CRC is a commonly diagnosed form of cancer and continues to increase every year. Genetic factors and more importantly extrinsic (e.g., environmental) reasons that alter the gut microbiota can actuate the risk of cancer. On the contrary, Manipulating the intestinal microbiome with host-friendly bacteria would confer anticancer benefits because of beneficial antioxidant and anti-inflammatory metabolites they produce [2, 8]. Notably, probiotics can modulate cancers via their ability to inhibit the growth of cancer cells, induction of apoptosis and block the cell cycle [17].
Results from the cytotoxicity assay provided evidence for anti-proliferative effects of L. acidophilus sonicated extract (LSE) against colon carcinoma in a concentration (108, 109 and 1010 CFU/mL) and time-dependent (24 hr and 72 hr) manner.
Several recent studies have illustrated the anti-proliferative effects of various probiotic extracts [2, 18]. A blend of probiotics including B. longum, B. bifidum, L.acidophilus, L. plantarum decreased the ability of migration, invasion and proliferation of the CT26 cells. Moreover, oral usage of these probiotic mixture suppressed tumor growth in BALB/c mice and increased tumor immunity [19].
In addition, our flow cytometry findings suggested that the growth inhibitory effect of LSE is relevant to cell-cycle stop. After the incubation of cells with LSE (109 cfu/ml), a significant subG1 cell-cycle arrest was observed at 24h. Meanwhile, LSE significantly caused growth arrest in the subG1 after 72 h with a simultaneous reduction of cells in the G1, S and G2 phases. Taken together, the induction of HT29 cell cytotoxicity occurred through growth arrest at subG1 phase but it could also be due to apoptosis. In our flow cytometry experiments, we also came to the conclusion that LSE induced a remarkable decline of viable cells percentage over time and dose. The results revealed that LSE (108 and 109 cfu/ml) enhanced apoptotic cell death by 18–23% after 24h and 55–70% after 72h.
In other potentially relevant work, the supernatant of L. acidophilus had apoptotic effect on Caco-2 cell line, induce down regulation of Survivin, an inhibitor of apoptosis, and postpone CRC progression [20, 21]. Also, a recent study by Jan etal, shows that consumption of high-doses of L. paracasei and L. reuteri probiotics had inhibitory effect on pancreatic cancer cells and pancreatic cancer BALB/C model [22].
As mentioned above, LSE triggers apoptosis. To further validate the mechanism by which LSE induced the apoptosis, we propose a hypothetical signaling pathway through mTOR/p62/Caspase8/Bax FAS pathway and investigated the effect of LSE on these gene’s expression. Interestingly, LSE induced cell apoptosis via the activation of Bax, caspase8 and Fas-mediated apoptotic pathway while inhibiting the expression of anti-apoptotic mTOR and p62 genes. The reason for proposing this route comes back to preceding studies. Previously, Nakayama et al. showed that p62 significantly promoted the cancer cell proliferation. Also, primary tumor samples of patients with CRC express higher levels of p62 compared with normal colon tissues [23, 24]. Moreover, Duran et al. reported that p62 promoted tumorigenesis by mTORC1 compartmentalization and activation [25]. mTORC1 inhibitors can stimulate internal pathway for apoptosis, upregulating the expression levels of Bax and caspase- 9/3. The activated caspase-9/3 pathway then activates pro-caspase-8 resulting in activation for apoptosis [26]. Meanwhile, extrinsic apoptosis is mediated by death receptors such as Fas and TNF related apoptosis ligands. Zhou etal, demonstrated that Lactobacillus plantarum suppressive efficacy may be mediated via the activation of Fas/Fasl-mediated apoptotic pathway. Fas/Fasl complex develop the death-inducing signaling complex (DISC) and stimulate Casp8 which leads to the activation of downstream caspases, like Caspase-3 [27, 28] (Fig. 5).