近日,圣约瑟夫医院的刊登于国际杂志PLoS ONE[PLoS One 2012;7(5):e36197]上一项研究揭示,生酮饮食其可以有效使用一种饮食和放疗结合的技术来有效处理大脑肿瘤细胞。
研究者表示,生酮膳食结合放疗方法可以有效应对个体的恶性神经胶质瘤(一种恶性神经脑瘤)。这种生酮膳食是一种高脂肪、低碳水化合物的膳食,其可以改变个体机体的新陈代谢,用于治疗儿童癫痫症。这种饮食对于大脑的动态平衡效应可以帮助研究者开发治疗其它神经性疾病的疗法。
这项研究中,研究者用标准的或者生酮的饮食来处理高水平恶性神经胶质瘤的小鼠,研究小鼠也都进行了放疗处理,研究者发现,喂食以生酮饮食的小鼠组相比标准饮食小鼠组,增加了长达5天的生存中值。同时进行生酮饮食和放疗的小鼠,11只中有9只并无任何肿瘤复发迹象。
研究者分析了生酮膳食配合放疗成功抑制脑瘤成功的原因,他们认为这种疗法降低了生长因子的兴奋性、抑制了肿瘤的生长。同时研究者也认为,这或许也可以降低炎症的发生以及肿瘤周围的浮肿。
研究者Scheck表示,这项研究对于开发人类恶性神经胶质瘤的疗法有明确的指示意义,我们发现生酮膳食可以明显增强放射的抗肿瘤效应,这也就揭示了这两种方法的结合或许可以有效抑制人类恶性神经胶质瘤的发生。他还补充道,而且生酮膳食可以快速简单地被添加到大脑肿瘤的疗法中,目前研究者正在进行临床试验,但是目前这种疗法还未得到FDA的批准。
Introduction
The ketogenic diet (KD) is a high-fat, low-carbohydrate diet that alters metabolism by increasing the level of ketone bodies in the blood. KetoCal® (KC) is a nutritionally complete, commercially available 4:1 (fat: carbohydrate+protein) ketogenic formula that is an effective non-pharmacologic treatment for the management of refractory pediatric epilepsy. Diet-induced ketosis causes changes to brain homeostasis that have potential for the treatment of other neurological diseases such as malignant gliomas.
Methods
We used an intracranial bioluminescent mouse model of malignant glioma. Following implantation animals were maintained on standard diet (SD) or KC. The mice received 2×4 Gy of whole brain radiation and tumor growth was followed by in vivo imaging.
Results
Animals fed KC had elevated levels of β-hydroxybutyrate (p = 0.0173) and an increased median survival of approximately 5 days relative to animals maintained on SD. KC plus radiation treatment were more than additive, and in 9 of 11 irradiated animals maintained on KC the bioluminescent signal from the tumor cells diminished below the level of detection (p<0.0001). Animals were switched to SD 101 days after implantation and no signs of tumor recurrence were seen for over 200 days.
Conclusions
KC significantly enhances the anti-tumor effect of radiation. This suggests that cellular metabolic alterations induced through KC may be useful as an adjuvant to the current standard of care for the treatment of human malignant gliomas.