Oxaliplatin-Fluoropyrimidine Combination (XELOX) Therapy Does Not Affect Plasma Amino Acid Levels and Plasma Markers of Oxidative Stress in Colorectal Cancer Surgery Patients: A Pilot Study

Abstract

Chemotherapy for colorectal cancer may lower muscle protein synthesis and increase oxidative stress. We hypothesize that chemotherapy may worsen plasma amino acids (AAs) and markers of oxidative stress (MOS). Therefore, this study aimed to document plasma AAs and MOS before, during and after chemotherapy in colorectal cancer (CRC) surgery patients. Fourteen normal-weight CRC patients were enrolled one month after surgery and scheduled for oxaliplatin-fluoropyrimidine combination (XELOX) therapy. Venous blood samples for AA and MOS (malondialdehyde, MDA; 8-hydroxy-2’-deoxyguanosine, 8-OHdG) measurements were drawn in fasting patients before each oxaliplatin infusion at initiation (A), 1 month (B) and 3 months (C) of the therapy, and after XELOX had finished (6 months, D). The results showed that during XELOX therapy (from phase B to phase D), in comparison to baseline (phase A), the branched chain amino acid/essential amino acid ratio, branched chain amino acids expressed as a percentage of total AAs, and arginine expressed as a percentage of total AAs significantly decreased (p = 0.017, p = 0.028, p = 0.028, respectively). Plasma levels of MOS did not change significantly. This study indicates that XELOX therapy does not affect plasma AA levels or worsen oxidative stress.

Mini Nutritional Assessment May Identify a Dual Pattern of Perturbed Plasma Amino Acids in Patients with Alzheimer’s Disease: A Window to Metabolic and Physical Rehabilitation?

“…This is supported by a low BCAA/EAA ratio. Had BCAAs mainly been used for protein synthesis, we would have observed a more balanced BCAA/EAA ratio [18].…”

“…The basic idea behind the current study was that we may be able to achieve more homogenous, reliable plasma AA profile measures by relating plasma AAs to patients' nutritional and metabolic states. Several factors may influence the levels of circulating AAs in AD including both physiological factors such as protein intake and body proteolysis [12,13] and pathological factors such as inflammation [14], in which oral [15] and intestinal [16] dysbioses may play a role, insulin resistance [17], oxidative stress [18], skeletal muscle mitochondrial dysfunction following β-amyloid (Aβ) deposition [19][20][21], and wasting of lean body mass [22].…”

Targeted Nutrition in Chronic Disease

“…The present Special Issue on “Targeted Nutrition in Chronic Disease” includes three reviews [ 2 , 3 , 4 ] and seven original research articles [ 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. A meta-analysis on coffee intake and obesity suggested that higher coffee intake was associated with modestly lower body mass index (BMI) and waist circumference in men but not in women [ 2 ].…”

“…Finally, a small longitudinal pilot study investigated whether chemotherapy (oxaliplatin-fluoropyrimidine combination, XELOX) may cause protein loss and increase oxidative stress in 14 patients with advanced colorectal cancer [ 11 ]. There are several potential advantages for patients that result from the maintenance of a balanced amino acid composition during and after therapy.…”

“…There are several potential advantages for patients that result from the maintenance of a balanced amino acid composition during and after therapy. The results showed that XELOX therapy does not affect plasma amino acid levels or worsen oxidative stress [ 11 ]. However, these results need to be confirmed in larger studies, preferably with an interventional design in which specific amino acid mixtures targeting muscle protein synthesis and aerobic energy formation could be analyzed.…”