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Influência do estado nutricional e da capacidade antioxidante no controlo do cancro
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O cancro é uma das principais causas de mortalidade a nível mundial, sendo uma doença com uma tendência de crescimento significativo nas próximas décadas. Dada a sua elevada incidência e o impacto que têm na vida das pessoas, as doenças oncológicas têm sido alvo de inúmeros estudos. Entre os principais intervenientes no processo de carcinogénese, estão as espécies reativas de oxigénio, algumas delas radicais livres instáveis que reagem com diferentes compostos para obter estabilidade. Estão envolvidas em reações em cadeia que causam danos celulares ao nível das proteínas, ácidos nucleicos e lípidos e, quando em excesso ou em caso de disfunção dos sistemas antioxidantes, contribuem para estados de stress oxidativo. Com a evolução do conhecimento científico, foi possível chegar a vários tratamentos para o cancro e, hoje em dia, o desenvolvimento de terapias inovadoras e eficazes é uma prioridade no panorama da investigação. No entanto, o sucesso das intervenções terapêuticas vai muito para além das questões diretamente associadas aos fármacos e às abordagens utilizadas e é também influenciado por uma série de fatores, desde o historial médico e co-morbilidades do doente até ao seu estado nutricional. O tratamento desta patologia varia de acordo com o tipo de cancro presente, a sua localização e as suas especificidades, englobando técnicas como a quimioterapia, a radioterapia ou a cirurgia. Recentemente, os antioxidantes têm sido estudados como potenciais adjuvantes desta terapêutica, podendo adicionalmente ter uma ação benéfica sobre os efeitos adversos do tratamento. São substâncias que conseguem neutralizar a produção de radicais livres e contrabalançar os mecanismos de oxidação. Podem ser classificados como endógenos (por exemplo, enzimas) ou exógenos (como carotenoides, compostos fenólicos, minerais e vitaminas). A presente monografia analisa os desafios nutricionais gerados pelas várias opções terapêuticas anticancerígenas e potenciais estratégias para minimização dos efeitos secundários com impacto no estado nutricional do doente oncológico, após ser feita a sua caracterização. É
ainda descrito o papel dos antioxidantes dietéticos e feita uma breve menção ao modo como os antioxidantes podem modular os níveis de espécies reativas de oxigénio de forma a avaliar as potencialidades dos mesmos como alvos terapêuticos.
Cancer is one of the main causes of mortality worldwide and a disease with a significant growth trend in the coming decades. Given their high incidence and the impact they have on the lives of patients, oncological diseases have been the subject of numerous studies. Among the key players in the carcinogenesis process, we have reactive oxygen species, some of them unstable free radicals that react with different compounds to obtain stability. They are involved in chain reactions that cause cellular damage to proteins, nucleic acids and lipids and, when in excess or in case of dysfunction of antioxidant systems, they contribute to states of oxidative stress. With the evolution of scientific knowledge, it was possible to get to several treatments for cancer and, nowadays, the development of innovative and effective therapies is a priority for researchers. However, the success of therapeutic interventions goes far beyond the issues directly associated with the drugs and approaches used and is also influenced by a number of factors, from the patients’ medical history and co-morbidities to their nutritional status. The treatment varies according to the type of cancer, its location and its characteristics, comprising techniques such as chemotherapy, radiotherapy and surgery. Recently, antioxidants have been studied as potential adjuvants of this therapy, which may additionally have a beneficial action on the adverse effects of the treatment. They are substances that can neutralize the production of free radicals and counterbalance the mechanisms of oxidation. They can be classified as endogenous (enzymes) or exogenous (carotenoids, phenolic compounds, minerals and vitamins). This monograph analyzes the nutritional challenges produced by the various anticancer therapeutic options and potential strategies to minimize the side effects that impact the nutritional status of cancer patients, after its characterization. The role of dietary antioxidants is also described and a brief mention is made about how antioxidants can modulate the levels of reactive oxygen species in order to assess their potential as therapeutic targets.
Cancer is one of the main causes of mortality worldwide and a disease with a significant growth trend in the coming decades. Given their high incidence and the impact they have on the lives of patients, oncological diseases have been the subject of numerous studies. Among the key players in the carcinogenesis process, we have reactive oxygen species, some of them unstable free radicals that react with different compounds to obtain stability. They are involved in chain reactions that cause cellular damage to proteins, nucleic acids and lipids and, when in excess or in case of dysfunction of antioxidant systems, they contribute to states of oxidative stress. With the evolution of scientific knowledge, it was possible to get to several treatments for cancer and, nowadays, the development of innovative and effective therapies is a priority for researchers. However, the success of therapeutic interventions goes far beyond the issues directly associated with the drugs and approaches used and is also influenced by a number of factors, from the patients’ medical history and co-morbidities to their nutritional status. The treatment varies according to the type of cancer, its location and its characteristics, comprising techniques such as chemotherapy, radiotherapy and surgery. Recently, antioxidants have been studied as potential adjuvants of this therapy, which may additionally have a beneficial action on the adverse effects of the treatment. They are substances that can neutralize the production of free radicals and counterbalance the mechanisms of oxidation. They can be classified as endogenous (enzymes) or exogenous (carotenoids, phenolic compounds, minerals and vitamins). This monograph analyzes the nutritional challenges produced by the various anticancer therapeutic options and potential strategies to minimize the side effects that impact the nutritional status of cancer patients, after its characterization. The role of dietary antioxidants is also described and a brief mention is made about how antioxidants can modulate the levels of reactive oxygen species in order to assess their potential as therapeutic targets.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2022, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
Cancro ROS Terapêutica oncológica Estado nutricional Antioxidantes Mestrado integrado - 2022