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β-葡聚糖补充改善接受化疗的晚期实体瘤患者的临床结局并维持免疫稳态:一项前瞻性 II 期随机三臂临床试验

英文原题:Beta-Glucan Supplementation Improves Clinical Outcomes and Preserves Immune Homeostasis in Patients with Advanced Solid Tumors Receiving Chemotherapy: A Prospective Phase II Randomized Three-Arm Clinical Trial.

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Beta-Glucan Supplementation Improves Clinical Outcomes and Preserves Immune Homeostasis in Patients with Advanced Solid Tumors Receiving Chemotherapy: A Prospective Phase II Randomized Three-Arm Clinical Trial.

PubMed 2026/08/11(内容时间) Int J Mol Sci Q1 · IF 5.6(JCR 2025)

研究概要

这些发现表明,补充β-葡聚糖有助于在化疗期间维持免疫稳态,并可能成为晚期实体瘤患者一种有前景的辅助免疫营养策略。

中文摘要

化疗引起的免疫失调仍是晚期实体瘤患者面临的主要挑战。β-葡聚糖已被报道具有免疫调节特性;然而,其在化疗期间对免疫稳态的纵向影响仍不清楚。在这项前瞻性、随机II期研究中,接受化疗的患者被分配接受β-葡聚糖粉(含L-谷氨酰胺和牛初乳生物活性蛋白)、β-葡聚糖胶囊(含L-谷氨酰胺)或标准治疗。评估了临床结局、系列血液学参数、纵向免疫谱分析以及体外Jurkat T细胞活力测定。与对照组相比,β-葡聚糖补充改善了疾病控制率,加速了中性粒细胞恢复,并在化疗期间维持了更稳定的中性粒细胞与淋巴细胞比值。纵向免疫谱分析显示,β-葡聚糖补充组中T细胞、NK细胞、NKT细胞和表达KIR(CD158)的免疫细胞群体稳定性更高,提示化疗诱导的免疫重塑减弱。两种β-葡聚糖制剂显示出相当的免疫调节作用,尽管在治疗后期,粉末组中CD158b(+)和CD158i(+) NK细胞亚群的表达保持更稳定。在体外,β-葡聚糖显著降低了Jurkat T细胞活力,表明其除临床免疫调节作用外还具有直接的生物学活性。这些发现表明,β-葡聚糖补充有助于在化疗期间维持免疫稳态,并可能作为晚期实体瘤患者一种有前景的辅助免疫营养策略。

展开英文摘要原文

Chemotherapy-induced immune dysregulation remains a major challenge in patients with advanced solid tumors. -Glucan has been reported to possess immunomodulatory properties; however, its longitudinal effects on immune homeostasis during chemotherapy remain unclear. In this prospective, randomized phase II study, patients receiving chemotherapy were assigned to receive -glucan powder (with L-glutamine and bioactive protein from bovine colostrum), -glucan capsules (with L-glutamine), or standard care. Clinical outcomes, serial hematologic parameters, longitudinal immune profiling, and an in vitro Jurkat T-cell viability assay were evaluated. Compared with controls, -glucan supplementation improved the disease control rate, accelerated neutrophil recovery, and maintained a more stable neutrophil-to-lymphocyte ratio during chemotherapy. Longitudinal immune profiling demonstrated greater stability of T-cell, NK-cell, NKT-cell, and KIR (CD158)-expressing immune-cell populations in -glucan supplementation groups, suggesting attenuation of chemotherapy-induced immune remodeling. Both -glucan formulations showed comparable immunomodulatory effects, although the expression of CD158b(+) and CD158i(+) NK-cell subsets remained more stable in the powder group during later treatment. In vitro, -glucan significantly reduced Jurkat T-cell viability, indicating direct biological activity in addition to its clinical immunomodulatory effects. These findings suggest that -glucan supplementation helps preserve immune homeostasis during chemotherapy and may serve as a promising adjunctive immunonutritional strategy for patients with advanced solid tumors.

论文信息

作者
Yang WC、Huang MS、Tsai YH
第一作者单位
Department of Nursing, Meiho University, PingTung 912, Taiwan.Taiwan
通讯作者单位
Department of Pharmacy and Master Program, College of Pharmacy and Health Care, Tajen University, Pingtung County 90741, Taiwan.Taiwan
文献类型
II 期临床试验 · 随机对照试验
期刊
International journal of molecular sciences2026 Aug 11
原文标识
PubMed 42653193 · DOI 10.3390/ijms27167189