胃饥饿素可能减轻头颈癌患者放疗引起的黏膜炎和厌食症。
Ghrelin may reduce radiation-induced mucositis and anorexia in head-neck cancer.
作者信息
Guney Yildiz, Ozel Turkcu Ummuhani, Hicsonmez Ayse, Nalca Andrieu Meltem, Kurtman Cengiz
机构信息
Department of Radiation Oncology, Ankara University School of Medicine, Cebeci Hospital, Dikimevi, Ankara 06590, Turkey.
出版信息
Med Hypotheses. 2007;68(3):538-40. doi: 10.1016/j.mehy.2006.08.022. Epub 2006 Oct 9.
Body weight loss is common in cancer patients, and is often associated with poor prognosis, it greatly impairs quality of life (QOL). Radiation therapy (RT) is used in head and neck cancers (HNC) either as a primary treatment or as an adjuvant therapy to surgery. Patients with HNC are most susceptible to malnutrition especially due to anorexia, which is aggravated by RT. Multiple pro-inflammatory cytokines, such as interleukin-6 (IL-6), interleukin-1beta (IL-1beta), interferon (IFN)-gamma and tumor necrosis factor-alpha(TNF-alpha), have been all associated with the development of both anorexia and oral mucositis. Radiation-induced mucositis occurs in almost all patients, who are treated for HNC, it could also cause weight loss. Ghrelin is a novel 28-amino acid peptide, which up-regulates body weight through appetite control, increase food intake, down-regulate energy expenditure and induces adiposity. Furthermore, ghrelin inhibits pro-inflammatory cytokines such as IL-1alpha, IL-1beta, TNF-alpha which may cause oral mucositis and aneroxia, which are the results of weight loss. Thus weight loss during RT is an early indicator of nutritional decline, we propose that recombinant ghrelin used prophylactically could be useful as an appetite stimulant; and preventive of mucositis because of its anti-inflammatory effect, it might help patients maintain weight over the course of curative RT of the HNC and can improve specific aspects of QOL. This issue warrants further studies.
体重减轻在癌症患者中很常见,并且常常与预后不良相关,它会极大地损害生活质量(QOL)。放射治疗(RT)用于头颈癌(HNC),既作为主要治疗手段,也作为手术的辅助治疗。HNC患者尤其容易营养不良,特别是由于厌食,而放疗会使厌食情况加重。多种促炎细胞因子,如白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、干扰素(IFN)-γ和肿瘤坏死因子-α(TNF-α),都与厌食和口腔黏膜炎的发生有关。几乎所有接受HNC治疗的患者都会发生放射性黏膜炎,它也可能导致体重减轻。胃饥饿素是一种新的28个氨基酸的肽,它通过控制食欲来上调体重,增加食物摄入量,下调能量消耗并诱导肥胖。此外,胃饥饿素抑制促炎细胞因子,如IL-1α、IL-1β、TNF-α,这些细胞因子可能导致口腔黏膜炎和厌食,而这两者都是体重减轻的结果。因此,放疗期间的体重减轻是营养状况下降的早期指标,我们提出预防性使用重组胃饥饿素可能作为一种食欲刺激剂有用;并且由于其抗炎作用可预防黏膜炎,它可能有助于患者在HNC根治性放疗过程中维持体重,并可改善生活质量的特定方面。这个问题值得进一步研究。