Suplementos vitamino-minerales y nutrientes enterales como adyuvantes de la citorreducción no quirúrgica en leucemias y procesos linfo-proliferativos

Luis Garcés García-Espinosa

Suplementos vitamino-minerales y nutrientes enterales como adyuvantes de la citorreducción no quirúrgica en leucemias y procesos linfo-proliferativos

Luis Garcés García-Espinosa

Texto completo:

PDF

Resumen

La citorreducción no quirúrgica en leucemias y procesos linfoproliferativos implica la administración de quimioterapia sola/combinada con radioterapia para la inducción de remisión de la enfermedad. Estos tratamientos deprimen la actividad anti-oxidante natural de la economía, depletan los depósitos tisulares de micronutrientes, causan anorexia, y eventualmente conducen al enfermo a la caquexia y la desnutrición. A pesar de estos efectos adversos, se discute todavía la efectividad de la suplementación vitamino-mineral y la Nutrición enteral volitiva como coadyuvantes de la citorreducción no quirúrgica en las leucemias y otros procesos linfoproliferativos. Las evidencias experimentales acumuladas en años recientes permiten afirmar que la administración de micronutrientes, estén éstos contenidos en preparaciones farmacológicas individuales o combinadas, o formando parte de diferentes soluciones enterales, pueden sinergizar la acción anti-neoplásica de los tratamientos citorreductores, aminorar los efectos adversos de tales terapias, y proteger a la célula sana de los daños colaterales propios de la quimioterapia y/o radioterapia. Las discusiones corrientes se centran en las dosis a administrar del micronutriente, y la superioridad terapéutica de uno sobre otro(s). La incorporación de la suplementación vitamino-mineral y la Nutrición enteral volitiva dentro del tratamiento médico de las leucemias y los procesos linfoproliferativos pudiera servir para asegurar la efectividad de la citorreducción tumoral, incrementar la calidad de vida percibida por el enfermo y los familiares, e incluso, reducir el riesgo de ocurrencia de recaídas y metástasis.

Palabras clave

Citorreducción tumoral; Antioxidantes; Leucemias; Nutrición; Micronutrientes; Nutrición enteral

Referencias

D'Andrea GM. Use of antioxidants during chemotherapy and radiotherapy should be avoided. CA Cancer J Clin 2005;55:319-21.

Lawenda BD, Kelly KM, Ladas EJ, Sagar SM, Vickers A, Blumberg JB. Should supplemental antioxidant administration be avoided during chemotherapy and radiation therapy? J Natl Cancer Inst 2008;100:773-83.

Martínez González C, Santana Porbén S. Diseño e implementación de un esquema intrahospitalario de Nutrición enteral. Rev Cubana Aliment Nutr 2001;15:130-8.

Santana Porbén S, Barreto Penié J, Martínez González C, Borrás Espinosa A. Diseño e implementación de un esquema intrahospitalario de Nutrición Parenteral. I. Nutrición Parenteral Periférica. RCAN Rev Cubana Aliment Nutr 2007;17:186-208.

Santana Porbén S, Barreto Penié J, Martínez González C, Borrás Espinosa A. Diseño e implementación de un esquema intrahospitalario de Nutrición Parenteral. II. Nutrición Parenteral Central. RCAN Rev Cubana Aliment Nutr 2008;18:93-125.

Nixon DW. Nutrition and cancer. J Med Assoc Ga 1991;80:141-3.

Klimczak A, Malinowska K, Kubiak K. Tumour illnesses and nutrition. Pol Merkur Lekarski 2009;27:242-4.

Chon Rivas I, Chi Ramírez D, León González R, Blanco Bouza J, Cuevas Véliz I, Rodríguez Abascal A, Mederos Alfonso N, Roca Muchuli C. La importancia del estado nutricional para el paciente oncológico. RCAN Rev Cub Aliment Nutr 2009;19:133-45.

Khanzode SS, Muddeshwar MG, Khanzode SD, Dakhale GN. Antioxidant enzymes and lipid peroxidation in different stages of breast cancer. Free Radic Res 2004;38:81-5.

Weijl NI, Hopman GD, Wipkink-Bakker A, Lentjes EGWM, Berget HM. Cisplatin combination chemotherapy induces a fall in plasma antioxidants of cancer patients. Ann Oncol 1998;9:1331-7.

Ladas EJ, Jacobson JS, Kennedy DD, Teel K, Fleischauer A, Kelly KM. Antioxidants and cancer therapy: A systematic review. J Clin Oncol 2004;22:517-28.

Kim YS, Maruvada P, Milner JA. Metabolomics in biomarker discovery: future uses for cancer prevention. Future Oncology 2008;4:93-102.

Amann T, Maegdefrau U, Hartmann A; et al. GLUT1 expression is increased in hepatocellular carcinoma and promotes tumorigenesis. Am J Pathol 2009;174:1544-52.

Glycolysis, gluconeogenesis, and the pentose phosphate pathway. En: Lehninger’s Principles of Biochemistry. Capítulo 14. (Editores Nelson DL, Cox MM). Cuarta Edición. Freeman WH Publishing House. Pensylvania: 2006. pp 521-559.

Wood T. Physiological functions of the pentose phosphate pathway. Cell Biochem Funct 1986;4:241-7.

Bode BP, Fuchs BC, Hurley BP; et al. Molecular and functional analysis of glutamine uptake in human hepatoma and liver-derived cells. Am J Physiol 2002;283:G1062-G1073.

Wise DR, DeBerardinis RJ, Mancuso A; et al. Myc regulates a transcriptional program that stimulates mitochondrial glutaminolysis and leads to glutamine addiction. PNAS 2008;105:18782-7.

Griffin JL, Kauppinen RA. A metabolomics perspective of human brain tumours. FEBS Journal 2007;274:1132-9.

Smith S. The animal fatty acid synthase: one gene, one polypeptide, seven enzymes. FASEB J 1994;8:1248-59.

Borek C. Dietary antioxidants and human cancer. Integr Cancer Ther 2004; 3:333-41.

Urquhart Fewell A. Training the hospital dietitian. American J Nurs 1916;16:970-4.

Coia LR, Moyland DJ. Introduction to Clinical Radiation Oncology. Medical Physics Publishing. Madison, Wisconsin: 1998.

Smith AD, Kim YI, Refsum H. Is folic acid good for everyone? Am J Clin Nutr 2008;87:517-33.

Prasad KN, Cole WC, Kumar B, Che Prasad K. Pros and cons of antioxidant use during radiation therapy. Cancer Treat Rev 2002;28:79-91.

Moss RW. Should patients undergoing chemotherapy and radiotherapy be prescribed antioxidants? Integr Cancer Ther 2006;5:63-82.

Simone CB 2nd, Simone NL, Simone V, Simone CB. Antioxidants and other nutrients do not interfere with chemotherapy or radiation therapy and can increase kill and increase survival, Part 1. Altern Ther Health Med 2007;13:22-8.

Block KI, Koch AC, Mead MN, Tothy PK, Newman RA, Gyllenhaal C. Impact of antioxidant supplementation on chemotherapeutic toxicity: A systematic review of the evidence from randomized controlled trials. Int J Cancer 2008;123:1227-39.

Ströhle A, Zänker K, Hahn A. Nutrition in oncology: The case of micronutrients (review). Oncol Rep 2010;24:815-28.

Moss RW. Do antioxidants interfere with radiation therapy for cancer? Integr Cancer Ther 2007;6:281-92.

Block KI. Antioxidants and cancer therapy: Furthering the debate. Integr Cancer Ther 2004;3:342-8.

Cao H, Hininger-Favier I, Kelly MA; et al. Green tea polyphenol extract regulates the expression of genes involved in glucose uptake and insulin signaling in rats fed a high fructose diet. J Agric Food Chem 2007;55:6372-8.

Cao H, Urban Jr JF, Anderson RA. Cinnamon polyphenol extract affects immune responses by regulating anti- and proinflammatory and glucose transporter gene expression in mouse macrophages. J Nutr 2008;138:833-40.

Pifferi F, Roux F, Langelier B; et al. (n-3) polyunsaturated fatty acid deficiency reduces the expression of both isoforms of the brain glucose transporter GLUT1 in rats. J Nutr 2005;135:2241-6.

Strobel P, Allard C, Pérez Acle T, Calderón R, Aldunate R, Leighton F. Myricetin, quercetin and catechin-gallate inhibit glucose uptake in isolated rat adipocytes. Biochem J 2005;386:471-8.

Raina K, Serkova NJ, Agarwal R. Silibinin feeding alters the metabolic profile in TRAMP prostatic tumors: 1hnmrs-based metabolomics study. Cancer Res 2009;69:3731-5.

Puig Miquel T, Relat J, Marrero PF, Haro D, Brunet J, Colomer R. Green tea catechin inhibits fatty acid synthase without stimulating carnitine palmitoyl-transferase-1 or inducing weight loss in experimental animals. Anticancer Res 2008;28:3671-6.

Gotoh N, Nagao K, Onoda S; et al. Effects of three different highly purified n-3 series highly unsaturated fatty acids on lipid metabolism in C57BL/KsJ-dbl db mice. J Agr Food Chem 2009;57:11047-54.

Choi JS, Kim H, Jung MH, Hong S, Song J. Consumption of barley β-glucan ameliorates fatty liver and insulin resistance in mice fed a high-fat diet. Mol Nutr Food Res 2010;54:1004-13.

Gnoni GV, Paglialonga G. Resveratrol inhibits fatty acid and triacylglycerol synthesis in rat hepatocytes. Eur J Clin Invest 2009;39:211-8.

Brusselmans K, Vrolix R, Verhoeven G, Swinnen JV. Induction of cancer cell apoptosis by flavonoids is associated with their ability to inhibit fatty acid synthase activity. J Biol Chem 2005;280: 5636-45.

Lau DSY, Archer MC. The 10t,12c isomer of conjugated linoleic acid inhibits fatty acid synthase expression and enzyme activity in human breast, colon, and prostate cancer cells. Nutr Cancer 2010;62:116-21.

Rock CL. Multivitamin-multimineral supplements: Who uses them? Am J Clin Nutr 2007;85(Suppl):277S-279S.

Ashino H, Shimamura M, Nakashima H; et al. Novel function of ascorbic acid as an angiostatic factor. Angiogenesis 2003;6:259-69.

Tuohimaa P. Vitamin D, aging, and cancer. Nutr Rev 2008;66(10 Suppl 2):S147-S152.

Goodwin PJ, Ennis M, Pritchard KI, Koo J, Hood N. Prognostic effects of 25-hydroxy-vitamin D levels in early breast cancer. J Clin Oncol 2009;27:3757-63.

Douron M. U-shaped dose-response curves: implications for risk characterization of essential elements and other chemicals. J Toxicol Environ Health A 2010;73:181-6.

Druesne-Pecollo N, Latino-Martel P, Norat T, Barrandon E, Bertrais S, Galan P, Hercberg S. Beta-carotene supplementation and cancer risk: a systematic review and metaanalysis of randomized controlled trials. Int J Cancer 2010;127:172-84.

Muenstedt K, El-Safadi S. Nutritive supplements- help or harm for breast cancer patients? Breast Care (Basel) 2010;5:383-7.

Prasad KN, Cole WC, Kumar B, Prasad KC. Scientific rationale for using high-dose multiple micronutrients as an adjunct to standard and experimental cancer therapies. J Am Coll Nutr 2001;20(5 Suppl):450S-463S.

Prasad KN. Multiple dietary antioxidants enhance the efficacy of standard and experimental cancer therapies and decrease their toxicity. Integr Cancer Ther 2004;3:310-22.

Lesperance ML, Olivotto IA, Forde N, Zhao Y, Speers C, Foster H, Tsao M, MacPherson N, Hoffer A. Mega-dose vitamins and minerals in the treatment of non-metastatic breast cancer: an historical cohort study. Breast Cancer Res Treat. 2002;76:137-43.

Greenlee H, Hershman DL, Jacobson JS. Use of antioxidant supplements during breast cancer treatment: a comprehensive review. Breast Cancer Res Treat 2009;115:437-52.

Enlaces refback

No hay ningún enlace refback.