ω-3 多不饱和脂肪酸(ω-3 PUFAs)有助于减轻进展期恶性肿瘤患者的恶液质症状,减少体重丢失。 其作为一种免 疫营养素,可提高恶性肿瘤患者围手术期免疫功能,降低炎症标志物水平,有助于提高治疗的敏感性和耐受性,降低治疗药物 或放射剂量。 作用机制主要是:①增加参与炎症反应的细胞膜磷脂中相应脂肪酸含量从而增强细胞膜的流动性,减少促炎转 录因子如核因子-κB 的激活,溶解素、保护素等特异性促炎症消退介质调控炎症过程;②衍生的二十碳五烯基乙醇酰胺 (EPEA)和二十二碳己烯基乙醇酰胺(DHEA)在细胞色素单氧合酶作用下转化为环氧二十碳四烯酸-乙醇酰胺(EEQ - EA) 和环氧二十二碳五烯酸-乙醇酰胺(DP-EA)异构体,抑制 JNK 信号通路的激活,减轻棕榈酸触发的巨噬细胞炎症反应,减弱 白三烯 B4 诱导的中性粒细胞迁移和激活,抑制血管内皮生成因子和成纤维细胞生长因子 2 诱导的血管生成;③在酸性肿瘤 环境可以选择性诱导肿瘤细胞发生铁死亡,对肿瘤细胞产生毒性作用。 尽管 ω-3 PUFAs 已在临床上得到较多应用,但在肿瘤 治疗和患者营养改善方面的效果仍存在差异,需要更多高质量的临床试验和深入的机制研究。

ω-3 polyunsaturated fatty acids ω-3 PUFAs can help reduce symptoms of cachexia and reduce weight loss in patients with advanced malignant tumors. As an immune nutrient it can improve the perioperative immune function of patients with malignant tumors and reduce the levels of inflammatory markers improvement of the sensitivity and tolerance of treatment and reduce the therapeutic drug or radiation dose. The potential mechanisms of ω-3 PUFAs are ① increase the content of corresponding fatty acids in the phospholipids of the cell membrane involved in the inflammatory response thereby enhancing the fluidity of the cell membrane and reducing the activation of pro-inflammatory transcription factors such as nuclear factor-κB NF-κB specialized pro-resolving mediators SPMs including resolvins protectins and maresins regulating the inflammatory process. ② Eicosapentaenyl ethanolamide EPEA and DHEA derived from EPA and DHA were converted into EEQ-EA and EDP-EA isomers under the action of Cytochrome P450 CYP monooxygenases which inhibited the activation of JNK signaling pathway and alleviated the macrophage inflammatory response triggered by palmitic acid attenuating LTB4 - induced neutrophil mobility and activation. In addition EDPs inhibits angiogenesis induced by vascular endothelial generating factor VEGF and fibroblast growth factor 2 in vivo. ③ ω - 3 PUFA can selectively induce ferroptosis in cancer cells under environmental acidosis and produce toxic effects on tumor cells. Although ω- 3 PUFAs has been widely used in clinical practice its effects in the treatment and nutrition improvement of cancer patients are still inconsistent. More high-quality clinical trials and in-depth mechanism studies are needed.