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运动对免疫和激素的影响:对癌症恶病质的影响。

Immunological and hormonal effects of exercise: implications for cancer cachexia.

机构信息

aDepartment of Palliative Care, Policy and Rehabilitation, King's College London, Cicely Saunders Institute, Bessemer Road, Denmark Hill, London, United Kingdom bDuke Cancer Institute, Durham, North Carolina, USA cHayward House Specialist Palliative Care Unit, Nottingham University Hospitals NHS Trust and Department of Palliative Medicine, University of Nottingham, Hucknall Road, Nottingham, United Kingdom.

出版信息

Curr Opin Support Palliat Care. 2013 Dec;7(4):376-82. doi: 10.1097/SPC.0000000000000010.

Abstract

PURPOSE OF REVIEW

There is increasing interest in the use of therapeutic exercise for cancer cachexia. Apart from the directly beneficial effects on muscle, exercise has the potential to attenuate some of the immunological and hormonal abnormalities found in cachexia. This review summarizes the findings of recent studies, which have explored such effects in patients with cancer, and discusses their relevance to patients with cancer cachexia.

RECENT FINDINGS

Our search identified 11 studies in patients with breast, colorectal, lung, and prostate cancer, predominantly with early stage disease or following primary curative treatment. Overall, exercise was associated with reduced levels of C-reactive protein (CRP), but not other markers of systemic inflammation. There was no consistent impact on levels of glucose, insulin or measures of insulin sensitivity or, in patients with prostate cancer, on levels of testosterone.

SUMMARY

There is limited scope to extrapolate these findings to patients with cancer cachexia, who are more likely to have advanced disease, higher levels of systemic inflammation, and greater degrees of metabolic dysfunction. Studies specific to this group are required to explore what, if any, changes exercise can make to levels of CRP and other immune and hormonal biomarkers, along with their potential clinical relevance.

摘要

目的综述

人们对癌症恶病质治疗性运动的应用越来越感兴趣。运动除了对肌肉有直接的益处外,还有可能减轻恶病质患者中发现的一些免疫和激素异常。本综述总结了最近的研究结果,这些研究探讨了运动对癌症患者的这些影响,并讨论了它们与癌症恶病质患者的相关性。

最近的发现

我们的检索确定了 11 项针对乳腺癌、结直肠癌、肺癌和前列腺癌患者的研究,这些患者主要处于早期疾病或接受过原发性治愈性治疗。总的来说,运动与 C 反应蛋白(CRP)水平降低有关,但与其他全身炎症标志物无关。运动对葡萄糖、胰岛素或胰岛素敏感性的测量值没有一致的影响,在前列腺癌患者中,也没有对睾酮水平产生影响。

总结

这些发现对癌症恶病质患者的外推有限,因为这些患者更有可能患有晚期疾病、更高水平的全身炎症和更大程度的代谢功能障碍。需要针对这一人群进行特定的研究,以探讨运动对 CRP 和其他免疫和激素生物标志物水平的影响,如果有的话,以及它们的潜在临床相关性。

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