A healthy diet, a healthy prostate? A brief commentary on the latest research on diet and prostate cancer.
A healthy diet, a healthy prostate? A brief commentary on the latest research on diet and prostate cancer.
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健康的饮食，健康的前列腺？
DOI：
10.1038/s41391-023-00651-9
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发表时间：
2023
影响因子：
4.8
通讯作者：
Freedland,StephenJ
中科院分区：
文献类型：
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作者：
Galván,GloriaCecilia;Daniels,JamesP;Friedrich,NadineA;Das,Sanjay;Freedland,StephenJ
全球每年估计有140万例新诊断，前列腺癌（PC）是第二大常见癌症，也是男性第五大死亡原因[1]。认识和扭转可改变的危险因素的负面影响仍然是至关重要的，以改善PC患者的发病率和死亡率。随着公众对饮食的看法不断变化，关于饮食方案和补充剂的新问题，以及它们与PC的关系正在被提出。某些饮食的炎症潜力在PC风险中发挥作用吗？碳水化合物限制会影响肿瘤生长吗？禁食模仿饮食对2型糖尿病和代谢综合征的管理有效，对PC患者的体重管理也安全吗？由于大多数关于可改变的风险因素的研究都来自高收入国家，因此低收入和中低收入国家的PC风险因素和饮食选择可能不一样，尽管迄今为止这方面的研究很少。此外，寻找对PC具有预防作用的膳食补充剂尚未取得有利的结果[2]。虽然缺乏推荐使用的明确证据，但对PC预防补充剂的研究仍在继续使用omega-3脂肪酸。最后，肥胖与多种慢性疾病的发展有关，包括冠状动脉疾病、高血压和糖尿病[3，4]。随着肥胖对健康的影响成为全球性的主要问题，问题也在出现。肥胖会增加PC的风险吗？肥胖和生化复发（BCR）之间的关系是什么？初次诊断时的体重管理是否会降低BCR的风险？我们在当前的收集中解决了这些问题，其中总结了2021年3月至2022年5月发表在前列腺癌和前列腺疾病中的8篇关于饮食和肥胖作为PC可改变风险因素的最新手稿。“膳食ω-3脂肪酸对原位前列腺癌进展、肿瘤相关巨噬细胞、血管生成和GPR 120依赖性T细胞活化的影响”[5]。在原位MycCaP模型中，与喂食omega-6脂肪酸饮食的小鼠相比，二十二碳六烯酸（DHA）补充剂减少了喂食omega-3脂肪酸饮食的小鼠的肿瘤生长。DHA还降低了M2巨噬细胞的浸润、M2巨噬细胞依赖性血管生成和T细胞的活化。这些作用被认为部分由GPR 120介导。这些数据提供了一些关于ω-3脂肪酸改变肿瘤微环境从而减缓PC生长的潜力的机制性理解。
With global estimates of 1.4 million new diagnoses per year, prostate cancer (PC) is the second most common cancer and the fifth leading cause of death in men [1]. Recognizing and reversing the negative impacts of modifiable risk factors continues to be vital for improving morbidity and mortality in PC patients. As public opinion on diet is ever changing, novel questions about dietary regimens and supplementation, and their association with PC are being asked. Does the inflammatory potential of certain diets play any role in PC risk? Can carbohydrate restriction affect tumor growth? Are fasting-mimicking diets, which are effective in the management of type 2 diabetes and metabolic syndrome, safe for weight management in PC patients as well? And since most research on modifiable risk factors comes out of high-income countries, the risk factors for PC in low-and lowmiddle-income countries and dietary choices may not be the same, though to date this has been little studied. In addition, the search for a dietary supplement with preventative effects on PC has yet to yield favorable results [2]. Though clear evidence for recommended use is lacking, the search for PC prevention supplements continues with omega-3 fatty acids. Lastly, obesity is associated with the development of multiple chronic diseases, including coronary artery disease, hypertension, and diabetes [3, 4]. With the impact of obesity on health becoming a major problem globally, questions are also emerging. Does obesity increase the risk of PC? What is the relationship between obesity and biochemical recurrence (BCR)? Does weight management at initial diagnosis diminish the risk of BCR? We address these questions in the current collection, which summarizes eight recent manuscripts on diet and obesity as modifiable risk factors for PC published from March 2021 to May2022 in Prostate Cancer and Prostatic Diseases.1.“Effects of dietary omega-3 fatty acids on orthotopic prostate cancer progression, tumor associated macrophages, angiogenesis and T-cell activation–dependence on GPR120”[5]. In an orthotopic MycCaP model, docosahexaenoic acid (DHA) supplementation reduced tumor growth in mice fed an omega-3 fatty acid diet compared to mice fed an omega-6 fatty acid diet. DHA also lowered infiltration of M2 macrophages, M2 macrophage-dependent angiogenesis and activation of T cells. These effects are thought to be partially mediated by GPR120. These data provide some mechanistic understanding of the potential of omega-3 fatty acids to modify the tumor microenvironment and thereby slow PC growth.