The gut barrier as a gatekeeper in colorectal cancer treatment (IMAGE)
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Figure 1: Graphical abstract.
Surgery and anastomotic leak (AL) weaken the gut barrier function, which promotes the dissemination and implantation of colorectal cancer cells in the peritoneal cavity and distant organs. A disrupted gut barrier leads to intestinal and systemic inflammation that promote carcinogenesis and decrease survival. Activation of peroxisome proliferator-activated receptor-gamma (PPAR-γ) by 5-aminosalicylate (5-ASA) and short-chain fatty acids, derived from bacterial fermentation of dietary fibers, reinforces the gut barrier, prevents AL, decreases inflammation, and ultimately improves oncological outcomes. Abbreviations: TNF-α: tumor necrosis factor alpha; IL1β: interleukin 1 beta; IL17A/F: interleukin 17 A/F; MIP-1α: macrophage inflammatory protein 1 alpha; MIP-2: macrophage inflammatory protein 2; MCP-1: monocyte chemoattractant protein 1; IL-5: interleukin 5; IL-10: interleukin 10; IFN-γ: interferon gamma; LCN2: lipocalin 2. Green arrows indicate promotion/stimulation, red arrows indicate inhibition/prevention. Created with https://www.biorender.com/.
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2024 Hajjar et al.
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