İMMÜNONÜTRİSYON VE KANSER

Yıl 2019, Cilt: 6 Sayı: 1, 93 - 101, 15.06.2019

Sema Çalapkorur Gamze Akbulut

Öz

İmmün sistemi daha etkin kılmak amacıyla arjinin, glutamin, n-3 yağ asitleri ve nükleotitler gibi çeşitli besin öğeleri ile zenginleştirilerek uygulanan beslenme şekline immünonütrisyon adı verilmektedir. Onkolojik hastalara uygulanan immünonütrisyon desteği; cerrahi sonrası morbiditeyi, enfeksiyöz komplikasyon oranlarını, yara gelişimini ve hastanede yatış süresini azaltmaktadır. İmmün sistemin diyetle güçlendirilmesi kanser hastalarında önemli bir ek tedavi olarak kabul edilmeye başlanmıştır. Bu derlemede; onkoloji hastalarında önemli rolleri olan immünonütrientler ve bu besin öğelerinin etkileri hakkında literatür bilgisi doğrultusunda bilgi vermek amaçlanmaktadır.

Anahtar Kelimeler

Kanser, İmmünonütrisyon

Kaynakça

• Arends J, Bodoky G, Bozzetti F, et al. ESPEN guidelines on enteral nutrition: non-surgical oncology. Clin Nutr 2006; 25 (2): 245-259.
• Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr 2016; 36 (1): 1-38.
• August D, Huhmann MB. ASPEN clinical guidelines: Nutrition support therapy during adult anticancer treatment and in hematopoietic cell transplantation. J Parenter Enteral Nutr 2009; 33 (5): 472-500.
• Barış N, Turgan N, Ersöz B. Argininin tıpsal biyokimyadaki önemi. Türk Klinik Biyokimya Derg 2004; 2 (2): 83-90.
• Braga M, Gianotti L, Nespoli L, et al. Nutritional approach in malnourished surgical patients. Arch Surg 2002; 137 (2): 174-180.
• Braga M, GianottiL, Radaelli G, et al. Perioperative immünonutrition in patients undergoing cancer surgery. Arch Surg 1999;134 (4): 428-433.
• Chasapis C, Loutsidou AC, Spiliopoulou CA, et al. Zinc and human health. Arch Toxicol 2012; 86 (4): 521-534.
• Chattopadhyay S, Saha A, Azam M, et al. Role of oral glutamine in alleviation and prevention of radiation-induced oral mucositis: A prospective randomized study. South Asian J Cancer 2014; 3 (1): 8-12.
• Coşkun T. İmmünonütrisyondan farmakonütrisyona. Çocuk Sağlığı ve Hastalıkları Dergisi 2011; 54: 164-181.
• Çoker A. İmmünonütrisyon. Yoğun Bakım Derneği Dergisi 2006; 4 (1): 40-44.
• Fairweather-Tait S, Bao Y, Broadley MR, et al. Selenium in human health and disease. Antioxid Redox Signal 2011; 14 (7): 1337- 1383.
• Farreras N, Artigas V, Cardona D, et al. Effect of early postoperative enteral immunonutrition on wound healing in patients undergoing surgery for gastric cancer. Clin Nutr 2005; 24 (1): 55-65.
• Federico A, Iodice P, Federico P, et al. Effects of selenium and zinc supplementation on nutritional status in patients with cancer of digestive tract. Eur J Clin Nutr 2001; 55 (4): 293- 297.
• Grimble R. Nutritional modulation of immune function. Proc Nutr Soc 2001; 60 (3): 389- 397.
• Hoang B, Han B, Shaw DG, et al. Zinc as a possible preventive and therapeutic agent in pancreatic, prostate, and breast cancer. Eur J Cancer Prev 2016; 25 (5): 457-461.
• Kanekiyo S, Takeda S, Iida M, et al. Efficacy of perioperative immunonutrition in esophageal cancer patients undergoing esophagectomy. Nutrition 2019; 59: 96-102.
• Levis S, Pugsley M, Schneider C, et al. The effect of immünonutrition on veterans undergoing major surgery for gastrointestinal cancer. Fed Pract 2018; 35(Suppl 4): 49–S56.
• Lın L, Que J, Lın LK, et al. Zinc supplementatıon to improve mucositis and dermatitis in patients after radıotherapy for head-and-neck cancers: a double-blind, randomized study. Int J Radiation Oncology Biol Phys 2006; 65 (3): 745-750.
• Luis D, Izaola O, Aller R, et al. A randomized clinical trial with oral immunonutrition (ω3- enhanced formula vs. arginine-enhanced formula) in ambulatory head and neck cancer patients. Ann Nutr Metab 2005; 49 (2) :95-99.
• May P, Barber A, D'Olimpio JT, et al. Reversal of cancer-related wasting using oral supplementation with a combination of β-hydroxy- β-methylbutyrate, arginine, and glutamine. Am J Surg 2002; 183 (4): 471-479.
• Öztürk E. Kanser ve immünonütrisyon. İç Hastalıkları Dergisi 2010; 17 : 239-246.
• Öztürk M. Preoperatif Alanin-Glutaminden Zenginleştirilmiş Diyetin Elektif Kolon Anastomozu Üzerine Etkileri (Deneysel Çalışma). Uzmanlık Tezi, Dr.Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi, İstanbul, 2004: 51.
• Prieto I, Montemuino S, Luna J, et al. The role of immunonutritional support in cancer treatment: Current evidence. Clin Nutr 2017; 36 (6): 1457-1464.
• Rajagopalan K, DeBerardinis RJ. Role of glutamine in cancer: Therapeutic and imaging implications. J Nucl Med 2011; 52 (7): 1005-1008.
• Rayman M. Selenium and human health. Lancet 2012; 379 : 1256-1268.
• Riso S, Aluffi P, Brugnani M, et al. Postoperative enteral immunonutrition in head and neck cancer patients. Clin Nutr 2000; 19 (6): 407- 412.
• Suchner U, Kuhn KS, Fürst P. The scientific basis of immunonutrition. Proc Nutr Soc 2000; 59 (4): 553-563.
• Tokatlı A. İmmünonütrisyon. Ankem Dergi 2002; 16 (3): 390-394.
• Vidal-Casariego A, Calleja-Fernández A, Ballesteros-Pomar MD, et al. Efficacy of glutamine in the prevention of oral mucositis and acute radiation-induced esophagitis: A retrospective study. Nutr Cancer 2013; 65 (3) : 424-429.
• Wu X, Tang J, Xie M. Serum and hair zinc levels in breast cancer: A meta-analysis. Sci Rep 2015; 5: 1-8.
• Xu J, Zhong Y, Jing D, et al. Preoperative enteral immunonutrition improves postoperative outcome in patients with gastrointestinal cancer. World J Surg 2006; 30 (7): 1284- 1289.
• Yıldırım Z, Bidev D, Büyükavcı M. Parenteral glutamine supplementation has no effect on chemotherapy-induced toxicity in children with non-hodgkin lymphoma. Am J Pediatr Hematol Oncol 2013; 35 (5): 371-376.
• Yoshida S, Kaibara A, Ishibashi N. Glutamine supplementation in cancer patients. Nutrition 2001; 17 (9): 766-768.
• Zhang Y, Gu Y, Guo T, et al. Perioperative immunonutrition for gastrointestinal cancer: A systematic review of randomized controlled trials. Surg Oncol 2012; 21 (2): 87-95.
• Zheng G, Zheng Z, Zhao Y, et al. Clinical application of glutamine enhanced hypo-nitrogen hypo-caloric parenteral nutrition in postoperative stress period for gastric cancer patients with nutritional risk. Progress in Modern Biomedicine 2013: 13.
• Ziegler T. Glutamine supplementation in cancer patients receiving bone marrow transplantation and high dose chemotherapy. J Nutr 2001; 131 (9): 2578-2584.
• Ziegler T. Glutamine supplementation in bone marrow transplantation (BMT). Br J Nutr 2002; 87 (1): 9-15.