Fucosylation stands as a pivotal post-translational modification intricately woven into the molecular fabric of cellular biology. This biochemical process facilitates the transfer of fucose, a hexose sugar, onto glycoproteins and glycolipids, thereby modulating a spectrum of physiological phenomena. Recent research in molecular medicine has cast fucosylation into the limelight, revealing its profound influence on the pathogenesis of digestive inflammatory diseases and various cancers. The enzymatic orchestration of fucosylation, primarily governed by fucosyltransferases (FUTs), plays a critical role in cell-cell adhesion, intracellular signal transduction, and immune system regulation, underscoring its importance in maintaining homeostasis within the gastrointestinal landscape.

Emerging evidence elucidates the molecular nuances of aberrant fucosylation, shedding light on its association with pathological conditions affecting major digestive organs, including the intestine, stomach, liver, and pancreas. Dysregulated fucosylation patterns have been implicated in disrupting epithelial barrier integrity, thereby fostering an inflammatory milieu conducive to disease progression. Furthermore, the complexity of fucosylated glycan structures intercedes in microbial colonization dynamics, influencing host-pathogen interactions and the immune microenvironment. Such findings propel fucosylation to the forefront as a biomolecular determinant in digestive disease etiology.

At the genetic level, mutations and polymorphisms within FUT genes emerge as key modulators of disease susceptibility. Alterations in FUT gene expression can lead to enzymatic dysfunction, resulting in altered fucosylation landscapes that compromise cellular communication and immune responses. For instance, in inflammatory bowel disease (IBD), these genetic variations affect fucosylation-mediated modulation of the gut microbiota, shifting the balance towards pathogenic bacterial populations. This dysbiosis exacerbates mucosal inflammation and contributes to the chronicity observed in IBD, revealing a direct molecular link between FUT genetics and gastrointestinal pathology.

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The pathogenic bacterium Helicobacter pylori exemplifies the critical role of fucosylated glycans in host-microbe interactions within the gastric niche. H. pylori exploits specific fucosylated structures on gastric epithelial cells to adhere and invade, processes that are instrumental in initiating gastric mucosal inflammation and subsequent carcinogenesis. Aberrant fucosylation enhances the adhesive capabilities of H. pylori, facilitating chronic infection and promoting oncogenic transformation. These insights pave the way for exploring fucosylation-targeted interventions as viable strategies to combat gastric cancer predisposition linked to persistent H. pylori infection.

In hepatology, aberrant fucosylation has been closely linked to the pathophysiology of liver cirrhosis and hepatocellular carcinoma (HCC). Changes in fucosylation patterns on serum glycoproteins serve as clinical biomarkers, differentiating malignant and benign hepatic conditions with increasing precision. The elevated presence of fucosylated antigens in circulation reflects underlying hepatic cellular dysregulation and tumorigenesis. Such glycomic signatures not only improve diagnostic accuracy but also offer prognostic insights, underscoring the translational potential of fucosylation research in hepatocellular disease management.

Pancreatic cancer, notable for its aggressiveness and chemoresistance, also exhibits distinct fucosylation alterations. Specific fucosylation motifs correlate with tumor progression, invasiveness, and resistance to conventional chemotherapy. Mechanistically, these modifications influence tumor microenvironment interactions and immune evasion pathways, contributing to the dismal clinical outcomes often observed. Understanding the role of fucosylation in pancreatic oncology opens avenues for novel biomarkers and therapeutic targets aimed at overcoming treatment barriers.

The burgeoning field of therapeutic modulation of fucosylation is gaining momentum, heralding an era of precision medicine tailored to glycosylation profiles. Fucose-based therapeutics and selective fucosylation inhibitors have demonstrated promising efficacy in experimental models by restoring normal glycan structures and attenuating pathological immune responses. These interventions aim to recalibrate aberrant signaling pathways intrinsic to disease progression, reducing tumor growth and enhancing immune surveillance. Such targeted approaches offer hope for improved clinical outcomes across a spectrum of digestive diseases and cancers driven by fucosylation dysregulation.

Critical to these advances is the elucidation of underlying molecular mechanisms governing fucosylation. High-resolution glycomics and advanced enzymology have uncovered the substrate specificity, reaction kinetics, and regulation of FUT family enzymes, providing a refined understanding of their biological roles. This mechanistic knowledge supports the rational design of inhibitors and mimetics capable of modulating fucosylation with high fidelity, minimizing off-target effects and maximizing therapeutic benefit.

Importantly, the immunomodulatory effects of fucosylation extend beyond the digestive system, highlighting its systemic relevance. Fucosylated glycans modulate immune cell trafficking, antigen presentation, and cytokine production, processes vital to both homeostatic and pathological inflammation. Dysregulated fucosylation thus amplifies immune dysregulation seen in chronic inflammatory diseases, further accentuating its potential as a therapeutic target. Translational research continues to explore the immunobiological intricacies of fucosylation, aiming to harness its regulatory capacity for clinical intervention.

Diagnostic innovations leveraging fucosylation biomarkers are transforming clinical practice, enabling earlier detection and improved disease stratification. Mass spectrometry-based glycoproteomic profiling and high-affinity lectin assays have elevated sensitivity and specificity in identifying fucosylated moieties linked to digestive malignancies and fibrosis. These technological strides support personalized monitoring and facilitate real-time assessment of therapeutic responses, embedding fucosylation analysis into precision oncology and hepatology workflows.

The intersection of fucosylation with the microbiome epitomizes the complexity of host-environment interactions in digestive health. Specific fucosylated structures serve as nutrient sources or attachment sites for commensal and pathogenic microbes, influencing microbial ecology. Altered fucosylation disturbs this balance, precipitating dysbiosis and metabolic imbalances that exacerbate inflammation and promote carcinogenesis. Integrative studies combining glycomics, microbiology, and immunology are dissecting these multifaceted relationships, fostering a holistic approach to disease understanding and management.

Future directions in fucosylation research incorporate genome editing technologies and synthetic biology to model and manipulate glycosylation pathways. CRISPR/Cas-mediated FUT gene editing and glycoengineering approaches enable precise modulation of fucosylation patterns in vitro and in vivo, facilitating functional studies and drug development. These cutting-edge methods hold the promise of unveiling novel fucosylation-dependent mechanisms and accelerating the translation of basic science into therapeutic innovations.

In summary, fucosylation emerges as a central biochemical process intricately linked to the pathogenesis of digestive inflammatory diseases and cancers. The convergence of genetic, enzymatic, immunological, and microbiome research delineates its crucial role in disease initiation and progression. Therapeutically, the precise targeting of fucosylation pathways offers a promising frontier for the development of personalized interventions aimed at improving patient outcomes. As scientific understanding deepens, fucosylation-based diagnostics and treatments are poised to become integral components of biomedical research and clinical practice in gastroenterology and oncology.

Subject of Research: Fucosylation in digestive inflammatory diseases and cancers

Article Title: Fucosylation in digestive inflammatory diseases and cancers: From mechanical studies to clinical translation

News Publication Date: 1-Nov-2025

References: Caihan Duan, Junhao Wu, Zhe Wang, Xiaohua Hou, Chaoqun Han, Fucosylation in digestive inflammatory diseases and cancers: From mechanical studies to clinical translation, Genes & Diseases, Volume 12, Issue 6, 2025, 101570, DOI: 10.1016/j.gendis.2025.101570

Image Credits: Genes & Diseases

Keywords: Cancer genetics

Tags: aberrant fucosylation and disease progressionffucosylated glycan structures in microbiome interactionsfucosylation and inflammatory diseasesfucosylation in digestive diseasesfucosylation in gastrointestinal healthfucosylation’s effect on epithelial barrier integritygenetic variations in FUT genesimpact of fucosylation on immune regulationmolecular mechanisms of fucosylationpost-translational modifications in cancerrole of fucosyltransferases in cancer