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World J Gastrointest Oncol. Aug 15, 2022; 14(8): 1456-1468
Published online Aug 15, 2022. doi: 10.4251/wjgo.v14.i8.1456
Crosstalk between gut microbiota and COVID-19 impacts pancreatic cancer progression
Chun-Ye Zhang, Shuai Liu, Ming Yang
Chun-Ye Zhang, Department of Veterinary Pathobiology, University of Missouri, Columbia, MO 65211, United States
Shuai Liu, The First Affiliated Hospital, Zhejiang University, Hangzhou 310006, Zhejiang Province, China
Ming Yang, Department of Surgery, University of Missouri, Columbia, MO 65211, United States
Author contributions: Zhang CY, Liu S and Yang M conceived the opinion, collected the data and wrote the manuscript, reviewed and edited the article; all authors contributed equally to this work, they all revised and approved the submitted version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ming Yang, DVM, PhD, Postdoctoral Fellow, Department of Surgery, University of Missouri, Roy Blunt NextGen Precision Health Building, Room 2203, 1030 Hitt Street, Columbia, MO 65211, United States. yangmin@health.missouri.edu
Received: March 20, 2022
Peer-review started: March 20, 2022
First decision: April 17, 2022
Revised: April 26, 2022
Accepted: July 5, 2022
Article in press: July 5, 2022
Published online: August 15, 2022
Abstract

Pancreatic cancer (PC) is one of the most common causes of cancer-associated death worldwide, with a low rate of 5-year survival. Currently, the pathogenesis of PC is complicated, with no efficient therapy. Coronavirus disease 2019 (COVID-19) disease caused by severe acute respiratory syndrome coronavirus 2 further exacerbates the challenge of patients with PC. The alteration of gut microbiota caused by COVID-19 infection may impact PC progression in patients via immune regulation. The expression of inflammatory immune mediators such as interleukin (IL)-6, IL-8, and IL-10 has been found to increase in both PC and COVID-19 patients, which is associated with the disease severity and prognostic outcome. Gut microbiome serves as a critical connector between viral infection and PC. It can regulate host systemic immune response and impact the efficacy of immunotherapy. Here, we first demonstrated the features of inflammatory cytokines in both diseases and their impact on disease outcomes. Then, we demonstrated the importance of immunotherapeutic strategies. This includes the immune modulation that targets a single or dual receptors using a single agent or their combinations for the treatment of PC in patients who get infected with COVID-19. Additionally, we explored the possibility of managing the disease by regulating gut microbiome. Overall, modulation of the lung-gut-pancreases axis can boost anti-cancer immunotherapy and reduce adverse prognostic outcomes.

Keywords: COVID-19, SARS-CoV-2, Gut microbiota, Pancreatic cancer, Interleukin-6, Interleukin-8, Interleukin-10, Monoclonal antibodies, Modulatory treatment

Core Tip: Pancreatic cancer (PC) is a leading cause of cancer-associated death worldwide. Currently, the pathogenesis of this disease is complicated without efficient therapy. Coronavirus disease 2019 (COVID-19) disease exacerbates the challenge of PC patients. The gut microbiome serves as a critical connector between viral infection and PC through the regulation of host systemic immune response. Therefore, by targeting the lung-gut-pancreases axis, we can modulate both cytokine storm and inflammation in patients with PC and COVID-19 infection.