Colorectal cancer microenvironment: among nutrition, gut microbiota, inflammation and epigenetics.

Colorectal cancer (CRC) is a major health problem causing significant morbidity and mortality. During the last decade, results from different studies indicate that the pathogenetic mechanisms of CRC encompass tumour microenvironment, emphasizing a tight correlation with aging, inflammation, nutrition, gut microbiome composition and epigenetic modifications. Aging is one of the most important risk factors for the development of a wide range of neoplasies, including CRC, as it represents the general framework in which the tumor environment evolves. Together, these elements likely contribute to the carcinogenic process with specific effects, impacts and roles in the different stages of the tumor progression. CRCs evolve through loops of deregulated inflammatory stimuli which are sustained by DNA damage signaling pathways, dysbiosis of gut microbiota (GM) and epigenetic re-modelling (DNA methylation). To date no studies address those elements simultaneously. The synergic analysis of such parameters could provide new biological insights and effective biomarkers that could have applications in prevention, molecular diagnosis, prognosis and treatment of CRC.