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World J Gastrointest Oncol. Jun 15, 2024; 16(6): 2394-2403
Published online Jun 15, 2024. doi: 10.4251/wjgo.v16.i6.2394
Unraveling colorectal cancer prevention: The vitamin D - gut flora - immune system nexus
Zhi-Song Zhan, Zu-Shun Zheng, Jing Shi, Juan Chen, Si-Yi Wu, Shi-Yan Zhang
Zhi-Song Zhan, Department of Dentistry, Fuding Hospital, Fujian University of Traditional Chinese Medicine, Fuding 355200, Fujian Province, China
Zu-Shun Zheng, Department of Physical Examination, Fuding Hospital, Fujian University of Traditional Chinese Medicine, Fuding 355200, Fujian Province, China
Jing Shi, Department of Anesthesiology, Fuding Hospital, Fujian University of Traditional Chinese Medicine, Fuding 355200, Fujian Province, China
Juan Chen, Shi-Yan Zhang, Department of Clinical Laboratory, Fuding Hospital, Fujian University of Traditional Chinese Medicine, Fuding 355200, Fujian Province, China
Si-Yi Wu, Department of Surgery, Fuding Hospital, Fujian University of Traditional Chinese Medicine, Fuding 355200, Fujian Province, China
Co-first authors: Zhi-Song Zhan and Zu-Shun Zheng.
Author contributions: Zhan ZS conducted the literature review, and drafted the manuscript; Zheng ZS participated in the conceptualization and design of the study, and supervised the project; Shi J provided clinical advice and guidance for improving the manuscript; Zhan ZS, Chen J and Wu SY were responsible for designing and illustrating the figure for the manuscript; Chen J and Wu SY offered clinical expertise and guidance to enhance the manuscript; Zhang SY participated in the conceptualization and design of the study, made critical revisions to the final version of the manuscript, providing valuable insights and enhancements; and all authors approved the final version of the manuscript and the authorship list.
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: Shi-Yan Zhang, MD, Director, Department of Clinical Laboratory, Fuding Hospital, Fujian University of Traditional Chinese Medicine, No. 120 South Road of Old City, Fuding 355200, Fujian Province, China. myebox@139.com
Received: December 26, 2023
Revised: March 2, 2024
Accepted: April 11, 2024
Published online: June 15, 2024
Processing time: 171 Days and 23.3 Hours
Abstract

Colorectal cancer (CRC) is one of the most common cancers diagnosed in the world. Although environmental and genetic factors play a major role in the pathogenesis of CRC, extensive research has suggested that vitamin D may play a pivotal role in the development of CRC. Vitamin D, primarily obtained through sunlight exposure, dietary sources, and supplements, has long been recognized for its essential functions in maintaining health, including immune regulation. This article delves into the intricate relationship between vitamin D, the immune system, gut flora, and the prevention of CRC. It presents a synthesis of epidemiological data, experimental studies, and clinical trials, highlighting the mechanisms by which vitamin D influences immune cell function, cytokine production, and inflammation. By enhancing the immune system’s surveillance and anti-tumor activity, vitamin D may offer a promising avenue for CRC prevention. Furthermore, this comprehensive review delves into the prospective clinical applications of vitamin D supplementation and delineates the forthcoming avenues of research in this dynamic domain. Additionally, the paper tentatively outlines a spectrum of prophylactic impacts of vitamin D on CRC, emphasizing its significant potential in reducing CRC risk through shedding light on its mechanisms, encompassing antineoplastic mechanisms, influences on the immune system, and modulation of the gut microbiome.

Keywords: Colorectal cancer, Vitamin D, Immune system, Gut flora, Immunomodulation, Microbial dysbiosis, Cancer prevention

Core Tip: Our study explores the intricate connections between vitamin D, the immune system, and gut flora in the context of colorectal cancer (CRC) prevention. We uncover how vitamin D influences these interrelated factors and its potential role in reducing CRC risk. This research sheds light on novel avenues for preventive strategies and underscores the importance of a holistic approach to CRC prevention.