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Identifying cancer indicators in gut health

How epigenetic studies have expanded our understanding of the gut health-cancer connection
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Takeaway: As new epigenetic studies emerge, data begins to outline the importance of a healthy gut microbiome on our overall long-term health and its potential significance as a key cancer prevention tool. 

There is a rising caseload of gastrointestinal cancers, and it is estimated by the American Cancer Society that approximately 8,000 of the annual carcinoid tumors and cancers start in the gut. Attempting to summarize the global burden, one study sought to elevate the impact of the top five types (esophageal, gastric, liver, colorectal, and pancreatic) of gastrointestinal cancers. The team noted that while the incidence of some GI cancer types have decreased, the overall group of malignancies continues to pose major challenges to public health.  

In response, we’ve witnessed a growing library of scientific research pointing us in the direction of improving our gut health to enhance our overall health. With the assistance of several large-scale projects, including the National Health Institute-funded Human Microbiome Project and the European Metagenomics of the Human Intestinal Tract, substantial reference banks derived from healthy individuals have created a significant resource for researchers interested in improving our understanding of the gut-health relationship.  

Methylation sequencing in cancer research 

Subsequent research identified what is thought to be a nearly complete set of genes for most human gut bacteria, which has been critical to improving our knowledge of diseases targeting the digestive tract. Despite this expanded information, identifying the direct connection between microbiome changes and with certain diseases has remained elusive. Next generation sequencing methods are opening new doors to information that may help improve patient diagnosis and outcomes. 

For years, methylation sequencing has been a trusted investigational method for cancer researchers, helping to expand our understanding of different gene functions. For example, determining why individuals experience different outcomes or develop certain illnesses as we age, while others do not. Looking at methylation patterns of DNA has also been used to identify alternations in our DNA that has become one of the earliest and most frequent signatures of cancer

Additionally, lower costs of methylation sequencing have led to increased research in areas that look to pinpoint varied gene activity, gene silencing, and the relationship between active and inactive gene regions, enabling researchers to better understand cause and outcome. Of note, these studies are aimed at uncovering the secrets behind gut flora, digestive diseases like inflammatory bowel disease, irritable bowel disease, and certain types of cancer.

The role of 16S rRNA sequencing in cancer research  

In most cases, study of the human microbiome has advanced, in part, thanks to the evolution of technology enabling the sequencing of the 16S rRNA encoding gene. One recent study links poor gut health to pancreatic cancer (PC) initiation and progression. To study the connection between gut health and cancer, researchers completed a functional examination of 16S rRNA DNA copies in pancreatic bacteria to determine if imbalances in the microbiome were present and had caused DNA damage in samples from pancreatic cancer surgical patients. Findings confirmed that bacteria culture-positive samples originated primarily from pancreas cysts histologically categorized as Intraductal Papillary Mucinous Neoplasm (IPMNs), precursors to further potential malignant changes.   

Gut health’s role in patient response to cancer therapies  

In addition to the development of cancer, poor gut health is also being linked to less successful responses to cancer immunotherapy, chemotherapy, cancer surgery, and more. A team at Brigham and Women’s Hospital outlined a connection between the gut microbiome and a patient’s response to cancer therapeutics. The team found that syncing immunotherapies with gut microbiota created the potential for meaningful impact in patient care.

While the blueprint for ideal gut health is still under investigation, the value of exploring gut health as a component of a treatment plan to ensure an optimal response is increasingly apparent. Additional studies and clinical trials are already underway and seek to expand our knowledge around how to leverage existing tools like probiotics and dietary changes with adjustments to the digestive microbiome to optimize patient response and outcome.

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