Division of Human Nutrition and Health, Wageningen University, The Netherlands.
Division of Human Nutrition and Health, Wageningen University, The Netherlands.
Eur J Pharmacol. 2018 Oct 5;836:102-114. doi: 10.1016/j.ejphar.2018.06.026. Epub 2018 Jun 21.
There is no evidence that Hippocrates, although being credited for it, ever literally stated 'let thy food be thy medicine and thy medicine be thy food'. However, yet in line with Hippocrates' philosophy, we are currently witnessing a reappraisal of the complementarity of nutrition and pharmacology. Recent studies not only underline the therapeutic potential of lifestyle interventions, but are also generating valuable insights in the complex and dynamic transition from health to disease. Next to this, nutritional biology can significantly contribute to the discovery of new molecular targets. It is clear that most of the current top-selling drugs used in chronic cardio-metabolic diseases modulate relatively late-stage complications, which generally indicate already longer existing homeostatic imbalances. Pharmacologists are increasingly aware that typical multifactorial disorders require subtle, multiple target pharmacological approaches, instead of the still often dominating 'one disease - one target - one drug' paradigm. This review discusses the recent developments in the pharma-nutrition interface and shows some relevant mechanisms, including receptors and other targets, and examples from clinical practice. The latter includes inflammatory diseases and progressive loss of muscle function. The examples also illustrate the potential of targeted combinations of medicines with nutrition and (or) other life-style interventions, to increase treatment efficacy and (or) reduce adverse effects. More attention to a potentially negative outcome of drug-food combinations is also required, as shown by the example of food-drug interactions. Together, the developments at the food-pharma interface underline the demand for intensified collaboration between the disciplines, in the clinic and in science.
虽然希波克拉底(Hippocrates)被认为是这句话的作者,但并没有确凿的证据表明他曾明确说过“让你的食物成为你的药物,让你的药物成为你的食物”。然而,与希波克拉底的哲学相一致的是,我们目前正在重新评估营养与药理学的互补性。最近的研究不仅强调了生活方式干预的治疗潜力,还为从健康到疾病的复杂和动态转变提供了有价值的见解。除此之外,营养生物学可以为发现新的分子靶标做出重大贡献。很明显,目前用于慢性心脏代谢疾病的大多数畅销药物调节的是相对晚期的并发症,这些并发症通常表明已经存在较长时间的体内平衡失调。药理学家越来越意识到,典型的多因素疾病需要微妙的、多靶点的药物治疗方法,而不是仍然经常主导的“一种疾病-一个靶点-一种药物”的范式。本文讨论了药物-营养相互作用的最新发展,并展示了一些相关的机制,包括受体和其他靶点,以及来自临床实践的例子。后者包括炎症性疾病和肌肉功能的进行性丧失。这些例子还说明了靶向药物与营养和(或)其他生活方式干预相结合的潜力,以提高治疗效果和(或)减少不良反应。还需要更多关注药物-食物组合可能产生的负面结果,正如食物-药物相互作用的例子所示。总之,在食品-药物界面的发展强调了在临床和科学中加强不同学科之间合作的需求。