免疫营养素抗恶性肿瘤作用及其临床应用

The effect of immune-modulating nutrients on malignant tumors and their clinical use

恶性肿瘤患者多伴有免疫抑制和营养不良。在恶性肿瘤患者营养配方中添加一些同时具有增强免疫和营养支持的药物即免疫营养素,不但可以改善肿瘤恶病质,而且可以发挥调节免疫的作用,兼有改善患者营养状况和抗肿瘤治疗的作用,这类具有免疫药理作用的营养物质被称为免疫营养素。目前研究较多并已开始应用于临床的免疫营养素包括谷氨酰胺(Gln)、精氨酸(Arg)、ω-3多不饱和脂肪酸(ω-3 PUFAs)、支链氨基酸(BCAA)、微生态制剂、核苷酸(Nt)和膳食纤维(DF)等。本文对常用免疫营养素的药理作用、抗肿瘤作用及其临床应用进行综述,以期为临床更好地改善恶性肿瘤患者营养状况和疗效提供参考。

Patients with malignant tumors often have immunosuppression and malnutrition. Some substances that enhance immunity and provide nutritional support are added to the nutritional formula of patients. These immune-modulating nutrients can alleviate cancer cachexia and also play a role in regulating the immune system in conjunction with a patient’s improved nutritional status and the action of anti-tumor therapy. Nutrients with an immunological effect are called immune-modulating nutrients. Many immune-modulating nutrients, including glutamine(Gln), arginine(Arg),ω-3 PUFAs, branched chain amino acids(BCAA), micro-ecological preparations, nucleotides(Nts), and dietary fiber(DF), have been studied and are initially being used in clinical practice. However, there is still some debate since the evidence of their efficacy is weak and there are concerns over whether immune-modulating nutrients might promote the growth of tumor cells, decrease the efficacy of chemoradiotherapy, and foster resistance to chemotherapy drugs. This review summarizes the pharmacological effects, anti-tumor action, and clinical use of common immune-modulating nutrients in order to provide a reference for improving the nutritional status of patients with malignant tumors and the efficacy of their treatment.