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  1. Sarkawi M, Raja Ali RA, Abdul Wahab N, Abdul Rathi ND, Mokhtar NM
    Sci Rep, 2024 Apr 25;14(1):9478.
    PMID: 38658619 DOI: 10.1038/s41598-024-60029-2
    Irritable bowel syndrome (IBS) is frequently linked with coexisting mental illnesses. Our previous study discovered that 32.1% of IBS patients had subthreshold depression (SD), placing them at higher risk of developing major depression. Gut microbiota modulation through psychobiotics was found to influence depression via the gut-brain axis. However, the efficacy of lessening depression among IBS patients remains ambiguous. The study's aim was to investigate the roles of cultured milk drinks containing 109 cfu Lactobacillus acidophilus LA-5 and Lactobacillus paracasei L. CASEI-01 on depression and related variables among IBS participants with SD. A total of 110 IBS participants with normal mood (NM) and SD, were randomly assigned to one of four intervention groups: IBS-NM with placebo, IBS-NM with probiotic, IBS-SD with placebo, and IBS-SD with probiotic. Each participant was required to consume two bottles of cultured milk every day for a duration of 12 weeks. The following outcomes were assessed: depression risk, quality of life, the severity of IBS, and hormonal changes. The depression scores were significantly reduced in IBS-SD with probiotic and placebo from baseline (p 
  2. Kendong SMA, Razali NN, Bo MS, Sarkawi M, Mokhtar MH, Hamid AA
    In Vivo, 2026;40(6):3297-3310.
    PMID: 42957227 DOI: 10.21873/invivo.14478
    The global incidence of colorectal cancer (CRC) is rising at an alarming rate, particularly among individuals under the age of 50, referred to as early-onset CRC (EOCRC). While genetic predisposition accounts for approximately 20% of the total cases, the majority are influenced by environmental and lifestyle factors. Among these, the rising prevalence of obesity is a major modifiable contributor to EOCRC pathogenesis. This narrative review explores the multifaceted role of obesity in EOCRC, focusing on how diet-induced adiposity reshapes the gut microbiota and host metabolic signaling. We synthesize evidence on how obesity-associated dysbiosis, characterized by the depletion of protective, short-chain fatty acid (SCFA)-producing bacteria and the enrichment of genotoxic pathobionts, compromises intestinal barrier integrity and promotes a "leaky gut" phenotype. In addition, we explore the systemic consequences of obesity-driven inflammation, including M1-polarized macrophage infiltration into adipose tissue, dysregulated adipokine signaling, and the hyperactivation of the insulin-IGF-1 axis. By integrating epidemiological data with molecular mechanisms, this review highlights how the synergy between metabolic dysfunction and microbial alterations creates a fertile niche for early-onset carcinogenesis. These findings underscore the importance of targeting lifestyle interventions to mitigate the rising burden of obesity and reduce the risk of EOCRC progression.
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