▎药明康德团队
结直肠癌是全球范围内第二常见的恶性肿瘤。《中国结直肠癌诊疗规范》也显示,2020年中国结直肠癌发病率和死亡率在全部恶性肿瘤中分别位居第二和第五。近年来,这种致命肿瘤的发病率和死亡率持续攀升,因此明确结直肠癌的诱发机制显得尤为重要。
在之前的研究中,一种名为
具核梭杆菌(
Fusobacterium nucleatum,简称
Fn)的细菌与结直肠癌的关系受到了关注。
Fn是常见的口腔细菌,在健康人群的下消化道中很少出现。但对于结直肠癌患者,情况就完全不同了。
Fn在他们的肿瘤中富集,并且
Fn水平较高时,患者更容易出现肿瘤复发、转移,预后也更差。
在这些发现的基础上,科学家们已经在动物和细胞模型中证实,
Fn可以感染肿瘤,通过多种途径促进结直肠癌发展,并且增强化疗耐药性。这些促癌途径包括调控免疫微环境、促进细胞循环、激活TLR4信号、调控自噬作用等等。
▲在结直肠癌患者的肿瘤中,具核梭杆菌富集
(图片来源:参考资料[2];Credit:Fred Hutchinson癌症中心)
因此,
Fn可以说是隐藏在口腔里的危险促癌“帮凶”。不过也有研究注意到,不同
Fn菌株之间的基因型和表型特征存在相当大的差异。或许,当我们认为起到促癌作用的是所有
Fn时,其实是错怪了其中的一部分菌株?
日前,一项刚刚发表于《自然》杂志的研究给出了这个问题的答案。由Fred Hutchinson癌症中心领导的研究团队发现,
Fn一个特定亚种的特定进化枝,在结直肠癌的肿瘤生态位中占据主导地位。换言之,
这个名为
Fna C2的亚型才是真正推动癌症发展、导致患者预后变差的罪魁祸首。这一发现为改善结直肠癌的治疗手段和早期筛查方法提供了重要线索。
在这项研究中,为了描述促瘤
Fn的遗传因素,首先广泛收集了结直肠癌患者的肿瘤样本,以及未患癌个体的口腔菌株样本。通过对这些样本的测序,研究团队生成了135个
Fn菌株的封闭基因组,泛基因组分析也确定了483个结直肠癌富集的遗传因子。
为了揭示
Fn的更多细节,最新研究将分析的分辨率提高到了亚种水平。
Fn包含了4个亚种,研究发现只有一种亚种(
Fn animalis,简称
Fna)与结直肠癌的生态位显著相关,肿瘤中分离的菌株也主要属于
Fna。
对研究团队而言,更大的惊喜还在后面。虽然
Fna是单一亚种,但基因组分析却指出,
Fna由两个不同的进化枝(
Fna C1和
Fna C2)组成,两者经历了不同的进化路径。其中,
只有
Fna C2在结直肠癌生态位中占主导地位。到这里,真正促癌的
Fn范围又一次缩小了。
在论文共同通讯Christopher Johnston博士看来,这个意料之外的发现有着重要意义:“我们往往认为,在系统发育上非常接近的菌株是一回事;但现在我们发现,它们在肿瘤和口腔中的相对丰度存在巨大差异。”
图片来源:123RF
接下来,研究团队在一系列分析中进一步证实了
Fna C2重要且特殊的促癌作用。
分离出两个进化枝之间的195处遗传差异,他们发现肿瘤浸润型
Fna C2类型获得了独特的遗传特征,使得它们在从口腔进入胃部后,能够承受酸性环境,继而在下消化道中生长。
对结直肠癌患者肿瘤组织的微生物组分析也显示
Fna C2富集,并且与正常相邻组织相比,只有
Fna C2亚型在结直肠肿瘤组织中显著富集。此外,对结直肠癌患者和健康个体粪便样本的宏基因组分析也支持了这一点,其中结直肠癌患者的
Fna C2水平始终较高。
▲人体组织微生物组和粪便宏基因组样本中的
Fn
(图片来源:参考资料[1])
因此,这项研究明确了
Fna的进化谱系,证实了其中的
Fna C2驱动了人类结直肠癌中的
Fn富集,并且揭示了
Fna C2对结直肠癌生态位病理适应的遗传基础。这些发现对于开发基于微生物的有效预防、治疗方法有着重要意义。
论文共同通讯Susan Bullman博士表示:“现在我们发现,这种微生物的特定亚型与肿瘤生长有关。这表明针对微生物群落中这一亚群的治疗和筛查,将帮助那些可能罹患侵袭性结直肠癌的高风险人群。”
参考资料:
[2]
Bacteria subtype linked to growth in up to 50% of human colorectal cancers, Fred Hutch researchers report. Retrieved Mar. 21, 2024 from https://www.eurekalert.org/news-releases/1038127
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