肠道微生态与白血病患者肌肉减少症相关性的研究进展

Research progress on the correlation between intestinal microecology and sarcopenia in leukemia patients

白血病患者因造血干细胞移植前大剂量化疗预处理,以及移植后的急、慢性移植物抗宿主病(graft-versus-host disease,GVHD)等使其肌肉减少症(sarcopenia,SP)发病率整体高于老年人群以及其他实体肿瘤患者。SP严重影响白血病患者生存质量,增加病死率,因此通过识别并控制危险因素来预防白血病患者相关SP的发生显得尤为重要。然而SP发病机制尚不清楚,目前主要认为是各种原因导致的肌肉蛋白质合成和分解代谢失衡,这一过程中肠道微生态的变化对其影响尤为突出。现有研究表明肠道微生态失调可能通过影响骨骼肌的营养代谢和增加体内炎症反应等机制导致肌肉质量和功能的变化。但目前涉及到白血病患者SP的相关研究较少,对肠道微生态与白血病相关SP的相关性暂无系统的描述与总结。因此,该文将综述近年来白血病患者SP发病情况的研究与报道,探讨肠道微生态与白血病相关SP之间的关系和可能的作用机制,为预防白血病相关SP提供理论基础。

The prevalence of sarcopenia(SP)in patients with leukaemia surpasses that of elderly individuals and those with other solid tumours.This is due to the administration of high-dose chemotherapy before hematopoietic stem cell transplantation as well as acute and chronic graft-versus-host disease(GVHD)following transplantation.SP has a deleterious effect on patients'quality of life and increases morbidity and mortality rates.Hence it is crucial to identify and manage risk factors to prevent SP in leukaemia patients.Nevertheless,the pathogenesis of SP is still unclear,and it is currently mainly believed to be an imbalance of muscle protein synthesis and catabolism stemming from diverse origins.Alterations in intestinal microecology have a particularly significant impact on this process.Studies indicate that intestinal dysbiosis can bring about alteration in skeletal muscle nutrient metabolism and induce inflammatory responses in vivo,leading to changes in muscle mass and function.However,few studies have investigated SP in patients with leukaemia,and the interrelationship between intestinal microecology and leukaemia-related SP has not been systematically characterized.Thus,this paper will review the recent studies and reports on the incidence of SP in patients with leukaemia and explore the association and potential mechanism between intestinal microecology and leukaemia-associated SP to offer a theoretical foundation for the prevention of leukaemia-associated SP.