Laparoscopic sleeve gastrectomy for premenstrual syndrome symptoms in patients with obesity.

BACKGROUND: Premenstrual syndrome (PMS) is a pathological condition characterized by a series of abnormal physical, psychological, and behavioral symptoms. We evaluated the effectiveness of laparoscopic sleeve gastrectomy (LSG) in the treatment of patients with obesity and PMS. METHODS: In this case-control study, 131 patients with obesity (BMI ≥ 27.5 kg/cm2) diagnosed with moderate-to-severe PMS from March 2018 to March 2022 were prospectively selected to undergo LSG or not at their own discretion. Participants self-reported their PMS severity using the Premenstrual Syndrome Screening Tool. Among them, 68 patients chose LSG surgery, and 63 control group patients were followed up without surgery. Data were recorded at baseline and at 3 months post-treatment. We used a multivariate analysis to assess the improvement in PMS symptoms and associated factors. RESULTS: Of the 131 patients with obesity and PMS, the improvement rate of PMS in the LSG group was 57.35% (n = 39), while the improvement rate of PMS in the control group was 25.40% (n = 16). Furthermore, our study revealed that surgery is an independent factor affecting the improvement of patients with PMS. Additionally, there was a correlation between alcohol use, T2DM and obesity-related metabolic diseases, and BMI with PMS. The changes in BMI, testosterone, and estradiol(E2) levels may also contribute to the improvement of patients with obesity and PMS. CONCLUSION: LSG can improve the management of obesity in patients with PMS to some extent. Changes in BMI, testosterone, and E2 may be indicative of improvement in patients with obesity and PMS.

Factors influencing the bariatric surgery treatment of bariatric surgery candidates in underdeveloped areas of China.

BACKGROUND: From year to year, the proportion of people living with overweight and obesity in China rises, along with the prevalence of diseases linked to obesity. Although bariatric surgery is gaining popularity, there are still several issues with its promotion compared to Western nations. Since less developed places in China are more widespread due to disparities in the development of different regions, there has been little exploration of the factors that might be related to acceptance of bariatric surgery in these regions. METHODS: Patients who visited the Department of Gastrointestinal Surgery at the North Sichuan Medical College Affiliated Hospital from 2018 to 2022 and had obesity or other relevant metabolic problems were surveyed using a questionnaire. The relationship between demographic factors, socioeconomic status, and acceptance of bariatric surgery was analyzed. RESULTS: Of 334 patients, 171 had bariatric surgery. BMI, education level, marriage history, medical insurance, family support, and a history of type 2 diabetes were all linked to having bariatric surgery, according to a univariate analysis. In a multivariate analysis, BMI (P = 0.02), education (P = 0.02), family support (P<0.001), medical insurance coverage (P<0.001), and history of type 2 diabetes (P = 0.004) were all positively associated with a willingness to have bariatric surgery. Among 163 non-bariatric patients with obesity, 15.3% were not opposed to surgery but preferred trying medication first, 54.6% leaned towards medical therapy, and 30% were hesitant. Additionally, a majority of patients (48.55%) often lacked adequate knowledge about weight reduction therapy. Age, height, gender, smoking, drinking, family history of type 2 diabetes, education, and marital status did not significantly differ (P > 0.05). CONCLUSIONS: Many patients are concerned about the safety of surgical treatment and the possibility of regaining weight. Due to the relatively high cost of bariatric surgery, they tend to choose medical treatment. To enhance the acceptance of bariatric surgery in underdeveloped regions of China, it is crucial to focus on disseminating knowledge about bariatric surgery, offer pertinent health education to the community, and foster support from patients' families. The government should pay more attention to obesity and provide support in the form of medical insurance.

Long-Term Protective Effects and Mechanisms of Gastric Bypass Surgery on the Kidneys in Hypertensive Obese Rat.

OBJECTIVE: Investigate the long-term protective effects of gastric bypass surgery on the kidneys of hypertensive obese rats to better understand the role of gastric bypass surgery in preventing renal injury in humans with hypertension and obesity. METHODS: Compare 6-week-old spontaneously hypertensive rats, including 30 Roux-en-Y gastric bypass (RYGB) and 30 sham operations. Body weight and blood pressure were monitored before and up to 12 months after the operation. Blood lipids, blood creatinine, and blood urea nitrogen were measured. Kidney pathology was assessed using HE staining, while renal fibrosis was observed via Masson staining. Inflammatory indicators were examined by ELISA. The expression of the NLRP3 gene in the kidney was measured using immunofluorescence and western blot, and the changes in key pathways including ASC/IL-1ß protein were verified. RESULTS: RYGB reduced the body weight of hypertensive obese rats and had a protective effect on blood pressure. Additionally, the bypass effectively mitigated renal inflammation and fibrosis. Moreover, RYGB modulated the expression of NLRP3 and prevented kidney damage via the ASC/IL-1 pathway. CONCLUSION: This study validates that RYGB effectively attains sustained blood pressure control in hypertensive obese rats and has a potential kidney-protective mechanism via the NLRP3-ASC/IL-1ß pathway.

Poly(l-lactic acid)-based double-layer composite scaffold for bone tissue repair.

Bone defect is a serious threat to human health. Osteopractic total flavone (OTF) extracted from Rhizoma Drynariae has the effects of promoting bone formation. Panax notoginseng saponin (PNS) has the function of activating blood circulation and removing blood stasis. Therefore, combining OTF and PNS with poly(l-lactic acid) (PLLA) to prepare scaffolds containing PNS in the outer layer and OTF in the inner layer is a feasible solution to rapidly remove blood stasis and continue to promote bone formation. In addition, degradation rate of the scaffold can affect the release time of two drugs. Adding Mg particles in outer layer can control the degradation rate of the scaffold and the drug release. Therefore, a double-layer drug-loaded PLLA scaffold containing OTF in the inner layer, PNS and Mg particles in the outer layer was prepared and characterized to verify its feasibility. The experimental results showed that the scaffold can realize the rapid release of PNS and the continuous release of OTF. With the increase of Mg content, the drug release rate became faster. Animal experiments showed that the scaffold containing 5% Mg particles could effectively promote the formation of new bone in the bone defect of male New Zealand white rabbits, and the area and density of new bone formed were much better than those in the control group. These results demonstrated that the double-layer drug-loaded scaffold had good ability to promote bone repair.

Hepatic COX1 loss leads to impaired autophagic flux and exacerbates nonalcoholic steatohepatitis.

The mechanisms underlying autophagic defects in nonalcoholic steatohepatitis (NASH) remain largely unknown. We aimed to elucidate the roles of hepatic cyclooxygenase 1 (COX1) in autophagy and the pathogenesis of diet-induced steatohepatitis in mice. Human nonalcoholic fatty liver disease (NAFLD) liver samples were used to examine the protein expression of COX1 and the level of autophagy. Cox1Δhepa mice and their wildtype littermates were generated and fed with 3 different NASH models. We found that hepatic COX1 expression was increased in patients with NASH and diet-induced NASH mice models accompanied by impaired autophagy. COX1 was required for basal autophagy in hepatocytes and liver specific COX1 deletion exacerbated steatohepatitis by inhibiting autophagy. Mechanistically, COX1 directly interacted with WD repeat domain, phosphoinositide interacting 2 (WIPI2), which was crucial for autophagosome maturation. Adeno-associated virus (AAV)-mediated rescue of WIPI2 reversed the impaired autophagic flux and improved NASH phenotypes in Cox1Δhepa mice, indicating that COX1 deletion-mediated steatohepatitis was partially dependent on WIPI2-mediated autophagy. In conclusion, we demonstrated a novel role of COX1 in hepatic autophagy that protected against NASH by interacting with WIPI2. Targeting the COX1-WIPI2 axis may be a novel therapeutic strategy for NASH.

[The role of group 3 innate lymphoid cells(ILC3) in the evolution of the immune system: An update].

Group 3 innate lymphoid cells (ILC3) are an ILC subset that is characterized by the expression of retinoic acid-related orphan nuclear receptor γt (RORγt) and interleukin 22 (IL-22). This review summarizes the role of ILC3 in coordinating innate immunity and adaptive immunity based on current research and elaborate the significance of ILC3 from the perspective of immune system evolution. In addition, based on immune-related functions, we propose a possible time when ILC3 appears in the evolution of the immune system. And then, the research limitations and prospects are discussed.

Melatonin alleviates alcoholic liver disease via EGFR-BRG1-TERT axis regulation.

Chronic alcohol consumption causes liver steatosis, cell death, and inflammation. Melatonin (MLT) is reported to alleviate alcoholic liver disease (ALD)-induced injury. However, its direct regulating targets in hepatocytes are not fully understood. In the current study, a cell-based screening model and a chronic ethanol-fed mice ALD model were used to test the protective mechanisms of MLT. MLT ameliorated ethanol-induced hepatocyte injury in both cell and animal models (optimal doses of 10 µmol/L and 5 mg/kg, respectively), including lowered liver steatosis, cell death, and inflammation. RNA-seq analysis and loss-of-function studies in AML-12 cells revealed that telomerase reverse transcriptase (TERT) was a key downstream effector of MLT. Biophysical assay found that epidermal growth factor receptor (EGFR) on the hepatocyte surface was a direct binding and regulating target of MLT. Liver specific knock-down of Tert or Egfr in the ALD mice model impaired MLT-mediated liver protection, partly through the regulation of nuclear brahma-related gene-1 (BRG1). Long-term administration (90 days) of MLT in healthy mice did not cause evident adverse effect. In conclusion, MLT is an efficacious and safe agent for ALD alleviation. Its direct regulating target in hepatocytes is EGFR and downstream BRG1-TERT axis. MLT might be used as a complimentary agent for alcoholics.

The early-stage triple-negative breast cancer landscape derives a novel prognostic signature and therapeutic target.

PURPOSE: Triple-negative breast cancer (TNBC) is a highly heterogeneous disease. Patients with early-stage TNBCs have distinct likelihood of distant recurrence. This study aimed to develop a prognostic signature of early-stage TNBC patients to improve risk stratification. METHODS: Using RNA-sequencing data, we analyzed 189 pathologically confirmed pT1-2N0M0 TNBC patients and identified 21 mRNAs that were highly expressed in tumor and related to relapse-free survival. All-subset regression program was used for constructing a 7-mRNA signature in the training set (n = 159); the accuracy and prognostic value were then validated using an independent validation set (n = 158). RESULTS: Here, we profiled the transcriptome data from 189 early-stage TNBC patients along with 50 paired normal tissues. Early-stage TNBCs mainly consisted of basal-like immune-suppressed subtype and had higher homologous recombination deficiency scores. We developed a prognostic signature including seven mRNAs (ACAN, KRT5, TMEM101, LCA5, RPP40, LAGE3, CDKL2). In both the training (n = 159) and validation set (n = 158), this signature could identify patients with relatively high recurrence risks and served as an independent prognostic factor. Time-dependent receiver operating curve showed that the signature had better prognostic value than traditional clinicopathological features in both sets. Functionally, we showed that TMEM101 promoted cell proliferation and migration in vitro, which represented a potential therapeutic target. CONCLUSIONS: Our 7-mRNA signature could accurately predict recurrence risks of early-stage TNBCs. This model may facilitate personalized therapy decision-making for early-stage TNBCs individuals.

Multiple Beneficial Effects of Laparoscopic Sleeve Gastrectomy for Patients with Obesity, Type 2 Diabetes Mellitus, and Restrictive Ventilatory Dysfunction.

BACKGROUND: Some studies have suggested that bariatric surgery improves pulmonary function in patients with obesity, but whether it alleviates pulmonary ventilation disorders in patients with obesity, type 2 diabetes mellitus (T2DM), and restrictive ventilatory dysfunction(RVD) is unclear. To evaluate the effect of laparoscopic sleeve gastrectomy (LSG) in improving pulmonary ventilation function in patients with obesity, T2DM, and RVD. METHODS: We studied patients with T2DM and RVD (forced vital capacity (FVC) predicted < 80%, forced expiratory volume in one second/forced vital capacity (FEV1/FVC) > 70%) who underwent LSG from March 2018 to January 2020. Baseline data was recorded and follow-up visits were made at 3, 6, 9, and 12 months after surgery to evaluate glucose, hemoglobin A1c (HbA1c), body mass index (BMI), and pulmonary ventilation function. We used multivariate analyses to assess the remission of RVD (reversion of FVC to ≥80% of the predicted value). RESULTS: We enrolled 33 patients (mean age 46.9±5.2 years, 21 males). Two patients were lost to follow-up and another patient died. Thirty patients completed follow-up; 24 had remission of RVD (24/33, 72.7%). Multivariate Cox regression analysis showed that lower HbA1c (HR=0.35 (0.16 ~ 0.76), p=0.008), reduced waist size (0.9 (0.83 ~ 0.98), p=0.017), and shorter duration of diabetes (0.67(0.47~0.97), p=0.033) were associated with alleviation of pulmonary ventilation function. CONCLUSIONS: LSG not only controls the body weight and T2DM; it may also relieve pulmonary ventilation dysfunction in patients with obesity, T2DM, and RVD. The waist size, duration of diabetes, and HbA1c before LSG negatively affect recovery of pulmonary ventilation dysfunction.

Sleeve Gastrectomy Surgery Improves Glucose Metabolism by Downregulating the Intestinal Expression of Sodium-Glucose Cotransporter-3.

AIMS: Sleeve gastrectomy (SG) has been proven effective in the treatment of obesity and type 2 diabetes. We hypothesized that SGLT3 may play an important role in the mechanism of glucose control and weight loss after SG. MATERIALS AND METHODS: Daily body weight and food intake were measured in SG and sham-operated mice. Glucose tolerance test, SGLT3 agonist (αMG), and SGLT1 inhibitor (phlorizin) perfusion experiments were used to detect changes in intestinal SGLT3 and SGLT1 activity following SG. Expression of SGLT3a and SGLT1 was assessed at 2 weeks, 1 month after surgery by quantitative PCR and fluorescence immunoassay. Hematoxylin and eosin staining was used to detect morphological changes in the villi. SGLT3 and SGLT1 expression was measured after stimulation of human intestinal epithelial cells (HIEC). RESULTS: Both the body weight and daily food intake of the SG-treated mice decreased within 30 days after surgery. Oral glucose absorption was significantly reduced at 30 days. The intestinal stimulation proved that SG can improve glucose metabolism, which can be reversed by αMG and enhanced by phlorizin. Villus height and surface area of the intestine in SG mice decreased after surgery. mRNA expression of SGLT3a and SGLT1 decreased at 2 weeks and 1 month after SG, immunofluorescence also confirmed these changes. HIEC stimulation confirmed that αMG could increase the expression of SGLT3 and SGLT1, but the expression of SGLT1 was down regulated when phlorizin was added to the medium. CONCLUSION: The results suggest that reducing SGLT3 expression might contribute to lowering blood glucose and controlling body weight after SG.

Sleeve Gastrectomy Attenuates the Severity of Cerulein-Induced Acute Pancreatitis in Obese Rats.

PURPOSE: Obesity is one of the most important risk factors for acute pancreatitis. Based on the effect of sleeve gastrectomy (SG) on improving body weight and blood lipids, we investigated whether SG is beneficial in improving pancreatitis in obese rats. MATERIALS AND METHODS: Two studies were used to evaluate the effect of SG on the first onset of pancreatitis and acute episodes of recurrent pancreatitis in obese rats. A high-fat diet (HFD) for 8 weeks resulted in obesity in rats. Study 1: Obese rats were treated with SG and sham surgery. Pancreatitis was induced by intraperitoneal injection of cerulein at 6 weeks after surgery. The severity of pancreatitis was assessed by histological examination, cytokines, and infiltration of inflammatory cells. Study 2 performed the same procedure as in study 1, except that rats were intraperitoneally injected with a small dose of cerulein three times a week for 6 weeks before surgery to induce recurrent pancreatitis. RESULTS: The body weight, food intake, and blood lipids of SG rats in study 1 and study 2 were significantly lower than those of sham rats during the 6 weeks after surgery. Compared with sham rats, SG rats in both studies had fewer inflammatory cytokines, inflammatory cell infiltration, and pathological injury in the pancreas after cerulein-induced acute pancreatitis. CONCLUSION: SG reduces the severity of the first onset of pancreatitis and the seriousness of acute episodes of recurrent pancreatitis. The improvement of lipid metabolism and body weight by SG may play an important role in this effect.

[Advantages and challenges of carbon nanotubes as bone repair materials].

With the in-depth research on bone repair process, and the progress in bone repair materials preparation and characterization, a variety of artificial bone substitutes have been fully developed in the treatment of bone related diseases such as bone defects. However, the current various natural or synthetic biomaterials are still unable to achieve the structure and properties of natural bone. Carbon nanotubes (CNTs) have provided a new direction for the development of new materials in the field of bone repair due to their excellent structural stability, mechanical properties, and functional group modifiability. Moreover, CNTs and their composites have broad prospects in the design of bone repair materials and as drug delivery carriers. This paper describes the advantages of CNTs related to bone tissue regeneration from the aspects of morphology, chemistry, mechanics, electromagnetism, and biosafety, as well as the application of CNTs in drug delivery carriers and reinforcement components of scaffold materials. In addition, the potential problems and prospects of CNTs in bone regenerative medicine are discussed.

[Experimental study on repairing rabbit skull defect with bone morphogenetic protein 2 peptide/functionalized carbon nanotube composite].

OBJECTIVE: To observe and compare the effects of peptides on the repair of rabbit skull defects through two different binding modes of non-covalent and covalent, and the combination of carboxyl (-COOH) and amino (-NH 2) groups with materials. METHODS: Twenty-one 3-month-old male ordinary New Zealand white rabbits were numbered 1 to 42 on the left and right parietal bones. They were divided into 5 groups using a random number table, the control group (group A, 6 sides) and the material group 1, 2, 3, 4 (respectively group B, C, D, E, 9 sides in each group). All animals were prepared with 12-mm-diameter skull defect models, and bone morphogenetic protein 2 (BMP-2) non-covalently bound multiwalled carbon nanotubes (MWCNT)-COOH+poly ( L-lactide) (PLLA), BMP-2 non-covalently bound MWCNT-NH 2+PLLA, BMP-2 covalently bound MWCNT-COOH+PLLA, and BMP-2 covalently bound MWCNT-NH 2+PLLA were implanted into the defects of groups B, C, D, and E, respectively. At 4, 8, and 12 weeks after operation, the samples were taken for CT scanning and three-dimensional reconstruction, the ratio of bone tissue regeneration volume to total volume and bone mineral density were measured, and the histological observation of HE staining and Masson trichrome staining were performed to quantitatively analyze the volume ratio of new bone tissue. RESULTS: CT scanning and three-dimensional reconstruction showed that with the extension of time, the defects in groups A-E were filled gradually, and the defect in group E was completely filled at 12 weeks after operation. HE staining and Masson trichrome staining showed that the volume of new bone tissue in each group gradually increased with time, and regenerated mature bone tissue appeared in groups D and E at 12 weeks after operation. Quantitative analysis showed that at 4, 8, and 12 weeks after operation, the ratio of bone tissue regeneration volume to total volume, bone mineral density, and the volume ratio of new bone tissue increased gradually over time; and at each time point, the above indexes increased gradually from group A to group E, and the differences between groups were significant ( P<0.05). CONCLUSION: Through covalent binding and using -NH 2 to bound peptides with materials, the best bone repair effect can be achieved.

Research Advances in Protective Effects of Ursolic Acid and Oleanolic Acid Against Gastrointestinal Diseases.

The intestinal tract plays an essential role in protecting tissues from the invasion of external harmful substances due to impaired barrier function. Furthermore, it participates in immunomodulation by intestinal microorganisms, which is important in health. When the intestinal tract is destroyed, it can lose its protective function, resulting in multiple systemic complications. In severe cases, it may lead to systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS). Thus far, there are no curative therapies for intestinal mucosal barrier injury, other than a few drugs that can relieve symptoms. Thus, the development of novel curative agents for gastrointestinal diseases remains a challenge. Ursolic acid (UA) and its isomer, Oleanolic acid (OA), are pentacyclic triterpene acid compounds. Both their aglycone and glycoside forms have anti-oxidative, anti-inflammatory, anti-ulcer, antibacterial, antiviral, antihypertensive, anti-obesity, anticancer, antidiabetic, cardio protective, hepatoprotective, and anti-neurodegenerative properties in living organisms. In recent years, several studies have shown that UA and OA can reduce the risk of intestinal pathological injury, alleviate intestinal dysfunction, and restore intestinal barrier function. The present study evaluated the beneficial effects of UA and OA on intestinal damage and diseases, including inflammatory bowel disease (IBD) and colorectal cancer (CRC).

Changes in Body Weight, Physical Activity, and Lifestyle During the Semi-lockdown Period After the Outbreak of COVID-19 in China: An Online Survey.

OBJECTIVES: The outbreak of novel coronavirus (COVID-19) provided an opportunity to undertake an online survey to study the relationships between body weight changes with changes in physical activity and lifestyle during an unusual event of forced isolation, or quarantine. METHODS: We distributed an electronic questionnaire using the popular social application WeChat to adults from any province of China except Hubei Province, the epicenter of the outbreak. The questionnaire asked for demographic information, body weight, physical activity, and lifestyle factors before and during the quarantine. RESULTS: Of 376 questionnaires returned, 339 were valid (90.2%). During the period of semi-lockdown, both females and males with BMI <24 gained weight, males with BMI ≥24 lost weight, and females with BMI ≥24 gained weight. The average steps per day and the average moderate or vigorous-intensity exercise declined significantly for both males and females during the semi-lockdown. Changes in body weight inversely correlated with changes in steps per day and moderate or vigorous-intensity exercise during the quarantine. CONCLUSIONS: Normal weight individuals, who are not normally troubled by overweight or obesity, had less awareness of weight gain than people with a BMI ≥ 24. Under the conditions of the semi-lockdown, they tended to gain weight.

Physiological function and regulatory signal of intestinal type 3 innate lymphoid cell(s).

Of the three groups of innate lymphoid cells, the type 3 innate lymphoid cell(s) (ILC3) include the subgroup of enteric ILC3 that participates in many physiological functions of the organism, such as promoting the repair of damaged mucosa, maintaining the homeostasis of gut symbiotic microorganisms, and presenting specific antigens. ILC3 also includes splenic and decidual ILC3. Like other physiological processes in the organism, enteric ILC3 functions are precisely regulated at the endogenous and exogenous levels. However, there has been no review on the physiological functions and regulatory signals of intestinal ILC3. In this paper, based on the current research on the physiological functions of enteric ILC3 in animals and the human, we summarize the signals that regulate cytokine secretion, antigen presentation and the quantity of ILC3 under normal intestinal conditions. We discuss for the first time the classification of the promoting mechanism of secretagogues of ILC3 into direct and indirect types. We also propose that ILC3 can promote intestinal homeostasis, and intestinal homeostasis can ensure the physiological phenotype of ILC3. If homeostasis is disturbed, ILC3 may participate in intestinal pathological changes. Therefore, regulating ILC3 and maintaining intestinal homeostasis are critical to the body.

Total laparoscopic segmental gastrectomy for gastrointestinal stromal tumors: A case report.

BACKGROUND: Gastrointestinal stromal tumors are lesions that originate from digestive tract walls. Several laparoscopic techniques, including local resections, wedge resections and partial gastrectomies, have been used successfully. However, there are no reports on laparoscopic segmental gastrectomy for gastrointestinal stromal tumors. CASE SUMMARY: We present our analysis of 17 patients who were admitted to our hospital from January 2014 to December 2018. All tumors were located in the corpus and antrum of the stomach, close to the lesser curvature of the stomach. The tumors originated from the anterior wall in nine cases and from the posterior wall of the stomach in eight cases. Laparoscopic segmental gastrectomy and end-to-end anastomosis between the proximal and the distal residual stomach were used in all patients. The mean operative time was 112.4 min. The mean length of hospital stay was 4.6 d. Mean operative blood loss was 73.5 mL. There were no leaks, no postoperative bleeding nor need for reintervention. Mean postoperative follow-up was 35.4 mo. The Visick grading index showed fewer gastrointestinal symptoms 3 mo after surgery. Two patients (11.8%) had reflux esophagitis and gastritis. CONCLUSION: Laparoscopic segmental gastrectomy may be a new function-preserving gastrectomy that is feasible for treatment of gastrointestinal stromal tumors that grow in the middle third of the stomach and on the lesser stomach curvature.

Autoinducer-2 of gut microbiota, a potential novel marker for human colorectal cancer, is associated with the activation of TNFSF9 signaling in macrophages.

Objectives: The interaction between the quorum sensing (QS) molecules of gut microbiota and the immunity of colorectal cancer (CRC) has not been investigated before. Methods: We measured the concentration of autoinducer-2 (AI-2) in samples of stool, colorectal tissue, saliva and serum of CRC patients, and compared this to AI-2 levels in colorectal adenoma (AD) and normal colon mucosa (NC). To explore the activated signaling pathways involved, we utilized AI-2 extracted from Fusobacterium nucleatum to stimulate macrophages and validated these in vitro findings in human CRC tissues. Results: The AI-2 concentration in both colorectal tissue and stool of CRC patients was significantly higher when compared to that in AD and NC (all P values < .01). The AI-2 concentration along with the progression of CRC in both tissues and stools was significantly increased (P= .045，P= .0003, respectively). After AI-2 stimulation, TNFSF9 was the most significantly increased protein in macrophage cells (P < .01). TNFSF9 expression was significantly higher in CRC tissues when compared to NCs (P< .0001), which was mainly derived from macrophages in the tumor microenvironment. Moreover, AI-2 level was positively associated with CD3 + T cell numbers (P= .0462), and negatively associated with CD4/CD8 ratio (P= .0113) within CRC tissues. Conclusions: We demonstrated for the first time that AI-2 may serve as a novel marker for screening CRC in the clinic. AI-2 was associated with tumor immunity in CRCs through tumor-associated macrophages and CD4/CD8 ratio in a TNFSF9-dependent manner.