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Background  Colon cancer is one of the most common malignancies and the fourth leading cause of cancer-related mortality in the world. Colibactin, which is synthesized by the  pks  genomic island of  E. coli  interfere with the eukaryotic cell cycle. Cinnamon has an antimicrobial effect and considered as a colon cancer-preventing agent. The aim of the study was to evaluate the effects of cinnamon extract and cinnamaldehyde on  clbB  gene expression and biofilm formation in clinical isolates of  E. coli .    Methods  Thirty  E. coli  carrying  pks  gene were isolated from the colon cancer patients, inflammatory bowel disease and healthy subjects. Antibiotic susceptibility was evaluated by disk diffusion method and the minimum inhibitory concentration of cinnamon essential oil and cinnamaldehyde by microdilution broth method. In vitro biofilm formation of  E.coli  isolates was monitored using a microtiter plate method. The presence of  clbB, clbA  and  clbQ  genes in  E.coli  isolates were evaluated by PCR. The effect of cinnamaldehyde and cinnamon essential oil on  clbB  gene expression was evaluated by Real-Time PCR.    Results  The highest antibiotic resistance was obtained with 94.4% for ticarcillin-clavulanic acid, azithromycin, amoxicillin, and amikacin. The MIC for all clinical isolates was 32 μl/ml of cinnamon essential oil and the MIC of cinnamaldehyde was between 0.00002 to 0.03 μl/ml. After exposure of isolates to cinnamon extract and cinnamaldehyde, 40 and 13.3% were weakly biofilm producers, respectively. The frequencies of  clbB, clbA,  and  clbQ  genes were 23.3, 23.3, and 26.7%, respectively. The expression of  clbB  gene in the presence of the Sub-MIC concentration of cinnamon essential oil and cinnamaldehyde was decreased in 8 isolates compared to untreated isolates ( p -value < 0.05).    Conclusions  The antibacterial activity of cinnamaldehyde and cinnamon essential oil allows the use of these herbal compounds for treatment or supplements in infections caused by  E. coli  and in patients with suspected colorectal cancer.

Evaluation of cinnamon extract effects on clbB gene expression and biofilm formation in Escherichia coli strains isolated from colon cancer patients