Información del artículo
Resumen
El resultado de estudios in vitro y en animales ofrecen evidencias científicas de que el consumo de dietas ricas en ácidos grasos poliinsaturados n-3 reduce el desarrollo y el riesgo de sufrir cáncer de colon, además de incrementar la efi cacia de la quimioterapia y reducir sus efectos secundarios. No obstante, los estudios epidemiológicos que relacionan el cáncer de colon y la ingestión de n-3 presentan resultados heterogéneos y, por lo tanto, no ofrecen sufi cientes evidencias que confi rmen las propiedades para reducir el crecimiento y el riesgo del cáncer de colon de los n-3. El presente trabajo tiene como objetivo revisar las últimas publicaciones que relacionan el cáncer de colon y los n-3, y pretende contribuir a conocer mejor el motivo de la heterogeneidad de resultados obtenidos en los estudios epidemiológicos que relacionan el cáncer de colon y los n-3. A pesar de que los resultados de los estudios disponibles no presentan evidencias concluyentes que demuestren que los n-3 reducen el desarrollo del cáncer de colon, los resultados de estos estudios inducen a hacer recomendaciones dietéticas encaminadas a mejorar la supervivencia de estos pacientes e incluso para la prevención. Por lo tanto, se recomienda el consumo de pescado azul 2 o 3 veces por semana en sustitución de alimentos que contengan grasas saturadas, o concentrados de aceites de pescado en dosis no superiores a 3g/día.
Palabras clave:
Cáncer colorrectal
Omega 3
PUFA
EPA
DHA
Abstract
Experimental studies in vitro and with animals provide scientifi c evidence that the ingestion of n-3 polyunsaturated fatty acids (n3-FA) leads to a reduction in the risk and the growth of colorectal cancer. n3-FA may also increase the effectiveness of chemotherapy treatment and reduce its side effects. However, the epidemiological studies that link colorectal cancer to the ingestion of n-3 FA, show a wide disparity of results, therefore there is not suffi cient evidence to confi rm that n-3 FA ingestion leads to a reduction in the growth of colorectal cancer. The aim of this study is to presents a review of the recent literature that associates cancer of the colon and n-3 FA. It also attempts to contribute to a better understanding of the reasons for the heterogeneity of the results in the epidemiological studies. Despite there being no conclusive evidence in current studies, the results of these studies have led to the making of dietary recommendations aimed at the improving the survival of patients and also of preventing the cancer. These patient dietary recommendations involve increasing the intake of unsaturated fat acids from blue fish 2 or 3 times per week, or concentrated fish oil to a maximum level of 3 g/day.
Keywords:
Colorectal cancer
Omega-3
PUFA
EPA
DHA
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Bibliografía
[1.]
G. Lopez-Abente, et al.
Situación del cáncer en españa: incidencia.
Anales Sis San Navarra, 27 (2004), pp. 165-173
[2.]
A. Jemal.
A Geographic analysis of prostate cancer mortality in the United States, 1970–89.
International Journal of Cancer, 101 (2002), pp. 168-174
[3.]
L. Paz Valinas, M. Atienza.
Cribado poblacional del cáncer colorrectal: una revisión sistemática.
Gastroenterol Hepatol, 27 (2004), pp. 450-459
[4.]
Brouwer, A. Ingeborg, et al.
Effect of fish oil on ventricular tachyarrhythmia and death in patients with implantable cardioverter defi brillators.
JAMA, 295 (2006), pp. 2613-2619
[5.]
E.K. Lund.
Dietary fatty acids and colon cancer.
Scand J Food Nutr, (2006), pp. 39-44
[6.]
Trazazzi, GISSI-HF investigators, et al.
Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF Trial): A randomised, double-blind, placebo-controlled trial.
Lancet, 372 (2008), pp. 1223-1230
[7.]
T. Holm, A.K. Andreassen, P. Aukrust, K. Andersen, O.R. Geiran, J. Kjekshus, et al.
Omega-3 fatty acids improve blood pressure control and preserve renal function in hypertensive heart transplant recipients.
Eur Heart J, 22 (2001), pp. 428-436
[8.]
W.E. Connor.
N-3 fatty acids: Effects on the plasma lipids and lipoproteins and on neural development.
Atherosclerosis Reviews, 23 (1991), pp. 191-220
[9.]
S.C. Larsson.
Dietary long-chain n-3 fatty acids for the prevention of cancer: a review of potential mechanisms.
Am J Clin Nutr, 79 (2004), pp. 935-945
[10.]
B.A. Narayanan.
Modulation of inducible nitric oxide synthase and related proinflammatory genes by the omega-3 fatty acid docosahexaenoic acid in human colon cancer cells.
Cancer Research, 63 (2003), pp. 972-979
[11.]
Nassiff-Hadad, Meriño-Ibarra.
Ácidos grasos omega-3: pescados de carne azul y concentrados de aceites de pescado Lo bueno y lo malo.
Revista Cubana de Medicina, 42 (2003),
[12.]
T.M. Devlin.
Bioquímica.
4.a ed., Reverté, (2004),
[13.]
J.R. Hibbeln.
Healthy intakes of n-3 and n-6 fatty acids: estimations considering worldwide diversity.
Am J Clin Nutr, 83 Suppl (2006), pp. S1483-S1493
[14.]
Food Standards Agency. McCance & Widdowson's the Composition of Foods, Fats a Oils. Royal Society of Chemistry; 1991.
[15.]
A. Hauenschild.
Successful treatment of severe hypertriglyceridemia with a formula diet rich in omega-3 fatty acids and medium-chain triglycerides.
Ann Nutr Metab, 56 (2010), pp. 170-175
[16.]
D.R. Morgan.
Effects of dietary omega-3 fatty acid supplementation on endothelium-dependent vasodilation in patients with chronic heart failure.
American Journal of Cardiology, 97 (2006), pp. 547-551
[17.]
E. Mulvihill, M. Huff.
Antiatherogenic properties of flavonoids: implications for cardiovascular health.
Canadian Cardiology Publications, (2010),
[18.]
G.P. Amminger.
Long-chain omega-3 fatty acids for indicated prevention of psychotic disorders a randomized, placebo-controlled trial.
Archives of General Psychiatry, 67 (2010), pp. 146-154
[19.]
M. Peet.
Omega-3 fatty acids in the treatment of psychiatric disorders.
Drugs, 65 (2005), pp. 1051-1059
[20.]
A.F.G. Cicero.
Omega-3 polyunsaturated fatty acids: their potential role in blood pressure prevention and management.
Current Vascular Pharmacology, 7 (2009), pp. 330-337
[21.]
A. Ramel.
Moderate consumption of fatty fish reduces diastolic blood pressure in overweight and obese European young adults during energy restriction.
Nutrition, 26 (2010), pp. 168-174
[22.]
P. Yee.
A role for omega-3 polyunsaturated fatty acid supplements in diabetic neuropathy.
Investigative Ophthalmology & Visual Science, 51 (2010), pp. 1755-1764
[23.]
Kato, Taeko, Kolenic, Nicoleand Pardini, S. Ronald.
Docosahexaenoic acid (DHA), a primary tumor suppressive omega-3 fatty acid, inhibits growth of colorectal cancer independent of p53 mutational status.
Nutrition & Cancer, 58 (2007), pp. 178-187
[24.]
W.E. Hardman.
Omega-3 fatty acids to augment cancer therapy.
J Nutr, 132 (2002), pp. S3508-S3512
[25.]
C.R. Daniel.
Dietary intake of omega-6 and omega-3 fatty acids and risk of colorectal cancer in a prospective cohort of us men and women.
Cancer Epidemiol Biomarkers Prev, 18 (2009), pp. 516-525
[26.]
H.J. Murff.
A prospective study of dietary polyunsaturated fatty acids and colorectal cancer risk in chinese women.
Cancer Epidemiol Biomarkers Prev, 18 (2009), pp. 2283-2291
[27.]
P. Terry, L. Bergkvist, L. Holmberg, A. Wolk.
No association between fat and fatty acids intake and risk of colorectal cancer.
Cancer Epidemiol Biomarkers Prev, 10 (2001), pp. 913-914
[28.]
J. Lin.
Dietary fat and fatty acids and risk of colorectal cancer in women.
Am J Epidemiol, 160 (2004), pp. 1011-1022
[29.]
P.C. Calder, P. Yaqoob, F. Thies, F.A. Wallace, E.A. Miles.
Fatty acids and lymphocyte functions.
Br J Nutr, 87 Suppl (2002), pp. S31-S48
[30.]
P.C. Calder, R.F. Grimble.
Polyunsaturated fatty acids, inflammation and immunity.
Eur J Clin Nutr, 56 Suppl (2002), pp. S14-S19
[31.]
J. Raud, S.E. Dahlen, A. Sydbom, L. Lindbom, P. Hedqvist.
Enhancement of acute allergic inflammation by indomethacin is reversed by prostaglandin E2: apparent correlation with in vivo modulation of mediator release.
Proc Natl Acad Sci U S A, 85 (1988), pp. 2315-2319
[32.]
K.M. Leahy, R.L. Ornberg, Y. Wang, B.S. Zweifel, A.T. Koki, J.L. Masferrer.
Cyclooxygenase-2 inhibition by celecoxib reduces proliferation andinduces apoptosis in angiogenic endothelial cells in vivo.
Cancer Res, 62 (2002), pp. 625-631
[33.]
S. Tsutsumi, R. Haruna, W. Tomisato, et al.
Effects of prostaglandins on spontaneous apoptosis in gastric mucosal cells.
Dig Dis Sci, 47 (2002), pp. 84-89
[34.]
G.P. Pidgeon, M. Kandouz, A. Meram, K.V. Honn.
Mechanisms controlling cell cycle arrest and induction of apoptosis after 12-lipoxygenase inhibition in prostate cancer cells.
Cancer Res, 62 (2002), pp. 2721-2727
[35.]
B. Damtew, P.J. Spagnuolo.
Tumor cell-endothelial cell interactions: evidence for roles for lipoxygenase products of arachidonic acid in metastasis.
Prostaglandins Leukot Essent Fatty Acids, 56 (1997), pp. 295-300
[36.]
D.P. Rose, J.M. Connolly.
Regulation of tumor angiogenesis by dietary fatty acids and eicosanoids.
Nutr Cancer, 37 (2000), pp. 119-127
[37.]
P.A. Grimaldi.
Fatty acid regulation of gene expression.
Curr Opin Clin Nutr Metab Care, 4 (2001), pp. 433-437
[38.]
D.B. Jump.
The biochemistry of n-3 polyunsaturated fatty acids.
J Biol Chem, 277 (2002), pp. 8755-8758
[39.]
J. Berger, D.E. Moller.
The mechanisms of action of PPARs.
Annu Rev Med, 53 (2002), pp. 409-435
[40.]
S.A. Schwartz, A. Hernandez, B. Mark Evers.
The role of NF-kappaB/ IkappaB proteins in cancer: implications for novel treatment strategies.
Surg Oncol, 8 (1999), pp. 143-153
[41.]
T.E. Novak, T.A. Babcock, D.H. Jho, W.S. Helton, N.J. Espat.
NF-kappa B inhibition by omega-3 fatty acids modulates LPS-stimulated macrophage TNF-alpha transcription.
Am J Physiol, 284 (2003), pp. L84-L89
[42.]
E.D. Collett, L.A. Davidson, Y.Y. Fan, J.R. Lupton, R.S. Chapkin.
n-6 And n-3 polyunsaturated fatty acids differentially modulate oncogenic Ras activation in colonocytes.
Am J Physiol, 280 (2001), pp. C1066-C1075
[43.]
W.L. Chang, R.S. Chapkin, J.R. Lupton.
Fish oil blocks azoxymethaneinduced rat colon tumorigenesis by increasing cell differentiation and apoptosis rather than decreasing cell proliferation.
J Nutr, 128 (1998), pp. 491-497
[44.]
Y. Gokmen-Polar, N.R. Murray, M.A. Velasco, Z. Gatalica, A.P. Fields.
Elevated protein kinase C betall is an early promotive event in colon carcinogenesis.
Cancer Res, 61 (2001), pp. 1375-1381
[45.]
C.V. Rao, B.S. Reddy.
Modulating effect of amount and types of dietary fat on ornithine decarboxylase, tyrosine protein kinase and prostaglandins production during colon carcinogenesis in male F344 rats.
Carcinogenesis, 14 (1993), pp. 1327-1333
[46.]
F.M. Giardiello, S.R. Hamilton, L.M. Hylind, V.W. Yang, P. Tamez, R.A. Casero Jr..
Ornithine decarboxylase and polyamines in familial adenomatous polyposis.
Cancer Res, 57 (1997), pp. 199-201
[47.]
A. El-Sohemy, M.C. Archer.
Regulation of mevalonate synthesis in rat mammary glands by dietary n_3 and n_6 polyunsaturated fatty acids.
Cancer Res, 57 (1997), pp. 3685-3687
[48.]
L. Froyland, H. Vaagenes, D.K. Asiedu, A. Garras, O. Lie, R.K. Berge.
Chronic administration of eicosapentaenoic acid and docosahexaenoic acid as ethyl esters reduced plasma cholesterol and changed the fatty acid composition in rat blood and organs.
Lipids, 31 (1996), pp. 169-178
[49.]
H.J. Park, D. Kong, L. Iruela-Arispe, U. Begley, D. Tang, J.B. Galper.
3-Hydroxy-3 methylglutaryl coenzyme A reductase inhibitors interfere with angiogenesis by inhibiting the geranylgeranylation of RhoA.
Circ Res, 91 (2002), pp. 143-150
[50.]
W. Dempke, C. Rie, A. Grothey, H.J. Schmoll.
Cyclooxygenase-2: a novel target for cancer chemotherapy.
J Cancer Res Clin Oncol, 127 (2001), pp. 411-417
[51.]
A.F. Badawi, A. El-Sohemy, L.L. Stephen, A.K. Ghoshal, M.C. Archer.
The effect of dietary n_3 and n_6 polyunsaturated fatty acids on the expression of cyclooxygenase 1 and 2 and levels of p21ras in rat mammary glands.
Carcinogenesis, 19 (1998), pp. 905-910
[52.]
D.P. Rose, J.M. Connolly.
Omega-3 fatty acids as cancer chemopreventive agents.
Pharmacol Ther, 83 (1999), pp. 217-244
[53.]
J.L. Fang, C.E. Vaca, L.M. Valsta, M. Mutanen.
Determination of DNA adducts of malonaldehyde in humans: effects of dietary fatty acid composition.
Carcinogenesis, 17 (1996), pp. 1035-1040
[54.]
P.K. Lala, C. Chakraborty.
Role of nitric oxide in carcinogenesis and tumour progression.
Lancet Oncol, 2 (2001), pp. 149-156
[55.]
L.C. Jadeski, C. Chakraborty, P.K. Lala.
Role of nitric oxide in tumour progression with special reference to a murine breast cancer model.
Can J Physiol Pharmacol, 80 (2002), pp. 125-135
[56.]
L.S. Noble, K. Takayama, K.M. Zeitoun, et al.
Prostaglandin E2 stimulates aromatase expression in endometriosis-derived stromal cells.
J Clin Endocrinol Metab, 82 (1997), pp. 600-606
[57.]
D.A. Wink, Y. Vodovotz, J. Laval, F. Laval, M.W. Dewhirst, J.B. Mitchell.
The multifaceted roles of nitric oxide in cancer.
Carcinogenesis, 19 (1998), pp. 711-721
[58.]
T. Ohata, K. Fukuda, M. Takahashi, T. Sugimura, K. Wakabayashi.
Suppression of nitric oxide production in lipopolysaccharidestimulated macrophage cells by omega 3 polyunsaturated fatty acids.
Jpn J Cancer Res, 88 (1997), pp. 234-237
[59.]
J. Nair, C.E. Vaca, I. Velic, M. Mutanen, L.M. Valsta, H. Bartsch.
High dietary omega-6 polyunsaturated fatty acids drastically increase the formation of etheno-DNA base adducts in white blood cells of female subjects.
Cancer Epidemiol Biomarkers Prev, 6 (1997), pp. 597-601
[60.]
H. Okuyama, T. Kobayashi, S. Watanabe.
Dietary fatty acids–the n-6/n-3 balance and chronic elderly diseases. Excess linoleic acid and relative n_3 deficiency syndrome seen in Japan.
Prog Lipid Res., 35 (1996), pp. 409-457
[61.]
Y.E. Dommels, M.M. Haring, N.G. Keestra, G.M. Alink, P.J. Van Bladeren, B. Van Ommen.
The role of cyclooxygenase in n_6 and n_3 polyunsaturated fatty acid mediated effects on cell proliferation, PGE(2) synthesis and cytotoxicity in human colorectal carcinoma cell lines.
Carcinogenesis, 24 (2003), pp. 385-392
[62.]
H. Seti, A. Leikin-Frenkel, H. Werner.
Effects of omega-3 and omega-6 fatty acids on IGF-I receptor signalling in colorectal cancer cells.
Arch Physiol Biochem, 115 (2009), pp. 127-136
[63.]
A. Minami, N. Ishimura, S. Sakamoto, et al.
Effect of eicosapentaenoic acid ethyl ester v. oleic acid–rich safflower oil on insulin resistance in type 2 diabetic model rats with hypertriacylglycerolaemia.
Br J Nutr, 87 (2002), pp. 157-162
[64.]
M. Ligo, T. Nakagawa, C. Ishikawa, et al.
Inhibitory effects of docosahexaenoic acid on colon carcinoma 26 metastasis to the lung.
Br J Cancer, 75 (1997), pp. 650-655
[65.]
F. Picard, J. Auwerx.
PPAR gamma and glucose homeostasis.
Annu Rev Nutr, 22 (2002), pp. 167-197
[66.]
Z. Hossain, et al.
Growth inhibition and induction of apoptosis of colon cancer cell lines by applying marine phospholipid.
Nutrition and Cancer, 61 (2009), pp. 123-130
[67.]
A.J Guidi, S.J. Schmitt, L. Fischer, K. Tognazzi, J. Harris, H.F. Dvorak, et al.
Vascular permeability factor (vascular endothelial growth factor) expression and angiogenesis in patients with ductal carcinomas in situ of the breast.
Cancer, 80 (1997), pp. 1945-1953
[68.]
B. Liang, S. Wang, Y. Jiang Ye, X.D. Yang, Y.L. Wang, J. Qu, et al.
Impact of postoperative omega-3 fatty acid-supplemented parenteral nutrition on clinical outcomes and immunomodulations in colorectal cancer patients.
World J Gastroenterol, 14 (2008), pp. 2434-2439
[69.]
G.C. Burdge, Y.E. Finnegan, A.M. Minihane, C.M. Williams, S.A. Wootton.
Effect of altered dietary n_3 fatty acid intake upon plasma lipid fatty acid composition, conversion of [13C]alpha-linolenic acid to longerchain fatty acids and partitioning towards betaoxidation in older men.
Br J Nutr, 90 (2003), pp. 311-321
[70.]
R.J. Pawlosky, J.R. Hibbeln, J.A. Novotny, N. Salem Jr..
Physiological compartmental analysis of alpha-linolenic acid metabolism in adult humans.
J Lipid Res, 42 (2001), pp. 1257-1265
[71.]
A.P. Simopoulos.
The Mediterranean diets: what is so special about the diet of Greece. The scientific evidence.
J Nutr, 131 Suppl (2001), pp. S3065-S3073
[72.]
E.L. Wynder, Y. Fujita, R.E. Harris, T. Hirayama, T. Hirayama.
Comparative epidemiology of cancer between the United States and Japan: a second look.
Cancer, 67 (1991), pp. 746-763
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