The Gut-Prostate Axis: A New Perspective of Prostate Cancer Biology through the Gut Microbiome

SIMPLE SUMMARY: The gut microbiome plays important roles in the development of several diseases. The gut microbiome is a dynamic system that is affected by several factors, such as dietary habits, and since prostate cancer and diet are closely linked, it is reasonable to hypothesize that a gut microbiome—affected by diet—could regulate prostate cancer far from the gut, thus creating a gut-prostate axis. Gut dysbiosis result in the leakage of gut bacterial metabolites, such as short-chain fatty acids and lipopolysaccharide into the systemic circulation, leading to the prostate cancer growth. Patients with prostate cancer have a distinct gut microbiome. Furthermore, the gut microbiome produces androgen, affecting castration-resistance of prostate cancer. The gut-prostate axis could be a new target for the prevention and management of human prostate cancer. ABSTRACT: Obesity and a high-fat diet are risk factors associated with prostate cancer, and lifestyle, especially diet, impacts the gut microbiome. The gut microbiome plays important roles in the development of several diseases, such as Alzheimer’s disease, rheumatoid arthritis, and colon cancer. The analysis of feces from patients with prostate cancer by 16S rRNA sequencing has uncovered various associations between altered gut microbiomes and prostate cancer. Gut dysbiosis caused by the leakage of gut bacterial metabolites, such as short-chain fatty acids and lipopolysaccharide results in prostate cancer growth. Gut microbiota also play a role in the metabolism of androgen which could affect castration-resistant prostate cancer. Moreover, men with high-risk prostate cancer share a specific gut microbiome and treatments such as androgen-deprivation therapy alter the gut microbiome in a manner that favors prostate cancer growth. Thus, implementing interventions aiming to modify lifestyle or altering the gut microbiome with prebiotics or probiotics may curtail the development of prostate cancer. From this perspective, the “Gut–Prostate Axis” plays a fundamental bidirectional role in prostate cancer biology and should be considered when screening and treating prostate cancer patients.