肿瘤营养代谢调节治疗

Cancer nutrition metabolism modulation treatment

越来越多的研究证实,肿瘤的生物学本质是一种代谢性疾病,基于肿瘤代谢靶点的代谢调节治疗因此成为肿瘤治疗的新方向。肿瘤代谢调节治疗的手段很多,如药物、手术、运动及营养素,单纯使用营养素实施代谢调节治疗者为营养代谢调节治疗。营养素包括宏量营养素和微量营养素,目前的研究更多聚焦于碳水化合物、蛋白质/氨基酸及脂肪三大宏量营养素代谢调节,包括减少葡萄糖供给,提高蛋白质供给,选择合适的脂肪酸及生酮饮食。营养代谢调节治疗不仅仅是提供营养素和能量,更加重要的是发挥营养素的代谢调节作用。肿瘤细胞具有高度代谢异质性,不同肿瘤细胞对同一种营养素的代谢表现出显著的差异,营养代谢调节治疗因此同样要求精准调节。由于肿瘤细胞的高度代谢适应性,当任何一条代谢通路遇到障碍时,肿瘤细胞会自动切换或启用其他通路,从而逃避应激损害,因此,肿瘤营养代谢调节治疗应该联合阻断或调控多个代谢途径,从而更好地发挥抗肿瘤作用,提高治疗效果。

Increasing body of evidence indicates that the biological basis of cancer is a metabolic disease.Based on the aberrant metabolic characteristics,cancer metabolism modulation treatment is an emerging,novel therapeutic strategy for the holistic treatment of cancer.Metabolic modulation can be achieved by medicine,operation,exercise and nutrient which includes two categories i.e.,macronutrient and micronutrient.Modulation by nutrients only is specifically called nutrition metabolism modulation treatment.Recent studies focus on the influence of macronutrients(carbohydrates,protein/amino acids and fat) rather than micronutrients as anti-cancer metabolism therapies,including low carbohydrate,high-protein,proper fat and ketogenic diet(KD).Nutrition modulation therapy not only provide nutrients,energy and more importantly metabolic modulation.Cancer cells response differently to the same nutrient due to metabolic heterogeneity,precision modulation is therefore vital for nutrition metabolic modulation treatment.The high adaptive capacity of cancer cell helps growing tumors rewire or shift to another metabolic pathway to promote survival,growth and its adaptive response to stress,metabolic modulation therapy should combinedly target different metabolic pathways in order to get a better effect.