Mikrobielle Einflüsse in der Tumorentwicklung und Tumortherapie

Zusammenfassung

Viren und Bakterien spielen eine zentrale Rolle in der Entstehung von Malignomen im Gastrointestinaltrakt. So konnte bereits vor Dekaden eine Assoziation von Helicobacter pylori und dem Magenkarzinom sowie MALT-Lymphomen, und von Hepatitis-B- und C-Virus-Infektionen und dem hepatozellulären Karzinom nachgewiesen werden. Faszinierende Daten der letzten Jahre deuten jedoch einen weit über diese Zusammenhänge hinausgehenden Beitrag mikrobieller Erreger zur Karzinogenese im Gastrointestinaltrakt und der Leber an. So konnte gezeigt werden, dass Barriere-Defekte sowie Veränderungen in der Komposition der intestinalen Mikrobiota die kolorektale und hepatozelluläre Karzinogenese fördern. Darüber hinaus konnte die überraschende Beobachtung gemacht werden, dass die Mikrobiota nicht nur in lokaler Weise die Tumorentwicklung reguliert, sondern auch maßgeblichen Einfluss auf die Wirksamkeit systemischer Tumortherapien hat. Im vorliegenden Artikel sollen aktuelle Daten zur mikrobiellen Regulation der Tumorentstehung und der Beeinflussung systemischer Tumortherapien dargestellt werden und Implikationen für die klinische Diagnostik und Therapie diskutiert werden.

Abstract

Viruses and bacteria play central roles in gastrointestinal tumor development. This includes well-characterized contributions of Helicobacter pylori to gastric carcinoma and MALT lymphoma and of Hepatitis B and C virus infections to hepatocellular cancer. However, recent studies have demonstrated a much broader role of the microbiota in the regulation of cancer development. As such, it was shown that barrier defects and alterations in microbial community structure contribute to colorectal and hepatocellular cancer. Moreover, intriguing studies have highlighted the microbiota as a central regulator of the efficacy of systemic anti-tumor therapies. Here, we provide an overview of recent observations on the role of the microbiota in tumor development and the regulation of therapeutic anti-tumor responses and discuss the implications of these findings for clinical diagnostics and treatment.

Schlüsselwörter

kolorektales Karzinom - kolorektales Adenom - Mikrobiota - Rektumkarzinom

Key words

colorectal cancer - rectal cancer - microbiota

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