Fabian Carol J, Kimler Bruce F, Hursting Stephen D
Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA.
Department of Radiation Oncology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA.
Breast Cancer Res. 2015 May 4;17(1):62. doi: 10.1186/s13058-015-0571-6.
Women with evidence of high intake ratios of the marine omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) relative to the omega-6 arachidonic acid have been found to have a reduced risk of breast cancer compared with those with low ratios in some but not all case-control and cohort studies. If increasing EPA and DHA relative to arachidonic acid is effective in reducing breast cancer risk, likely mechanisms include reduction in proinflammatory lipid derivatives, inhibition of nuclear factor-κB-induced cytokine production, and decreased growth factor receptor signaling as a result of alteration in membrane lipid rafts. Primary prevention trials with either risk biomarkers or cancer incidence as endpoints are underway but final results of these trials are currently unavailable. EPA and DHA supplementation is also being explored in an effort to help prevent or alleviate common problems after a breast cancer diagnosis, including cardiac and cognitive dysfunction and chemotherapy-induced peripheral neuropathy. The insulin-sensitizing and anabolic properties of EPA and DHA also suggest supplementation studies to determine whether these omega-3 fatty acids might reduce chemotherapy-associated loss of muscle mass and weight gain. We will briefly review relevant omega-3 fatty acid metabolism, and early investigations in breast cancer prevention and survivorship.
在一些但并非所有的病例对照研究和队列研究中，相对于ω-6花生四烯酸而言，海洋ω-3脂肪酸二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）摄入比例较高的女性，其患乳腺癌的风险低于摄入比例较低的女性。如果提高EPA和DHA相对于花生四烯酸的比例对降低乳腺癌风险有效，可能的机制包括减少促炎脂质衍生物、抑制核因子-κB诱导的细胞因子产生，以及由于膜脂筏改变导致生长因子受体信号传导减少。以风险生物标志物或癌症发病率为终点的一级预防试验正在进行，但目前这些试验的最终结果尚未可得。人们也在探索补充EPA和DHA，以帮助预防或缓解乳腺癌诊断后的常见问题，包括心脏和认知功能障碍以及化疗引起的周围神经病变。EPA和DHA的胰岛素增敏和合成代谢特性也提示了补充研究，以确定这些ω-3脂肪酸是否可以减少化疗相关的肌肉量损失和体重增加。我们将简要回顾相关的ω-3脂肪酸代谢，以及乳腺癌预防和生存方面的早期研究。
