Probiotics intervention in colorectal cancer: From traditional approaches to novel strategies

Abstract

The intestine harbors a large population of microorganisms that interact with epithelial cells to maintain host healthy physiological status. These intestinal microbiota engage in the fermentation of non-digestible nutrients and produce beneficial metabolites to regulate host homeostasis, metabolism, and immune response. The disruption of microbiota, known as dysbiosis, has been implicated in many intestinal diseases, including colorectal cancer (CRC). As the third most common cancer and the second leading cause of cancer-related death worldwide, CRC poses a significant health burden. There is an urgent need for novel interventions to reduce CRC incidence and improve clinical outcomes. Modulating the intestinal microbiota has emerged as a promising approach for CRC prevention and treatment. Current research efforts in CRC probiotics primarily focus on reducing the incidence of CRC, alleviating treatment-related side effects, and potentiating the efficacy of anticancer therapy, which is the key to successful translation to clinical practice. This paper aims to review the traditional probiotics and new interventions, such as next-generation probiotics and postbiotics, in the context of CRC. The underlying mechanisms of probiotic anti-cancer effects are also discussed, including the restoration of microbial composition, reinforcement of gut barrier integrity, induction of cancer cell apoptosis, inactivation of carcinogens, and modulation of host immune response. This paper further evaluates the novel strategy of probiotics as an adjuvant therapy in boosting the efficacy of chemotherapy and immunotherapy. Despite all the promising findings presented in studies, the evaluation of potential risks, optimization of delivery methods, and consideration of intra-patient variability of gut microbial baseline must be thoroughly interpreted before bench-to-bedside translation.

Anti-oral cancer properties of potential probiotic lactobacilli isolated from traditional milk, cheese, and yogurt

“…Similar observations have been reported in studies investigating the apoptotic effects of probiotics. For instance, the work by Ha et al 32 demonstrated the ability of certain probiotic strains to modulate apoptosis-related genes in colorectal cancer cells.…”

Gut microbiota modulating intestinal stem cell differentiation

“…Ha et al [ 10 ] proposed that restoration of microbial composition, enhancement of gut barrier integrity, induction of apoptosis in cancer cells, inactivation of carcinogens, and modulation of host immune response through probiotics. Reducing the incidence of colorectal cancer, attenuating treatment-related side effects, and enhancing the efficacy of anticancer therapies are key to successful translation into clinical practice.…”

“…Reducing the incidence of colorectal cancer, attenuating treatment-related side effects, and enhancing the efficacy of anticancer therapies are key to successful translation into clinical practice. However, before their use in the clinic, it is important to assess the potential risks, optimize the method of administration, and consider the changes in the baseline gut microbiology in the patient’s body[ 10 ].…”