肠道菌群介导的抗肿瘤药物代谢研究进展

Research Progress on the Metabolism of Anticancer Drugs by Gut Microbiota

关键词:  肠道菌群  抗肿瘤药物  代谢机制  个体化治疗

Key words:  gut microbiota  anticancer drugs  metabolic mechanisms  personalized therapy

摘要:

癌症是全球范围内严重的公共健康问题，随着发病率的不断增加，抗肿瘤药物逐渐成为临床治疗的重要手段。然而，抗肿瘤药物的疗效和毒性常表现出显著的个体差异。近年来的研究表明，肠道菌群在抗肿瘤药物的代谢过程中扮演着关键角色，能够显著影响药物的治疗效果与副作用。本文总结了肠道菌群在抗肿瘤药物代谢中的研究进展，阐述了其通过直接代谢、间接调控和生物蓄积三大机制对药物代谢的影响；同时分析了伊立替康、卡培他滨和顺铂等常用抗肿瘤药物在肠道菌群影响下的代谢路径及其对疗效和不良反应的影响。此外，本文探讨了益生菌、益生元及粪菌移植等肠道菌群调控策略的应用，为优化抗肿瘤药物疗效、减少副作用及克服药物耐受性提供了理论依据和科学参考。

Abstract:

Cancer is a major global public health issue, and with the increasing incidence, anticancer drugs have gradually become a crucial therapeutic approach. However, the efficacy and toxicity of anticancer drugs often show significant individual variability. Recent studies have highlighted the pivotal role of the gut microbiota in the metabolism of anticancer drugs, significantly influencing the therapeutic effects and side effects of these drugs. This review summarizes the research progress on the involvement of gut microbiota in drug metabolism, discussing its impact on drug metabolism through three main mechanisms: direct metabolism, indirect regulation, and bioaccumulation. Additionally, the metabolic pathways of commonly used anticancer drugs, such as irinotecan, capecitabine, and cisplatin, under the influence of gut microbiota, as well as their effects on both therapeutic efficacy and adverse reactions, are analyzed. Furthermore, this paper explores the application of gut microbiota modulation strategies, such as probiotics, prebiotics, and fecal microbiota transplantation, providing theoretical and scientific insights for optimizing anticancer drug efficacy, reducing side effects, and overcoming drug resistance.