Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy.
Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy.
Nutrients. 2023 Oct 21;15(20):4465. doi: 10.3390/nu15204465.
The incidence of pancreatic cancer is increasing worldwide. The most common form is represented by pancreatic ductal adenocarcinoma (PDAC) which has been shown to be linked to chronic inflammation. Notably, the gut microbiota has emerged as a critical player in regulating immune responses and inflammation. Indeed, intestinal dysbiosis, characterized by an imbalance in the gut microbiota composition, can contribute to the initiation of chronic inflammation. Sterile chronic inflammation can occur, probably activated by the translocation of bacterial components, such as lipopolysaccharide (LPS), the major component of Gram-negative microbiota, with the consequent induction of innate mucosal immunity, through the activation of Toll-like receptors (TLRs). Furthermore, the interaction between LPS and TLRs could enhance cancer progression. Recent research has shed light on the pivotal role of nutrition, as a modifiable risk factor, in PDAC immunological processes, particularly focusing on the immuno-modulatory effects of the gut microbiota. Different dietary regimens, fiber intake, immunonutrients, and antioxidants have the potential to either exacerbate or mitigate chronic inflammation, thereby influencing the pathogenesis and natural history of PDAC. These dietary components may affect the gut microbiota composition and, consequently, the level of inflammation, either promoting or protecting against PDAC. In this review of reviews, we discuss the modulatory role of nutrition and the gut microbiota in PDAC's immunological processes to explore a translational therapeutic approach that could improve the survival and quality of life of these patients.
全球范围内胰腺癌的发病率正在上升。最常见的形式是胰腺导管腺癌 (PDAC)，现已证实其与慢性炎症有关。值得注意的是，肠道微生物群已成为调节免疫反应和炎症的关键因素。事实上，肠道菌群失调（以肠道微生物群组成失衡为特征）可导致慢性炎症的发生。无菌性慢性炎症可能会发生，可能是由细菌成分（如脂多糖（LPS））的易位激活的，LPS 是革兰氏阴性菌群的主要成分，随后通过激活 Toll 样受体 (TLR) 诱导先天黏膜免疫。此外，LPS 和 TLR 之间的相互作用可能会促进癌症的进展。最近的研究揭示了营养作为可改变的风险因素在 PDAC 免疫过程中的关键作用，特别是关注肠道微生物群的免疫调节作用。不同的饮食方案、纤维摄入、免疫营养素和抗氧化剂有可能加剧或减轻慢性炎症，从而影响 PDAC 的发病机制和自然史。这些饮食成分可能会影响肠道微生物群的组成，从而影响炎症水平，促进或预防 PDAC。在这篇综述中，我们讨论了营养和肠道微生物群在 PDAC 免疫过程中的调节作用，以探索一种可能改善这些患者生存和生活质量的转化治疗方法。
