To provide a comprehensive review of the current evidence on the role of diet, nutrition, microbial metabolism, and chronic inflammation in colorectal cancer (CRC), with emphasis on emerging translational applications including microbiome-based biomarkers and microbiota-targeted therapeutic strategies.
Approach:
Literature Search: A literature search was performed using PubMed, Scopus, and the Cochrane Library to identify relevant studies on diet-microbiota interactions, microbial metabolites, inflammatory mechanisms, and microbiota-targeted interventions.
Key Findings:
Dietary patterns significantly impact gut microbiota composition and function.
Rich-fiber diets and short-chain fatty acids (SCFAs) are protective against CRC.
Western dietary patterns and ultra-processed foods promote a pro-inflammatory environment linked to carcinogenesis.
Specific microorganisms like Fusobacterium nucleatum, enterotoxigenic Bacteroides fragilis, and pks-positive Escherichia coli are associated with CRC through inflammatory, genotoxic, and immune-modulatory mechanisms.
Advances in sequencing technologies have identified microbial signatures with potential diagnostic and prognostic value.
Microbiota-targeted interventions, including probiotics and faecal microbiota transplantation, show promising preclinical and early clinical results.
Interpretation:
The diet-microbiota-inflammation axis is a key player in colorectal carcinogenesis and presents opportunities for translational research.
Limitations:
Challenges in establishing causation between diet, microbiota, and CRC.
Standardization issues in microbiome research.
Difficulties in translating findings into clinical practice.
Conclusion:
Microbiome-based biomarkers and microbiota-targeted therapies may play a role in future precision prevention and personalized management strategies for colorectal cancer, despite significant challenges in terms of causation, standardization, and translation into clinical practice.
