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<front>
<journal-meta>
<journal-id journal-id-type="pmc">BIOCELL</journal-id>
<journal-id journal-id-type="nlm-ta">BIOCELL</journal-id>
<journal-id journal-id-type="publisher-id">BIOCELL</journal-id>
<journal-title-group>
<journal-title>BIOCELL</journal-title>
</journal-title-group>
<issn pub-type="epub">1667-5746</issn>
<issn pub-type="ppub">0327-9545</issn>
<publisher>
<publisher-name>Tech Science Press</publisher-name>
<publisher-loc>USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">30383</article-id>
<article-id pub-id-type="doi">10.32604/biocell.2023.030383</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Review</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Possible therapeutic role of short-chain fatty acids from skin commensal bacteria in UVB-induced skin carcinogenesis</article-title><alt-title alt-title-type="left-running-head">Possible therapeutic role of short-chain fatty acids from skin commensal bacteria in UVB-induced skin carcinogenesis</alt-title><alt-title alt-title-type="right-running-head">Possible therapeutic role of short-chain fatty acids from skin commensal bacteria in UVB-induced skin carcinogenesis</alt-title>
</title-group>
<contrib-group>
<contrib id="author-1" contrib-type="author">
<name name-style="western"><surname>SUBRAMANI</surname><given-names>PAVITHRA</given-names></name>
<xref ref-type="aff" rid="aff-1">1</xref>
<xref ref-type="aff" rid="aff-2">2</xref>
</contrib>
<contrib id="author-2" contrib-type="author" corresp="yes">
<name name-style="western"><surname>DAS</surname><given-names>RAUNAK KUMAR</given-names></name>
<xref ref-type="aff" rid="aff-1">1</xref><email>raunakkumardas@vit.ac.in</email>
</contrib>
<aff id="aff-1"><label>1</label><institution>Centre for Biomaterials, Cellular &#x0026; Molecular Theranostics (CBCMT), Vellore Institute of Technology (VIT)</institution>, <addr-line>Vellore, 632014</addr-line>, <country>India</country></aff>
<aff id="aff-2"><label>2</label><institution>School of Biosciences and Technology (SBST), Vellore Institute of Technology (VIT)</institution>, <addr-line>Vellore, 632014</addr-line>, <country>India</country></aff>
</contrib-group><author-notes><corresp id="cor1"><label>&#x002A;</label>Address correspondence to: Raunak Kumar Das, <email>raunakkumardas@vit.ac.in</email></corresp></author-notes>
<pub-date date-type="collection" publication-format="electronic">
<year>2023</year></pub-date>
<pub-date date-type="pub" publication-format="electronic"><day>08</day><month>11</month><year>2023</year></pub-date>
<volume>47</volume>
<issue>10</issue>
<fpage>2195</fpage>
<lpage>2205</lpage>
<history>
<date date-type="received"><day>03</day><month>4</month><year>2023</year></date>
<date date-type="accepted"><day>01</day><month>6</month><year>2023</year></date>
</history>
<permissions>
<copyright-statement>&#x00A9; 2023 Subramani and Das</copyright-statement>
<copyright-year>2023</copyright-year>
<copyright-holder>Subramani and Das</copyright-holder>
<license xlink:href="https://creativecommons.org/licenses/by/4.0/">
<license-p>This work is licensed under a <ext-link ext-link-type="uri" xlink:type="simple" xlink:href="https://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution 4.0 International License</ext-link>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:href="TSP_BIOCELL_30383.pdf"></self-uri>
<abstract>
<p>Solar ultraviolet B (UVB) radiation is a major skin cancer-causing agent. Initiation, promotion, and progression are the diverse phases of UVB-induced carcinogenesis. Exposure to UVB causes abnormalities in a series of biochemical and molecular pathways: thymine dimer formation, DNA damage, oxidative stress, inflammatory responses, and altered cell signaling, eventually resulting in tumor formation. The increased skin cancer rates urge researchers to develop more efficient drugs, but synthetic chemotherapeutic drugs have more contrary effects and drug resistance issues, which have been reported recently. The current review focuses on the relationship between microbes and cancer. Human skin acts as a barrier against the external environment and serves as a protective shield for its inhabitant microbiota, collectively called skin microbes. The gut microbiome plays a vital role in cancer therapy. Production of short-chain fatty acids (SCFAs) such as butyrate, acetate, and propionate by intestinal microbes has anti-cancer properties against various cancer cell lines. Yet, the knowledge of SCFAs produced by skin microbes remains yet to be elucidated exhaustively. In this review, we strive to summarize the findings of studies performed to date regarding the anti-cancer properties of SCFA against various cancer cell lines and provide insight into future directions in the skin microbiome field.</p>
</abstract>
<kwd-group kwd-group-type="author">
<kwd>Photo carcinogenesis</kwd>
<kwd>UVB radiation</kwd>
<kwd>Intestinal microbiota</kwd>
<kwd>Small chain fatty acids</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<sec id="s1">
<title>Introduction</title>
<p>In the United States, about 40%&#x2013;50% of all diagnosed cancers represent skin cancer (<xref ref-type="bibr" rid="ref-13">Bray <italic>et al</italic>., 2013</xref>) and are extensively classified into (a) melanomas and (b) non-melanoma skin cancers (NMSCs) (<xref ref-type="bibr" rid="ref-71">Sim&#x00F5;es <italic>et al</italic>., 2015</xref>). NMSCs include basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) (<xref ref-type="bibr" rid="ref-4">Apalla <italic>et al</italic>., 2017</xref>). The aggressive form of skin cancer is melanoma which spreads to different areas of the body and accounts for around 70% of skin cancer-related deaths (<xref ref-type="bibr" rid="ref-56">Nikolaou and Stratigos, 2014</xref>; <xref ref-type="bibr" rid="ref-75">Stockert and Bl&#x00E1;zquez-Castro, 2022</xref>). BCCs have rare metastatic characteristics, whereas SCCs display a high metastatic rate (<xref ref-type="bibr" rid="ref-21">Didona <italic>et al</italic>., 2018</xref>). Skin is generally susceptible to injury, as it is exposed to pathogens, solar ultraviolet radiation (UVR), and various chemicals that finally lead to the development of skin cancers (<xref ref-type="bibr" rid="ref-54">Ng <italic>et al</italic>., 2018</xref>). Of all possible exposures, UVR from sunlight has been perceived as the primary causal agent of skin cancer (<xref ref-type="bibr" rid="ref-74">Solar and Ultraviolet Radiation, 2011</xref>). Both UVA and UVB are carcinogens. Especially, UVB directly causes DNA damage, prompting the development of massive damage between adjacent pyrimidine sites and the generation of reactive oxygen species (ROS) (<xref ref-type="bibr" rid="ref-43">Levav-Cohen <italic>et al</italic>., 2014</xref>). Preventive measures should be taken to overcome the global increase in skin cancer rates (<xref ref-type="bibr" rid="ref-22">Domingues <italic>et al</italic>., 2018</xref>). This review addresses the harmful side of UVB in skin cancer and the necessity of short-chain fatty acids (SCFAs) in managing them.</p>
<sec id="s1_1">
<title>Harmful effects of ultraviolet B on the skin</title>
<p>The sun produces electromagnetic radiation that encompasses a broad range of wavelengths. Among them, only a few wavelengths are able to pass through the ozone layer and reach the earth surface; these include ultraviolet (UV) radiation, infrared (IR), and visible light (VL). Solar UV radiations occur in the wavelength range of around 200&#x2013;400 nm; however, only UVA (400&#x2013;315 nm) and UVB (315&#x2013;280 nm) can reach the earthbound surface, while UVC (280&#x2013;100 nm) is completely absorbed by the ozone layer (<xref ref-type="bibr" rid="ref-79">Svobodov&#x00E1; <italic>et al</italic>., 2003</xref>). <xref ref-type="fig" rid="fig-1">Fig. 1</xref> demonstrates how extreme exposure to UVB harms the capacity of basal keratinocytes for maintaining skin homeostasis and will prompt different skin diseases, which incorporate erythema, edema, sunburn, keratinocyte hyperplasia, and causes DNA mutations, photo-aging, and skin cancer (<xref ref-type="bibr" rid="ref-76">Strozyk and Kulms, 2013</xref>).</p>
<fig id="fig-1">
<label>Figure 1</label>
<caption>
<title>Effects of ultraviolet radiation on human skin. TNF&#x03B1;, tumor necrosis factor alpha; TGF&#x03B2;, transforming growth factor beta; PDGF, platelet-derived growth factor; NGF, nerve growth factor; CSF-1, colony stimulating factor-1; Cyt C, cytochrome C; APAF-1, apoptotic protease activating factor-1; Casp9, caspase 9; Casp3, caspase 3; Casp8, caspase 8; SSB, single strand break; 8-oxoG, 8-hydroxy-2&#x2032;-deoxyguanine.</title></caption>
<graphic mimetype="image" mime-subtype="tif" xlink:href="Biocell-47-30383-f001.tif"/>
</fig>
</sec>
<sec id="s1_2">
<title>DNA damage and skin cancer</title>
<p>UVB radiation instigated Different DNA damage classes, specifically cyclobutane pyrimidine dimers (CPDs), pyrimidine (6-4) photoproducts (6-4PPs), DNA strand breaks, and DNA cross-links (<xref ref-type="bibr" rid="ref-11">Brash, 1997</xref>). CPDs are the most cytotoxic lesions which are responsible for cell death, but 6-4PPs cause more prominent alterations in the structure of the DNA double helix (<xref ref-type="bibr" rid="ref-34">Kciuk <italic>et al</italic>., 2020</xref>) and UVA does not induce 6-4PPs. However, longer UV wavelengths cause more DNA strand breaks (<xref ref-type="bibr" rid="ref-68">Sczepanski <italic>et al</italic>., 2009</xref>). Upon exposure to UVA or UVB, 6-4PPs undergo photoisomerization to Dewar isomers (<xref ref-type="bibr" rid="ref-34">Kciuk <italic>et al</italic>., 2020</xref>). Tandem pyrimidine residues form at the site of UV-induced DNA damage (<xref ref-type="bibr" rid="ref-63">Rochette <italic>et al</italic>., 2003</xref>). After DNA damage, cells respond by promptly halting cell division to prevent further DNA damage, which allows the DNA repair mechanism to begin. If the DNA damage induced by UVB is not fixed, it brings about mutations in the genome, prompting skin carcinogenesis (<xref ref-type="bibr" rid="ref-12">Brash <italic>et al</italic>., 1991</xref>). NER is essential in the repair of CPDs and 6-4 PPs (<xref ref-type="bibr" rid="ref-78">Sugasawa <italic>et al</italic>., 1998</xref>). The p53 mutations, which include T<inline-formula id="ieqn-1">
<mml:math id="mml-ieqn-1"><mml:mo stretchy="false">&#x2192;</mml:mo></mml:math>
</inline-formula>C transition or double base changes such as TT<inline-formula id="ieqn-2">
<mml:math id="mml-ieqn-2"><mml:mo stretchy="false">&#x2192;</mml:mo></mml:math>
</inline-formula>CC transition, are frequently found in all types of skin malignancies, the so-called &#x201C;UVB signature&#x201D; (<xref ref-type="bibr" rid="ref-88">Wikonkal and Brash, 1999</xref>). UVA radiation causes indirect DNA damage by driving photons and energy transfer from cellular photosensitizers, such as porphyrins, bilirubin, and melanin, to oxygen molecules leading to the formation of singlet oxygen, which induces guanine moiety oxidation followed by structural rearrangement and formation of 8-oxo-7,8-dihydroguanine (8-oxo-G) and 8-oxo-7,8-dihydro-2&#x2032;-deoxyguanosine (8-oxo-dG) (<xref ref-type="bibr" rid="ref-37">Klungland <italic>et al</italic>., 1999</xref>).</p>
<p>The chief cause of both BCC and SCC is exposure to UVR. Almost all BCC occur on UVR-exposed body sites, and SCC originates from a malignant mutation of keratinocytes in the epidermis and skin adnexa and is capable of metastasis (<xref ref-type="bibr" rid="ref-45">Lo and Fisher, 2014</xref>). Early diagnosis of both BCC and SCC can be treated, but the metastatic potential of BCC and SCC is really lethal (<xref ref-type="bibr" rid="ref-40">Kumar <italic>et al</italic>., 2015</xref>). Studies have proven that UV-induced DNA damage is the chief source of SCCs (<xref ref-type="bibr" rid="ref-12">Brash <italic>et al</italic>., 1991</xref>). Tumor growth was controlled by Ras proteins which incorporate H-ras, K-ras, and N-ras (<xref ref-type="bibr" rid="ref-10">Bos, 1989</xref>). Any changes in Ras oncogene leads to NMSCs (<xref ref-type="bibr" rid="ref-59">Pierceall <italic>et al</italic>., 1991</xref>). Hedgehog signaling, which is one of the very important pathways in embryonic development and furthermore identified to be associated with cancer promotion, was regulated by genomic phenylthiocarbamide protein (<xref ref-type="bibr" rid="ref-87">Wicking <italic>et al</italic>., 1997</xref>).</p>
</sec>
<sec id="s1_3">
<title>Oxidative damage</title>
<p>Vulnerability to ultraviolet radiation is the fundamental source of skin carcinogenesis that disrupts cutaneous cells by reactive oxygen species (ROS) overproduction (<xref ref-type="bibr" rid="ref-44">Liu-Smith <italic>et al</italic>., 2017</xref>). Direct exposure of the epidermis to UVR can lead to oxidative stress through NADPH oxidase activation or by prompting lipid peroxidation, which initiates ROS. Substantial increase in ROS by UVB irradiation triggers nuclear DNA damage via the development of cyclobutane pyrimidine dimers (CPDs), pyrimidine (6-4) photoproducts, and 8-hydroxy-2&#x2032;-deoxyguanine (8-OHdG) (<xref ref-type="bibr" rid="ref-27">Gilbert <italic>et al</italic>., 2012</xref>). 8-OHdG, a biomarker for oxidative DNA damage, binds with adenine rather than cytosine, suggesting that oxidative damage can be tumorigenic (<xref ref-type="bibr" rid="ref-2">Agar <italic>et al</italic>., 2004</xref>). ROS-mediated carcinogenesis is of two types&#x2013;genotoxic and non-genotoxic(<xref ref-type="bibr" rid="ref-8">Benedetti <italic>et al</italic>., 2021</xref>). ROS-mediated genotoxicity causes protooncogene actuation (BRAF, N-Ras, Ras-related C3 botulinum toxin substrate 1, phosphatase and tensin homolog etc.), tumor suppressor gene deactivation (p53 and protein patched homolog 1), genomic instability, and epigenetic modification. These alterations may further lead to mutations (<xref ref-type="bibr" rid="ref-24">Farhood <italic>et al</italic>., 2019</xref>; <xref ref-type="bibr" rid="ref-89">Xian <italic>et al</italic>., 2019</xref>). <xref ref-type="fig" rid="fig-2">Fig. 2</xref> represents the non-genotoxicity-intervened carcinogenesis that circuitously affects DNA via activation of various pathways-oxidative-stress related pathways and antioxidant stress pathways (<xref ref-type="bibr" rid="ref-24">Farhood <italic>et al</italic>., 2019</xref>; <xref ref-type="bibr" rid="ref-89">Xian <italic>et al</italic>., 2019</xref>).</p>
<fig id="fig-2">
<label>Figure 2</label>
<caption>
<title>Reactive oxygen species (ROS)-mediated skin carcinogenesis. Increased ROS levels undergo genotoxicity and non-genotoxicity pathways and result in cancer.</title></caption>
<graphic mimetype="image" mime-subtype="tif" xlink:href="Biocell-47-30383-f002.tif"/>
</fig>
<p>ROS induced by UVB is produced through various mechanisms. The very first mechanism is the induction of ROS by the enzyme catalase. Through the catalytic activity, the enzyme catalase degrades hydrogen peroxide into water and oxygen (<xref ref-type="bibr" rid="ref-20">de Jager <italic>et al</italic>., 2017</xref>). The other antioxidant enzymes, such as glutathione and superoxide dismutase (SOD), are involved in scavenging ROS (<xref ref-type="bibr" rid="ref-8">Benedetti <italic>et al</italic>., 2021</xref>; <xref ref-type="bibr" rid="ref-39">Kora <italic>et al</italic>., 2023</xref>). Due to increased ROS production by UVB, these antioxidants fail to scavenge ROS, which altogether results in photocarcinogenesis (<xref ref-type="bibr" rid="ref-89">Xian <italic>et al</italic>., 2019</xref>). ROS production leads to the activation of mitogen-activated protein kinases (MAPKs), such as extracellular-signal-regulated kinase (ERK) and c-Jun N-terminal kinases (JNK), further leading to the downstream activation of transcription factor AP-1. The regulation of genes involved in the cell cycle, proliferation, and apoptosis is controlled by activator protein 1 and nuclear factor &#x03BA;B (NF-kB) (<xref ref-type="bibr" rid="ref-9">Bickers and Athar, 2006</xref>).</p>
</sec>
<sec id="s1_4">
<title>Inflammation</title>
<p>Overexposure to UVR, particularly UVB, can cause inflammation of the skin. Inflammation is the self-defensive response of the body and is classified into-(i) acute inflammation-caused as a result of exposure to any causative agents, which starts rapidly and becomes severe within a few; (ii) chronic inflammation, which can last for a few weeks to several months. Studies have shown that there is a strong relationship between UVR-spurred inflammation and cancer in the skin. Cancer mostly forms at the site of chronic inflammation (<xref ref-type="bibr" rid="ref-5">Balkwill and Mantovani, 2001</xref>). Exposure to UVB primes the secretion of various cytokines and chemokines from different skin cells, i.e., keratinocytes and Langerhans cells secretes a number of cytokines, such as transforming growth factor beta (TGF&#x03B2;), tumor necrosis factor-alpha (TNF&#x03B1;), growth factors such as platelet-derived growth factor (PDGF), nerve growth factor (NGF), colony stimulating factor-1 (CSF-1), etc., and interleukins such as IL-1&#x03B2;, IL-6, IL-8, IL-10, and IL-12. UVB irradiation induces keratinocytes to deliver these cytokines, and the liberation of this production has been depicted in several skin cancers (<xref ref-type="bibr" rid="ref-83">van Kempen <italic>et al</italic>., 2003</xref>).</p>
<p>The activation of p38, MAPK, and Akt by UVB helps in the endurance of keratinocytes and opposes apoptosis that results in the accumulation of DNA damage, which may prompt malignant growth (<xref ref-type="bibr" rid="ref-42">Lee <italic>et al</italic>., 2011</xref>). UVB instigates the PI3K pathway for cell survival and aggravation, accomplished as a downstream movement of epithelial growth factor receptor (<xref ref-type="bibr" rid="ref-86">Wan <italic>et al</italic>., 2001</xref>). DNA damage by UVB is sufficient to intervene in NF-kB stimulation (<xref ref-type="bibr" rid="ref-1">Abeyama <italic>et al</italic>., 2000</xref>). Besides, (<xref ref-type="bibr" rid="ref-70">Simon <italic>et al</italic>., 1994</xref>) showed that UVB can directly actuate NF-kB from chromosomal DNA damage. Inhibitors of nuclear factor-kB kinase alpha (IKK&#x03B1;) and NF-kB assume a major function in maintaining skin homeostasis. Decrease in the outflow of IKK&#x03B1; promotes UVB-induced chronic inflammation and the process of carcinogenesis in mice models (<xref ref-type="bibr" rid="ref-83">van Kempen <italic>et al</italic>., 2003</xref>). IKK&#x03B1; similarly has a role in the promotion of SCC (<xref ref-type="bibr" rid="ref-84">Van Waes <italic>et al</italic>., 2007</xref>).</p>
</sec>
<sec id="s1_5">
<title>Apoptosis</title>
<p>Solar UVB is a potent genotoxic agent that leads to apoptosis, portrayed by membrane blebbing and nuclear fragmentation (<xref ref-type="bibr" rid="ref-77">Su <italic>et al</italic>., 2015</xref>). Skin cells activate apoptosis to overcome the damage caused by UVB (<xref ref-type="bibr" rid="ref-84">Van Waes <italic>et al</italic>., 2007</xref>). UVB irradiation, a strong inducer of apoptosis in cultured cells, triggers both intrinsic and extrinsic pathways (<xref ref-type="bibr" rid="ref-77">Su <italic>et al</italic>., 2015</xref>). However, a few cells escape and may result in tumorigenesis. Henceforth, for the protection of normal cells from UVB, apoptosis aids as an essential process (<xref ref-type="bibr" rid="ref-23">Elmore, 2007</xref>; <xref ref-type="bibr" rid="ref-94">Zhang <italic>et al</italic>., 2023</xref>).</p>
<p>(i) Intrinsic pathway: UVB-triggered cell death generally occurs through the intrinsic apoptotic pathway, which is initiated by p53. Transformed p53 often exists in non-melanoma skin cancers (<xref ref-type="bibr" rid="ref-64">Rodust <italic>et al</italic>., 2009</xref>). In mitochondria, p53 increases the production of the pro-apoptotic protein, such as Bcl-2 associated X-protein (Bax), and diminishes the action of anti-apoptotic proteins, for example, B-cell lymphoma 2 (Bcl-2). The modification of the outer mitochondrial membrane structure by UVB gives rise to an imbalance in Bax/Bcl-2 ratio and delivers cytochrome c. Once delivered, cytochrome c and the apoptotic protease activating factor-1 form the apoptosome. This protein complex recruits and enacts caspase 9 and 3, bringing about apoptosis (<xref ref-type="bibr" rid="ref-72">Singh <italic>et al</italic>., 2019</xref>).</p>
<p>(ii) Extrinsic pathway: The multimerization of CD95 (Fas/APO-1) by UVB brings out its attachment to the adapter protein Fas-associated protein with death domain, followed by the activation of caspase cascade from caspase 8 to caspase 3 (<xref ref-type="bibr" rid="ref-6">Bang <italic>et al</italic>., 2003</xref>). After UVB irradiation, the TNF receptor is grouped and internalized in keratinocytes. TRAIL receptors, including TRAIL-R1 and TRAIL-R2, serve as lure receptors because of their competitive binding to cease apoptosis. UVB irradiation may change this equilibrium and may induce TRAIL-mediated apoptosis by the hindrance of binding with lure receptors (<xref ref-type="bibr" rid="ref-62">Qin <italic>et al</italic>., 2004</xref>).</p>
</sec>
<sec id="s1_6">
<title>Epithelial-mesenchymal transition (EMT) and skin carcinogenesis</title>
<p>In the property of invasiveness, EMT plays a leading role in which the phenotypic changes combined with EMT contribute to tumor heterogeneity and therapeutic resistance (<xref ref-type="bibr" rid="ref-69">Shu <italic>et al</italic>., 2013</xref>; <xref ref-type="bibr" rid="ref-85">Veloz <italic>et al</italic>., 2021</xref>). EMT is facilitated by EMT-inducing transcription factors (EMT-TFs) and is connected with normal organ advancement, wound healing, and the intrusiveness of cancer cells (<xref ref-type="bibr" rid="ref-66">Sato <italic>et al</italic>., 2016</xref>). TGF-&#x03B2; is the key regulator persuader of EMT; also, the epidermal growth factor (EGF), fibroblast growth factor, hepatocyte growth factor, Wnt, and ECM components have been proven to prompt this action (<xref ref-type="bibr" rid="ref-55">Nieto and Cano, 2012</xref>). EMT-TFs can be classified into two groups, in which one group suppresses the expression of E-cadherin, Snail, Slug, ZEB1, ZEB2, E47, KLF8, and Brachyury directly correlate with the E-cadherin gene promoter to arrest gene expression. In contrast, the other group-Twist1, FOXC2, Goosecoid, E2-2, SIX1, and PRRX1 trigger the EMT without direct attachment to the E-cadherin gene promoter (<xref ref-type="bibr" rid="ref-19">De Craene and Berx, 2013</xref>; <xref ref-type="bibr" rid="ref-91">Yang <italic>et al</italic>., 2021</xref>). N-cadherin, fibronectin, and vimentin are the mesenchyme-associated genes whose expression is initiated by EMT-TFs. EMT prompts the up-regulation of N-cadherin and simultaneous down-regulation of E-cadherin, termed as &#x201C;Cadherin Switch Field&#x201D; (<xref ref-type="bibr" rid="ref-82">Tyagi <italic>et al</italic>., 2015</xref>). In various human cancers, overexpression of EMT-TFs has been identified in various human cancers (<xref ref-type="bibr" rid="ref-19">De Craene and Berx, 2013</xref>). UVB-irradiated HaCaT cells exhibit amplified aggressiveness with exaggerated migration and invasive potential, and mesenchymal phenotypes, which validate that UVB causes EMT and is related to skin carcinogenesis (<xref ref-type="bibr" rid="ref-82">Tyagi <italic>et al</italic>., 2015</xref>).</p>
</sec>
<sec id="s1_7">
<title>Short-chain fatty acids in biological research</title>
<p>Fatty acids (FA) are essential components for energy metabolism, stability of cell membranes, and modulation in multiple biological processes. Based on the hydrocarbon chain length, FA is classified into short-, medium- and long-chain fatty acids (<xref ref-type="bibr" rid="ref-26">Fung <italic>et al</italic>., 2011</xref>). The FA are mainly produced in the diet. SCFA can be easily absorbed, recycled, and metabolized in the body to make the body functional. <xref ref-type="fig" rid="fig-3">Fig. 3</xref> presents the pathway for SCFA production.</p>
<fig id="fig-3">
<label>Figure 3</label>
<caption>
<title>Production of small chain fatty acid. Intestinal microbes hydrolyze indigestible carbohydrates and produce short-chain fatty acids (SCFAs).</title></caption>
<graphic mimetype="image" mime-subtype="tif" xlink:href="Biocell-47-30383-f003.tif"/>
</fig>
<p>Even though the uptake of long-chain fatty acids (LCFA) and medium-chain fatty acids (MCFA) occur through similar mechanisms, there exist some differences. Both LCFA and MCFA are absorbed to some extent, and are the rate-limiting step for MCFA and LCFA is passaging across the brush-border membrane and unstirred water layer (UWL), respectively (<xref ref-type="bibr" rid="ref-67">Sch&#x00F6;nfeld and Wojtczak, 2016</xref>; <xref ref-type="bibr" rid="ref-90">Xu <italic>et al</italic>., 2021</xref>). For cellular uptake, intracellular transport, and metabolism, LCFA needs free fatty acid-binding proteins. However, SCFAs require no or much fewer free fatty acid binding proteins for their intracellular transport and metabolism. Also, SCFAs are secreted endogenously, whereas MCFAs and LCFAs are exogenous (<xref ref-type="bibr" rid="ref-67">Sch&#x00F6;nfeld and Wojtczak, 2016</xref>).</p>
<p>Based on the efficiency and bioavailability of SCFA, it is broadly used in research. Acetate (C2), propionate (C3), and butyrate (C4) are most abundantly secreted SCFAs via the gut flora as an end product of anaerobic fermentation (<xref ref-type="fig" rid="fig-3">Fig. 3</xref>) (<xref ref-type="bibr" rid="ref-58">Parada Venegas <italic>et al</italic>., 2019</xref>). In the gut, Bacteroidetes and Firmicutes are the predominant bacterial phyla, whereas Actinobacteria, Proteobacteria, and Verrucomicrobia are the minor phyla. These microbes ferment most of the dietary substances and produce an array of metabolites, in which many are beneficial (<xref ref-type="bibr" rid="ref-38">Kobayashi <italic>et al</italic>., 2018</xref>). SCFAs have been linked to beneficial effects on human health associated with their metabolic and signaling properties. <xref ref-type="fig" rid="fig-4">Fig. 4</xref> represents the regulatory functions of SCFAs produced by gut flora will depend on specific receptors expressed in different cell types, which are mainly free fatty acid receptors (<xref ref-type="bibr" rid="ref-35">Keshari <italic>et al</italic>., 2019</xref>).</p>
<fig id="fig-4">
<label>Figure 4</label>
<caption>
<title>Short-chain fatty acids and their receptors. FFAR1: free fatty receptor 1; FFAR2: free fatty acid receptor 2; FFAR3: free fatty acid receptor 3; GPR40: G-protein coupled receptor 40; GPR41: G-protein coupled receptor 41; GPR43: G-protein coupled receptor 43; GPR109A: G-protein coupled receptor 109A; olfr78: olfactory receptor 78.</title></caption>
<graphic mimetype="image" mime-subtype="tif" xlink:href="Biocell-47-30383-f004.tif"/>
</fig>
<p>Each SCFAs bind to its specific free fatty acid receptors and mediates the cyclic adenosine monophosphate (cAMP) or extracellular-signal-regulated kinase 1/2 (ERK 1/2) signaling via G-protein dependent or independent pathways (<xref ref-type="bibr" rid="ref-49">Marinissen and Gutkind, 2001</xref>). The epithelial cells have free fatty acid receptors FFAR3 or GPR41, FFAR2 or GPR43, and GPR109A. Enteric neurons and intestinal leukocytes express GPR41 and GPR43, respectively, while intestine endocrine cells express both GPR41 and GPR43 (<xref ref-type="bibr" rid="ref-73">Sivaprakasam <italic>et al</italic>., 2016</xref>). The list of SCFAs receptors and their functions are briefed in <xref ref-type="table" rid="table-1">Table 1</xref>.</p>
<table-wrap id="table-1"><label>TABLE 1</label>
<caption>
<title>Short chain fatty acids and the receptors. FFAR1: free fatty receptor 1; FFAR2: free fatty acid receptor 2; FFAR3: free fatty acid receptor 3; GPR40: G-protein coupled receptor 40; GPR41: G-protein coupled receptor 41; GPR43: G-protein coupled receptor 43; GPR109A: G-protein coupled receptor 109A; olfr78: olfactory receptor 78</title></caption>
<table>
<colgroup>
<col/>
<col/>
<col/>
<col/>
<col/>
<col/>
<col/>
<col/>
<col/>
<col/>
</colgroup>
<thead valign="top">
<tr>
<th>S.No.</th>
<th>SCFAs</th>
<th>No. of carbon atoms</th>
<th>Systemic name</th>
<th>Simplified formula</th>
<th>Receptors</th>
<th>Expression of GPR receptors</th>
<th>Signaling of GPR receptors</th>
<th>Biological effects</th>
<th>References</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td>1</td>
<td>Acetate</td>
<td>2</td>
<td>Ethanoic acid</td>
<td>(C2:0)</td>
<td>FFAR3 (GPR41); FFAR2 (GPR43); Olfr78</td>
<td>Pancreas, enteroendocrine cells, and enteric neurons</td>
<td>G&#x03B1;i/o, &#x03B2;-gustducin</td>
<td>Dendritic cell maturation, inhibits gut motility and insulin secretion</td>
<td><xref ref-type="bibr" rid="ref-73">Sivaprakasam <italic>et al</italic>. (2016)</xref>, <xref ref-type="bibr" rid="ref-14">Brown <italic>et al</italic>. (2003)</xref>, <xref ref-type="bibr" rid="ref-41">Le Poul <italic>et al</italic>. (2003)</xref>, <xref ref-type="bibr" rid="ref-81">Trompette <italic>et al</italic>. (2014)</xref>, <xref ref-type="bibr" rid="ref-80">Tang <italic>et al</italic>. (2015)</xref>, <xref ref-type="bibr" rid="ref-47">Lu <italic>et al</italic>. (2020)</xref></td>
</tr>
<tr>
<td>2</td>
<td>Propionate</td>
<td>3</td>
<td>Propanoic acid</td>
<td>(C3:0)</td>
<td>FFAR3 (GPR41); FFAR2 (GPR43); Olfr78</td>
<td>Adipocytes, enteroendocrine cells, innate immune cells, and gut epithelium</td>
<td>G&#x03B1;i/o, G&#x03B1;q, &#x03B2;-arrestin-2</td>
<td>Gut homeostasis, Treg proliferation, inhibits insulin secretion, tumor suppressor, neutrophil chemotaxis, GLP-1 secretion</td>
<td><xref ref-type="bibr" rid="ref-73">Sivaprakasam <italic>et al</italic>. (2016)</xref>, <xref ref-type="bibr" rid="ref-14">Brown <italic>et al</italic>. (2003)</xref>, <xref ref-type="bibr" rid="ref-41">Le Poul <italic>et al</italic>. (2003)</xref>, <xref ref-type="bibr" rid="ref-52">Maslowski <italic>et al</italic>. (2009)</xref>, <xref ref-type="bibr" rid="ref-80">Tang <italic>et al</italic>. (2015)</xref></td>
</tr>
<tr>
<td>3</td>
<td>Butyrate</td>
<td>4</td>
<td>Butanoic acid</td>
<td>(C4:0)</td>
<td>FFAR3 (GPR41); FFAR2 (GPR43); GPR109A</td>
<td>Adipocytes, innate immune cells, and intestinal epithelium</td>
<td>G&#x03B1;i/o, &#x03B2;-arrestin-1</td>
<td>Gut homeostasis of colonic Treg cells, inhibits lipolysis, atherosclerosis, and inflammation in brain</td>
<td><xref ref-type="bibr" rid="ref-73">Sivaprakasam <italic>et al</italic>. (2016)</xref>, <xref ref-type="bibr" rid="ref-48">Lukasova <italic>et al</italic>. (2011)</xref>, <xref ref-type="bibr" rid="ref-17">Coakley <italic>et al</italic>. (2014)</xref></td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec id="s1_8">
<title>Evidence for the benefits of SCFAs</title>
<p>The comprehensive anti-tumor properties of acetate, propionate, and butyrate are mentioned in this review. Butyrate renders protection against carcinogenesis by delivering 70% energy to colonocytes and sustains intestinal barrier functions, reducing inflammation (<xref ref-type="bibr" rid="ref-7">Bedford and Gong, 2018</xref>). Butyrate is produced by specific gut bacteria that come under the order Clostridiales, such as Lachnospiraceae (<italic>Coprococcus, Eubacterium, Anaerostipes</italic>, and <italic>Roseburia</italic>), Ruminococcaceae (<italic>Faecalibacterium</italic> and <italic>Subdoligranulum</italic>) and Erysipelotrichaceae (<italic>Holdemanella</italic>) (<xref ref-type="bibr" rid="ref-46">Louis <italic>et al</italic>., 2014</xref>; <xref ref-type="bibr" rid="ref-25">Flint, 2016</xref>). Many investigations have shown that butyrate exhibits anti-cancer activity through various signaling pathways that control cell survival and apoptosis in multiple cancer cells (<xref ref-type="bibr" rid="ref-15">Candido <italic>et al</italic>., 1978</xref>). Detailed information on the effects of butyrate on oncogenic signaling pathways is provided in an earlier publication (<xref ref-type="bibr" rid="ref-16">Chen <italic>et al</italic>., 2019</xref>). <italic>In vivo</italic> investigations revealed that butyrate diminishes the rate of colon cancer (<xref ref-type="bibr" rid="ref-53">McIntyre <italic>et al</italic>., 1993</xref>). <xref ref-type="bibr" rid="ref-28">Gon&#x00E7;alves <italic>et al</italic>. (2011)</xref> indicated that butyrate is a breast cancer-resistant protein (BCRP) substrate. Butyrate-induced apoptosis in a colon cancer cell line HCT116 (<xref ref-type="bibr" rid="ref-26">Fung <italic>et al</italic>., 2011</xref>). The anti-cancer effect of butyrate was explored in a breast cancer cell line MCF-7 (<xref ref-type="bibr" rid="ref-92">Yonezawa <italic>et al</italic>., 2007</xref>). The viability of U937 leukemia cells was decreased by butyrate to about 60% (<xref ref-type="bibr" rid="ref-61">Pulliam <italic>et al</italic>., 2016</xref>). 12-0-tetradecanoylphorbol-13-acetate (TPA) induced skin tumors in mice were reduced by topical application of butyric acid (<xref ref-type="bibr" rid="ref-30">Gupta and Mehrotra, 1997</xref>). This provides us the evidence that butyrate has anti-cancer properties against multiple cancer cell types.</p>
<p>Acetate is one of the most important SCFAs and has been less explored than propionate and butyrate. Also, acetate is the net fermentation end product for most gut bacteria, while butyrate and propionate are produced by very specific species (<xref ref-type="bibr" rid="ref-51">Martin-Gallausiaux <italic>et al</italic>., 2021</xref>). Acetate impedes proliferation and stimulates apoptosis in colon cancer cells, also acetate-induced apoptosis in CRC cells, further roots to mitochondrial alterations (<xref ref-type="bibr" rid="ref-50">Marques <italic>et al</italic>., 2013</xref>). The primary end products of Propionibacteria were acetate and propionate, which destroys two human adenocarcinoma cell lines by apoptosis through co-cultures with the dairy species <italic>Propionibacterium freudenreichii</italic> and <italic>Propionibacterium acidipropionici</italic> (<xref ref-type="bibr" rid="ref-33">Jan <italic>et al</italic>., 2002</xref>).</p>
<p>The anti-inflammatory properties of acetate and propionate were proved in human monocytes and <italic>in vivo</italic> colitis models (<xref ref-type="bibr" rid="ref-18">Cox <italic>et al</italic>., 2009</xref>; <xref ref-type="bibr" rid="ref-52">Maslowski <italic>et al</italic>., 2009</xref>). Propionate is considered the most powerful endogenic agonist for both G-protein coupled receptors, free fatty acid receptor 3 (FFA3) and FFA2 (<xref ref-type="bibr" rid="ref-14">Brown <italic>et al</italic>., 2003</xref>; <xref ref-type="bibr" rid="ref-41">Le Poul <italic>et al</italic>., 2003</xref>). Propionate is produced by Bacteroidetes and some Firmicutes, such as the Negativicutes (<italic>Veillonella</italic> and <italic>Phascolarctobacterium</italic>). Some other Firmicutes, belonging to Negativicutes (<italic>Megasphaera</italic>), Lachnospiraceae (<italic>Coprococcus</italic>), Ruminococcaceae, Proteobacteria, and Lachnospiraceae species (<xref ref-type="bibr" rid="ref-51">Martin-Gallausiaux <italic>et al</italic>., 2021</xref>). <italic>In vitro</italic> studies have shown that propionate reduces BaF3 cell proliferation through a cAMP level-dependent pathway, and FFA2 activation changes BaF3 cell growth which shows that propionate decreases cancer cell proliferation in the liver. An ongoing investigation (<xref ref-type="bibr" rid="ref-32">H&#x00F8;gh <italic>et al</italic>., 2020</xref>) revealed that the propionate causes metabolic changes bringing about the natural-killer group 2, member D (NKG2D) ligand surface expression, which renders as a potential immune activating anti-cancer therapy. Also, studies by <xref ref-type="bibr" rid="ref-36">Kim <italic>et al</italic>. (2019)</xref> have demonstrated that propionate prompts cell apoptosis and cell cycle arrest in lung cancer.</p>
<p>The anti-cancer properties of these SCFAs against colorectal cancer cells has been listed in numerous publications (<xref ref-type="bibr" rid="ref-29">Gu <italic>et al</italic>., 2012</xref>; <xref ref-type="bibr" rid="ref-38">Kobayashi <italic>et al</italic>., 2018</xref>; <xref ref-type="bibr" rid="ref-57">Ohara and Suzutani, 2018</xref>; <xref ref-type="bibr" rid="ref-93">You <italic>et al</italic>., 2018</xref>). In human colon cells and neutrophils, the anti-proliferative capacity of SCFAs has been related to the capacity of SCFA to hinder histone deacetylase function (<xref ref-type="bibr" rid="ref-3">Aoyama <italic>et al</italic>., 2010</xref>). The most remarkable histone deacetylase inhibitor is butyrate, though propionate exhibited the intermediate profile and acetate didn&#x2019;t impact the deacetylase activity (<xref ref-type="bibr" rid="ref-3">Aoyama <italic>et al</italic>., 2010</xref>). Studies by (<xref ref-type="bibr" rid="ref-52">Maslowski <italic>et al</italic>., 2009</xref>; <xref ref-type="bibr" rid="ref-60">Pirozzi et al., 2018</xref>; <xref ref-type="bibr" rid="ref-35">Keshari <italic>et al</italic>., 2019</xref>) have shown that butyric acid from skin commensal bacteria reduces inflammation by binding to its free fatty acid receptors. <xref ref-type="fig" rid="fig-5">Fig. 5</xref> shows the possible molecular mechanisms of small-chain fatty acids in cancer cell inhibition (<xref ref-type="bibr" rid="ref-31">He <italic>et al</italic>., 2020</xref>).</p>
<fig id="fig-5">
<label>Figure 5</label>
<caption>
<title>Possible mechanism of small chain fatty acids in cancer in the RAS-RAF-ERK kinase (MEK)-extracellular-signal-regulated kinase (ERK) signal transduction cascade. Skin commensal bacteria produce SCFAs that bind to specific FFARs and inhibit Bcl-2 family proteins, thereby increasing ROS and apoptosis, altogether inhibiting cancer cell proliferation.</title></caption>
<graphic mimetype="image" mime-subtype="tif" xlink:href="Biocell-47-30383-f005.tif"/>
</fig>
</sec>
</sec>
<sec id="s2">
<title>Discussion</title>
<p>Being a very delicate organ, skin cells are very susceptible to UVR. The studies elaborated above clearly indicate the potential of UVB in prompting skin cancer. An increase in skin cancer rates triggers researchers to develop novel and efficient therapeutic strategies to treat skin cancer. The benefits of SCFAs in various cancer cell lines were listed out in this review. Although SCFAs produced by gut microbes play a vital role in reducing inflammation and carcinogenesis, the time required for them to travel the skin exceeds the optimal duration (<xref ref-type="bibr" rid="ref-16">Chen <italic>et al</italic>., 2019</xref>). Thus, an effective methodology in which a considerable amount of SCFAs reaching the skin in enough time need to be discovered.</p>
<p>The skin is a resilient organ that provides diverse microbial habitats. The role of skin microbes on the skin remain understudied, and their microbiome are largely unknown. Along with SCFA, MCFA also have anti-inflammatory properties; however, the lower absorption capacity of MCFA remains a drawback. SCFAs are not just secreted by gut commensal bacteria, and even skin microbiome ferments glycerol in the skin and produces SCFAs (<xref ref-type="bibr" rid="ref-65">Sahuri-Arisoylu <italic>et al</italic>., 2021</xref>). Glycerol metabolism in microorganisms has been investigated for &#x003E;50 years. Therefore, the period of SCFAs drifting from gut to skin will be minimized if it is already produced by the skin commensals. MCFA and LCFA are not produced by the skin microbes, and it is only available through the diet. The knowledge of the underlying mechanisms of SCFAs from skin commensals is not yet clear. Hence, we propose that understanding the functions of SCFAs which are secreted by skin microbes, will be more supportive in studying their effects on skin cancer. Considering all the published reports, SCFAs are non-toxic to skin cells; the role of SCFAs from skin microbiome in skin cancer needs to be discovered with the actual aim of avoiding the intense effects of chronic UVB. Overall, a better understanding of skin commensals could lead the way to reduce skin cancer burden.</p>
</sec>
</body>
<back>
<ack>
<p>We would like to thank the Centre for Biomaterials, Cellular &#x0026; Molecular Theranostics, School of Biosciences and Technology, Vellore Institute of Technology, Vellore.</p>
</ack>
<sec>
<title>Funding Statement</title>
<p>This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</p>
</sec>
<sec>
<title>Author Contributions</title>
<p>Conceptualization, literature search, and data analysis, writing-original draft preparation: Pavithra S; Reviewing and editing, approval, investigation: Dr. Raunak Kumar Das. All authors read and approved the final manuscript.</p>
</sec>
<sec sec-type="data-availability">
<title>Availability of Data and Materials</title>
<p>Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.</p>
</sec>
<sec>
<title>Ethics Approval</title>
<p>Not applicable.</p>
</sec>
<sec sec-type="COI-statement">
<title>Conflicts of Interest</title>
<p>The authors declare that they have no conflicts of interest to report regarding the present study.</p>
</sec>
<ref-list content-type="authoryear">
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