Kim Jin-Soo, Galvão Daniel A, Newton Robert U, Gray Elin, Taaffe Dennis R
Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia.
School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
Nat Rev Urol. 2021 Sep;18(9):519-542. doi: 10.1038/s41585-021-00476-y. Epub 2021 Jun 22.
Exercise is recognized by clinicians in the field of clinical oncology for its potential role in reducing the risk of certain cancers and in reducing the risk of disease recurrence and progression; yet, the underlying mechanisms behind this reduction in risk are not fully understood. Studies applying post-exercise blood serum directly to various types of cancer cell lines provide insight that exercise might have a role in inhibiting cancer growth via altered soluble and cell-free blood contents. Myokines, which are cytokines produced by muscle and secreted into the bloodstream, might offer multiple benefits to cellular metabolism (such as a reduction in insulin resistance, improved glucose uptake and reduced adiposity), and blood myokine levels can be altered with exercise. Alterations in the levels of myokines such as IL-6, IL-15, IL-10, irisin, secreted protein acidic risk in cysteine (SPARC), myostatin, oncostatin M and decorin might exert a direct inhibitory effect on cancer growth via inhibiting proliferation, promoting apoptosis, inducing cell-cycle arrest and inhibiting the epithermal transition to mesenchymal cells. The association of insulin resistance, hyperinsulinaemia and hyperlipidaemia with obesity can create a tumour-favourable environment; exercise-induced myokines can manipulate this environment by regulating adipose tissue and adipocytes. Exercise-induced myokines also have a critical role in increasing cytotoxicity and the infiltration of immune cells into the tumour.
临床肿瘤学领域的临床医生认识到运动在降低某些癌症风险以及降低疾病复发和进展风险方面具有潜在作用；然而，这种风险降低背后的潜在机制尚未完全了解。将运动后血清直接应用于各种类型癌细胞系的研究表明，运动可能通过改变可溶性和无细胞血液成分来抑制癌症生长。肌动蛋白是由肌肉产生并分泌到血液中的细胞因子，可能对细胞代谢有多种益处（如降低胰岛素抵抗、改善葡萄糖摄取和减少肥胖），并且血液中肌动蛋白水平可通过运动改变。白细胞介素-6、白细胞介素-15、白细胞介素-10、鸢尾素、富含半胱氨酸的酸性分泌蛋白（SPARC）、肌肉生长抑制素、制瘤素M和核心蛋白聚糖等肌动蛋白水平的改变可能通过抑制增殖、促进凋亡、诱导细胞周期停滞和抑制上皮-间充质细胞转化对癌症生长产生直接抑制作用。胰岛素抵抗、高胰岛素血症和高脂血症与肥胖的关联可营造有利于肿瘤的环境；运动诱导的肌动蛋白可通过调节脂肪组织和脂肪细胞来改变这种环境。运动诱导的肌动蛋白在增加细胞毒性和免疫细胞向肿瘤浸润方面也起着关键作用。
