The Mechanistic Crosstalk between Probiotics, ncRNAs, and Autophagy: Implications for Colorectal Cancer Precision Medicine

Colorectal cancer (CRC) remains a leading cause of cancer-related morbidity and mortality worldwide.Emerging evidence suggests a dynamic mechanistic crosstalk between probiotics, non-coding RNAs (ncRNAs), and autophagy in CRC management.This review synthesizes the intricate interplay within this signaling axis to provide a comprehensive framework for precision medicine.Probiotics modulate the gut microenvironment and immune responses, while ncRNAs-specifically microRNAs (miRNAs) and long non-coding RNAs (lncRNAs)-act as molecular rheostats regulating CRC progression and therapy resistance.Autophagy, a conserved cellular degradation process, plays a paradoxical role in tumor dynamics.This review elucidates the integrated signaling axis wherein probiotics directly influence autophagic flux and indirectly reprogram it through ncRNA-mediated pathways.Preclinical and clinical evidence highlight synergistic effects, such as probiotic-induced ncRNA shifts that fine-tune autophagy to induce apoptosis, curb tumor proliferation, and break resistance mechanisms.By linking this microbial-epigenetic-autophagy crosstalk with current multimodal therapies, we propose an innovative framework for personalized oncology.This axis represents a critical new direction for future research, aiming to translate mechanistic insights into targeted therapeutic strategies for CRC.