科普專欄–薯不揀單 - 三十秒科學–談生酮飲食作癌症輔助治療的可行性

癌細胞跟正常細胞一樣，就算處於停止生長的狀態，均需攝取營養維持細胞運作。470Please respect copyright.ＰＥＮＡＮＡIbAo7z83wA
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在這個基礎下，有不少主張提倡以生酮飲食(Ketogenic Diet)作為醫治癌症的輔助療法。470Please respect copyright.ＰＥＮＡＮＡJaESr1TaLv
究竟這是「武肺乃由5G網路而起」之流，還是有其實質科學實據支持呢?470Please respect copyright.ＰＥＮＡＮＡRmIgZrgkbL
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（圖2）有不少的癌細胞均出現與PI3K蛋白質有關的變異，促使到它們具備更強大的快速繁殖及抵禦進行自我滅亡機制特性。470Please respect copyright.ＰＥＮＡＮＡI0DC7iAJtH
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有見及此，科學家們攜手合作，研發出藥物針對已變異的PI3K蛋白質，並在2010年其間進行大量的人類臨床研究，對相應的癌症病人下藥。470Please respect copyright.ＰＥＮＡＮＡCpBoZB8v8q
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遺憾的是，結果非常參差，整體成效並不理想。470Please respect copyright.ＰＥＮＡＮＡzDKLYzOAmz
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（圖3）深入探討為何會失敗後，科學家發現藥物對人體產生了一道副作用，就是誘使肝臟產生糖份，使血糖上升。470Please respect copyright.ＰＥＮＡＮＡAI5krPGAPl
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胰臟因著血糖的上升而產生胰島素，而非常諷刺的是，胰島素是激勵PI3K蛋白質的物質。470Please respect copyright.ＰＥＮＡＮＡM6sihZUDT7
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亦即是說，藥物副作用所產生的胰島素，抵消了藥物本來抑制PI3K的功用。470Please respect copyright.ＰＥＮＡＮＡkQQJkKzWEh
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（圖4）基於生酮飲食能夠消耗肝臟的糖原，以及維持血液低胰島素水平，科學家嘗試利用生酮飲食來制衡藥物的副作用，並在老鼠模型上取得非常可觀的成果。470Please respect copyright.ＰＥＮＡＮＡhqHBcQ5RFq
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現在即將進行子宮內壁膜癌症患者的臨床測試，以生酮飲食再配上PI3K藥物，希望能夠取得理想的成果。470Please respect copyright.ＰＥＮＡＮＡv4TtIy2eQp
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但有一點要注意的是，在某類型血癌及腦癌個案，生酮飲食反之然會鼓吹癌細胞加速生長，這很有可能是因為是某類別的癌細胞特別傾向吸收脂肪或酮體。470Please respect copyright.ＰＥＮＡＮＡ7peZSqbsye
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換句話說，在尚未摸透自身所患的癌細胞其新陳代謝特性之前，胡亂採取生酮飲食將有機會引來反效果，間接為癌細胞提供有利生長的環境。470Please respect copyright.ＰＥＮＡＮＡqSWz3hpr3x
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Ref1:https://www.nature.com/articles/s41586-018-0343-4470Please respect copyright.ＰＥＮＡＮＡ5AtMcfGQLM
Ref2:https://science.sciencemag.org/content/372/6537/20470Please respect copyright.ＰＥＮＡＮＡ6GDFpi0eLr

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