Colorectal cancer inhibitory properties of polysaccharides and their molecular mechanisms: A review

Colorectal cancer (CRC) is one of the three major malignant tumors in the world. The major treatments currently recommended for it are surgery, radiotherapy, and chemotherapy, all of which are frequently accompanied by a poor prognosis and high recurrence rate. To limit cell proliferation and metastasis, trigger cell apoptosis, and regulate tumor microenvironment (TME), researchers are focusing attention on investigating highly effective and non-toxic natural medicines. According to the research reported in 89 pieces of related literature, between 2018 and 2021, specialists extracted 48 different types of polysaccharides with CRC inhibitory actions from various plants, including Dendrobium officinale Kimura et Migo., Nostoc commune Vaucher, and Ganoderma lucidum (Leyss. ex Fr.) Karst. The novel founded mechanisms mainly include: inhibiting cancer cell proliferation by acting on IRS1/PI3K/Akt and IL-6/STAT3 pathways; inducing cancer cell apoptosis by acting on LncRNA HOTAIR/Akt mediated-intrinsic apoptosis, or regulating the TNF-α-mediated extrinsic apoptosis; inducing cancer cell autophagy by acting on endoplasmic reticulum stress or mTOR-TFEB pathway; inhibiting cancer cell metastasis by regulating Smad2/3 and TLR4/JNK pathways; regulating TME in CRC; and maintaining the intestinal barrier. This review will provide more novel research strategies and a solid literature basis for the application of polysaccharides in the treatment of CRC.