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免疫治疗时代营养支持对肿瘤疗效的影响

Impact of Nutritional Support on Antitumor Efficacy in the Era of Immunotherapy

  • 摘要: 尽管免疫治疗在实体瘤领域取得突破,但其疗效存在显著差异。高达80%的肿瘤患者伴有营养不良,这会导致淋巴组织萎缩、T细胞储备减少;T细胞激活与扩增所需底物匮乏;合并炎症阻碍T细胞向肿瘤浸润以及恶病质加速PD-1抗体清除。临床研究证实,严重营养不良会显著削弱免疫应答并增加治疗毒性风险。因此,实施规范的营养治疗对于优化免疫细胞的储备、激活、扩增及浸润能力至关重要,为免疫治疗提供健全的免疫系统基础。免疫营养治疗通过强化精氨酸、ω-3多不饱和脂肪酸和核苷酸等免疫营养素,可降低促炎介质分泌,促进T细胞活化与增殖,从而提升抗肿瘤免疫应答并延长生存期,推动肿瘤治疗向多模式联合与精准化方向发展。
     

     

    Abstract: Despite breakthroughs in immunotherapy for solid tumors, significant variations in treatment efficacy persist. Up to 80% of cancer patients suffer from malnutrition, which leads to: lymphoid atrophy and reduced T-cell reserves; deficiency of substrates required for T-cell activation and expansion; concurrent inflammation hindering T-cell infiltration into tumors; and cachexia accelerating PD-1 antibody clearance. Clinical studies confirm that severe malnutrition significantly impairs immune responses and increases the risk of treatment toxicity. Therefore, implementing standardized nutritional therapy is crucial for optimizing the reserve, activation, expansion, and infiltration capacity of immune cells, thereby providing a sound immune system foundation for immunotherapy. Immunonutrition therapy, by enhancing immunonutrients such as arginine, omega-3 polyunsaturated fatty acids, and nucleotides, reduces the secretion of pro-inflammatory mediators and promotes T-cell activation and proliferation. This enhances anti-tumor immune responses, prolongs survival, and advances cancer treatment towards multimodal combination and precision approaches.

     

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