Open AccessFamilial adenomatous polyposis and changes in the gut microbiota: New insights into colorectal cancer carcinogenesis
Author(s) -
Antonio Biondi,
Francesco Burzotta,
Marco Vacante
Publication year - 2021
Publication title -
world journal of gastrointestinal oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.924
H-Index - 26
ISSN - 1948-5204
DOI - 10.4251/wjgo.v13.i6.495
Subject(s) - colorectal cancer , medicine , familial adenomatous polyposis , fusobacterium nucleatum , adenomatous polyposis coli , bacteroides fragilis , gut flora , carcinogenesis , cancer , mouse model of colorectal and intestinal cancer , dysbiosis , cancer research , gastroenterology , immunology , antibiotics , microbiology and biotechnology , biology , periodontitis , porphyromonas gingivalis
Patients with familial adenomatous polyposis (FAP), an autosomal dominant hereditary colorectal cancer syndrome, have a lifetime risk of developing cancer of nearly 100%. Recent studies have pointed out that the gut microbiota could play a crucial role in the development of colorectal adenomas and the consequent progression to colorectal cancer. Some gut bacteria, such as Fusobacterium nucleatum , Escherichia coli, Clostridium difficile , Peptostreptococcus , and enterotoxigenic Bacteroides fragilis, could be implicated in colorectal carcinogenesis through different mechanisms, including the maintenance of a chronic inflammatory state, production of bioactive tumorigenic metabolites, and DNA damage. Studies using the adenomatous polyposis coli Min/+ mouse model, which resembles FAP in most respects, have shown that specific changes in the intestinal microbial community could influence a multistep progression, the intestinal "adenoma-carcinoma sequence", which involves mucosal barrier injury, low-grade inflammation, activation of the Wnt pathway. Therefore, modulation of gut microbiota might represent a novel therapeutic target for patients with FAP. Administration of probiotics, prebiotics, antibiotics, and nonsteroidal anti-inflammatory drugs could potentially prevent the progression of the adenoma-carcinoma sequence in FAP. The aim of this review was to summarize the best available knowledge on the role of gut microbiota in colorectal carcinogenesis in patients with FAP.