Published online Jan 14, 2019. doi: 10.3748/wjg.v25.i2.151
Peer-review started: November 5, 2018
First decision: December 12, 2018
Revised: December 20, 2018
Accepted: December 27, 2018
Article in press: December 28, 2018
Published online: January 14, 2019
Colorectal cancer (CRC) is one of the most commonly diagnosed cancers, and it is characterized by genetic and epigenetic alterations, as well as by inflammatory cell infiltration among malignant and stromal cells. However, this dynamic infiltration can be influenced by the microenvironment to promote tumor proliferation, survival and metastasis or cancer inhibition. In particular, the cancer microenvironment metabolites can regulate the inflammatory cells to induce a chronic inflammatory response that can be a predisposing condition for CRC retention. In addition, some nutritional components might contribute to a chronic inflammatory condition by regulating various immune and inflammatory pathways. Besides that, diet strongly modulates the gut microbiota composition, which has a key role in maintaining gut homeostasis and is associated with the modulation of host inflammatory and immune responses. Therefore, diet has a fundamental role in CRC initiation, progression and prevention. In particular, functional foods such as probiotics, prebiotics and symbiotics can have a potentially positive effect on health beyond basic nutrition and have anti-inflammatory effects. In this review, we discuss the influence of diet on gut microbiota composition, focusing on its role on gut inflammation and immunity. Finally, we describe the potential benefits of using probiotics and prebiotics to modulate the host inflammatory response, as well as its application in CRC prevention and treatment.
Core tip: The host immune system plays a central role in colorectal cancer prevention and development. However, the immune response is deeply influenced by gut microbiota composition, which in turn is modulated by host diet. Therefore, diet could be used as a strong ally to prevent colorectal cancer and to support its treatment.