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      Human colon mucosal biofilms from healthy or colon cancer hosts are carcinogenic

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          Abstract

          Mucus-invasive bacterial biofilms are identified on the colon mucosa of approximately 50% of colorectal cancer (CRC) patients and approximately 13% of healthy subjects. Here, we test the hypothesis that human colon biofilms comprise microbial communities that are carcinogenic in CRC mouse models. Homogenates of human biofilm-positive colon mucosa were prepared from tumor patients (tumor and paired normal tissues from surgical resections) or biofilm-positive biopsies from healthy individuals undergoing screening colonoscopy; homogenates of biofilm-negative colon biopsies from healthy individuals undergoing screening colonoscopy served as controls. After 12 weeks, biofilm-positive, but not biofilm-negative, human colon mucosal homogenates induced colon tumor formation in 3 mouse colon tumor models (germ-free Apc MinΔ850/+ ; Il10 –/– or Apc MinΔ850/+ and specific pathogen–free Apc MinΔ716/+ mice). Remarkably, biofilm-positive communities from healthy colonoscopy biopsies induced colon inflammation and tumors similarly to biofilm-positive tumor tissues. By 1 week, biofilm-positive human tumor homogenates, but not healthy biopsies, displayed consistent bacterial mucus invasion and biofilm formation in mouse colons. 16S rRNA gene sequencing and RNA-Seq analyses identified compositional and functional microbiota differences between mice colonized with biofilm-positive and biofilm-negative communities. These results suggest human colon mucosal biofilms, whether from tumor hosts or healthy individuals undergoing screening colonoscopy, are carcinogenic in murine models of CRC.

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          The two mucus layers of colon are organized by the MUC2 mucin, whereas the outer layer is a legislator of host-microbial interactions.

          The normal intestinal microbiota inhabits the colon mucus without triggering an inflammatory response. The reason for this and how the intestinal mucus of the colon is organized have begun to be unraveled. The mucus is organized in two layers: an inner, stratified mucus layer that is firmly adherent to the epithelial cells and approximately 50 μm thick; and an outer, nonattached layer that is usually approximately 100 μm thick as measured in mouse. These mucus layers are organized around the highly glycosylated MUC2 mucin, forming a large, net-like polymer that is secreted by the goblet cells. The inner mucus layer is dense and does not allow bacteria to penetrate, thus keeping the epithelial cell surface free from bacteria. The inner mucus layer is converted into the outer layer, which is the habitat of the commensal flora. The outer mucus layer has an expanded volume due to proteolytic activities provided by the host but probably also caused by commensal bacterial proteases and glycosidases. The numerous O-glycans on the MUC2 mucin not only serve as nutrients for the bacteria but also as attachment sites and, as such, probably contribute to the selection of the species-specific colon flora. This observation that normal human individuals carry a uniform MUC2 mucin glycan array in colon may indicate such a specific selection.
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            Clinical impact of different classes of infiltrating T cytotoxic and helper cells (Th1, th2, treg, th17) in patients with colorectal cancer.

            The tumor microenvironment includes a complex network of immune T-cell subpopulations. In this study, we systematically analyzed the balance between cytotoxic T cells and different subsets of helper T cells in human colorectal cancers and we correlated their impact on disease-free survival. A panel of immune related genes were analyzed in 125 frozen colorectal tumor specimens. Infiltrating cytotoxic T cells, Treg, Th1, and Th17 cells were also quantified in the center and the invasive margin of the tumors. By hierarchical clustering of a correlation matrix we identified functional clusters of genes associated with Th17 (RORC, IL17A), Th2 (IL4, IL5, IL13), Th1 (Tbet, IRF1, IL12Rb2, STAT4), and cytotoxicity (GNLY, GZMB, PRF1). Patients with high expression of the Th17 cluster had a poor prognosis, whereas patients with high expression of the Th1 cluster had prolonged disease-free survival. In contrast, none of the Th2 clusters were predictive of prognosis. Combined analysis of cytotoxic/Th1 and Th17 clusters improved the ability to discriminate relapse. In situ analysis of the density of IL17+ cells and CD8+ cells in tumor tissues confirmed the results. Our findings argue that functional Th1 and Th17 clusters yield opposite effects on patient survival in colorectal cancer, and they provide complementary information that may improve prognosis. ©2011 AACR.
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              The mucus and mucins of the goblet cells and enterocytes provide the first defense line of the gastrointestinal tract and interact with the immune system.

              The gastrointestinal tract is covered by mucus that has different properties in the stomach, small intestine, and colon. The large highly glycosylated gel-forming mucins MUC2 and MUC5AC are the major components of the mucus in the intestine and stomach, respectively. In the small intestine, mucus limits the number of bacteria that can reach the epithelium and the Peyer's patches. In the large intestine, the inner mucus layer separates the commensal bacteria from the host epithelium. The outer colonic mucus layer is the natural habitat for the commensal bacteria. The intestinal goblet cells secrete not only the MUC2 mucin but also a number of typical mucus components: CLCA1, FCGBP, AGR2, ZG16, and TFF3. The goblet cells have recently been shown to have a novel gate-keeping role for the presentation of oral antigens to the immune system. Goblet cells deliver small intestinal luminal material to the lamina propria dendritic cells of the tolerogenic CD103(+) type. In addition to the gel-forming mucins, the transmembrane mucins MUC3, MUC12, and MUC17 form the enterocyte glycocalyx that can reach about a micrometer out from the brush border. The MUC17 mucin can shuttle from a surface to an intracellular vesicle localization, suggesting that enterocytes might control and report epithelial microbial challenge. There is communication not only from the epithelial cells to the immune system but also in the opposite direction. One example of this is IL10 that can affect and improve the properties of the inner colonic mucus layer. The mucus and epithelial cells of the gastrointestinal tract are the primary gate keepers and controllers of bacterial interactions with the host immune system, but our understanding of this relationship is still in its infancy. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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                Author and article information

                Contributors
                Journal
                J Clin Invest
                J. Clin. Invest
                J Clin Invest
                The Journal of Clinical Investigation
                American Society for Clinical Investigation
                0021-9738
                1558-8238
                11 March 2019
                11 March 2019
                1 April 2019
                1 July 2019
                : 129
                : 4
                : 1699-1712
                Affiliations
                [1 ]Department of Medicine, University of Florida, Gainesville, Florida, USA.
                [2 ]Bloomberg-Kimmel Institute for Immunotherapy, Departments of Oncology and Medicine and the Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
                [3 ]Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, Charlotte, North Carolina, USA.
                [4 ]Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, Florida, USA.
                [5 ]Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.
                [6 ]Resphera Biosciences, Baltimore, Maryland, USA.
                [7 ]Department of Infectious Diseases and Immunology, University of Florida, Gainesville, Florida, USA.
                Author notes
                Address correspondence to: Cynthia L. Sears, 1550 Orleans Street, CRB2 Building, Suite 1M.05, Baltimore, Maryland 21231, USA. Phone: 410.614.0141; Email: csears@ 123456jhmi.edu . Or to: Christian Jobin, 2033 Mowry Road, PO Box 103633, Gainesville, Florida 32611-0882, USA. Phone: 352.294.5148; Christian.Jobin@ 123456medicine.ufl.edu .

                Authorship note: ST, CMD, CJ, and CLS contributed equally to this work.

                Author information
                http://orcid.org/0000-0003-1638-5307
                http://orcid.org/0000-0002-3623-0700
                http://orcid.org/0000-0002-5060-0624
                http://orcid.org/0000-0001-5601-0812
                http://orcid.org/0000-0003-3200-1895
                http://orcid.org/0000-0002-7576-3067
                http://orcid.org/0000-0003-4661-799X
                http://orcid.org/0000-0003-4059-1661
                Article
                PMC6436866 PMC6436866 6436866 124196
                10.1172/JCI124196
                6436866
                30855275
                798d0ba5-53ce-403d-9a63-20bbbcd800aa
                © 2019 American Society for Clinical Investigation
                History
                : 14 August 2018
                : 1 February 2019
                Funding
                Funded by: NIH
                Award ID: R01DK073338
                Funded by: NIH
                Award ID: R01DK47700
                Funded by: NIH
                Award ID: R01DK47700
                Funded by: NIH
                Award ID: R01 CA151393
                Funded by: NIH
                Award ID: R01CA196845
                Funded by: NIH
                Award ID: P50 CA62924
                Funded by: NIH
                Award ID: P30 CA006973
                Funded by: NIH
                Award ID: P30 DK089502
                Funded by: NIH
                Award ID: K99 CA230192
                Funded by: NIH
                Award ID: S10OD016374
                Funded by: Bloomberg Philanthropies
                Award ID: Microbiome Project
                Funded by: Johns Hopkins Discovery Award
                Award ID: Internal award
                Funded by: Commonwealth Foundation
                Award ID: Johns Hopkins
                Funded by: Cancer Research Institute/Fight Colorectal Cancer coalition
                Award ID: CRC discovery award
                Funded by: University of Florida Health Cancer Center Funds
                Award ID: internal award
                Funded by: University of Florida Department of Medicine Gatorade Fund
                Award ID: internal award
                Funded by: Crohn’s and Colitis Foundation, https://doi.org/10.13039/100011684;
                Award ID: CCFA Ref. #409472
                Categories
                Research Article

                Mouse models,Colorectal cancer,Bacterial infections,Oncology,Microbiology

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