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The gut barrier as a gatekeeper in colorectal cancer treatment
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Abstract
Roy Hajjar1,2,3,4,5, Carole Richard2,3,5 and Manuela M. Santos1,4,6
1 Nutrition and Microbiome Laboratory, Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, Québec, Canada
2 Department of Surgery, Digestive Surgery Service, Centre hospitalier de l’Université de Montréal (CHUM), Montréal, Québec, Canada
3 Department of Surgery, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
4 Institut du cancer de Montréal, Montréal, Québec, Canada
5 Division of General Surgery, Université de Montréal, Montréal, Québec, Canada
6 Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
Correspondence to:
Roy Hajjar, | email: | [email protected] |
Keywords: colorectal cancer; gut microbiome; gut barrier; colorectal surgery; anastomotic leak
Received: July 09, 2024 Accepted: July 15, 2024 Published: August 14, 2024
ABSTRACT
Colorectal cancer (CRC) is highly prevalent and is a major cause of cancer-related deaths worldwide. The incidence rate of CRC remains alarmingly high despite screening measures. The main curative treatment for CRC is a surgical resection of the diseased bowel segment. Postoperative complications usually involve a weakened gut barrier and a dissemination of bacterial proinflammatory lipopolysaccharides. Herein we discuss how gut microbiota and microbial metabolites regulate basal inflammation levels in the gut and the healing process of the bowel after surgery. We further elaborate on the restoration of the gut barrier function in patients with CRC and how this potentially impacts the dissemination and implantation of CRC cells in extracolonic tissues, contributing therefore to worse survival after surgery.
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