Impact of gut microbiome in the development and treatment of pancreatic cancer: Newer insights

Table 2 Impact of gut microbiota in the treatment of Pancreatic cancer

Bacteria	Primary site	Potential mechanism	Subsequent effect	Ref.
Escherichia coli	Large bowel	Cytolysin A production; Cytolethal distending toxin production	Imposing cell death in the eukaryotic membrane by the caspase-dependent pathway; DNA double stranded breaks, leading to cell cycle arrest and cytotoxicity	[49,86,87]
Staphylococcus aureus	Variable	Cytolysin A production	Imposing cell death in the eukaryotic membrane by the caspase-dependent pathway	[86]
Streptococcus pyogenes	Variable	Streptolysin O production	Increase in apoptosis and cytolysis	[88]
Aggregatibacter actinomycetemcomitans, Campylobacter and Helicobacter	Mouth, stomach, large bowel	Cytolethal distending toxin production	DNA double stranded breaks, leading to cell cycle arrest and cytotoxicity	[87]
Lactobacillus casei	Mouth and small intestine	P53 activation	Upregulation of apoptosis	[90]
Bacteroidales, Burkholderiales	Large bowel	CTLA-4 upregulation	Enhancing activity of monoclonal antibody against CTLA-4	[95]

CTLA-4: Cytotoxic T-lymphocyte-associated protein 4.