胃と腸58巻2号

2023年02月発行

今月の主題 鋸歯状病変関連の早期大腸癌 ノート

鋸歯状病変と腸内細菌の関係

著者： 福井広一¹ 富田寿彦¹ 大島忠之¹ 新崎信一郎¹

所属機関： ¹兵庫医科大学消化器内科学講座

ページ範囲：P.204 - P.206

要旨●serrated pathwayではBRAF変異，CIMP，MSI，MLH1メチル化などの遺伝子異常が特徴的であり，大腸癌組織においてF. nucleatumの存在とそれらの遺伝子異常に相関関係が認められることから，F. nucleatumが大腸鋸歯状病変の発生や発育・進展において重要な役割を果たしている可能性がある．F. nucleatumはFadAを介して大腸上皮細胞のE-cadherinに結合したりTLR4を刺激するなどしてβ-cateninの核内移行を促進し，細胞増殖作用を示す．他方，大腸癌細胞に結合したF. nucleatum はNK細胞やT細胞に発現するTIGITに結合してそれらの腫瘍攻撃作用を抑制する．F. nucleatumが前述の遺伝子異常を惹起して大腸鋸歯状病変を発生させる機序は解明されていないが，その発育・進展に関与しているのは明らかと考えられる．

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