卵巢癌的免疫营养治疗研究现状
摘要
<正>目前,临床卵巢癌的基本治疗模式为手术联合化疗,但临床结局不理想。原因一方面是由于卵巢癌发现晚,2/3的患者发现时已处于晚期,难以实施理想的肿瘤细胞减灭术;另一方面肿瘤本身恶病质及日后化疗的不良反应,常引起机体抵抗力下降,导致肿瘤复发。免疫营养治疗作为继手术和化疗以外新的抗肿瘤治疗方法引起了人们的重视,下面就此领域的一些问题综述如下。1 免疫营养治疗的概念营养不良往往是导致卵巢癌临床结局不佳的重要风险因素[1]。肿瘤相关性营养不良
引文
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[8] Fukatsu K, Kudsk K A. Nutrition and gut immunity[J].Surg Clin North Am, 2011,91(4):755-770.
[9] Kich D M, Vincenzi A, Majolo F, et al. Probiotic: effectiveness nutrition in cancer treatment and prevention[J].Nutr Hosp, 2016,33(6):1430-1437.
[10] Greene E R, Huang S, Serhan C N, et al. Egulation of inflammation in cancer by eicosanoids[J].Prostaglandins Other Lipid Mediat, 2011,96(1-4):27-36.
[11] Andreoli A, De Lorenzo A, Cadeddu F, et al. New trends in nutritional status assessment of cancer patients[J].Eur Rev Med Pharmacol Sci, 2011,15(5):469-480.
[12] Talvas J, Garrait G, Goncalves-Mendes N, et al. Immunonutrition stimulates immune functions and antioxidant defense capacities of leukocytes in radiochemotherapy-treated head & neck and esophageal cancer patients: A double-blind randomized clinical trial[J].Clin Nutr, 2015,34(5):810-817.
[13] Kang K, Shu X L, Zhang Y S, et al. Effect of glutamine enriched nutrition support on surgical patients with gastrointestinal tumor: a meta-analysis of randomized controlled trials[J].Chin Med J (Engl), 2015,128(2):245-251.
[14] Caneba C A, Yang L, Baddour J, et al. Nitric oxide is a positive regulator of the Warburg effect in ovarian cancer cells[J].Cell Death Dis, 2014,5:e1302.
[15] Rajagopalan K N, DeBerardinis R J. Role of glutamine in cancer: therapeutic and imaging implications[J].J Nucl Med, 2011,52(7):1005-1008.
[16] Gul K, Muge A, Taner A, et al. Oral glutamine supplementation reduces radiotherapy-induced esophagitis in lung cancer patients[J].Asian Pac J Cancer Prev, 2015,16(1):53-58.
[17] Gerlach A T, Murphy C. An update on nutrition support in the critically ill[J].J Pharm Pract, 2011,24(1):70-77.
[18] Schlemmer M, Suchner U, Schapers B, et al. Is glutamine deficiency the link between inflammation, malnutrition, and fatigue in cancer patients?[J].Clin Nutr, 2015,34(6):1258-1265.
[19] 陈博,熊茂明,孟翔凌.免疫营养素临床应用的合理选择[J].华西医学,2018,33(3):354-358.
[20] Gaurav K, Goel R K, Shukla M, et al. Glutamine: A novel approach to chemotherapy-induced toxicity[J].Indian J Med Paediatr Oncol, 2012,33(1):13-20.
[21] Yuan L, Sheng X, Willson A K, et al. Glutamine promotes ovarian cancer cell proliferation through the mTOR/S6 pathway[J].Endocr Relat Cancer, 2015,22(4):577-591.
[22] Hensley C T, Wasti A T, DeBerardinis R J. Glutamine and cancer: cell biology, physiology, and clinical opportunities[J].J Clin Invest, 2013,123(9):3678-3684.
[23] Yang L, Moss T, Mangala L S, et al. Metabolic shifts toward glutamine regulate tumor growth, invasion and bioenergetics in ovarian cancer[J].Mol Syst Biol, 2014,5:728.
[24] 陆怡,濮丽英,周利群,等.免疫营养在恶性肿瘤治疗中的研究现状及进展[J].现代肿瘤医学,2017,25(22):3722-3726.
[25] Klek S, Szybinski P, Szczepanek K. Perioperative immunonutrition in surgical cancer patients: a summary of a decade of research[J].World J Surg, 2014,38(4):803-812.
[26] 陈亚军,齐玉梅.精氨酸免疫营养作用的研究进展[J].中国临床营养杂志,2007,15(5):310-314.
[27] Qiu F, Huang J, Sui M. Targeting arginine metabolism pathway to treat arginine-dependent cancers[J].Cancer Lett, 2015,364(1):1-7.
[28] Li P, Yin Y L, Li D, et al. Amino acids and immune function[J].Br J Nutr, 2007,98(2):237-252.
[29] 焦广宇,周春凌,孙长颢.不平衡氨基酸对卵巢癌多细胞球体生长影响[J].中国公共卫生,2007,23(7):837-838.
[30] Miraki-Moud F, Ghazaly E, Ariza-McNaughton L, et al. Arginine deprivation using pegylated arginine deiminase has activity against primary acute myeloid leukemia cells in vivo[J].Blood, 2015,125(26):4060-4068.
[31] Shuvayeva G, Bobak Y, Lqumentseva N, et al. Single amino acid arginine deprivation triggers prosurvival autophagic response in ovarian carcinoma SKOV3[J].Biomed Res Int, 2014,2014:505041.
[32] Rath M, Muller I, Kropf P, et al. Metabolism via Arginase or Nitric Oxide Synthase: Two Competing Arginine Pathways in Macrophages[J].Front Immunol, 2014,5:532.
[33] Bossola M, Pacelli F, Rosa F, et al. Does nutrition support stimulate tumor growth in humans?[J].Nutr Clin Pract, 2011,26(2):174-180.
[34] Alizadeh F, Bolhassani A, Khawari A, et al. Retinoids and their biological effects against cancer[J].Int Immunopharmacol, 2014,18(1):43-49.
[35] Harris H R, Cramer D W, Vitonis A F, et al. Folate, vitamin B(6) , vitamin B(12) , methionine and alcohol intake in relation to ovarian cancer risk[J].Int J Cancer, 2012,131(4):E518-E529.
[36] Matxain J M, Padro D, Ristila M, et al. Evidence of high *OH radical quenching efficiency by vitamin B6[J].J Phys Chem B, 2009,113(29):9629-9632.
[37] Perez-Lopez F R. Sunlight, the vitamin D endocrine system, and their relationships with gynaecologic cancer[J].Maturitas, 2008,59(2):101-113.
[38] Yin L, Grandi N, Raum E, et al. Meta-analysis: Circulating vitamin D and ovarian cancer risk[J].Gynecol Oncol, 2011,121(2):369-375.
[39] Webb P M, de Fazio A, Protani M M, et al. Circulating 25-hydroxyvitamin D and survival in women with ovarian cancer[J].Am J Clin Nutr, 2015,102(1):109-114.
[40] Safarzadeh E, Sandoghchian Shotorbani S, Baradaran B. Herbal medicine as inducers of apoptosis in cancer treatment[J].Adv Pharm Bull, 2014,4(Suppl 1):421-427.
[41] Niedzwiecki A, Roomi M W, Kalinovsky T, et al. Anticancer Efficacy of Polyphenols and Their Combinations[J].Nutrients, 2016,8(9). pii:E552.
[42] Zimmermann M C, Tilghman S L, Boue S M, et al. Glyceollin I, a novel antiestrogenic phytoalexin isolated from activated soy[J].J Pharmacol Exp Ther, 2010,332(1):35-45.
[43] Xin T, Zhang F, Jiang Q, et al. Extraction, purification and antitumor activity of a water-soluble polysaccharide from the roots of Polygala tenuifolia[J].Carbohydr Polym, 2012,90(2):1127-1131.
[44] 李研.白藜芦醇对荷卵巢癌大鼠免疫功能的影响[J].医学研究杂志,2016,45(5):122-125,99.
[45] Barua A, Bradaric M J, Bitterman P, et al. Dietary supplementation of Ashwagandha (Withania somnifera, Dunal) enhances NK cell function in ovarian tumors in the laying hen model of spontaneous ovarian cancer[J].Am J Reprod Immunol, 2013,70(6):538-550.
[2] Oberholzer R, Hopkinson J B, Baumann K, et al. Psychosocial effects of cancer cachexia: a systematic literature search and qualitative analysis[J].J Pain Symptom Manage, 2013,46(1):77-95.
[3] Moya P, Miranda E, Soriano-Irigaray L, et al. Perioperative immunonutrition in normo-nourished patients undergoing laparoscopic colorectal resection[J].Surg Endosc, 2016,30(11):4946-4953.
[4] Liu Y D, Cui J W. Cancer nutritional immunology therpy[J].Electron J Metab Nutr Cancer, 2015,2(4):19-24.
[5] Laky B, Janda M, Cleghorn G, et al. Comparison of different nutritional assessments and body-composition measurements in detecting malnutrition among gynecologic cancer patients[J].Am J Clin Nutr, 2008,87(6):1678-1685.
[6] Skipworth R J, Fearon K C. The scientific rationale for optimizing nutritional support in cancer[J].Eur J Gastroenterol Hepatol, 2007,19(5):371-377.
[7] Prieto I, Montemuino S, Luna J, et al. The role of immunonutritional support in cancer treatment: Current evidence[J].Clin Nutr, 2017,36(6):1457-1464.
[8] Fukatsu K, Kudsk K A. Nutrition and gut immunity[J].Surg Clin North Am, 2011,91(4):755-770.
[9] Kich D M, Vincenzi A, Majolo F, et al. Probiotic: effectiveness nutrition in cancer treatment and prevention[J].Nutr Hosp, 2016,33(6):1430-1437.
[10] Greene E R, Huang S, Serhan C N, et al. Egulation of inflammation in cancer by eicosanoids[J].Prostaglandins Other Lipid Mediat, 2011,96(1-4):27-36.
[11] Andreoli A, De Lorenzo A, Cadeddu F, et al. New trends in nutritional status assessment of cancer patients[J].Eur Rev Med Pharmacol Sci, 2011,15(5):469-480.
[12] Talvas J, Garrait G, Goncalves-Mendes N, et al. Immunonutrition stimulates immune functions and antioxidant defense capacities of leukocytes in radiochemotherapy-treated head & neck and esophageal cancer patients: A double-blind randomized clinical trial[J].Clin Nutr, 2015,34(5):810-817.
[13] Kang K, Shu X L, Zhang Y S, et al. Effect of glutamine enriched nutrition support on surgical patients with gastrointestinal tumor: a meta-analysis of randomized controlled trials[J].Chin Med J (Engl), 2015,128(2):245-251.
[14] Caneba C A, Yang L, Baddour J, et al. Nitric oxide is a positive regulator of the Warburg effect in ovarian cancer cells[J].Cell Death Dis, 2014,5:e1302.
[15] Rajagopalan K N, DeBerardinis R J. Role of glutamine in cancer: therapeutic and imaging implications[J].J Nucl Med, 2011,52(7):1005-1008.
[16] Gul K, Muge A, Taner A, et al. Oral glutamine supplementation reduces radiotherapy-induced esophagitis in lung cancer patients[J].Asian Pac J Cancer Prev, 2015,16(1):53-58.
[17] Gerlach A T, Murphy C. An update on nutrition support in the critically ill[J].J Pharm Pract, 2011,24(1):70-77.
[18] Schlemmer M, Suchner U, Schapers B, et al. Is glutamine deficiency the link between inflammation, malnutrition, and fatigue in cancer patients?[J].Clin Nutr, 2015,34(6):1258-1265.
[19] 陈博,熊茂明,孟翔凌.免疫营养素临床应用的合理选择[J].华西医学,2018,33(3):354-358.
[20] Gaurav K, Goel R K, Shukla M, et al. Glutamine: A novel approach to chemotherapy-induced toxicity[J].Indian J Med Paediatr Oncol, 2012,33(1):13-20.
[21] Yuan L, Sheng X, Willson A K, et al. Glutamine promotes ovarian cancer cell proliferation through the mTOR/S6 pathway[J].Endocr Relat Cancer, 2015,22(4):577-591.
[22] Hensley C T, Wasti A T, DeBerardinis R J. Glutamine and cancer: cell biology, physiology, and clinical opportunities[J].J Clin Invest, 2013,123(9):3678-3684.
[23] Yang L, Moss T, Mangala L S, et al. Metabolic shifts toward glutamine regulate tumor growth, invasion and bioenergetics in ovarian cancer[J].Mol Syst Biol, 2014,5:728.
[24] 陆怡,濮丽英,周利群,等.免疫营养在恶性肿瘤治疗中的研究现状及进展[J].现代肿瘤医学,2017,25(22):3722-3726.
[25] Klek S, Szybinski P, Szczepanek K. Perioperative immunonutrition in surgical cancer patients: a summary of a decade of research[J].World J Surg, 2014,38(4):803-812.
[26] 陈亚军,齐玉梅.精氨酸免疫营养作用的研究进展[J].中国临床营养杂志,2007,15(5):310-314.
[27] Qiu F, Huang J, Sui M. Targeting arginine metabolism pathway to treat arginine-dependent cancers[J].Cancer Lett, 2015,364(1):1-7.
[28] Li P, Yin Y L, Li D, et al. Amino acids and immune function[J].Br J Nutr, 2007,98(2):237-252.
[29] 焦广宇,周春凌,孙长颢.不平衡氨基酸对卵巢癌多细胞球体生长影响[J].中国公共卫生,2007,23(7):837-838.
[30] Miraki-Moud F, Ghazaly E, Ariza-McNaughton L, et al. Arginine deprivation using pegylated arginine deiminase has activity against primary acute myeloid leukemia cells in vivo[J].Blood, 2015,125(26):4060-4068.
[31] Shuvayeva G, Bobak Y, Lqumentseva N, et al. Single amino acid arginine deprivation triggers prosurvival autophagic response in ovarian carcinoma SKOV3[J].Biomed Res Int, 2014,2014:505041.
[32] Rath M, Muller I, Kropf P, et al. Metabolism via Arginase or Nitric Oxide Synthase: Two Competing Arginine Pathways in Macrophages[J].Front Immunol, 2014,5:532.
[33] Bossola M, Pacelli F, Rosa F, et al. Does nutrition support stimulate tumor growth in humans?[J].Nutr Clin Pract, 2011,26(2):174-180.
[34] Alizadeh F, Bolhassani A, Khawari A, et al. Retinoids and their biological effects against cancer[J].Int Immunopharmacol, 2014,18(1):43-49.
[35] Harris H R, Cramer D W, Vitonis A F, et al. Folate, vitamin B(6) , vitamin B(12) , methionine and alcohol intake in relation to ovarian cancer risk[J].Int J Cancer, 2012,131(4):E518-E529.
[36] Matxain J M, Padro D, Ristila M, et al. Evidence of high *OH radical quenching efficiency by vitamin B6[J].J Phys Chem B, 2009,113(29):9629-9632.
[37] Perez-Lopez F R. Sunlight, the vitamin D endocrine system, and their relationships with gynaecologic cancer[J].Maturitas, 2008,59(2):101-113.
[38] Yin L, Grandi N, Raum E, et al. Meta-analysis: Circulating vitamin D and ovarian cancer risk[J].Gynecol Oncol, 2011,121(2):369-375.
[39] Webb P M, de Fazio A, Protani M M, et al. Circulating 25-hydroxyvitamin D and survival in women with ovarian cancer[J].Am J Clin Nutr, 2015,102(1):109-114.
[40] Safarzadeh E, Sandoghchian Shotorbani S, Baradaran B. Herbal medicine as inducers of apoptosis in cancer treatment[J].Adv Pharm Bull, 2014,4(Suppl 1):421-427.
[41] Niedzwiecki A, Roomi M W, Kalinovsky T, et al. Anticancer Efficacy of Polyphenols and Their Combinations[J].Nutrients, 2016,8(9). pii:E552.
[42] Zimmermann M C, Tilghman S L, Boue S M, et al. Glyceollin I, a novel antiestrogenic phytoalexin isolated from activated soy[J].J Pharmacol Exp Ther, 2010,332(1):35-45.
[43] Xin T, Zhang F, Jiang Q, et al. Extraction, purification and antitumor activity of a water-soluble polysaccharide from the roots of Polygala tenuifolia[J].Carbohydr Polym, 2012,90(2):1127-1131.
[44] 李研.白藜芦醇对荷卵巢癌大鼠免疫功能的影响[J].医学研究杂志,2016,45(5):122-125,99.
[45] Barua A, Bradaric M J, Bitterman P, et al. Dietary supplementation of Ashwagandha (Withania somnifera, Dunal) enhances NK cell function in ovarian tumors in the laying hen model of spontaneous ovarian cancer[J].Am J Reprod Immunol, 2013,70(6):538-550.