Balanço entre ácidos graxos ômega-3 e 6 na resposta inflamatória em pacientes com câncer e caquexia

Autores/as

  • Adriana GARÓFOLO Universidade Federal de São Paulo
  • Antônio Sérgio PETRILLI Universidade Federal de São Paulo

Palabras clave:

ácidos graxos, caquexia, desnutrição, inflamação, neoplasias

Resumen

O emagrecimento, associado à perda de massa magra, é um fenômeno observado com freqüência em pacientes com câncer. Tal condição predispõe o paciente ao maior risco de infecções, pior resposta aos tratamentos implantados e, como conseqüência, desfavorece o prognóstico de cura. Além disso, a desnutrição também está associada à pior qualidade de vida. Dessa forma, algumas terapias têm sido propostas na tentativa de reverter o catabolismo, por meio da atenuação da resposta inflamatória, observado em grande porcentagem de pacientes com câncer e caquexia. Entre elas, a suplementação com ácidos graxos da família ômega-3 pode representar uma estratégia na redução da formação de citocinas pró-inflamatórias, favorecendo a tolerância metabólica dos substratos energéticos e atenuando o catabolismo protéico, com o intuito de melhorar o prognóstico de cura de pacientes com câncer. Entretanto, os estudos mostram alguns resultados conflitantes da suplementação com ômega-3 na resposta imunológica. Por outro lado, em pacientes com câncer, os ensaios clínicos mostraram atenuar a resposta inflamatória e melhorar o estado nutricional. O objetivo deste artigo é realizar uma revisão criteriosa do assunto. 

Descargas

Los datos de descargas todavía no están disponibles.

Citas

Wong PW, Enriquez A, Barrera R. Nutritional support in critically ill patients with cancer. Crit Care Clin. 2001; 17(3)

Harrison LE, Brennan MF. The role of total parenteral nutrition in the patient with cancer. Curr Prob Surg. 1995; 32(10):833-924.

Garófolo A. Estado nutricional de crianças e adolescentes com câncer [dissertação]. São Paulo: Escola Paulista de Medicina, Universidade Federal de São Paulo; 2000.

Holcomb GW, Ziegler MM. Nutrition and cancer in children. Surg Ann. 1990; 129-41.

Mauer AM, et al. Special nutrition needs of children with malignancies: a review. JPEN. 1990; 14:315-24.

Laviano A, Meguid MM, Yang ZJ, Gleason JR, Cangiano C, Fanelli FR. Cracking the riddle of cancer anorexia. Nutrition. 1996; 12:706-10.

Keefe DMK, Cummins AG, Dale BM, Kotasek D, Robb TA, Sage E. Effect of high-dose chemotherapy on intestinal permeability in humans. Clin Sci. 1997; 92:385-9.

Tisdale MJ. Cancer caquexia: metabolic alterations and clinical manifestations. Nutrition. 1997; 13:1-7.

Kyle UG, Pirlich M, Schuetz T, Lochs H, Pichard C. Is nutritional depletion by nutritional risk index associated with increased length of hospital stay? A population-based study JPEN. 2004; 28(2): 99-104.

Windsor JA, Graham LH. Weight loss with physiologic impairment. A basic indicator of surgical risk. Ann Surg. 1987; 207(3):290-6.

Villa ML, Ferrario E, Bergamasco E, Bozzetti F, Cozzaglio L, Clerici E. Reduced natural killer cell activity and IL-2 production in malnourished cancer patients. Br J Cancer. 1991; 63:1010-4.

Gogos CA, Ginopoulos P, Salsa B, Apostolidou E, Zoumbos NC, Kalfarentzos F. Dietary omega-3 polyunsaturated fatty acids plus vitamin E restore immunodeficiency and prolong survival for severely ill patients with generalized malignancy. A

randomized control trial. Cancer. 1998; 82(2): 395-401.

Garófolo A, Lopez FA. Novos conceitos e propostas na assistência nutricional da criança com câncer. Rev Paul Pediatr. 2002; 20:140-6.

Torosian MH. Cancer cachexia and nutrition support in the cancer patient. A clinical review. Cancerología. 1993; 39:1768-74.

Tchekmedyian SN, Halpert C, Ashley J, Herber D. Nutrition in advanced cancer: anorexia as a outcome variable and target of therapy. JPEN. 1992; 16(6):88S-92S.

Tisdale MJ. Cancer anorexia and cachexia. Nutrition. 2001; 17:438-42.

Cohen J, Lefor AT. Nutrition support and cancer. Nutrition. 2001; 17:698-9.

Slaviero KA, Clarke SJ, Rivory LP. Inflammatory response: an unrecognized source of variability in the pharmacokinetics and pharmacodynamics of cancer chemotherapy. Lancet Oncol. 2003; 4(4):224-32.

Calder PC. Long-chain n-3 fatty acids and inflammation: potential application in surgical and trauma patients. Braz J Med Biol Res. 2003; 36(4):433.

Bistrian BR. Clinical aspects of essential fatty acid metabolism: Jonathan Rhoads lecture. JPEN. 2003; 27(3):168.

Thompson WA, Lowry SF. Effect of nutrition on inflammatory mediators. In: Zaloga GP. Nutrition in critical care. St Louis: Mosby; 1994. p.505-23.

Agency for Healthcare Research and Quality. Effects of omega-3 fatty acids on organ transplantation. Department of Health and Human Services; 2005. p.115.

Fürst P. The striking diet of the island of Crete: lipid nutrition from the palaeolithic to the affluent modern society. Clin Nutr. 2002; 21(S2):9-14.

James MJ, Gibson RA, Cleland LG. Dietary polyunsaturated fatty acids and inflammatory mediator production. Am J Clin Nutr. 2000; 71(S):343-8.

Kelley DS. Modulation of human immune and inflammatory responses by dietary fatty acids. Nutrition. 2001; 17:669-73.

Grimble R. Use of n-3 fatty acid-containing lipid emulsions in the Intensive Care Unit environment: the scientist’s view. Clin Nutr. 2002; 21(S2):15-21.

Robert O. Practical applications of fish oil (w-3 fatty acids) in primary care. J Am Board Pract. 2005; 18:28-36.

Institute of Medicine. Dietary Reference Intakes (DRIs) for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids. Part 1. Washington (DC): National Academy Press; 2002.

Nutrition and Health Collection. Danone Research Center. Nutritional recommendations. Lipids from alpha to omega. Paris: John Libbey Eurotext; 1999.

Lasztity N, Hamvas J, Biro L, et al. Effect of enterally administrad n-3 polynsaturated fatty acids in acute pancreatitis-a prospective radomized clinical trial. Clin Nutr. 2005; 24:198-205.

Meier R. Enteral fish oil in acute pancreatitis. Clin Nutr. 2005; 24:169-71.

Barber MD. Cancer caquexia and its treatment with fish-oil-enriched nutritional supplementation. Nutrition. 2001; 17:751-5.

Fearon KCH. The anticancer and anticachetic effects of n-3 fatty acids. Clin Nutr. 2002; 21(S2):73-7.

Hardmam WE. Omega-3 fatty acid to augment cancer therapy. J Nutr. 2002; 132:3508S-12S.

Barber MD, Ross JA, Preston T, Shenkin A, Fearon KCH. Fish oil-enriched nutritional supplement attenuates progression of the acute-phase response in weight-losing patients with advanced pancreatic cancer. J Nutr. 1999; 129:1120-5.

Barber MD, McMillan DC, Preston T, Ross JA, Fearon CH. Metabolic response to feeding in weight-losing pancreatic cancer patients and its modulation by a fish-oil-enriched nutritional supplement. Clin Sci. 2000; 98:389-99.

Park Y, Harris WS. Omega-3 fatty acid supplementation accelerates chylomicron triglyceride clearence. J Lipid Res. 2003; 44(3): 455-63.

Swails WS, Kenler AS, Driscoll DF, et al. Effect of a fish oil structured lipid-based diet on prostaglandin release from mononuclear cells in cancer patients after surgery. JPEN. 1997; 21(5): 266-74.

Mayer K, Gokorsch S, Fegbeutel C, et al. Parenteral nutrition with fish oil modulates cytokine response in patients with sepsis. Am J Respir Crit Care Med. 2003; 167(10):1321-8.

Tsekos E, Reuter C, Stehle P, Boeden G. Perioperative administration of parenteral fish oil supplements in a routine clinical setting improves patient outcome after major adbominal surgery. Clin Nutr. 2004; 23(3):325-30.

Tsekos E, Reuter C, Stehle P, Boeden G. Corrigendum to “Perioperative administration of parenteral fish oil supplements in a routine clinical setting improves patient outcome after major adbominal surgery”. Clin Nutr. 2004; 23(4): 755-6.

Maclean CH, Newberry SJ, Mojica WA, et al. Effects of Omega-3 fatty acids on cancer. Evid Rep Technol Assess. 2005; 113(summ):1-4.

Grimble RF, Howell WM, O’Reilly, et al. The ability of fish oil to suppress tumor necrosis factor a production by peripheral blood mononuclear cells in healthy men is associated with polymorphisms in genes that influence tumor necrosis factor a

production. Am J Clin Nutr. 2002; 76(2):454-9.

Hughes DA, Pinder AC, Piper Z, Johnson IT, Lund EK. Fish oil supplementation inhibits the expression of major histocompatibility complex class II molecules and adhesion molecules on human monocytes. Am J Clin Nutr. 1996; 63(2):267-72.

Beck AS, Smith KL, Tisdale MJ. Anticachetic and antitumor effect of eicosapentaenoic acid and its effect on protein turnover. Cancer Res. 1991; 51(15):6089-93.

Thies F, Nebe-von-Caron G, Powell JR, Yaqoob P, Newsholme EA, Calder PC. Dietary supplementation with eicosapentaenoic acid, but not with other long-chain n-3 or n-6 polyunsaturated fatty acids, decreases natural killer

cell activity in healthy subjects aged>55 y. Am J Clin Nutr. 2001; 73(3):539-48.

Wu D, Meydani SN. N-3 polyunsaturated fatty acids and immune function. Proc Nutr Soc. 1998; 57(4):503-9.

Institute of Medicine. Dietary reference intakes (DRIs) for vitamin C, vitamin E, selenium, and carotenoids. Washington (DC): National Academy Press; 2000.

Bloch AS, Shils ME. Appendix. In: Shils ME, Olson JA, Shike M. Modern nutrition in health and disease. 8th ed. Malvern: Lea & Febiger; 1994. p.A100-4.

Grimminger F, Seeger W, Mayer K. Use of n-3 fatty acid-containing lipid emulsions in the intensive care unit environment: the clinician’s view. Clin Nutr. 2002; 21(S2):23-9.

Pablo MA, Puertollano MA, Cienfuegos GA. Biological and clinical significance of lipids as modulators of immune system functions. Clin Diagn Lab Immunol. 2002; 9(5):945-50.

Publicado

2023-09-18

Cómo citar

GARÓFOLO, A., & PETRILLI, A. S. (2023). Balanço entre ácidos graxos ômega-3 e 6 na resposta inflamatória em pacientes com câncer e caquexia. Revista De Nutrição, 19(5). Recuperado a partir de https://puccampinas.emnuvens.com.br/nutricao/article/view/9751