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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Oncol. Jun 15, 2026; 18(6): 117110
Published online Jun 15, 2026. doi: 10.4251/wjgo.v18.i6.117110
Letter to the Editor: Exosomal miR-191 activates the NF-κB pathway to drive M2 macrophages polarization in colorectal cancer
Amr Ahmed El-Arabey
Amr Ahmed El-Arabey, Health and Medical Research Center, King Khalid University, Abha 61413, Asir, Saudi Arabia
Amr Ahmed El-Arabey, Center of Bee Research and its Products, King Khalid University, Abha 61413, Asir, Saudi Arabia
Amr Ahmed El-Arabey, Department of Health Specialties, Basic Sciences and their Applications, Applied College, King Khalid University, Abha 61413, Asir, Saudi Arabia
Author contributions: El-Arabey AA solely conceived and designed the study, performed data acquisition, analysis, and interpretation, drafted and critically revised the manuscript, approved the final version for publication, and takes full responsibility for the accuracy and integrity of the work.
Supported by Deanship of Research and Graduate Studies at King Khalid University - Small Research Project, No. RGP.1/260/46.
Conflict-of-interest statement: The author declares no conflict of interest.
Corresponding author: Amr Ahmed El-Arabey, PhD, Assistant Professor, Department of Health Specialties, Basic Sciences and their Applications, Applied College, King Khalid University, Abha 61413, Asir, Saudi Arabia. ph.amrcapa@gmail.com
Received: November 28, 2025
Revised: December 20, 2025
Accepted: January 6, 2026
Published online: June 15, 2026
Processing time: 193 Days and 7.2 Hours
Core Tip

Core Tip: Exosomal miR-191 is becoming a crucial pathway of how inflammatory signaling works within tumor microenvironment of colorectal cancer. By activating NF-κB, miR-191 can change the tumor microenvironment to make it immunosuppressive and pro-angiogenic, via shifting the polarization into M2 macrophages. Utilizing The Cancer Genomic Atlas data analyzed via tumor immune estimation resource, version 3, NF-κB1 expression correlated positively with M2 macrophage infiltration, whereas NF-κB1 -mutant tumors had lower macrophage infiltration. Elevated M2 infiltration predicted a shorter disease-free duration in the NF-κB1-high sample, indicating a context-dependent prognostic factor and highlighting the miR-191/NF-κB/M2 macrophages axis as a therapeutic target.

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