孕期黄酮类化合物摄入与婴幼儿白血病相关性研究的现状

Maternal flavonoids intake and infant leukemia

目的:探讨黄酮类化合物作为DNA拓扑异构酶Ⅱ抑制剂以及孕期黄酮类化合物摄入与婴幼儿白血病间的关系。方法:应用PubMed、万方和维普科技期刊数据库检索系统,以"黄酮类化合物、白血病和拓扑异构酶Ⅱ抑制剂"为关键词,检索1987-01-2012-09的相关文献,共检索到英文文献7条,中文文献0条,以任意2个关键词搜索,共检索到英文文献1 445条,中文文献108条。纳入标准:1)黄酮类化合物的基本资料介绍。2)婴幼儿白血病的基本资料介绍。3)拓扑异构酶及拓扑异构酶Ⅱ抑制剂的基本资料介绍。4)拓扑异构酶Ⅱ抑制剂与白血病的关系。5)黄酮类化合物与婴幼儿白血病的关系。根据纳入标准精选46篇文献,最后纳入分析32篇。结果:黄酮类化合物广泛存在于日常食物中,对人类健康有许多积极作用。但是,黄酮类化合物作为拓扑异构酶Ⅱ抑制剂也存在遗传毒性、细胞毒性,某些实体瘤患者在应用DNA拓扑异构酶Ⅱ抑制剂治疗后可继发白血病,其细胞遗传学异常多与原发急性髓系白血病(AML)有关,其中最常见的是位于染色体11q23的混合系白血病(MLL)基因异位。孕期黄酮类化合物摄入与婴幼儿某种类型白血病的发生风险增高有一定的关系。在急性婴幼儿白血病患者中,>80%都包括位于染色体11q23的MLL基因异位或异常重组。样本量均超过200例的5个病例对照研究显示,孕期摄入大量含DNA拓扑异构酶Ⅱ抑制剂的食物(主要为含黄酮类化合物的水果和蔬菜等)后,MLL重排引起的AML的发病风险增高。结论:了解黄酮类化合物作为DNA拓扑异构酶Ⅱ抑制剂以及孕期黄酮类化合物摄入与婴幼儿白血病间的关系,有助于孕妇膳食指导及膳食指南的修订与完善。

OBJECTIVE：To explore whether flavonoids as the DNA topoisomerase Ⅱ inhibitors have risks on infant leukemia during maternal flavonoids intake. METHODS：By inputting the keywords ＂flavonoids,leukemia and topoisomerase Ⅱ inhibitors＂ in literature searching tool such as PubMed, Chinese Science and Technology Periodical Database （WANFANG DATA and VIP information） from January 1987 to September 2012, only 7 English literatures have been found. Searched by any of the above two key words, 1445 English and 108 Chinese literatures have been shown. Inclusive criteria are as following：1） the basic information of the flavonoids;2） the basic information of the infant leukemia;3） the basic information of topoisomerase and topoisomerase IT inhibitors; 4） the relationship between topoisomerase Ⅱ inhibitors and leukemia~ 5） the relationship between flavonoids and infant leukemia. According to these criteria,46 articles were selected and finally 32 literatures were analyzed into this review. RESULTS ： Flavonoids are widely presented in daily food. They have many positive effects on human health. However,they have genotoxicity and cytotoxicity. Some patients with solid tumors after treatment with DNA topoisomerase Ⅱ inhibitors may be secondary leukemia. Cytogenetic abnormalities are always associated with AML, the most common of which is located on chromosome 11q23 MLL gene＇s rearrangements. Maternal intake of flavonoids may increase the risk of certain type of infant leukemia. More than 80% of acute inrant leukemia cases include MLL gene＇s rearrangements which is located on chromosome 11q23. Sample volume of more than 200 cases of five case-control studies have shown： Maternal intake of flavonoids which contains DNA topoisomerase Ⅱ inhibitors （mainly including fruits and vegetables containing flavonoids） may increase the risk of AML induced by MLL rearrangements. CONCLUSION：Investigation of flavonoids as DNA topoisomerase Ⅱinhibitors,as well as the relationship between maternal flavonoids intake and infant leukemia will contribute to the revision and improvement of maternal dietary guideline.