运动干预对癌症儿童和青少年及 HSCT 受者免疫功能的影响：系统评价。
Effects of Exercise Interventions on Immune Function in Children and Adolescents With Cancer and HSCT Recipients - A Systematic Review.
机构信息
Department of Pediatric Hematology/Oncology, Center for Child and Adolescent Medicine, Clinic for Pediatrics III, West German Cancer Centre, University Hospital Essen, Essen, Germany.
Institute for Transplantation Diagnostics and Cell Therapeutics, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.
出版信息
Front Immunol. 2021 Sep 27;12:746171. doi: 10.3389/fimmu.2021.746171. eCollection 2021.
BACKGROUND
Pediatric cancer patients are at high risk for life-threatening infections, therapy associated complications and cancer-related side effects. Exercise is a promising tool to support the immune system and reduce inflammation. The primary objective of this systematic review was to evaluate the effects of exercise interventions in pediatric cancer patients and survivors on the immune system.
METHODS
For this systematic review (PROSPERO ID: CRD42021194282) we searched four databases (MEDLINE, Cochrane Library, ClinicalTrials.gov, SPORTDiscus) in June 2021. Studies with pediatric patients with oncological disease were included as main criterion. Two authors independently performed data extraction, risk of bias assessment, descriptive analysis and a direction ratio was calculated for all immune cell parameters.
FINDINGS
Of the 1448 detected articles, eight studies with overall n = 400 children and adolescents with cancer and n = 17 healthy children as controls aged 4-19 years met the inclusion criteria. Three randomized, four non-randomized controlled trials and one case series were analyzed descriptively. The exercise interventions had no negative adverse effects on the immune system. Statistically significant results indicated enhanced cytotoxicity through exercise, while changes in immune cell numbers did not differ significantly. Interventions further reduced days of in-hospitalization and reduced the risk of infections. Several beneficial direction ratios in immune parameters were identified favoring the intervention group.
INTERPRETATION
Exercise interventions for pediatric cancer patients and survivors had no negative but promising beneficial effects on the immune system, especially regarding cytotoxicity, but data is very limited. Further research should be conducted on the immunological effects of different training modalities and intensities, during various treatment phases, and for different pediatric cancer types. The direction ratio parameters given here may provide useful guidance for future clinical trials.
SYSTEMIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021194282, Prospero ID: CRD42021194282.
背景
儿科癌症患者存在发生危及生命的感染、治疗相关并发症和癌症相关副作用的高风险。运动是一种支持免疫系统和减轻炎症的有前途的工具。本系统评价的主要目的是评估运动干预对儿科癌症患者和幸存者免疫系统的影响。
方法
本系统评价（PROSPERO 注册号：CRD42021194282）于 2021 年 6 月在四个数据库（MEDLINE、Cochrane 图书馆、ClinicalTrials.gov、SPORTDiscus）中进行检索。主要纳入标准为患有肿瘤疾病的儿科患者的研究。两位作者独立进行数据提取、偏倚风险评估、描述性分析，并计算了所有免疫细胞参数的方向比。
结果
在检测到的 1448 篇文章中，有 8 项研究符合纳入标准，共纳入 400 名患有癌症的儿童和青少年患者和 17 名作为对照的健康儿童，年龄为 4-19 岁。3 项随机对照试验、4 项非随机对照试验和 1 项病例系列研究进行了描述性分析。运动干预对免疫系统没有负面影响。有统计学意义的结果表明，运动可增强细胞毒性，而免疫细胞数量的变化则没有显著差异。干预措施还进一步减少了住院天数，降低了感染风险。在免疫参数方面，确定了一些有益的方向比，有利于干预组。
解释
对于儿科癌症患者和幸存者，运动干预对免疫系统没有负面影响，但有令人鼓舞的有益作用，特别是在细胞毒性方面，但数据非常有限。应进一步研究不同训练模式和强度、在不同治疗阶段以及不同儿科癌症类型下的免疫效应。这里给出的方向比参数可能为未来的临床试验提供有用的指导。
系统评价注册
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021194282，PROSPERO 注册号：CRD42021194282。
Zotero 插件