Huang QY, Yao F, Zhou CR, Huang XY, Wang Q, Long H, Wu QM. Role of gut microbiome in regulating the effectiveness of metformin in reducing colorectal cancer in type 2 diabetes. World J Clin Cases 2020; 8(24): 6213-6228 [PMID: 33392303 DOI: 10.12998/wjcc.v8.i24.6213]
Corresponding Author of This Article
Qing-Ming Wu, MD, PhD, Chief Doctor, Professor, Institute of Infection, Immunology and Tumor Microenvironment, Medical College, Wuhan University of Science and Technology, No. 2 Huangjiahu West Road, Baishazhou Avenue, Hongshan District, Wuhan 430065, Hubei Province, China. wuhe9224@sina.com
Research Domain of This Article
Oncology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
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/
Qi-You Huang, Fei Yao, Chuan-Ren Zhou, Xiao-Ying Huang, Qiang Wang, Qing-Ming Wu, Institute of Infection, Immunology and Tumor Microenvironment, Medical College, Wuhan University of Science and Technology, Wuhan 430065, Hubei Province, China
Hui Long, Department of Gastroenterology, Tianyou Affiliated Hospital, Wuhan University of Science and Technology, Wuhan 430064, Hubei Province, China
Author contributions: Huang QY and Wu QM designed the research review; Yao F, Zhou CR, and Huang XY collected relevant documents and sorted out the data; Wang Q and Long H analyzed the data and made critical revisions related to important intellectual content of the manuscript; Huang QY and Wu QM wrote the manuscript; All authors have read and approved the final manuscript.
Supported byNational Natural Science Foundation of China, No. 81573239.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qing-Ming Wu, MD, PhD, Chief Doctor, Professor, Institute of Infection, Immunology and Tumor Microenvironment, Medical College, Wuhan University of Science and Technology, No. 2 Huangjiahu West Road, Baishazhou Avenue, Hongshan District, Wuhan 430065, Hubei Province, China. wuhe9224@sina.com
Received: July 13, 2020 Peer-review started: July 13, 2020 First decision: September 30, 2020 Revised: October 13, 2020 Accepted: November 2, 2020 Article in press: November 2, 2020 Published online: December 26, 2020
Abstract
The prevalence of colorectal cancer (CRC) and type 2 diabetes mellitus (T2DM) is increasing globally. It is rarely noticed that the incidence of CRC is higher in patients with T2DM. What needs to be mentioned is that metformin, a commonly used clinical drug for T2DM, attracts scholars’ attention because of its benefits in lowering the risk of developing CRC. Hence, we try to find the common grounds of initiation of T2DM and CRC and the reason why metformin reduces the risk of CRC in patients with T2DM. We noticed consistent changes of gut microbiota, such as elevated Bacteroides, Prevotella and Bifidobacterium and depressed Firmicutes and Lactobacillus. Furthermore, many studies in recent years have proved that the efficacy of metformin, such as improving blood glucose, depends on the gut microbiota. Coincidentally, the progression of CRC is inseparable from the contributions of gut microbiota. Therefore, we first proposed the concept of the metformin-gut microbiota–CRC (in T2DM) axis to explain the effect of metformin in reducing CRC in patients with T2DM. In this review, we elaborated the new concept and its potential clinical application value.
Core Tip: Metformin has been found to reduce colorectal cancer in patients with type 2 diabetes, but the mechanism is unknown. Studies have confirmed that gut microbiota is not only closely related to type 2 diabetes and colorectal cancer, but also mediates the effects of metformin. Therefore, we proposed the concept of the metformin-gut microbiota-colorectal cancer axis in type 2 diabetes mellitus. The concept also provides new ideas for clinical drug use, clinical cancer treatment, and clinical application of gut microbiota.
