生酮饮食的抗肿瘤机制研究进展

Research progress on the anti-tumor mechanism of ketogenic diet

肿瘤作为危害人类健康的常见疾病,在全球范围内有着较高的患病率及疾病负担。针对肿瘤的治疗方案,现阶段主要以手术和放化疗等为主。对于早期或局部晚期肿瘤患者,手术可以完整切除肿瘤,提供根治的机会。放化疗对局部肿瘤有良好控制效果。但单一手术、放化疗或者手术联合放化疗的疗效可能受限于患者的耐药性和临床分期,需临床积极寻求辅助疗法。近年肿瘤代谢和肿瘤营养成为临床抗肿瘤研究热点。生酮饮食属于一种高脂低糖、合理配比蛋白质及其他营养素的配方饮食,被广泛应用于脑部疾病和代谢性疾病的临床治疗中。肿瘤可视为代谢性疾病。为肿瘤患者提供生酮饮食治疗,一方面可满足正常细胞生存能量,另一方面因肿瘤细胞的酮体利用限制,可有效抑制其生长代谢,进而发挥抗肿瘤作用。目前生酮饮食可通过降低葡萄糖水平、诱导氧化应激,改善线粒体酮体代谢、抗炎和增强免疫等多种机制来发挥抗肿瘤作用。本文现对生酮饮食的抗肿瘤机制及近年临床取得的研究进展进行综述。

As a common disease endangering human health,cancer has a high prevalence and disease burden in the world.At present,surgery and chemoradiotherapy are the main treatment options for tumor.For early or locally advanced tumors,surgery can remove the tumor completely,providing the opportunity for radical treatment.Chemoradiotherapy has a good effect on local tumor control.However,the efficacy of single operation,chemoradiotherapy or combined operation with chemoradiotherapy may be limited by the drug resistance and clinical stage of patients,and adjuvant therapy should be actively sought clinically.In recent years,tumor metabolism and tumor nutrition have become the focus of clinical anti-tumor research.Ketogenic diet is a high fat and low sugar formula diet with reasonable proportion of protein and other nutrients,which is widely used in the clinical treatment of brain diseases and metabolic diseases.Neoplasms can be regarded as metabolic diseases.On the one hand,ketogenic diet therapy for tumor patients can satisfy the survival energy of normal cells,on the other hand,due to the restriction of ketone body utilization of tumor cells,it can effectively inhibit their growth and metabolism,and thus play an anti-tumor role.At present,ketogenic diet can play an anti-tumor role by reducing glucose level,inducing oxidative stress,improving mitochondrial ketogenic body metabolism,anti-inflammatory and enhancing immunity and other mechanisms.This article reviews the anti-tumor mechanism of ketogenic diet and the recent clinical research progress.