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释放抗肿瘤免疫:饮食限制和运动干预联合化疗治疗癌症患者。

Unleashing anti-tumour immunity: dietary restriction and exercise interventions adjunct to chemotherapy for cancer patients.

机构信息

Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia.

School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.

出版信息

Exerc Immunol Rev. 2024;30:26-48.


DOI:
PMID:39094178
Abstract

Conventional chemotherapies can stimulate the immune system by increasing tumour antigenicity (e.g., neoantigen exposure to immune cells) and altering adjuvanticity in the tumour (e.g., danger associated molecular patterns and cytokines). These molecules promote the recruitment, activation, and maturation of dendritic cells, which in turn, prime and activate cytotoxic T cells against tumour cells. However, several factors can decrease the immunostimulatory efficacy of chemotherapeutic agents. These include reduced tumour cell antigenicity and adjuvanticity and compromised immune function at a local and systemic level. Findings from preclinical studies show that dietary restriction and exercise promote systemic changes that may help to restore immune system function through several mechanisms, including an enhanced infiltration and function of antitumoral immune cells and a decrease in immunosuppressive cells, leading to a reduction in tumour volume. In addition, dietary restriction and exercise training in mice have been shown to enhance the efficacy of chemotherapy. In human studies there is also emerging evidence that dietary restriction and exercise can impact the immune system towards a more antitumoral profile. In this review, we discuss the immunostimulatory effects of dietary restriction (caloric restriction and fasting) and exercise training in preclinical cancer models, and potential synergies with chemotherapy. We then review clinical studies assessing the effects of these interventions on immune-related endpoints and tumour responses. Finally, we propose that combining dietary restriction with exercise could be a promising strategy to increase chemotherapy efficacy.

摘要

传统的化疗可以通过增加肿瘤抗原性(例如,新抗原暴露于免疫细胞)和改变肿瘤的佐剂性(例如,危险相关分子模式和细胞因子)来刺激免疫系统。这些分子促进树突状细胞的募集、激活和成熟,进而针对肿瘤细胞对细胞毒性 T 细胞进行致敏和激活。然而,有几个因素可以降低化疗药物的免疫刺激效果。这些因素包括肿瘤细胞抗原性和佐剂性降低,以及局部和全身免疫功能受损。临床前研究的结果表明,饮食限制和运动促进了全身性变化,这些变化可能通过多种机制有助于恢复免疫系统功能,包括增强抗肿瘤免疫细胞的浸润和功能,以及减少免疫抑制细胞,从而导致肿瘤体积缩小。此外,在小鼠中进行的饮食限制和运动训练已被证明可以增强化疗的疗效。在人类研究中,也有越来越多的证据表明,饮食限制和运动可以使免疫系统向更抗肿瘤的表型转变。在这篇综述中,我们讨论了饮食限制(热量限制和禁食)和运动训练在临床前癌症模型中的免疫刺激作用,以及它们与化疗的潜在协同作用。然后,我们回顾了评估这些干预措施对免疫相关终点和肿瘤反应影响的临床研究。最后,我们提出,将饮食限制与运动相结合可能是提高化疗疗效的一种有前途的策略。

相似文献

[1]
Unleashing anti-tumour immunity: dietary restriction and exercise interventions adjunct to chemotherapy for cancer patients.

Exerc Immunol Rev. 2024

[2]
Exercise as Adjunct Therapy in Cancer.

Semin Radiat Oncol. 2019-1

[3]
Rationale and design of the Diet Restriction and Exercise-induced Adaptations in Metastatic breast cancer (DREAM) study: a 2-arm, parallel-group, phase II, randomized control trial of a short-term, calorie-restricted, and ketogenic diet plus exercise during intravenous chemotherapy versus usual care.

BMC Cancer. 2021-10-10

[4]
Cancer chemotherapy: not only a direct cytotoxic effect, but also an adjuvant for antitumor immunity.

Cancer Immunol Immunother. 2008-11

[5]
Caloric restriction and cancer: molecular mechanisms and clinical implications.

Trends Mol Med. 2014-6-8

[6]
Rationale and design of the Caloric Restriction and Exercise protection from Anthracycline Toxic Effects (CREATE) study: a 3-arm parallel group phase II randomized controlled trial in early breast cancer.

BMC Cancer. 2018-9-3

[7]
Pre-treatment with chemotherapy can enhance the antigenicity and immunogenicity of tumours by promoting adaptive immune responses.

Br J Cancer. 2009-12-8

[8]
Energy and caloric restriction, and fasting and cancer: a narrative review.

Support Care Cancer. 2021-5

[9]
Fasting and Caloric Restriction in Cancer Prevention and Treatment.

Recent Results Cancer Res. 2016

[10]
Influence of physical activity on the immune system in breast cancer patients during chemotherapy.

J Cancer Res Clin Oncol. 2018-3

引用本文的文献

[1]
Accelerating precision exercise medicine in cancer patients using pooled individual patient data: POLARIS experience.

JNCI Cancer Spectr. 2025-9-1

[2]
Exercise-related immune gene signature for hepatocellular carcinoma: machine learning and multi-omics analysis.

Front Immunol. 2025-6-20

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