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Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2019; 7(13): 1554-1570
Published online Jul 6, 2019. doi: 10.12998/wjcc.v7.i13.1554
Role of the brain-gut axis in gastrointestinal cancer
Yang-Zi Di, Bo-Sheng Han, Jun-Mao Di, Wei-Yan Liu, Qiang Tang
Yang-Zi Di, Jun-Mao Di, Wei-Yan Liu, Qiang Tang, Department of General Surgery, Shiyan Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei Province, China
Bo-Sheng Han, Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 443000, Hubei Province, China
Author contributions: Di YZ and Han BS contributed equally to this work; all authors contributed to this paper with regard to the conception and design of the study, literature review and analysis, manuscript drafting, critical revision, and editing, and approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Qiang Tang, PhD, Chief Doctor, Doctor, Department of General Surgery, Shiyan Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei Province, China. tang_8q@126.com
Telephone: +86+15171363579
Received: January 7, 2019
Peer-review started: January 7, 2019
First decision: February 13, 2019
Revised: April 4, 2019
Accepted: May 2, 2019
Article in press: May 2, 2019
Published online: July 6, 2019
Abstract

Several studies have largely focused on the significant role of the nervous and immune systems in the process of tumorigenesis, including tumor growth, proliferation, apoptosis, and metastasis. The brain-gut-axis is a new paradigm in neuroscience, which describes the biochemical signaling between the gastrointestinal (GI) tract and the central nervous system. This axis may play a critical role in the tumorigenesis and development of GI cancers. Mechanistically, the bidirectional signal transmission of the brain-gut-axis is complex and remains to be elucidated. In this article, we review the current findings concerning the relationship between the brain-gut axis and GI cancer cells, focusing on the significant role of the brain-gut axis in the processes of tumor proliferation, invasion, apoptosis, autophagy, and metastasis. It appears that the brain might modulate GI cancer by two pathways: the anatomical nerve pathway and the neuroendocrine route. The simulation and inactivation of the central nervous, sympathetic, and parasympathetic nervous systems, or changes in the innervation of the GI tract might contribute to a higher incidence of GI cancers. In addition, neurotransmitters and neurotrophic factors can produce stimulatory or inhibitory effects in the progression of GI cancers. Insights into these mechanisms may lead to the discovery of potential prognostic and therapeutic targets.

Keywords: Brain-gut axis, Gastrointestinal cancer, Neurotransmitters, Neuropeptides

Core tip: Although studies have revealed the role of the brain-gut axis in cancer, the bidirectional signal transmission of the brain-gut axis remains unclear. This review summarizes current findings concerning the relationship between the brain-gut axis and gastrointestinal (GI) cancer and focuses on the significant role of the brain-gut axis in tumorigenesis and cancer progression, including tumor proliferation, invasion, apoptosis, autophagy, and metastasis. The central nervous, sympathetic, and parasympathetic nervous systems, neurotransmitters, and neuropeptides may regulate the malignant tumor phenotype in GI cancers. An insight into these mechanisms may lead to the discovery of potential prognostic markers and new targets for GI cancer therapy.