Ketogenic Diets in Pancreatic Cancer and Associated Cachexia: Cellular Mechanisms and Clinical Perspectives.
Ketogenic Diets in Pancreatic Cancer and Associated Cachexia: Cellular Mechanisms and Clinical Perspectives.
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DOI：
10.3390/nu13093202
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发表时间：
2021-09-15
期刊：
影响因子：
5.9
通讯作者：
Mackenzie GG
中科院分区：
文献类型：
--
作者：
Cortez NE;Mackenzie GG
胰腺导管腺癌（PDAC）是一种侵袭性和极难治疗的癌症。据估计，高达80%的PDAC患者存在恶病质，这是一种多因素疾病，其特征在于影响治疗反应和生存的骨骼肌的不自主和持续消耗。在过去的十年中，人们对探索饮食干预以补充PDAC和相关恶病质的治疗越来越感兴趣。生酮饮食（KD）因其抗肿瘤潜力而受到关注。这种饮食的特点是碳水化合物含量非常低，蛋白质含量适中，脂肪含量高，模拟了禁食时发生的代谢变化。许多研究报道KD减少肿瘤生长，并可作为各种癌症（包括胰腺癌）的辅助治疗。然而，KD对PDAC相关恶病质的作用和作用机制的研究有限。在这篇叙述性综述中，我们总结了KD在PDAC治疗和恶病质缓解中的影响的证据。此外，我们讨论了解释KD潜在的抗肿瘤和抗恶病质作用的关键细胞机制，主要关注细胞代谢，表观基因组和肠道微生物组的重编程。最后，我们提供了一个未来的研究需要推进KDs进入临床使用的角度。
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive and extremely therapy-resistant cancer. It is estimated that up to 80% of PDAC patients present with cachexia, a multifactorial disorder characterized by the involuntary and ongoing wasting of skeletal muscle that affects therapeutic response and survival. During the last decade, there has been an increased interest in exploring dietary interventions to complement the treatment of PDAC and associated cachexia. Ketogenic diets (KDs) have gained attention for their anti-tumor potential. Characterized by a very low carbohydrate, moderate protein, and high fat composition, this diet mimics the metabolic changes that occur in fasting. Numerous studies report that a KD reduces tumor growth and can act as an adjuvant therapy in various cancers, including pancreatic cancer. However, research on the effect and mechanisms of action of KDs on PDAC-associated cachexia is limited. In this narrative review, we summarize the evidence of the impact of KDs in PDAC treatment and cachexia mitigation. Furthermore, we discuss key cellular mechanisms that explain KDs’ potential anti-tumor and anti-cachexia effects, focusing primarily on reprogramming of cell metabolism, epigenome, and the gut microbiome. Finally, we provide a perspective on future research needed to advance KDs into clinical use.
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影响因子：
11.4
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