Obesity is a pathology characterized by an excessive accumulation of body fat, especially at the level of visceral fat (which surrounds, protects and supports the internal organs), which has important consequences on the state of health and quality of life. Obesity is defined as a clinical situation in which the patient has a body mass index, called Bmi, greater than 30 (a Bmi between 18.5 and 24.9 indicates a situation of normal weight).
Obesity is in most cases due to an imbalance between calorie consumption and energy intake, in favor of the latter, resulting in the accumulation of calories within the body in the form of fat. For this reason, a first step towards resolving the disease consists in profoundly changing one’s lifestyle, including nutrition, through a balanced diet regime, and increasing physical activity carried out continuously. Today obesity is considered a real plague for society, with the number of sufferers on the rise.
The data updated to 2019 of the Passi surveillance system, coordinated by the Higher Institute of Health, show that in the adult population between 18 and 69 years old in Italy, 4 out of 10 adults are overweight, and 1 out of 10 adults is obese. The clinical repercussions of obesity on the occurrence of other diseases are diverse, such as high blood pressure, diabetes, cardiovascular disease, and cancers, including colorectal cancer.
Despite recent successes in screening, early diagnosis and therapy, colon cancer remains the second leading cause of cancer-related death. It is important to note that the data highlighted that obesity plays a key role not only in predisposing individuals to developing different types of cancer, including that of the colon, but also in worsening the prognosis in cancer patients by reducing survival. However, the molecular mechanisms underlying these biological phenomena are not yet fully understood.
In this scenario, the research group of the Cellular and Molecular Pathophysiology Laboratory of the University of Palermo, coordinated by me, has recently shed light on the molecules produced by colon cancer cells and by adipose tissue cells, in the tumor microenvironment. . These molecules are the basis of communication between the different cellular components and regulate the metastasis potential of cancer cells.
The recent discovery suggests that the factors released by adipose tissue can be considered excellent targets in obese patients with colon cancer, which could allow the development of new precision therapies to prevent the onset of metastases, currently considered the main cause of death. in cancer patients.
Our work is already moving towards the possible identification of factors (molecular biomarkers) that can help oncologists to recognize in advance the cancer patients most at risk of developing metastases, so as to be able to treat them in a preventive manner (adjuvant therapy, immediately after surgical therapy), and significantly decrease the onset of distant metastases.
Giorgio Stassi is a professor at the department of surgical, oncological and stomatological disciplines of the University of Palermo.
G. Stassi et al., Adipose stem cell niche reprograms the colorectal cancer stem cell metastatic machinery, Nature Communications (2021)