Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC, USA.
Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA.
Nature. 2019 Aug;572(7769):397-401. doi: 10.1038/s41586-019-1437-3. Epub 2019 Jul 31.
Nutrition exerts considerable effects on health, and dietary interventions are commonly used to treat diseases of metabolic aetiology. Although cancer has a substantial metabolic component, the principles that define whether nutrition may be used to influence outcomes of cancer are unclear. Nevertheless, it is established that targeting metabolic pathways with pharmacological agents or radiation can sometimes lead to controlled therapeutic outcomes. By contrast, whether specific dietary interventions can influence the metabolic pathways that are targeted in standard cancer therapies is not known. Here we show that dietary restriction of the essential amino acid methionine-the reduction of which has anti-ageing and anti-obesogenic properties-influences cancer outcome, through controlled and reproducible changes to one-carbon metabolism. This pathway metabolizes methionine and is the target of a variety of cancer interventions that involve chemotherapy and radiation. Methionine restriction produced therapeutic responses in two patient-derived xenograft models of chemotherapy-resistant RAS-driven colorectal cancer, and in a mouse model of autochthonous soft-tissue sarcoma driven by a G12D mutation in KRAS and knockout of p53 (Kras;Trp53) that is resistant to radiation. Metabolomics revealed that the therapeutic mechanisms operate via tumour-cell-autonomous effects on flux through one-carbon metabolism that affects redox and nucleotide metabolism-and thus interact with the antimetabolite or radiation intervention. In a controlled and tolerated feeding study in humans, methionine restriction resulted in effects on systemic metabolism that were similar to those obtained in mice. These findings provide evidence that a targeted dietary manipulation can specifically affect tumour-cell metabolism to mediate broad aspects of cancer outcome.
营养对健康有很大的影响,饮食干预通常被用于治疗代谢病因的疾病。虽然癌症有很大的代谢成分,但定义营养是否可以用于影响癌症结果的原则尚不清楚。尽管如此,用药物或辐射靶向代谢途径有时可以导致可控的治疗结果。相比之下,特定的饮食干预是否可以影响标准癌症治疗中靶向的代谢途径尚不清楚。在这里,我们表明,通过对必需氨基酸蛋氨酸进行饮食限制(减少蛋氨酸具有抗衰老和抗肥胖的特性),可以通过对一碳代谢的可控和可重复的改变来影响癌症的结果。该途径代谢蛋氨酸,是涉及化疗和放疗的多种癌症干预的目标。蛋氨酸限制在两种对化疗耐药的 RAS 驱动的结直肠癌患者来源的异种移植模型中产生了治疗反应,并且在一种由 KRAS 的 G12D 突变和 p53(Kras;Trp53)敲除驱动的同源软组织肉瘤的小鼠模型中产生了治疗反应,该模型对辐射有抗性。代谢组学揭示,治疗机制通过对一碳代谢通量的肿瘤细胞自主作用来发挥作用,影响氧化还原和核苷酸代谢-从而与抗代谢物或辐射干预相互作用。在人类中进行的一项受控和耐受的喂养研究中,蛋氨酸限制导致了类似于在小鼠中获得的系统代谢效应。这些发现提供了证据,表明靶向饮食干预可以特异性地影响肿瘤细胞代谢,从而介导癌症结果的广泛方面。
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