The Mechanistic Crosstalk Between Probiotics, Ncrnas, and Autophagy: Implications for Colorectal Cancer Precision Medicine Publisher



Fatemi N ; Alizadeh AM ; Sadeghloo Z ; Sadeghi A
Source: Expert Reviews in Molecular Medicine Published:2026

Abstract

Colorectal cancer (CRC) remains a leading cause of cancer-related morbidity and mortality worldwide. Emerging evidence suggests a dynamic mechanistic crosstalk between probiotics, non-coding RNAs (ncRNAs), and autophagy in CRC management. This review synthesizes the intricate interplay within this signaling axis to provide a comprehensive framework for precision medicine. Probiotics modulate the gut microenvironment and immune responses, while ncRNAs—specifically microRNAs (miRNAs) and long non-coding RNAs (lncRNAs)—act as molecular rheostats regulating CRC progression and therapy resistance. Autophagy, a conserved cellular degradation process, plays a paradoxical role in tumor dynamics. This review elucidates the integrated signaling axis wherein probiotics directly influence autophagic flux and indirectly reprogram it through ncRNA-mediated pathways. Preclinical and clinical evidence highlight synergistic effects, such as probiotic-induced ncRNA shifts that fine-tune autophagy to induce apoptosis, curb tumor proliferation, and break resistance mechanisms. By linking this microbial-epigenetic-autophagy crosstalk with current multimodal therapies, we propose an innovative framework for personalized oncology. This axis represents a critical new direction for future research, aiming to translate mechanistic insights into targeted therapeutic strategies for CRC. © 2026 Cambridge University Press. All rights reserved.