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营养在预防炎症性肠病相关结直肠癌中的可能作用:以人类研究为重点。

Possible role of nutrition in the prevention of inflammatory bowel disease-related colorectal cancer: A focus on human studies.

机构信息

Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Santander, Spain.

Department of Clinical Sciences, Faculty of Medicine, Polytechnic University of Marche, Ancona, Italy.

出版信息

Nutrition. 2023 Jun;110:111980. doi: 10.1016/j.nut.2023.111980. Epub 2023 Feb 3.

Abstract

Patients with inflammatory bowel disease (IBD) are at substantially high risk for colorectal cancer (CRC). IBD-associated CRC accounts for roughly 10% to 15% of the annual mortality in patients with IBD. IBD-related CRC also affects younger patients compared with sporadic CRC, with a 5-y survival rate of 50%. Regardless of medical therapies, the persistent inflammatory state characterizing IBD raises the risk for precancerous changes and CRC, with additional input from several elements, including genetic and environmental risk factors, IBD-associated comorbidities, intestinal barrier dysfunction, and gut microbiota modifications. It is well known that nutritional habits and dietary bioactive compounds can influence IBD-associated inflammation, microbiome abundance and composition, oxidative stress balance, and gut permeability. Additionally, in recent years, results from broad epidemiologic and experimental studies have associated certain foods or nutritional patterns with the risk for colorectal neoplasia. The present study aimed to review the possible role of nutrition in preventing IBD-related CRC, focusing specifically on human studies. It emerges that nutritional interventions based on healthy, nutrient-dense dietary patterns characterized by a high intake of fiber, vegetables, fruit, ω-3 polyunsaturated fatty acids, and a low amount of animal proteins, processed foods, and alcohol, combined with probiotic supplementation have the potential of reducing IBD-activity and preventing the risk of IBD-related CRC through different mechanisms, suggesting that targeted nutritional interventions may represent a novel promising approach for the prevention and management of IBD-associated CRC.

摘要

炎症性肠病(IBD)患者发生结直肠癌(CRC)的风险显著增高。IBD 相关 CRC 约占 IBD 患者年死亡率的 10%至 15%。与散发性 CRC 相比,IBD 相关 CRC 还影响更年轻的患者,其 5 年生存率为 50%。无论采用何种医学治疗,IBD 所特有的持续炎症状态都会增加癌前病变和 CRC 的风险,此外,遗传和环境危险因素、IBD 相关合并症、肠道屏障功能障碍和肠道微生物群改变等多种因素也会增加这种风险。众所周知,营养习惯和膳食生物活性化合物可以影响 IBD 相关炎症、微生物群丰度和组成、氧化应激平衡和肠道通透性。此外,近年来,广泛的流行病学和实验研究结果表明,某些食物或营养模式与结直肠肿瘤的风险相关。本研究旨在综述营养在预防 IBD 相关 CRC 中的可能作用,重点关注人体研究。结果表明,基于健康、富含营养的饮食模式的营养干预,其特点是高纤维、蔬菜、水果、ω-3 多不饱和脂肪酸的摄入和低动物蛋白、加工食品和酒精的摄入,同时补充益生菌,有可能通过不同的机制降低 IBD 活动度并预防 IBD 相关 CRC 的发生,这表明有针对性的营养干预可能是预防和管理 IBD 相关 CRC 的一种有前途的新方法。

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