Fusobacterium nucleatum in tumors: from tumorigenesis to tumor metastasis and tumor resistance

Figures & data

Table 1. F. nucleatum and tumor.

Cancer Type	Relation	Reference
Oral Squamous Cell Carcinoma	F. nucleatum is abundant in oral squamous cell carcinoma (OSCC) tissue, and its load is associated with OSCC’s high incidence, advanced tumor staging, and dismal prognosis.	^Citation2,Citation3
Esophageal Cancer	Compared to normal esophageal mucosa, esophageal cancer tissue had a significant excess of F. nucleatum DNA. F. nucleatum DNA positive was substantially linked with tumor stage.	^Citation4,Citation5
Colorectal Cancer	F. nucleatum is much more prevalent in CRC samples than it is in normal control samples. High loads of F. nucleatum in CRC tissues were strongly associated with tumor size, clinical stage, and overall patient survival.	^Citation6
Gastric Cancer	Fusobacterium, Clostridium, and Lactobacillus species were commonly found in GC patients.	^Citation7,Citation8
Pancreatic Cancer	Fusobacterium species-positive groups had significantly lower survival rates. Cystic Pancreatic Neoplasm (precancerous lesions of pancreatic cancer) is highly correlated with the presence of antibodies against F. nucleatum in body fluid samples.	^Citation9
Breast Cancer	The over-expression of F. nucleatum DNA and galactose-N-acetyl-D-galactosamine (Gal-GalNAc) levels in breast cancer specimens increases in parallel with the malignancy of breast cancers.	^Citation10

Table 2. Summary of F. nucleatum pro-tumorigenic and pro-metastasis mechanisms.

Cancer Type	Mechanism	Specific ways in which F. nucleatum plays a role	The role of F. nucleatum in cancer *	Reference
CRC	Suppression of the immune response	Selectively increases MDSC number and inhibits T cell proliferation	B	^Citation26,Citation27
		Induces S100A9 expression and activates M2 macrophages by recognizing toll-like receptor 4 (TLR4)	B	^Citation28
		Induces Foxp3+ regulatory T cell differentiation and suppresses effector T cells	T	^Citation29
		Recognizes TIGIT through Fap2 thereby protecting tumor cells from attack	T	^Citation30
		Promotes an inflammatory environment through activation of NF-κB, CREB, and extracellular signal-regulated kinases	T	^Citation31,Citation32
		Stimulates pro-inflammatory cytokines into the liver to establish a chronic inflammatory environment and an immunosuppressive environment	M	^Citation33
	Promotion of oncogenic gene expression	Stimulates tumor cell division by promoting microRNA-21 expression	T	^Citation34
		Promotes cell proliferation by increasing lncRNA ENO1-IT1 transcription to lower the pH of the TMET	T	^Citation35
		Increases miR-1246/92b-3p/27a-3p levels to enhance tumor invasion	B	^Citation36
		Promotes HIF-1α enrichment and H3K27Ac acetylation thereby promoting angiogenesis	B	^Citation37
		Upregulates KRT7-AS/KRT7 expression thereby stimulating tumor cell migration and metastasis	M	^Citation38
		Upregulates long noncoding RNA EVADR and promotes CYP2J2 transcription for EMT	M	^Citation39–41
		Induces intercellular adhesion molecule 1 expression	M	^Citation42
		Upregulates cellular autophagy-related protein gene expression to promote tumor development	M	^Citation43
		Down-regulates gene expression of related encoded proteins and reduces m6A to promote tumor invasion	M	^Citation44
	DNA damage	Induces ROS generation thereby promoting CpG methylation as well as MSI-H, inducing DNA damage	T	^Citation45,Citation46
		Upregulates the level of NEL2 which in turn accumulates DSBs	T	^Citation47
	Metabolite effect	Formate production promotes tumor stem cell renewal	T	^Citation48
		Generation of succinic acid mediates inflammatory response	T	^Citation49,Citation50
		SCFAs and butyrate inhibit anti-tumor immune cells and promote tumor angiogenesis	T	^Citation51
	Toxicokinetic effect	FadA promotes oncogenic factor expression through activation of the β-catenin/E-cadherin/Wnt signaling pathway	T	^Citation52
		Fap2 binding to Gal-GalNAc induces lymphocyte death and binds ITIM	T	^Citation53
		lipopolysaccharides (LPS) activates the TLR4/p-PAK1/p-catenin protein S675 signaling pathway to promote tumor cell proliferation	T	^Citation32
OSCC	Regulation of protein synthesis	Upregulates cell cycle protein and MMP expression by acting on TLR4	B	^Citation54
	Remodeling the tumor microenvironment	Maintains the inflammatory microenvironment of tumor tissues by activating NLRP3 or releasing OMV	T	^Citation55
		Induces M2-type macrophage polarization through activation of TLR4	M	^Citation56
	DNA damage	Down-regulates the expression of repair protein Ku70 thereby promoting DSB, causing DNA damage	T	^Citation57
	Formation of EMT	Promotes EMT by Up-regulating the expression of relevant autophagy genes to promote EMT	M	^Citation58
		Upregulates the expression of related genes and transforming growth factor receptors to activate EMT	M	^Citation58,Citation59
Pancreatic cancer	Toxicokinetic effect	Fap2 mediates tumorigenesis and metastasis by promoting the synthesis of GM-CSF and CXCL1	B	^Citation60
	Remodeling the tumor microenvironment	Downregulates PTEN expression to regulate the immunosuppressive tumor microenvironment	M	^Citation45
Breast cancer	Toxicokinetic effect	Promotes lymphocyte death by colonizing breast cancer tissues through Fap2	M	^Citation10
	Related Protein Synthesis	Induction of MMP9 promotes tumor metastasis	M	^Citation10
ESCC	Inhibit immune response	Promotes tumor invasion by activating CCL20	T	^Citation61
		Impairs immune system sensitivity by increasing KIR2DL1 expression in CD8+ T cells	T	^Citation62
		Promotes cancer cell immune escape by pooling Treg infiltrate	T	^Citation63
		Promotes tumor invasion by affecting lymphocyte density in tumor tissue	T	^Citation64
	Metabolite effects	LPS upregulates iNOS expression and thereby promotes esophageal sphincter dysfunction	T	^Citation65
		Upregulates the concentration of putrescine and spermine	B	^Citation66
GC	Toxicokinetic effect	FadA promotes an inflammatory relief environment through the activation of the E-cadherin signaling pathway	T	^Citation67
	Remodeling the cytoskeleton	F. nucleatum colonization alters actin dynamics	M	^Citation68
	Promotion of oncogenic gene expression	Induces organelle dysfunction by up-regulating the expression of related genes	M	^Citation69

*T F. nucleatum promotes tumorigenesis. M F. nucleatum promotes metastasis. B F. nucleatum promotes tumorigenesis and metastasis.

Figure 1. F. nucleatum promotes tumorigenesis and metastasis by influencing the immune response. Fn, fusobacterium nucleatum. Figure created with BioRender.com.

Figure 2. F. Nucleatum promotes tumorigenesis metastasis through affecting RNA expression. Figure created with BioRender.com.

Figure 3. Mechanism of F. Nucleatum for CRC. Figure created with BioRender.com.

Figure 4. Mechanism of F. Nucleatum for oral cancer, pancreatic cancer, and breast cancer. Figure created with BioRender.com.

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