Fusobacterium nucleatum promotes the development of colorectal cancer by activating a cytochrome P450/epoxyoctadecenoic acid axis via TLR4/Keap1/NRF2 signaling

Emerging research has revealed regulation of colorectal cancer (CRC) metabolism by bacteria. Fusobacterium nucleatum (Fn) plays a crucial role in the development of CRC; however, whether Fn infection modifies metabolism in CRC patients remains unknown. Here, LC-MS/MS-based lipidomics identified the upregulation of cytochrome P450 monooxygenases, primarily CYP2J2, and their mediated product 12,13-EpOME in CRC patient tumors and mouse models, which increased the invasive and migratory ability of CRC cells in vivo and in vitro by regulating the epithelial-mesenchymal transition (EMT). Metagenomic sequencing indicated a positive correlation between increased levels of fecal Fn and serum 12,13-EpOME in CRC patients. High levels of CYP2J2 in tumor tissues also correlated with high Fn levels and worse overall survival in stage III/IV CRC patients. Moreover, Fn was found to activate TLR4/AKT signaling, downregulating Keap1 and increasing NRF2 to promote transcription of CYP2J2. Collectively, these data identify that Fn promotes EMT and metastasis in CRC by activating a TLR4/Keap1/NRF2 axis to increase CYP2J2 and 12,13-EpOME, which could serve as clinical biomarkers and therapeutic targets for Fn-infected CRC patients.