Molecular Pathogenesis of Colorectal Cancer with an Emphasis on Recent Advances in Biomarkers, as Well as Nanotechnology-Based Diagnostic and Therapeutic Approaches

Abstract

Colorectal cancer (CRC) is a serious disease that affects millions of people throughout the world, despite considerable advances in therapy. The formation of colorectal adenomas and invasive adenocarcinomas is the consequence of a succession of genetic and epigenetic changes in the normal colonic epithelium. Genetic and epigenetic processes associated with the onset, development, and metastasis of sporadic CRC have been studied in depth, resulting in identifying biomarkers that might be used to predict behaviour and prognosis beyond staging and influence therapeutic options. A novel biomarker, or a group of biomarkers, must be discovered in order to build an accurate and clinically useful test that may be used as an alternative to conventional methods for the early detection of CRC and to identify prospective new therapeutic intervention targets. To minimise the mortality burden of colorectal cancer, new screening methods with higher accuracy and nano-based diagnostic precision are needed. Cytotoxic medication has negative side effects and is restricted by medication resistance. One of the most promising cancer treatment techniques is the use of nano-based carrier system as a medication delivery mechanism. To deliver cytotoxic medicines, targeted nanoparticles might take advantage of differently expressed molecules on the surface of cancer cells. The use of different compounds as ligands on the surface of nanoparticles to interact with cancer cells, enabling the efficient delivery of antitumor medicines. Formulations based on nanoparticles might aid in early cancer diagnosis and help to overcome the limitations of traditional treatments, including low water solubility, nonspecific biodistribution, and restricted bioavailability. This article addresses about the molecular pathogenesis of CRC and highlights about biomarkers. It also provides conceptual knowledge of nanotechnology-based diagnostic techniques and therapeutic approaches for malignant colorectal cancer.

Keywords: biomarkers; colorectal cancer; cytotoxic medication; epigenetic changes; genetic pathways; nanotechnology; phytomedicine; prognostic.

Figure 1

Multiple genetic pathways of CRC pathogenesis.

Figure 2

Pathways of signalling that have been genetically changed by CRC.

Figure 3

Involvement of MSI, CpG, and CIMP in the progression of CRC. (A) Every age groups are susceptible to malignancy, and progression of colorectal cancer shows after the occurrence of metastasis; (B) In the case of CIN, various molecular pathways play crucial roles such as Wnt, KRAS, TP53, and EMAST and forms CRC progression. While MSI-H shows progression via hMLH1 and BRAF. Whereas, CIMP is interconnected with KRAS mutation and causes cytogenetic to normal cells.

Figure 4

Epidemiology of colorectal cancer.

Figure 5

Epigenetic biomarkers in CRC.

Figure 6

Diagnostic/materialistic tool for the treatment of colorectal cancer.

Figure 7

Curcumin and the arachidonic acid metabolism: A potential inhibitory effect.

Figure 8

Schematic illustration of resveratrol as a novel healing method for treating CRC by targeting distinct signalling pathways.

Figure 9

Mechanism of 5-FU for the treatment of CRC.

Figure 10

Numerous influx and efflux transporters that allow oxaliplatin to enter the cell passively (dashed arrow). There are several kinds of organic cation transporters, such as the OCT 1/2/3 transporters, copper transporters, MRP2 multidrug resistance-associated proteins, glutathione transporters, MATE 1 multidrug and toxin extrusion transporter, and ATP7A/B ATP-binding cassette transporters.