Alpha-linolenic acid reverses colorectal cancer drug resistance by suppressing secreted phosphoprotein 1 expression and tumor stemness.

[BACKGROUND] Chemotherapy remains the main treatment for colon cancer, but the development of resistance has limited its efficacy. There is an urgent need to exploit a more effective therapeutic strategy. Alpha-linolenic acid (ALA), as an essential nutrient for the human body, has been found to increase the therapeutic effect of chemotherapy drugs.

[PURPOSE] Exploring the potential mechanism of alpha linolenic acid reversing chemotherapy resistance in colon cancer.

[RESULTS] ALA reverses chemoresistance in colorectal cancer and suppresses stemness in resistant colorectal cancer cells. SPP1 functions as a key mediator in ALA-induced reversal of chemoresistance; its downregulation disrupts the interaction with the downstream receptor CD44, thereby mitigating chemotherapy resistance. Subsequently, ALA inhibits the expression of SOX2, a transcription factor that promotes SPP1 transcription. Further analysis reveals that decreased SPP1 expression leads to reduced levels of FAP, a marker of cancer-associated fibroblasts (CAFs), and that a functional interaction exists between SPP1 and FAP. Interestingly, ALA disrupts the interaction between SPP1 and FAP, thereby preventing CAFs accumulation. In vivo studies confirm that ALA reverses colorectal cancer chemoresistance via the SOX2/SPP1/FAP signaling axis.

[CONCLUSION] The study demonstrates that ALA in quinoa depresses the stemness of colorectal cancer and reduces the number of CAFs via SPP1, thereby reversing chemotherapy resistance. These findings highlight ALA as a promising dietary-based adjuvant for enhancing chemotherapy efficacy in colorectal cancer and provide new mechanistic insights into targeting tumor stemness and stromal remodeling.