Effects of a preoperative immune-modulating diet in patients with esophageal cancer: a prospective parallel group randomized study

Kitagawa, Hiroyuki; Namikawa, Tsutomu; Yatabe, Tomoaki; Munekage, Masaya; Yamasaki, Fumiyasu; Kobayashi, Mariko; Hanazaki, Kazuhiro

doi:10.1007/s00423-016-1538-5

Cited by 22 publications

(26 citation statements)

References 43 publications

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“…Moon et al 32 showed that oleic acid and linolenic acid could downregulate the malignant potential of OE19 and OE33 esophageal cancer cells, mainly through regulating the AMPK/S6 axis. Kitagawa et al 33 found that γ-linolenic acid inhibited esophageal tumor growth based on clinical statistical data. The antitumor activities of lactoferrin or the three unsaturated fatty acids alone have been widely validated, but the effect of lactoferrin + oleic acid/DHA/linolenic combinations in inhibiting esophageal tumors has been rarely studied.…”

Section: Discussionmentioning

confidence: 99%

The Combination of Two Bioactive Constituents, Lactoferrin and Linolenic Acid, Inhibits Mouse Xenograft Esophageal Tumor Growth by Downregulating Lithocholyltaurine and Inhibiting the JAK2/STAT3-Related Pathway

Yao

et al. 2020

ACS Omega

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The addition of lactoferrin and three unsaturated fatty acids, oleic acid, docosahexaenoic acid (DHA), and linolenic acid, to dairy products was approved in recent years. Research into the biological activities of lactoferrin and these three unsaturated fatty acids has revealed anti-inflammatory, antiviral, antioxidant, antitumor, antiparasitic, and antibiotic effects. However, investigations and comparisons of lactoferrin + oleic acid/DHA/linolenic acid combinations in an esophageal cancer cell model and in xenograft tumor models have not been extensively reported, and the related mechanism of these combinations remains elusive. In the present study, the effects of lactoferrin and the three fatty acids on KYSE450 cell viability, migration, and invasion were investigated to choose the proper doses and effective combination in vitro . A tumor-bearing nude mouse model was established to investigate the role of selected combinations in inhibiting esophageal tumor formation in vivo . Metabonomics detection and data analysis were performed to screen special metabolites and related pathways, which were validated by western blotting. The results demonstrated that lactoferrin, the three unsaturated fatty acids, and their combinations inhibited the viability, migration, and invasion of KYSE450 cells and induced apoptosis and the lactoferrin + linolenic acid combination exhibited the strongest activity in suppressing KYSE450 tumor formation in vivo. The lactoferrin + linolenic acid combination inhibited phosphorylation in the JAK2/STAT3-related pathway by downregulating the special metabolite lithocholyltaurine, thereby suppressing formation of KYSE450 tumors.

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Section: Discussionmentioning

confidence: 99%

The Combination of Two Bioactive Constituents, Lactoferrin and Linolenic Acid, Inhibits Mouse Xenograft Esophageal Tumor Growth by Downregulating Lithocholyltaurine and Inhibiting the JAK2/STAT3-Related Pathway

Yao

et al. 2020

ACS Omega

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“…Among 14 eligible studies, nine (13, 14, 37, 38, 40-42, 45, 46) reported the details of generating random sequence such as computerized random program and random number table. Eight studies (13,14,37,(39)(40)(41)(42)(43) correctly performed allocation concealment, and three studies (13,14,42) did not blind participant, personnel or outcome assessor. Details of the risk of bias were summarized in Fig.…”

Section: Risk Of Biasmentioning

confidence: 99%

“…Previous studies suggested that enteral nutrition (EN) can effectively decrease the risk of postoperative complications and enhance the recovery among patients undergoing gastrointestinal surgery compared to parenteral nutrition (PN) (9)(10)(11). However, standard EN do not contain immuneenhancing ingredients of improving host immunity and relieving in ammatory response (12), and thus additional immune-modulating substances such as arginine and omega-3 polyunsaturated fatty acids has been added to standard EN, which is de ned as enteral immunonutrition (EIN) (13,14).…”

Section: Introductionmentioning

confidence: 99%

The Optimal Time of Applying Enteral Immunonutrition in Esophageal Cancer Patients Receiving Esophagectomy: A Network Meta-Analysis of Randomized Clinical Trials

Tian¹,

Jin²,

Zhang³

et al. 2021

Preprint

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Background: Enteral immunonutrition (EIN) has been extensively applied in cancer patients, however its role in esophageal cancer (EC) patients receiving esophagectomy remains unclear. We performed this network meta-analysis to investigate the impact of EIN on patients undergoing surgery for EC and further determine the optimal time of applying EIN.Methods: We searched PubMed, EMBASE, Cochrane library, and China National Knowledgement Infrastructure (CNKI) to identify eligible studies. Categorical data was expressed as the odds ratio with 95% confidence interval (CI), and continuous data was expressed as mean difference (MD) with 95% CI. Pair-wise and network meta-analysis was performed to evaluate the impact of EIN on clinical outcomes using RevMan 5.3 and ADDIS V.1.16.8 softwares. The surface under the cumulative ranking curve (SUCRA) was calculated to rank all nutritional regimes.Results: Total 14 studies involving 1071 patients were included. Pair-wise meta-analysis indicated no difference between EIN regardless of the application time and standard EN (SEN), however subgroup analyses found that postoperative EIN was associated with decreased incidence of total infectious complications (OR=0.47; 95%CI=0.26 to 0.84; p=0.01) and pneumonia (OR=0.47; 95%CI=0.25 to 0.90; p=0.02) and shortened LOH (MD=-1.01; 95%CI=-1.44 to -0.57; p<0.001) compared to SEN, which were all supported by network meta-analyses. Ranking probability analysis further indicated that postoperative EIN has the highest probability of being the optimal option in terms of these three outcomes.Conclusions: Postoperative EIN should be preferentially utilized in EC patients undergoing esophagectomy because it has optimal potential of decreasing the risk of total infectious complications and pneumonia and shortening LOH.OSF registration number: 10.17605/OSF.IO/KJ9UY.

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“…Moreover, that trial showed a significant difference in the 6-month survival rates between the intervention group and the control group (92 vs. 72%; p = 0.028). One prospective randomized trial by Kitagawa et al [27] evaluated the effects of preoperative IN in patients undergoing thoracoscopic esophagectomy. In that study, MHN-02 (MEIN ® ; Meiji Dairies Co., Tokyo, Japan) as an immune-modulating diet was administrated during the 5 days before surgery.…”

Section: In In Patients Undergoing Esophagectomymentioning

confidence: 99%

“…Four trials [21,23,25,27] compared the preoperative administration of IN with an ordinary diet. Three trials were retrospective studies and one was a prospective randomized study.…”

Section: In In Patients Undergoing Esophagectomymentioning

confidence: 99%

Effects of Enteral Immunonutrition in Esophageal Cancer

Mimatsu

Fukino

Ogasawara

et al. 2017

Gastrointest Tumors

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Background: Immunonutrition (IN) significantly reduces the incidence of postoperative infectious complications and the length of hospitalization in patients undergoing major elective surgery for gastrointestinal malignances. However, the clinical benefit of IN in patients who have undergone esophagectomy for esophageal cancer is unclear. Moreover, the effect of enteral IN in patients during preoperative adjuvant chemoradiotherapy and in patients treated with concurrent chemoradiotherapy for advanced esophageal cancer is unknown. Summary: This review analyzes the evidence supporting the enteral administration of IN in patients who have undergone esophagectomy and/or chemoradiotherapy for esophageal cancer. Twelve trials that evaluated IN exclusively in patients who underwent esophagectomy were published between January 1980 and August 2017. Two trials concerning IN during chemoradiotherapy for esophageal cancer were identified in the same period. However, the evidence is insufficient to recommend enteral IN in patients who have undergone esophagectomy and/or chemoradiotherapy for esophageal cancer. Key Message: Further evidence from well-designed randomized controlled trials is required to verify the clinical benefits of enteral IN in patients undergoing esophagectomy and/or chemoradiotherapy for esophageal cancer. Practical Implications: Resolvins, which are generated from EPA, are novel anti-inflammatory lipid mediators and may play a key role in the resolution of acute inflammation when IN is supplemented with EPA in patients undergoing severely stressful operations.

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Effects of a preoperative immune-modulating diet in patients with esophageal cancer: a prospective parallel group randomized study

Abstract: Preoperative IMD suppressed the elevation of the TNF-α levels after thoracoscopic esophagectomy in patients with esophageal cancer, although no different tendency was detected in terms of IL-6, CRP or postoperative complications.

Cited by 22 publications

References 43 publications

The Combination of Two Bioactive Constituents, Lactoferrin and Linolenic Acid, Inhibits Mouse Xenograft Esophageal Tumor Growth by Downregulating Lithocholyltaurine and Inhibiting the JAK2/STAT3-Related Pathway

The Combination of Two Bioactive Constituents, Lactoferrin and Linolenic Acid, Inhibits Mouse Xenograft Esophageal Tumor Growth by Downregulating Lithocholyltaurine and Inhibiting the JAK2/STAT3-Related Pathway

The Optimal Time of Applying Enteral Immunonutrition in Esophageal Cancer Patients Receiving Esophagectomy: A Network Meta-Analysis of Randomized Clinical Trials

Effects of Enteral Immunonutrition in Esophageal Cancer

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