Chronotherapy: Circadian Rhythms and Their Influence in Cancer Therapy.
Chronotherapy: Circadian Rhythms and Their Influence in Cancer Therapy.
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生物体在其行为和代谢中每24小时呈现有节奏的波动，以预测环境的变化。这些波动是由一个非常复杂的分子机制控制的，即生物钟，它调节多个基因的表达，以确保身体的正常运作。个体的昼夜节律系统在衰老过程中发生变化，这与许多与年龄相关的病理学和其他可能导致癌症发展的变化有关。如今，人们越来越感兴趣的是如何了解昼夜节律可以用于治疗癌症。时间疗法旨在了解生物节律对治疗反应的影响，以优化其作用，最大限度地提高健康效益，并最大限度地减少可能的不良影响。在这篇综述中，我们探讨了时间疗法在癌症治疗改善中的作用，使用不同的方法，并分析了根据人的昼夜节律在特定和最佳时间进行治疗的效果。生物体在其行为和代谢中每24小时呈现有节奏的波动，以预测环境的变化。这些波动是由一个非常复杂的分子机制控制的，即生物钟，它调节多个基因的表达，以确保身体的正常运作。个体的昼夜节律系统在衰老过程中发生变化，这与许多与年龄相关的病理学和其他可能导致癌症发展的变化有关。如今，人们越来越感兴趣的是如何了解昼夜节律可以用于治疗癌症。时间疗法旨在了解生物节律对治疗反应的影响，以优化其作用，最大限度地提高健康益处并最大限度地减少可能的不良影响。迄今为止的临床试验已经证实，化疗或免疫疗法的最佳治疗时机可以降低药物毒性并提高疗效。相反，时辰放射疗法似乎最大限度地减少了治疗相关的症状，而不是肿瘤进展或患者生存。此外，分子钟内的潜在治疗靶点也已确定。因此，到目前为止，时间疗法在癌症治疗中的应用结果是具有挑战性的，可行的，并且可以应用于临床实践以改善癌症治疗而无需额外的成本。然而，不同的限制和变量，如年龄，性别或时辰，除其他外，应该克服时间疗法可以真正投入临床实践之前。
Living organisms present rhythmic fluctuations every 24 h in their behavior and metabolism to anticipate changes in the environment. These fluctuations are controlled by a very complex molecular mechanism, the circadian clock, that regulates the expression of multiple genes to ensure the right functioning of the body. An individual’s circadian system is altered during aging, and this is related to numerous age-associated pathologies and other alterations that could contribute to the development of cancer. Nowadays, there is an increasing interest in understanding how circadian rhythms could be used in the treatment of cancer. Chronotherapy aims to understand the impact that biological rhythms have on the response to a therapy to optimize its action, maximize health benefits, and minimize possible adverse effects. In this review, we explore the role of chronotherapy in cancer therapy improvement using different approaches and analyze the effect of administering a therapeutic treatment at a specific and optimal time based on the person’s circadian rhythm. Living organisms present rhythmic fluctuations every 24 h in their behavior and metabolism to anticipate changes in the environment. These fluctuations are controlled by a very complex molecular mechanism, the circadian clock, that regulates the expression of multiple genes to ensure the right functioning of the body. An individual’s circadian system is altered during aging, and this is related to numerous age-associated pathologies and other alterations that could contribute to the development of cancer. Nowadays, there is an increasing interest in understanding how circadian rhythms could be used in the treatment of cancer. Chronotherapy aims to understand the impact that biological rhythms have on the response to a therapy to optimize its action, maximize health benefits and minimize possible adverse effects. Clinical trials so far have confirmed that optimal timing of treatment with chemo or immunotherapies could decrease drug toxicity and increase efficacy. Instead, chronoradiotherapy seems to minimize treatment-related symptoms rather than tumor progression or patient survival. In addition, potential therapeutic targets within the molecular clock have also been identified. Therefore, results of the application of chronotherapy in cancer therapy until now are challenging, feasible, and could be applied to clinical practice to improve cancer treatment without additional costs. However, different limitations and variables such as age, sex, or chronotypes, among others, should be overcome before chronotherapy can really be put into clinical practice.