Abstract

The accumulating evidence and establishment of the consensus that living organisms constitute not only blood, organs and tissues, but includes microbiota (bacteria, fungus, virus, parasites) is gaining attention in the pathogenesis of cancers. Globally, millions are affected by pathogen related cancers. Humans are made up of resident microbiota that are implicated in the health and sickness paradigm. The role of these resident microbiotas is demonstrated in homeostasis maintenance, such as hydrolysis of glucoraphanin to sulforaphane by myrosinase or gut microbiome. Sulforaphane inhibits the Kelch-like ECH-associated protein mediated degradation of NrF2, allowing NrF2 to migrate from cell cytoplasm into the nucleus where it binds to antioxidant responsive element in the promoter regions of NrF2 target genes, including GSTM1 (family of Glutathione-S-Transferase, which is phase II antioxidant enzymes), thus increasing their transcription, activities and resulting in decrease in reactive oxygen species (ROS), reactive aldehydes (RAs) and factors involved in inflammation. Interindividual variations in microbiota occurs, which gives rise to inter-individual heterogeneity in drug response. Pathogens are agents of mutations and play pivotal role in tumour growth and cancer evolution, acting as hidden drivers. Infectious agents such as Human Papillomavirus (HPV), Epstein-Barr Virus, Helicobacter pylori, disrupt host cellular homeostasis and facilitate tumour development. Recent therapeutic strategies are exploring pathogen-specific immunotherapies, such as immune check-point inhibitors, vaccines’ therapy and cutting-edge gene-editing technologies like CRISPR. Advancing technologies that aim at oncogenic pathway as antifungal, antibacterial, and antiviral are highlighted in addition to integration with conventional cancer treatments. This review highlights the urgency of enhancing cancer prognosis through multidisciplinary methods with the view of cancer pathogens.