PDF(Pubmed)
Abstract：
There is increasing evidence about the role of inflammation in sarcopenia and tumor progression; thus, its modulation would represent a valuable strategy for improving clinical outcomes in patients with cancer. Several studies have reported that whey protein has significant anti-inflammatory and antioxidant characteristics in humans. We aimed to evaluate the effects of whey protein-based oral nutritional support on circulating cytokines in patients with solid tumors undergoing systemic treatment. Forty-six patients with solid tumors of different origin and undergoing systemic treatment were evaluated. Nutritional support with two daily whey protein-based oral supplements was administered. Circulating levels of IL-6, IL-8, IL-10, MCP-1 and IP-10 were determined. Nutritional evaluation included anthropometric, instrumental and biochemical parameters. Over 63% of the evaluated patients underwent surgery, 56.5% required chemotherapy and almost 50% received combined treatment. Patients with resected primary tumor presented with lower baseline IL-6 (p < 0.05) and IP-10 (p < 0.001); after three months of nutritional support, they presented with lower IL-8 (p < 0.05) and tended to present lower IL-6 and IP-10 (p = 0.053 and 0.067, respectively). Significant positive correlations between circulating cytokines, C-reactive protein and ferritin were observed; similarly, negative correlations with anthropometric and biochemical nutritional parameters were noticed (p < 0.05). We did not observe significant changes in circulating cytokine levels (IL-6, IL-8, IL-10, MCP-1 and IP-10) in patients with cancer undergoing systemic treatment after three months of nutritional support with whey protein-based oral supplements. According to a univariate analysis in our cohort, circulating IL-8 was associated with mortality in these patients, additionally, MCP-1 and IP-10 tended to correlate; but an age- and sex-adjusted multivariate analysis revealed that only baseline MCP-1 was significantly associated with mortality (OR 1.03 (95% CI: 1.00-1.05)). In conclusion, surgery of the primary solid tumor and combination treatment allow significant reduction in circulating cytokine levels, which remained stable while patients received nutritional support with whey protein-based oral supplements over three months. The role of MCP-1 as an independent factor for mortality in these patients should be further evaluated.
摘要：
越来越多的证据表明炎症在少肌症和肿瘤进展中的作用；因此，它的调制将成为改善癌症患者临床结局的有价值的策略.多项研究报道乳清蛋白在人体中具有显著的抗炎和抗氧化特性。我们旨在评估基于乳清蛋白的口服营养支持对接受全身治疗的实体瘤患者循环细胞因子的影响。对46例不同来源并接受全身治疗的实体瘤患者进行了评估。每天服用两种基于乳清蛋白的口服补充剂的营养支持。测定IL-6、IL-8、IL-10、MCP-1和IP-10的循环水平。营养评估包括人体测量学，仪器和生化参数。超过63%的被评估患者接受了手术，56.5％需要化疗，近50％接受联合治疗。切除原发肿瘤的患者基线IL-6(p<0.05)和IP-10(p<0.001)较低；营养支持三个月后，它们呈现较低的IL-8（p<0.05），并倾向于呈现较低的IL-6和IP-10（分别为p=0.053和0.067）。循环细胞因子之间的显着正相关，观察到C反应蛋白和铁蛋白；类似地，与人体测量和生化营养指标呈负相关（p<0.05）。在使用基于乳清蛋白的口服补充剂进行营养支持三个月后，接受全身治疗的癌症患者中，我们没有观察到循环细胞因子水平（IL-6，IL-8，IL-10，MCP-1和IP-10）的显着变化。根据我们队列中的单变量分析，循环IL-8与这些患者的死亡率相关，此外，MCP-1和IP-10倾向于相关；但是年龄和性别调整的多变量分析显示，只有基线MCP-1与死亡率显着相关（OR1.03（95％CI：1.00-1.05））。总之,原发性实体瘤的手术和联合治疗可以显着降低循环细胞因子水平，当患者接受基于乳清蛋白的口服补充剂的营养支持超过3个月时，该指数保持稳定。应进一步评估MCP-1作为这些患者死亡率的独立因素的作用。
