5-Fluorouracil (5-FU) is an essential drug in systemic chemotherapy
treatments for colorectal cancer (CRC). Despite
the development of several treatment strategies over the past
decades, the patient benefits of 5-FU-based therapies have
been compromised by the development of chemoresistance.
Differences in treatment responses among CRC patients may
be due to genetic and epigenetic factors unique to individuals.
Therefore, important factors for realizing personalized medicine
are to accurately understand the causes and mechanisms
of drug resistance to 5-FU-based therapies and to identify
and validate prognostic biomarkers. Gut microbes that
interact directly with the host contribute to human health
and cancer control. Lactobacillus plantarum, in particular, has
the potential to be a therapeutic agent by producing bioactive
compounds that may benefit the host. Here, we investigated
the gamma-aminobutyric acid (GABA) and GABAB
receptor (GABABR)-dependent signaling pathway as a treatment
option for 5-FU-resistant HT-29 cells. GABA-producing
L. plantarum activates anti-proliferative, anti-migration,
and anti-invasion effects against 5-FU-resistant HT-29 cells.
The inhibitory effects of GABA-producing L. plantarum are
mediated via GABABR. Activated GABABR induces apoptosis
through the inhibition of cAMP-dependent signaling
pathways and cellular inhibitor of apoptosis protein 2 (cIAP2)
expression. Thus, the GABAergic system has potential in 5-
FU-resistant HT-29 cells as a predictive biomarker. In addition,
GABA-producing L. plantarum is promising as an adjuvant
treatment for 5-FU-resistant CRC, and its intervention
in neurobiological signaling imply new possibilities for
chemoprevention and the treatment of colon cancer-related
diseases.
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