Polyphenols and colorectal cancer Assessment Answer

Introduction

Polyphenols are micronutrient and bioactive compounds found naturally in plants (1). These are plant secondary metabolites produced as the intermediate product of the biosynthetic pathway and from primary metabolites. However, polyphenols are not responsible for plant growth and development but have an essential role in the plant’s environmental survival (2). Currently, various polyphenols are expected to be used as a dietary factor to prevent chronic diseases like diabetes, stroke and cancer (2). The study done by Dobani et al (2021) stated that the intake of a diet rich in fruits and vegetables is related to the decreased incidence of Colorectal cancer (CRC).

Phenolic components can be compounds with an aromatic ring with a minimum of one hydroxyl group. There are approximately 8000 compounds of polyphenols that are found in the plant kingdom (3). However, these are categorized into four main categories: flavonoids, phenolic acids, polyphenolic amides, and other polyphenols (5). Among these, flavonoids include the majority of dietary phenolic compounds and are an essential part of the diet (5). Some of the major sources are fruits, beverages like tea, coffee, wine and fruit juice, vegetables, herbs, spices, wholegrain, cereals, and cocoa (6). The dietary intake of polyphenols ranges from 500 to 1500 mg/day; however, intrinsic factors like geographical area, age, gender, socio-economic factors and dietary habits cause variations in the dietary intake (7). Studies reported that prolonged consumption of polyphenols has favourable results in the prevention of chronic illnesses like diabetes, cardiovascular disease, and cancer due to the biological actions like antioxidant, anti-inflammatory, antimicrobial & hormonal regulation capacities (8,9).

The bioavailability of polyphenols can be defined as the ingested quantity of polyphenolic compounds, which can exert beneficial effects in target tissues (4). However, the bioavailability of polyphenols is less because of their deprived solubility and low gastrointestinal absorption (10). They are extensively metabolized in tissues and absorbed by gut barriers; the structure of polyphenols has an imperative impact on intestinal absorption polyphenols having large molecular weight are poorly absorbed (4). The consumption of food having phenolic compounds helps increase the effectiveness of the intestinal microbiota by enhancing intestinal immune functions (2).

After the oral consumption of dietary polyphenols, the body recognizes them in the form of xenobiotics; after hydrolyzation, a minor quantity of polyphenols is absorbed in the small intestine, and the rest of the amount gets accumulates in the lumen of the large intestine. It gets hydrolyzed due to the enzymatic activity of the gut microbes (11). Recent advances make it clear that microbiota has an essential role in the availability of phenolic compounds; also, their consumption maintains gut health by reducing the level of inflammation and by inhibiting the development of pathogenic microbe in the gut like bifidobacterial whereas resisting harmful ones (9, 11).

The occurrence of cancer is increasing hastily. According to GLOBOCON, it is estimated that in 2018 about 18.1 million new cancer patients were reported, with 9.6 million deaths (12). Over the last 10-15 years, the connection between the consumption of phenolic compounds and cancer risk incidence has been assessed (12). CRC is known as the world's second most lethal cancer after lung carcinoma (13). Bahrami et al (2019) stated that foods having polyphenolic compounds might have a preventive role by decreasing the chances of Colorectal Cancer (CRC). Phenolic compounds help maintain the stability between the gut's inflammatory and anti-inflammatory actions and reduce pathogenic microorganisms' provocative action (6, 14). The prolonged occurrence of inflammatory cells and mediators in the colon is responsible for chronic inflammation, leading to cancer development (14). In several studies, phenolic compounds are stated as potential anti-inflammatory and anti-tumour agents, which may have a beneficial action in preventing colorectal cancer (12,13). These compounds show the anticancer effect by a broad range of mechanisms like apoptosis induction, inhibition of cell cycle events, and cancer cell removal by modifications of a signalling pathway (13). After years of study, the protective action of phenolic compounds is demonstrated in vivo studies. The studies show that fruits like apples and black raspberries have tumorigenic effects, downregulating the pro-inflammatory cytokines and induce preventive actions against CRC (11).

Here the current study will focus on the action of polyphenols in preventing colorectal cancer. The study will explain in detail the polyphenol properties, the anti-inflammatory role of polyphenols and various mechanisms used by polyphenols in cancer treatment and prevention.

References:

• .Vitale M, Masulli M, Rivellese AA, Bonora E, Cappellini F, Nicolucci A, Squatrito S, Antenucci D, Barrea A, Bianchi C, Bianchini F. Dietary intake and major food sources of polyphenols in people with type 2 diabetes: The TOSCA. IT Study. European Journal of Nutrition. 2018 Mar;57(2):679-88. https://doi.org/10.1007/s00394-016-1355-1
• Kawabata K, Yoshioka Y, Terao J. Role of intestinal microbiota in the bioavailability and physiological functions of dietary polyphenols. Molecules. 2019 Jan 21;24(2):370. https://doi.org/10.3390/molecules24020370
• Truzzi F, Tibaldi C, Zhang Y, Dinelli G, D′ Amen E. An overview on dietary polyphenols and their biopharmaceutical classification system (BCS). International Journal of Molecular Sciences. 2021 May 24;22(11):5514.https://doi.org/10.3390/ijms22115514
• Di Lorenzo C, Colombo F, Biella S, Stockley C, Restani P. Polyphenols and human health: The role of bioavailability. Nutrients. 2021 Jan 19;13(1):273. https://doi.org/10.3390/nu13010273
• Durazzo A, Lucarini M, Souto EB, Cicala C, Caiazzo E, Izzo AA, Novellino E, Santini A. Polyphenols: A concise overview on the chemistry, occurrence, and human health. Phytotherapy Research. 2019 Sep;33(9):2221-43. https://doi.org/10.1002/ptr.6419
• Del Bo’ C, Bernardi S, Marino M, Porrini M, Tucci M, Guglielmetti S, Cherubini A, Carrieri B, Kirkup B, Kroon P, Zamora-Ros R. Systematic review on polyphenol intake and health outcomes: is there sufficient evidence to define a health-promoting polyphenol-rich dietary pattern?. Nutrients. 2019 Jun 16;11(6):1355. https://doi.org/10.3390/nu11061355
• Taguchi C, Kishimoto Y, Fukushima Y, Kondo K, Yamakawa M, Wada K, Nagata C. Dietary intake of total polyphenols and the risk of all-cause and specific-cause mortality in Japanese adults: The Takayama study. European Journal of Nutrition. 2020 Apr;59(3):1263-71. https://doi.org/10.1007/s00394-019-02136-9
• Singla RK, Dubey AK, Garg A, Sharma RK, Fiorino M, Ameen SM, Haddad MA, Al-Hiary M. Natural polyphenols: Chemical classification, definition of classes, subcategories, and structures. Journal of AOAC International. 2019 Sep 1;102(5):1397-400.https://doi.org/10.1093/jaoac/102.5.1397
• Dobani S, Latimer C, McDougall GJ, Allwood JW, Pereira-Caro G, Moreno-Rojas JM, Ternan NG, Pourshahidi LK, Lawther R, Tuohy KM, Del Rio D. Ex vivo fecal fermentation of human ileal fluid collected after raspberry consumption modifies (poly) phenolics and modulates genoprotective effects in colonic epithelial cells. Redox Biology. 2021 Apr 1;40:101862.
• Wu X, Li M, Xiao Z, Daglia M, Dragan S, Delmas D, Vong CT, Wang Y, Zhao Y, Shen J, Nabavi SM. Dietary polyphenols for managing cancers: What have we ignored? Trends in Food Science & Technology. 2020 Jul 1;101:150-64. https://doi.org/10.1016/j.tifs.2020.05.017
• Mileo AM, Nisticò P, Miccadei S. Polyphenols: Immunomodulatory and therapeutic implication in colorectal cancer. Frontiers in Immunology. 2019 Apr 11;10:729. https://doi.org/10.3389/fimmu.2019.00729
• Bhosale PB, Ha SE, Vetrivel P, Kim HH, Kim SM, Kim GS. Functions of polyphenols and its anticancer properties in biomedical research: a narrative review. Translational Cancer Research. 2020 Dec;9(12):7619.https://doi.org/10.21037%2Ftcr-20-2359
• Baky MH, Elshahed M, Wessjohann L, Farag MA. Interactions between dietary flavonoids and the gut microbiome: a comprehensive review. British Journal of Nutrition. 2022 Aug;128(4):577-91. https://doi.org/10.1017/S0007114521003627
• Bahrami A, Jafari S, Rafiei P, Beigrezaei S, Sadeghi A, Hekmatdoost A, Rashidkhani B, Hejazi E. Dietary intake of polyphenols and risk of colorectal cancer and adenoma–A case-control study from Iran. Complementary Therapies in Medicine. 2019 Aug 1;45:269-74. https://doi.org/10.1016/j.ctim.2019.04.011

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