{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:16:03Z","timestamp":1788419763083,"version":"build-2803163510"},"reference-count":127,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:p>\n                    The gut microbiota is a critical modulator of intestinal inflammation and colorectal cancer (CRC), yet the specific microbial drivers that bridge inflammatory bowel disease (IBD) to rectal carcinogenesis remain poorly defined.\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    (\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    ) has recently emerged as a compelling candidate at this nexus; however, several critical questions remain unresolved: (i) whether\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    colonization is a cause or a consequence of rectal carcinogenesis; (ii) how strain level heterogeneity determines pathogenic versus commensal outcomes; and (iii) which rectal microenvironmental factors selectively amplify its carcinogenic potential. Moreover, the potential utility of persistent colonization with carcinogenic\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    strains as a predictive biomarker and target for chemoprevention warrants further investigation. This review systematically addresses these questions by integrating findings from microbial ecology, virulence factor biology, host immunology, and oncogenic signaling. We dissect the dual role of\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    along the inflammation cancer axis, focusing on its capacity to promote T helper 17 (Th17) driven inflammation, disrupt the epithelial barrier, and directly alkylate host DNA via colibactin-like genotoxins. We propose a mechanistic framework in which chronic\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    colonization acts as a bridge between IBD activity and rectal tumorigenesis, and we critically evaluate the potential of phage therapy, virulence inhibitors, and microbiome-based biomarkers to intercept this process. Finally, we highlight key knowledge gaps and outline future directions required to establish causality and translate these insights into clinical strategies for IBD associated rectal cancer prevention.\n                  <\/jats:p>","DOI":"10.3389\/fmicb.2026.1948813","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:43:23Z","timestamp":1788417803000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Klebsiella pneumoniae in inflammatory bowel disease and rectal cancer: from gut inflammation to a potential driver of carcinogenesis"],"prefix":"10.3389","volume":"17","author":[{"given":"Shuxin","family":"Xiong","sequence":"first","affiliation":[{"name":"Biomedical Research Institute, Hubei University of Medicine, Shiyan","place":["Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Yao","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering, Hubei University of Medicine, Shiyan","place":["Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1196\/annals.1378.063","article-title":"Targeting signal-transducer-and-activator-of-transcription-3 for prevention and therapy of cancer: Modern target but ancient solution.","volume":"1091","author":"Aggarwal","year":"2006","journal-title":"Ann. 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