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World J Gastroenterol. May 14, 2014; 20(18): 5177-5190
Published online May 14, 2014. doi: 10.3748/wjg.v20.i18.5177
Obesity and colorectal cancer: Role of adipokines in tumor initiation and progression
Silvia Riondino, Mario Roselli, Raffaele Palmirotta, David Della-Morte, Patrizia Ferroni, Fiorella Guadagni
Silvia Riondino, Mario Roselli, Department of Systems Medicine, Medical Oncology, Tor Vergata Clinical Center, University of Rome “Tor Vergata”, 00133 Rome, Italy
Raffaele Palmirotta, David Della-Morte, Patrizia Ferroni, Fiorella Guadagni, Biomarker Discovery and Advanced Technologies (BioDAT) Laboratory, IRCCS San Raffaele Pisana-Research Center, 00166 Rome, Italy
Author contributions: Riondino S and Roselli M contributed equally to this work; Riondino S, Roselli M, Palmirotta R, Della-Morte D, Ferroni P and Guadagni F analyzed the literature; Riondino S and Roselli M wrote the paper; all authors revised and approved the final version of the manuscript
Supported by Partially supported by the Italian Ministry of Health, Grant No. MERIT RBNE08NKH7
Correspondence to: Patrizia Ferroni, MD, PhD, Biomarker Discovery and Advanced Technologies (BioDAT) Laboratory, IRCCS San Raffaele Pisana-Research Center, Via di Val Cannuta 247, 00166 Rome, Italy. patrizia.ferroni@sanraffaele.it
Telephone: +39-6-52253733 Fax: +39-6-52255668
Received: September 26, 2013
Revised: January 20, 2014
Accepted: March 6, 2014
Published online: May 14, 2014
Processing time: 229 Days and 17.6 Hours
Abstract

Obesity-associated diseases account for a large portion of public health challenges. Among obesity-related disorders, a direct and independent relationship has been ascertained for colorectal cancer (CRC). The evidence that adipocyte hypertrophy and excessive adipose tissue accumulation (mainly visceral) can promote pathogenic adipocyte and adipose tissue-related diseases, has led to formulate the concept of “adiposopathy”, defined as adipocyte and adipose tissue dysfunction that contributes to metabolic syndrome. Adipose tissue can, indeed, be regarded as an important and highly active player of the innate immune response, in which cytokine/adipokine secretion is responsible for a paracrine loop between adipocytes and macrophages, thus contributing to the systemic chronic low-grade inflammation associated with visceral obesity, which represents a favorable niche for tumor development. The adipocyte itself participates as a central mediator of this inflammatory response in obese individuals by secreting hormones, growth factors and proinflammatory cytokines, which are of particular relevance for the pathogenesis of CRC. Among adipocyte-secreted hormones, the most relevant to colorectal tumorigenesis are adiponectin, leptin, resistin and ghrelin. All these molecules have been involved in cell growth and proliferation, as well as tumor angiogenesis and it has been demonstrated that their expression changes from normal colonic mucosa to adenoma and adenocarcinoma, suggesting their involvement in multistep colorectal carcinogenesis. These findings have led to the hypothesis that an unfavorable adipokine profile, with a reduction of those with an anti-inflammatory and anti-cancerous activity, might serve as a prognostic factor in CRC patients and that adipokines or their analogues/antagonists might become useful agents in the management or chemoprevention of CRC.

Keywords: Obesity; Colorectal cancer; Inflammation; Adiponectin; Leptin; Resistin; Ghrelin; Cytokines

Core tip: Obesity-associated diseases account for a large portion of public health challenges, and adipose tissue can be regarded as an important and highly active player of the innate immune response, in which cytokine/adipokine secretion is responsible for a paracrine loop between adipocytes and macrophages. This interplay contributes to the systemic chronic low-grade inflammation associated with visceral obesity, which represents a favorable niche for tumor development. Available findings suggest that an unbalanced adipokine profile might serve as a prognostic factor in colorectal cancer patients and that adipokines or their analogues/antagonists might become useful agents in the management or chemoprevention of colon cancer.