectal cancer is similar to those acted in the oral mucosa.…”

“…Starting from this supposition, a number of studies focused on the prevention of neoplastic transformation and retardation of cancer progression by modulating the carcinogenic or protective microbiome. In this context, probiotics administration was recently considered a good cancer preventive strategy due to the immunological effects (8,9,25). The beneficial effects of lactic ferments and probiotics were identified in the 19th century by dr Ilya Metchnikoff.…”

“…It was widely demonstrated that the development of tumors, including that of OSCC, is sustained by several risk factors and predisposing conditions such as fibers, chemicals, pesticides and heavy metals able to induce pro-oncogenic genetic and epigenetic alterations (2)(3)(4)(5)(6). Other factors, including oral injuries, inflammatory diseases, infections, and bacterial dysbiosis are now recognized as risk factors for cancer development (7)(8)(9)(10).…”

Antioxidative activity of probiotics

“…This mechanisms could even play a major role in many severe diseases. Preclinical studies have documented Lactobacillus rhamnosus GG effects in reducing chronic inflammation associated with cancer development [87]. Nutraceuticals including probiotics are characterized by lipid-lowering properties, important in clinical practice [88].…”

Ribosomal protein L4 of Lactobacillus rhamnosus LRB alters resistance to macrolides and other antibiotics

“…This LAB is often used in the dairy industry due to its lactic acid production and cheese‐ripening traits. However, in recent years, various strains of L. rahamnosus are extensively used as a probiotic supplement because many of the isolates exhibit immunomodulatory and antimicrobial properties, and thus it is used for treatment of various human ailments (for reviews see, Banna et al, ; Segers & Lebeer, ). Among the probiotic strains that are currently used, L. rhamnosus GG (LGG; ATCC 53103) is perhaps the best characterized strain, which was originally isolated from human feces (Lebeer, Verhoeven, Perea Velez, Vanderleyden, & De Keersmaecker, ; Silva, Jacobus, Deneke, & Gorbach, ).…”