β-羟基-β-甲基丁酸治疗肿瘤恶病质的研究进展

Research Progress of β-Hydroxy-β-Methylbutyrate in Treatment of Cancer Cachexia

肿瘤恶病质是一种多因素疾病,以骨骼肌量持续下降为主要特征。保持肌肉质量不仅关系到肿瘤恶病质患者进行日常生活活动的能力,而且是肿瘤恶病质患者生存的关键决定因素。就营养治疗而言,亮氨酸代谢产物β-羟基-β-甲基丁酸(HMB)可激活蛋白质合成和骨骼肌生长之间的信号通路,抑制蛋白质降解,减轻炎症反应,并促进肌肉再生及减轻肿瘤负荷等。联合应用HMB在肿瘤恶病质患者中显示出良好的疗效。因此,补充HMB可能是多模式治疗肿瘤恶病质的有效方式,但单独施用HMB的临床价值有待进一步研究。

Cancer cachexia is a multifactorial disease characterized by a sustained decline in skeletal muscle mass.Maintaining muscle mass is not only related to the ability of patients with cancer cachexia to perform activities of daily living,but also a key determinant of the survival of the patients.In terms of nutritional therapy,the leucine metaboliteβ-hydroxy-β-methylbutyrate(HMB)activates the signaling pathway between protein synthesis and skeletal muscle growth,inhibits protein degradation,reduces inflammation,promotes muscle regeneration and reduces tumor burden.Combined use of HMB shows good efficacy in patients with cancer cachexia.Therefore,supplementation of HMB may be an effective way to treat cancer cachexia by multi-mode therapy,but the clinical value of HMB alone needs further studies.