Raffaghello L, Longo V
Laboratory of Oncology, Istituto Giannina Gaslini, Genova, Italy.
Longevity Institute, Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States; IFOM, FIRC Institute of Molecular Oncology, Milano, Italy.
Int Rev Cell Mol Biol. 2017;332:1-42. doi: 10.1016/bs.ircmb.2017.01.003. Epub 2017 Feb 28.
Aging represents the major risk factor for cancer. Cancer and aging are characterized by a similar dysregulated metabolism consisting in upregulation of glycolysis and downmodulation of oxidative phosphorylation. In this respect, metabolic interventions can be viewed as promising strategies to promote longevity and to prevent or delay age-related disorders including cancer. In this review, we discuss the most promising metabolic approaches including chronic calorie restriction, periodic fasting/fasting-mimicking diets, and pharmacological interventions mimicking calorie restriction. Metabolic interventions can also be viewed as adjuvant anticancer strategies to be combined to standard cancer therapy (chemotherapeutic agents, ionizing radiation, and drugs with specific molecular target), whose major limiting factors are represented by toxicity against healthy cells but also limited efficacy easily circumvented by tumor cells. In fact, conventional cancer therapy is unable to distinguish normal and cancerous cells and thus causes toxic side effects including secondary malignancies, cardiovascular and respiratory complications, endocrinopathies, and other chronic conditions, that resemble and, in some cases, accelerate the age-related disorders and profoundly affect the quality of life. In this scenario, geroscience contributes to the understanding of the mechanisms of protection of normal cells against a cytotoxic agent and finding strategies focused on the preserving healthy cells while enhancing the efficacy of the treatment against malignant cells.
衰老代表着癌症的主要风险因素。癌症和衰老的特征是代谢失调相似,表现为糖酵解上调和氧化磷酸化下调。在这方面,代谢干预可被视为促进长寿以及预防或延缓包括癌症在内的与年龄相关疾病的有前景的策略。在本综述中,我们讨论了最有前景的代谢方法,包括长期热量限制、周期性禁食/模拟禁食饮食以及模拟热量限制的药物干预。代谢干预也可被视为辅助抗癌策略,可与标准癌症治疗(化疗药物、电离辐射以及具有特定分子靶点的药物)相结合,标准癌症治疗的主要限制因素包括对健康细胞的毒性以及肿瘤细胞容易规避的有限疗效。事实上,传统癌症治疗无法区分正常细胞和癌细胞,因此会导致毒性副作用,包括继发性恶性肿瘤、心血管和呼吸系统并发症、内分泌疾病以及其他慢性疾病,这些疾病类似于某些情况下还会加速与年龄相关的疾病,并深刻影响生活质量。在这种情况下,老年科学有助于理解正常细胞对细胞毒性剂的保护机制,并找到专注于保护健康细胞同时提高对恶性细胞治疗效果的策略。