The role of lactic acid bacteria in colon cancer prevention: mechanistic considerations.

Colorectal cancer is one of the most important causes of cancer morbidity and mortality in Western countries. While a myriad of healthful effects have been attributed to the probiotic lactic acid bacteria, perhaps the most controversial remains that of anticancer activity. It should be pointed out already at this point that there is no direct experimental evidence for cancer suppression in humans as a result of consumption of lactic cultures in fermented or unfermented dairy products. However, there is a wealth of indirect evidence, based largely on laboratory studies, in the literature. The precise mechanisms by which lactic acid bacteria may inhibit colon cancer are presently unknown. However, such mechanisms might include: enhancing the host's immune response; binding and degrading potential carcinogens; quantitative and/or qualitative alterations in the intestinal microflora incriminated in producing putative carcinogen(s) and promoters (e.g. bile acid-degrading bacteria); producing antitumorigenic or antimutagenic compounds in the colon; alteration of the metabolic activities of intestinal microflora; alteration of physicochemical conditions in the colon; effects on physiology of the host. These potential mechanisms are discussed in the present paper.