Colonization with enterotoxigenic Bacteroides fragilis is associated with early-stage colorectal neoplasia
Open accessAbstract
BACKGROUND: Enterotoxigenic Bacteroides fragilis (ETBF) is a toxin-producing bacteria thought to possibly promote colorectal carcinogenesis by modulating the mucosal immune response and inducing epithelial cell changes. Here, we aim to examine the association of colonic mucosal colonization with ETBF and the presence of a range of lesions on the colonic neoplastic spectrum. METHODS: Mucosal tissue from up to four different colonic sites was obtained from a consecutive series of 150 patients referred for colonoscopy. The presence and relative abundance of the B. fragilis toxin gene (bft) in each tissue sample was determined using quantitative PCR, and associations with clinicopathological characteristics were analysed. FINDINGS: We found a high concordance of ETBF between different colonic sites (86%). Univariate analysis showed statistically significant associations between ETBF positivity and the presence of low-grade dysplasia (LGD), tubular adenomas (TA), and serrated polyps (P-values of 0.007, 0.027, and 0.007, respectively). A higher relative abundance of ETBF was significantly associated with LGD and TA (P-values of < 0.0001 and 0.025, respectively). Increased ETBF positivity and abundance was also associated with left-sided biopsies, compared to those from the right side of the colon. CONCLUSION: Our results showing association of ETBF positivity and increased abundance with early-stage carcinogenic lesions underlines its importance in the development of colorectal cancer, and we suggest that detection of ETBF may be a potential marker of early colorectal carcinogenesis.
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Higher proportions of patients with familial adenomatous polyposis or sporadic premalignant lesions had intestinal mucosa positive for enterotoxigenic Bacteroides fragilis than controls.
“Higher proportions of patients with familial adenomatous polyposis42 or sporadic premalignant lesions had intestinal mucosa that tested positive for ETBF than of controls.41”
From Influence of the Gut Microbiome, Diet, and Environment on Risk of Colorectal Cancer (2020) · cites this paper as [41]
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- Authors
- Purcell, R. V., Pearson, J., Aitchison, A., Dixon, L., Frizelle, F. A., & Keenan, J. I.
- Affiliations
- University of Otago (NZ)
- Corresponding author
- Purcell, Rachel V.
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2017-02-02
- Volume
- 12
- Issue
- 2
- Pages
- e0171602
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5289627
- OpenAlex
- W2583680774
- Cited by
- 230
- References
- 30
- Citations by year
- 2026: 18 · 2025: 21 · 2024: 20 · 2023: 27 · 2022: 28 · 2021: 27 · 2020: 36 · 2019: 31 · 2018: 18 · 2017: 4
- FWCI
- 10.73
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Infectious Diseases › Clostridium difficile and Clostridium perfringens research
- Keywords
- enterotoxigenic Bacteroides fragilis, colorectal neoplasia, colorectal carcinogenesis, low-grade dysplasia, tubular adenoma, serrated polyps, left-sided colon
- MeSH terms
- Adult, Aged, Aged, 80 and over, Bacterial Toxins, Bacteroides fragilis, Bacteroides Infections, Colon, Female, Humans, Intestinal Mucosa, Male, Metalloendopeptidases, Middle Aged, Colorectal Neoplasms, Polymerase Chain Reaction, Young Adult
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