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Immunol. 14:1128774 .  \ndoi: 10.3389/fimmu.2023.1128774  \nCOPYRIGHT  \n© 2023 Yuan, Gui, Wang, Fang and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.  \nGut microbiota: A novel and potential target for radioimmunotherapy in colorectal cancer  \nHanghang Yuan 1,2†, Ruirui Gui 1,2†, Zhicheng Wang 2, Fang Fang 2* and Hongguang Zhao 1*  \n1 Department of Nuclear Medicine, The First Hospital of Jilin University, Changchun, China, 2 National Health Commission (NHC) Key laboratory of Radiobiology, School of Public Health, Jilin University, Changchun, China  \nColorectal cancer (CRC) is one of the most common cancers, with a high mortality rate, and is a major burden on human health worldwide. Gut microbiota regulate human immunity and metabolism through producing numerous metabolites, which act as signaling molecules and substrates for metabolic reactions in various biological processes. The importance of host-gut microbiota interactions in immunometabolic mechanisms in CRC is increasingly recognized, and interest in modulating the microbiota to improve patient’s response to therapy has been raising. However, the specific mechanisms by which gut microbiota interact with immunotherapy and radiotherapy remain incongruent. Here we review recent advances and discuss the feasibility of gut microbiota as a regulatory target to enhance the immunogenicity of CRC, improve the radiosensitivity of colorectal tumor cells and ameliorate complications such as radiotoxicity. Currently, great breakthroughs in the treatment of non-small cell lung cancer and others have been achieved by radioimmunotherapy, but radioimmunotherapy alone has not been effective in CRC patients. By summarizing the recent preclinical and clinical evidence and considering regulatory roles played by microflora in the gut, such as anti-tumor immunity, we discuss the potential of targeting gut microbiota to enhance the efficacy of radioimmunotherapy in CRC and expect this review can provide references and fresh ideas for the clinical application of this novel strategy.  \nKEYWORDS  \ncolorectal cancer, radioimmunotherapy, gut micro biota, fecal micro biota transplantation, probiotics  \n1 Introduction  \nColorectal cancer (CRC) is the third most common cancer in the world (1) . Comprehensive data show that, globally, the incidence rate of CRC is 10%, and the mortality rate is 9.4% . The latest data shows that the average risk incidence rate and mortality ofCRC among the middle-aged and elderly (50 years old and above) are declining, but it is worth noting that the incidence rate of CRC among young patients is increasing,  \nFrontiers in Immunology 01 [frontiersin.org](frontiersin.org)  \nwhich is the second ","cbCaiuStNEdSmbHd","https://ap.wps.com/l/cbCaiuStNEdSmbHd","pdf",1656419,16,"English","# Introduction\n## Gut microbiota and host–gut immunometabolic mechanisms in CRC\n## Limitations of immunotherapy and radioimmunotherapy in CRC\n## Rationale for targeting gut microbiota to enhance radioimmunotherapy","[{\"question\":\"Why are gut microbiota considered a potential target in colorectal cancer?\",\"answer\":\"Gut microbiota produce metabolites that regulate immunity and metabolism, and host–gut interactions are increasingly recognized in CRC. The review discusses microbiota as a regulatory target to influence therapy outcomes.\"},{\"question\":\"What challenge does radioimmunotherapy face in colorectal cancer patients?\",\"answer\":\"Radioimmunotherapy alone has not been effective for CRC patients. The review summarizes evidence on how gut microbiota targeting may enhance its efficacy.\"},{\"question\":\"How might gut microbiota improve treatment responses and safety?\",\"answer\":\"Targeting gut microbiota is proposed to enhance CRC immunogenicity, increase radiosensitivity of tumor cells, and ameliorate complications such as radiotoxicity.\"}]","Gut microbiota: A novel and potential target for radioimmunotherapy in colorectal cancer | PDF"]