Bacterial translocation in colorectal cancer patients

Alina Ogizbayeva 1 * , Yermek Turgunov 1
More Detail
1 Department of Surgical Diseases, Karaganda Medical University, Karaganda city, Republic of Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 18, Issue 3, pp. 8-13. https://doi.org/10.23950/jcmk/10926
OPEN ACCESS 1557 Views 994 Downloads
Download Full Text (PDF)

ABSTRACT

Bacterial translocation is the penetration of intestinal bacteria through the intestinal mucosa into usually sterile tissues and internal organs. Commensal bacteria, despite their presence in the intestine in extremely large numbers, rarely cause local or systemic inflammation, because the unicellular epithelial layer of the intestinal mucosa prevents the migration of these bacteria from the intestine. For years, researchers have wondered how a single layer of intestinal epithelial cells can prevent microorganisms from entering the systemic circulation. Today, the phenomenon of bacterial translocation is considered as one of the main mechanisms of endotoxemia and systemic inflammatory response syndrome in various pathologies, including colorectal cancer and acute bowel obstruction. This narrative review is devoted to the search for factors promoting to bacterial translocation from the intestine in colorectal cancer and acute malignant bowel obstruction.   

           
Keywords: bacterial translocation, gut microbiota, intestinal barrier, colorectal cancer, bowel obstruction.

CITATION

Ogizbayeva A, Turgunov Y. Bacterial translocation in colorectal cancer patients. J CLIN MED KAZ. 2021;18(3):8-13. https://doi.org/10.23950/jcmk/10926

REFERENCES

  • Alexopoulou A, Agiasotelli D, Vasilieva LE, Dourakis SP. Bacterial translocation markers in liver cirrhosis. Ann Gastroenterol. 2017;30(5):486–497. https://doi.org/10.20524/aog.2017.0178
  • Arnold MS, Laversanne SM, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66(4):683-691. https://doi.org/10.1136/gutjnl-2015-310912
  • Pisano M, Zorcolo L, Merli C, Cimbanassi S, Poiasina E, Ceresoli M, et al. 2017 WSES guidelines on colon and rectal cancer emergencies: obstruction and perforation. World J Emerg Surg. 2018;13(1):36. https://doi.org/10.1186/s13017-018-0192-3
  • Torre LA, Siegel RL, Ward EM, Jemal A. Global cancer incidence and mortality rates and trends — an update. Cancer Epidemiol Biomarkers Prev. 2016;25(1):16-27. https://doi.org/10.1158/1055-9965.EPI-15-0578
  • Kaydarova DR, Baltabekov NT, Dushimova ZD, Shatkovskaya OV, Seisenbaeyva GT, Azhmagambetova AE, et al. Indicators of the Oncological Service of the Republic of Kazakhstan for 2019 (statistical and analytical materials) [in Russian and Kazakh]. JSC "Kazakh Institute of Oncology and Radiology" of the Ministry of Health of the Republic of Kazakhstan. Almaty; 2020. 230 p.
  • Kam MH, Tang CL, Chan E, Lim JF, Eu KW. Systematic review of intraoperative colonic irrigation vs manual decompression in obstructed left-sided colorectal emergencies. Int J Colorectal Dis. 2009;24(9):1031-1037. https://doi.org/10.1007/s00384-009-0723-1
  • Harris GJ, Church JM, Senagore AJ, Lavery IC, Hull TL, Strong SA, Fazio VW. Factors affecting local recurrence of colonic adenocarcinoma. Dis. Colon. Rectum. 2002;45:1029-1034. https://doi.org/10.1007/s10350-004-6355-1
  • Barnett A, Cedar A, Siddiqui F, Herzig D, Fowlkes E, Thomas Jr. CR. Colorectal cancer emergencies. J Gastrointest Cancer. 2013;44(2):132–142. https://doi.org/10.1007/s12029-012-9468-0
  • Gore RM, Silvers RI, Thakrar KH, Wenzke DR, Mehta UK, Newmark GM, Berlin JW. Bowel obstruction. Radiol Clin N Am. 2015;53(6):1225–1240. https://doi.org/10.1016/j.rcl.2015.06.008
  • Catena F., De Simone B., Coccolini F, Di Saverio S, Sartelli M, Ansaloni L. Bowel obstruction: a narrative review for all physicians. World J Emerg Surg. 2019;14:20. https://doi.org/10.1186/s13017-019-0240-7
  • Webster PJ, Aldoori J, Burke DA. Optimal management of malignant left-sided large bowel obstruction: do international guidelines agree? World J Emerg Surg. 2019;14(1):23. https://doi.org/10.1186/s13017-019-0242-5
  • Morris EJA, Taylor EF, Thomas JD, Quirke P, Finan PJ, Coleman MP, et al. Thirtyday postoperative mortality after colorectal cancer surgery in England. Gut. 2011;60(6):806–813. https://doi.org/10.1136/gut.2010.232181
  • Sperry J, Cohen MJ. Acute Obstruction. Surg Clin North Am. 2014;94(1):77-96. https://doi.org/10.1016/j.suc.2013.10.001
  • Stubljar D, Skvarc M. Effective strategies for diagnosis of systemic inflammatory response syndrome (SIRS) due to bacterial infection in surgical patients. Infect Disord Drug Targets. 2015;15(1):53-56. https://doi.org/10.2174/1871526515666150320161804
  • Assimakopoulos SF, Triantos C, Thomopoulos K, Fligou F, Maroulis I, Marangos M, Gogos CA. Gut-origin sepsis in the critically ill patient: pathophysiology and treatment. Infection 2018;46(6):751-760. https://doi.org/10.1007/s15010-018-1178-5
  • Clark JA, Coopersmith CM. Intestinal crosstalk: a new paradigm for understanding the gut as the ‘motor’ of critical illness. Shock. 2007;28:384–393. https://doi.org/10.1097/shk.0b013e31805569df
  • Tremaroli V, Bаckhed F. Functional interactions between the gut microbiota and host metabolism. Nature. 2012;489:242–9. https://doi.org/10.1038/nature11552
  • Kaiko GE, Stappenbeck TS. Host–microbe interactions shaping the gastrointestinal environment. Trends Immunol. 2014;35:538–48. https://doi.org/10.1016/j.it.2014.08.002
  • Kamada N, Chen GY, Inohara N. Control of pathogens and pathobionts by the gut microbiota. Nat Immunol. 2013;14:685–690. https://doi.org/10.1038/ni.2608
  • Natividad JM, Verdu EF. Modulation of intestinal barrier by intestinal microbiota: pathological and therapeutic implications. Pharmacol Res. 2013;69:42–51. https://doi.org/10.1016/j.phrs.2012.10.007
  • Zaborin A, Smith D, Garfield K, Quensen J, Shakhsheer B, Kade M, et al. Membership and behavior of ultra low-diversity pathogen communities present in the gut of humans during prolonged critical illness. MBio. 2014;5:e01361–14. https://doi.org/10.1128/mBio.01361-14
  • McDonald D, Ackermann G, Khailova L, Baird C, Heyland D, Kozar R, et al. Extreme dysbiosis Provisional 40 / 54 of the microbiome in critical illness. mSphere. 2016; 1:e00199–16. https://doi.org/10.1128/mSphere.00199-16
  • Ojima M, Motooka D, Shimizu K, Gotoh K, Shintani A, Yoshiya K, et al. Metagenomic analysis reveals dynamic changes of whole gut microbiota in the acute phase of intensive care unit patients. Dig Dis Sci. 2016;61:1628–34. https://doi.org/10.1007/s10620-015-4011-3
  • Lankelma JM, van Vught LA, Belzer C, Schultz MJ, van der Poll T, de Vos WM, et al. Critically ill patients demonstrate large interpersonal variation in intestinal microbiota dysregulation: a pilot study. Intensive Care Med. 2017;43:59–68. https://doi.org/10.1007/s00134-016-4613-z
  • Freedberg DE, Zhou MJ, Cohen ME, Annavajhala MK, Khan S, Moscoso DI, et al. Pathogen colonization of the gastrointestinal microbiome at intensive care unit admission and risk for subsequent death or infection. Intensive Care Med. 2018;44:1203–11. https://doi.org/10.1007/s00134-018-5268-8
  • Tan C, Ling Z, Huang Y, Cao Y, Liu Q, Cai T, et al. Dysbiosis of intestinal microbiota associated with inflammation involved in the progression of acute pancreatitis. Pancreas. 2015;44:868–75. https://doi.org/10.1097/MPA.0000000000000355
  • Howard BM, Kornblith LZ, Christie SA, Conroy AS, Nelson MF, Campion EM, et al. Characterizing the gut microbiome in trauma: significant changes in microbial diversity occur early after severe injury. Trauma Surg Acute Care Open. 2017;2:e000108. https://doi.org/10.1136/tsaco-2017-000108
  • Wang X, Yang J, Tian F, Zhang L, Lei Q, Jiang T, et al. Gut microbiota trajectory in patients with severe burn: A time series study. J Crit Care. 2017;42:310–6. https://doi.org/10.1016/j.jcrc.2017.08.020
  • Klingensmith NJ, Coopersmith CM. The gut as the motor of multiple organ dysfunction in critical illness. Crit Care Clin. 2016;32:203–212. https://doi.org/10.1016/j.ccc.2015.11.004
  • Haak BW, Wiersinga WJ. The role of the gut microbiota in sepsis. Lancet Gastroenterol Hepatol. 2017;2:135–43. https://doi.org/10.1016/S2468-1253(16)30119-4
  • Buffie CG, Pamer EG. Microbiota–mediated colonization resistance against intestinal pathogens. Nat Rev Immunol. 2013;13:790–801. https://doi.org/10.1038/nri3535
  • Diehl GE, Longman RS, Zhang JX, Breart B, Galan C, Cuesta A, et al. Microbiota restricts trafficking of bacteria to mesenteric lymph nodes by CX3CR1hi cells. Nature. 2013;494(7435):116–120. https://doi.org/10.1038/nature11809
  • Farache J, Koren I, Milo I, Gurevich I, Kim KW, Zigmond E, et al. Luminal bacteria recruit CD103+ dendritic cells into the intestinal epithelium to sample bacterial antigens for presentation. Immunity. 2013;38(3):581–595. https://doi.org/10.1016/j.immuni.2013.01.009
  • Meng M, Klingensmith NJ, Coopersmith CM. New insights into the gut as the driver of critical illness and organ failure. Curr Opin Crit Care. 2017:23(2):143-148. https://doi.org/10.1097/MCC.0000000000000386
  • Kabaroudis A, Papaziogas B, Koutelidakis I, Kyparissi-Kanellaki M, Kouzi-Koliakou K, Papaziogas T. Disruption of the small-intestine mucosal barrier after intestinal occlusion: a study with light and electron microscopy. J Invest Surg. 2003;16(1):23–28 https://doi.org/10.1080/08941930390153069
  • Sagar PM, MacFie J, Sedman P, May J, Mancey-Jones B, Johnstone D. Intestinal obstruction promotes gut translocation of bacteria. Dis Colon Rectum. 1995;38(6):640–644 https://doi.org/10.1007/BF02054126
  • Kamada N, Kim YG, Sham HP, Vallance BA, Puente JL, Martens EC, et al. Regulated virulence controls the ability of a pathogen to compete with the gut microbiota. Science 2012;336:1325–9. https://doi.org/10.1126/science.1222195
  • de Sablet T, Chassard C, Bernalier-Donadille A, Vareille M, Gobert AP, Martin C. Human microbiota-secreted factors inhibit Shiga toxin synthesis by enterohemorrhagic Escherichia coli O157:H7. Infect Immun. 2009;77:783–90. https://doi.org/10.1128/IAI.01048-08
  • Hamer HM, De Preter V, Windey K, Verbeke K. Functional analysis of colonic bacterial metabolism: relevant to health? Am J Physiol Gastrointest Liver Physiol. 2012;302:G1–9. https://doi.org/10.1152/ajpgi.00048.2011
  • McCall IC, Betanzos A, Weber DA, Nava P, Miller GW, Parkos CA. Effects of phenol on barrier function of a human intestinal epithelial cell line correlate with altered tight junction protein localization. Toxicol Appl Pharmacol. 2009;241:61–70. https://doi.org/10.1016/j.taap.2009.08.002
  • Cox LM, Yamanishi S, Sohn J, Alekseyenko AV, Leung JM, Cho I, et al. Altering the intestinal microbiota during a critical developmental window has lasting metabolic consequences. Cell. 2014;158:705–21. https://doi.org/10.1016/j.cell.2014.05.052
  • Thaiss CA, Zmora N, Levy M, Elinav E. The microbiome and innate immunity. Nature. 2016;535(7610):65–74. https://doi.org/10.1038/nature18847
  • Levy M, Kolodziejczyk AA, Thaiss CA, Elinav E. Dysbiosis and the immune system. Nat Rev Immunol. 2017;17:219-232. https://doi.org/10.1038/nri.2017.7
  • van der Poll T, van de Veerdonk FL, Scicluna BP, Netea MG. The immunopathology of sepsis and potential therapeutic targets. Nat Rev Immunol. 2017;17:407–420. https://doi.org/10.1038/nri.2017.36
  • Delano MJ, Ward PA. Sepsis–induced immune dysfunction: can immune therapies reduce mortality? J Clin Invest. 2016;126:23–31. https://doi.org/10.1172/JCI82224
  • Deitch EA. Bacterial translocation or lymphatic drainage of toxic products from the gut: what is important in human beings? Surgery. 2002;131(3):241–244 https://doi.org/10.1067/msy.2002.116408
  • Zapater P, Francés R, González-Navajas JM. Serum and ascitic fluid bacterial DNA: a new independent prognostic factor in noninfected patients with cirrhosis. Hepatology. 2008;48:1924-1931. https://doi.org/10.1002/hep.22564
  • Brennan CA, Garrett WS. Gut microbiota, inflammation, and colorectal cancer. Annu Rev Microbiol 70:395–411. https://doi.org/10.1146/annurev-micro-102215-095513
  • Baumgart DC, Dignass AU (2002) Intestinal barrier function. Curr Opin Clin Nutr Metab Care. 2016;5:685-694. https://doi.org/10.1097/00075197-200211000-00012
  • Schietroma M., Pessia B., Colozzi S. Septic complications after resection for middle or low rectal cancer: role of gut barrier function and inflammatory serum markers. Dig Surg. 2017;34(6):507–517. https://doi.org/10.1159/000475847
  • Wiest R, Rath HC (2003) Bacterial translocation in the gut. Best Pract Res Clin Gastroenterol 17:397-425. https://doi.org/10.1016/s1521-6918(03)00024-6
  • Steinberg SM. Bacterial translocation. What it is and what it is not. Am J Surg. 2003;186:301-305. https://doi.org/10.1016/s0002-9610(03)00220-4
  • Dederer YuM. Pathogenesis and treatment of acute bowel obstruction. Moskva: Medicine; 1971.
  • Achkasov EE, Alekperov SF, Melnikov PV. Histopathological changes in the intestine with colon tumor obstruction [in Russian]. Biomedicine. 2012;4:117-127.
  • Zembower TR. Epidemiology of infections in cancer patients. Cancer Treat Res. 2014;161:43–89. https://doi.org/10.1007/978-3-319-04220-6_2
  • Galloway-Peña J, Brumlow C, Shelburne S. Impact of the Microbiota on Bacterial Infections during Cancer Treatment. Trends Microbiol. 2017;25(12):992-1004. https://doi.org/10.1016/j.tim.2017.06.006
  • Sears CL, Garrett WS. Microbes, microbiota, and colon cancer. Cell Host Microbe. 2014;15(3):317–328. https://doi.org/10.1016/j.chom.2014.02.007
  • Irrazabal T, Belcheva A, Girardin SE, Martin A, Philpott DJ. The multifaceted role of the intestinal microbiota in colon cancer. Mol Cell. 2014;54(2):309– 320. https://doi.org/10.1016/j.molcel.2014.03.039
  • van Praagh JB, de Goffau MC, Bakker IS. van Goor H, Harmsen HJM, Olinga P, Havenga K. Mucus microbiome of anastomotic tissue during surgery has predictive value for colorectal anastomotic leakage. Ann Surg. 2019;269: 911–916. https://doi.org/10.1097/SLA.0000000000002651
  • Takesue Y, Kakehashi M, Ohge H, Uemura K, Imamura Y, Murakami Y, et al. Bacterial translocation: not a clinically relevant phenomenon in colorectal cancer. World J Surg. 2005;29(2):198-202. https://doi.org/10.1007/s00268-004-7576-0
  • Ivachyov P, Amanova D, Akhmaltdinova L, Koishibayev Z, Turgunov E. Comparison of dynamics of level of procalcitonin, lipopolysaccharide binding protein and interleukin-6 in blood serum of experimental animals at strangulated and obturative intestinal obstruction. Georgian Med. News. 2020;303:173-177.
  • Mugazov M, Turgunov Y, Kaliyeva D, Matyushko D, Koishibayev Z, Omertayeva D, et al. The role of presepsin in patients with acute surgical diseases. Open Access Maced. J. Med. Sci. 2019;7(8):1282-1286. https://doi.org/10.3889/oamjms.2019.292