Go to JCI Insight
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Advertising
  • Job board
  • Contact
  • Clinical Research and Public Health
  • Current issue
  • Past issues
  • By specialty
    • COVID-19
    • Cardiology
    • Gastroenterology
    • Immunology
    • Metabolism
    • Nephrology
    • Neuroscience
    • Oncology
    • Pulmonology
    • Vascular biology
    • All ...
  • Videos
    • Conversations with Giants in Medicine
    • Video Abstracts
  • Reviews
    • View all reviews ...
    • Pancreatic Cancer (Jul 2025)
    • Complement Biology and Therapeutics (May 2025)
    • Evolving insights into MASLD and MASH pathogenesis and treatment (Apr 2025)
    • Microbiome in Health and Disease (Feb 2025)
    • Substance Use Disorders (Oct 2024)
    • Clonal Hematopoiesis (Oct 2024)
    • Sex Differences in Medicine (Sep 2024)
    • View all review series ...
  • Viewpoint
  • Collections
    • In-Press Preview
    • Clinical Research and Public Health
    • Research Letters
    • Letters to the Editor
    • Editorials
    • Commentaries
    • Editor's notes
    • Reviews
    • Viewpoints
    • 100th anniversary
    • Top read articles

  • Current issue
  • Past issues
  • Specialties
  • Reviews
  • Review series
  • Conversations with Giants in Medicine
  • Video Abstracts
  • In-Press Preview
  • Clinical Research and Public Health
  • Research Letters
  • Letters to the Editor
  • Editorials
  • Commentaries
  • Editor's notes
  • Reviews
  • Viewpoints
  • 100th anniversary
  • Top read articles
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Advertising
  • Job board
  • Contact
Colorectal cancer: the facts in the case of the microbiota
Slater L. Clay, … , Diogo Fonseca-Pereira, Wendy S. Garrett
Slater L. Clay, … , Diogo Fonseca-Pereira, Wendy S. Garrett
Published February 15, 2022
Citation Information: J Clin Invest. 2022;132(4):e155101. https://doi.org/10.1172/JCI155101.
View: Text | PDF
Review

Colorectal cancer: the facts in the case of the microbiota

  • Text
  • PDF
Abstract

The importance of the microbiota in the development of colorectal cancer (CRC) is increasingly evident, but identifying specific microbial features that influence CRC initiation and progression remains a central task for investigators. Studies determining the microbial mechanisms that directly contribute to CRC development or progression are revealing bacterial factors such as toxins that contribute to colorectal carcinogenesis. However, even when investigators have identified bacteria that express toxins, questions remain about the host determinants of a toxin’s cancer-potentiating effects. For other cancer-correlating bacteria that lack toxins, the challenge is to define cancer-relevant virulence factors. Herein, we evaluate three CRC-correlating bacteria, colibactin-producing Escherichia coli, enterotoxigenic Bacteroides fragilis, and Fusobacterium nucleatum, for their virulence features relevant to CRC. We also consider the beneficial bioactivity of gut microbes by highlighting a microbial metabolite that may enhance CRC antitumor immunity. In doing so, we aim to elucidate unique and shared mechanisms underlying the microbiota’s contributions to CRC and to accelerate investigation from target validation to CRC therapeutic discovery.

Authors

Slater L. Clay, Diogo Fonseca-Pereira, Wendy S. Garrett

×

Figure 3

Potential mechanisms of Fusobacterium nucleatum activity in CRC.

Options: View larger image (or click on image) Download as PowerPoint
Potential mechanisms of Fusobacterium nucleatum activity in CRC.
(A) Fus...
(A) Fusobacterium adhesin A (FadA) binding to E-cadherin increases β-catenin and WNT signaling and upregulates annexin A1 that drives epithelial cell proliferation. FadA also has amyloid-like properties that enhance F. nucleatum (Fn) adhesion to cancer cells. (B) Fusobacterium autotransporter protein 2 (Fap2) binds d-galactose-β(1-3)-N-acetyl-d-galactosamine (Gal-GalNAc) on cancer cells and recruits Fn to tumors. Fap2 also binds to T cell immunoreceptor with Ig and immunoreceptor tyrosine-based inhibitory motif domains (TIGIT) and impairs T and NK cell function, reduces cytotoxicity, and promotes immune cell death, resulting in tumor escape from immunosurveillance. Fap2+ Fn activates epithelial and myeloid cells and induces a pro-tumorigenic inflammatory response. (C) Fn LPS induces the expression of microRNA-21 in colon epithelial cells in a TLR4-dependent manner, which results in dysregulated cell proliferation and tumor growth. This same pathway also increases cancer cell autophagy, which enhances resistance to chemotherapy-induced cell death.

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

Sign up for email alerts