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Review
. 2020 Dec 8:10:603086.
doi: 10.3389/fcimb.2020.603086. eCollection 2020.

Colon Carcinogenesis: The Interplay Between Diet and Gut Microbiota

Affiliations
Review

Colon Carcinogenesis: The Interplay Between Diet and Gut Microbiota

Yean Leng Loke et al. Front Cell Infect Microbiol. .

Abstract

Colorectal cancer (CRC) incidence increases yearly, and is three to four times higher in developed countries compared to developing countries. The well-known risk factors have been attributed to low physical activity, overweight, obesity, dietary consumption including excessive consumption of red processed meats, alcohol, and low dietary fiber content. There is growing evidence of the interplay between diet and gut microbiota in CRC carcinogenesis. Although there appears to be a direct causal role for gut microbes in the development of CRC in some animal models, the link between diet, gut microbes, and colonic carcinogenesis has been established largely as an association rather than as a cause-and-effect relationship. This is especially true for human studies. As essential dietary factors influence CRC risk, the role of proteins, carbohydrates, fat, and their end products are considered as part of the interplay between diet and gut microbiota. The underlying molecular mechanisms of colon carcinogenesis mediated by gut microbiota are also discussed. Human biological responses such as inflammation, oxidative stress, deoxyribonucleic acid (DNA) damage can all influence dysbiosis and consequently CRC carcinogenesis. Dysbiosis could add to CRC risk by shifting the effect of dietary components toward promoting a colonic neoplasm together with interacting with gut microbiota. It follows that dietary intervention and gut microbiota modulation may play a vital role in reducing CRC risk.

Keywords: bacteria interaction; carbohydrate; colon carcinogenesis; colorectal cancer; diet; fat; gut microbiota; protein.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Diet, gut microbiota, and increased colorectal cancer (CRC) risk. Red and processed meat, saturated fat, and simple sugar could independently promote colon carcinogenesis via different mechanisms. Similarly, they can induce microbial dysbiosis in the intestine, further elevating CRC risk. Gut microbiota modulates the metabolism of ingested food via different processes to produce carcinogenic metabolites such as NOC, TMAO, and secondary bile acids. The interaction between diet and gut microbiota is hence bidirectional. TMAO, trimethylamine-N-oxide; NOC, N-nitroso compounds, HCA, heterocyclic amines; PAH, polycyclic aromatic hydrocarbons; DCA, deoxycholic acid; LCA, lithocholic acid; IGF, insulin-like growth factor.
Figure 2
Figure 2
Dysbiosis and colon carcinogenesis. Dysbiotic gut microbiota may drive the malignant transformation of colon cells via the induction of inflammation, the secretion of bacterial toxin, the action of bacterial adherence factors and the induction of DNA damage. The transformation of early neoplastic lesions (adenomatous polyps) to colorectal cancer (CRC) may take up to 15 years depending on the characteristics of the lesions and other risk factors including body weight, gender, physical inactivity, etc. (De Palma et al., 2019). NF-κB, nuclear factor-κB; CNF, cytotoxic necrotizing factor; CDT, cytolethal distending toxin; bft, Bacteroides fragilis toxin; VacA, vacuolating toxin A; FadA, Fusobacterium adhesin A; Fap2, fibroblast activation protein 2; afa, afimbrial adhesin; pil3, pilus 3; ROS, reactive oxygen species; MMR, mismatch repair system, BER, base excision repair system.
Figure 3
Figure 3
Diet, gut microbiota, and decreased colorectal cancer (CRC) risk. The fermentation of dietary fiber by gut microbiota results in the production of butyrate. Butyrate exerts inhibitory effect against colon carcinogenesis through several mechanisms, including the restoration of gut dysbiosis induced by high-fat diet. Probiotics such as Lactobacillus and Bifidobacterium prevents gut colonization by pathogenic bacteria, modulates gut immunity, and maintains gut barrier integrity.

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