免疫营养素在恶性肿瘤防治中的研究进展

The research progress of immunonutrients in the prevention and treatment of malignant tumors

伴随对恶性肿瘤免疫机制研究的深入,免疫营养素的研究和临床运用也在不断创新发展。多种免疫营养素通过抗炎、增强各类免疫细胞功能、抑制恶性肿瘤细胞增殖和转移及促进恶性肿瘤细胞凋亡等机制,来预防恶性肿瘤发生、降低恶性肿瘤对部分化疗药物的耐药性、减轻恶性肿瘤术后各类并发症、缩短住院时间及加速免疫功能和营养状况的恢复等,但由于缺乏大样本、高质量研究的证据,目前对谷氨酰胺(Gln)、精氨酸(Arg)、ω-3多不饱和脂肪酸(ω-3PUFAs)、维生素等免疫营养素在恶性肿瘤的预防、治疗和预后作用上依然没有达成一致结论。本文旨在系统综述蛋白质类免疫营养素(谷氨酰胺、精氨酸)、脂肪酸类免疫营养素(ω-3 PUFAs)、微量营养素(维生素、硒)、微生态免疫营养素(合生元)、植物提取物免疫营养素(人参皂苷)在恶性肿瘤防治中的作用机制和临床疗效,探索各类免疫营养素的优点和自身局限性,以便为免疫营养素抗恶性肿瘤的深入研究和临床联合用药提供思路和依据。

With the deepening research on the immune mechanisms of malignant tumors,the study and clinical application of immunonutrients are continually advancing and innovating.A multitude of studies have shown that various immunonutrients can prevent the occurrence of malignant tumors,reduce resistance to certain chemotherapeutic drugs,alleviate postoperative complications,shorten hospital stays,and expedite recovery of immune function and nutritional status through mechanisms such as anti-inflammation,enhancement of immune cell functions,inhibition of malignant tumor cell proliferation and metastasis,as well as induction of tumor cell apoptosis.However,despite this extensive research,there is currently no consensus on the preventive,therapeutic,and prognostic roles of immunonutrients like glutamine,arginine,ω-3 polyunsaturated fatty acids,and vitamins in the context of malignant tumors,due to the scarcity of large-scale,high-quality evidence.This article aims to systematically review the mechanistic roles and clinical efficacies of protein-based immunonutrients(glutamine and arginine),fatty acid-based immunonutrients(ω-3 polyunsaturated fatty acids),micronutrients(vitamins and selenium),microecological immunonutrients(synbiotics),and plant extract-based immunonutrients(ginsenosides)in the context of malignant tumor prevention and management.The objective is to explore the distinct features and inherent limitations of these different categories of immunonutrients,thereby providing a foundation and direction for further in-depth research on the use of immunonutrients against malignant tumors and their integration into clinical practice.