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Colorectal cancer is associated with increased circulating lipopolysaccharide, inflammation and hypercoagulability

De Waal, Greta M. ; De Villiers, Willem J. S. ; Forgan, Timothy ; Roberts, Timothy ; Pretorius, Etheresia (2020-05-29)

CITATION: De Waal, G. M., et al. 2020. Colorectal cancer is associated with increased circulating lipopolysaccharide, inflammation and hypercoagulability. Scientific Reports, 10:8777, doi:10.1038/s41598-020-65324-2.

The original publication is available at

Publication of this article was funded by the Stellenbosch University Open Access Fund


Gut dysbiosis contributes to the development of a dysfunctional gut barrier, facilitating the translocation of bacteria and inflammagens, and is implicated in colorectal cancer (CRC) pathogenesis. Such ‘leaky gut’ conditions result in systemic inflammation, of which a hallmark is increased hypercoagulability. Fluorescence antibody confocal microscopy was used to determine circulating levels of lipopolysaccharide (LPS) in control and CRC populations. Here we showed that circulating levels of LPS are significantly elevated in the CRC population. We also showed that markers of inflammation and hypercoagulability are increased in this population. Furthermore, anomalous blood clotting and structural changes in blood components are presented. Importantly, the association between LPS levels, inflammation, and hematological dysfunction was analysed. Statistical regression models were applied to identify markers with strong association with CRC, and to investigate the correlation between markers. A core aim is enhanced biomarker discovery for CRC. We conclude that circulating LPS can promote systemic inflammation and contribute to the development of a pathological coagulation system, with resulting chronic inflammation and an activated coagulation system implicated in tumorigenesis. Blood-based screening tools are an emerging research area of interest for CRC screening. We propose the use of additional (novel) biomarkers to effectively screen for CRC.

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