更新于：2024-05-01

Lactose Intolerance

乳糖不耐症

更新于：2024-05-01

基本信息

别名

Alactasia、Cows milk enteropathy、Dairy Product Intolerance

+ [44]

简介

The condition resulting from the absence or deficiency of LACTASE in the MUCOSA cells of the GASTROINTESTINAL TRACT, and the inability to break down LACTOSE in milk for ABSORPTION. Bacterial fermentation of the unabsorbed lactose leads to symptoms that range from a mild indigestion (DYSPEPSIA) to severe DIARRHEA. Lactose intolerance may be an inborn error or acquired.

关联

项与乳糖不耐症相关的药物

Agalsidase Beta(Nipro ES Pharma)

阿加糖酶β(Nipro ES Pharma)

靶点

GLA

作用机制

GLA刺激剂

在研机构

Nipro ES Pharma KK

原研机构

Nipro ES Pharma KK

在研适应症

乳糖不耐症

非在研适应症-

最高研发阶段批准上市

首次获批国家/地区

日本

首次获批日期2008-09-25

Tilactase(Recordati SpA)

半乳糖苷酶(Recordati SpA)

靶点-

作用机制

酶替代物

在研机构

Recordati SpA

原研机构

Recordati SpA

在研适应症

乳糖不耐症

非在研适应症-

最高研发阶段批准上市

首次获批国家/地区

瑞士

首次获批日期2003-12-08

Tilactase(Takata Seiyaku)

半乳糖苷酶(Takata Seiyaku)

靶点-

作用机制

酶替代物

在研机构

Takata Seiyaku Co., Ltd.

原研机构

Takata Seiyaku Co., Ltd.

在研适应症

乳糖不耐症

非在研适应症-

最高研发阶段批准上市

首次获批国家/地区

日本

首次获批日期1986-03-10

103

项与乳糖不耐症相关的临床试验

NCT06315517 / Not yet recruitingN/AIIT

A Randomized Controlled Crossover Trial to Assess Tolerance, Gastrointestinal Distress & Preference for Milks Varying in Casein Types & Lactose Content

The investigators will recruit 45 fluid milk avoiding adults to participate in a five-week double-blind, double-crossover study in which the physiological responses to increasing doses of lactose-free (A1-rich milk), A2 milk, and lactose-free A2 milk will be explored.

开始日期2024-04-01

申办/合作机构

Auburn University

NCT05979532 / RecruitingN/A

A Longitudinal Prospective, Observational, Cohort Study in Lactating Mothers and Their Newborns to Further Unravel the Complexity of Human Milk

The current longitudinal (max. 2-year) observational cohort study in 120 lactating mothers and their newborns will make it possible to explore human milk composition across different lactation stages, between different human milk groups, and in relation to maternal, perinatal, infant, and sample characteristics as well as to the microbiota of the infant.

开始日期2024-02-13

申办/合作机构-

NCT06177938 / RecruitingN/AIIT

Lactobreath: A Pilot Study to Diagnose Lactose Intolerance Based on the Exhaled Breath Metabolome

Food intolerances affect many people and can cause discomfort and dietary challenges. One common cause is difficulty digesting certain carbohydrates called FODMAPs. Diagnosing food intolerance is often done by excluding and then slowly reintroducing these carbohydrates or using a hydrogen breath test, but these methods have limitations.
To address these issues, this project uses the breath we exhale to find markers for lactose intolerance as a model for food intolerance diagnosis. Our aim is to identify breath markers for lactose tolerance and intolerance and link them to metabolic traits, including those found in urine. We use a real-time breath analysis method and a special sensor to measure gases in the digestive system, and we also explore genetic factors using saliva samples.
This project aims to help clinicians better identify patients who should follow low FODMAP diets and provide non-invasive breath tests to predict how patients will respond to these diets. It will also advance the use of breath analysis for personalized nutrition, contributes to the broader field of food intolerance research, and has the potential to benefit millions of individuals worldwide.

开始日期2024-01-01

申办/合作机构

University of Zurich

100 项与乳糖不耐症相关的临床结果

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100 项与乳糖不耐症相关的转化医学

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0 项与乳糖不耐症相关的专利（医药）

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2,853

项与乳糖不耐症相关的文献（医药）

2024-02-19·Journal of the National Medical Association

A review of dairy food intake for improving health among black adults in the US.

Review

作者: Edith Mitchell ; Kevin Comerford ; Michael Knight ; Kevin McKinney ; Yolanda Lawson

The adult life stage encompasses a range of new experiences, opportunities, and responsibilities that impact health and well-being. During this life stage, health disparities continue to increase for Black Americans, with Black adults having a disproportionate burden of obesity, chronic diseases, comorbidities, and worse treatment outcomes compared to their White peers. While many of the underlying factors for these disparities can be linked to longstanding sociopolitical factors such as systemic racism, food insecurity, and poor access to healthcare, there are also several modifiable risk factors that are known to significantly impact health outcomes, such as improving diet quality, increasing physical activity, and not smoking. Of all the modifiable risk factors known to impact health, improving dietary habits is the factor most consistently associated with better outcomes for body weight and chronic disease. Of the major food groups recommended by the 2020-2025 Dietary Guidelines for Americans (DGA) for achieving healthier dietary patterns, dairy foods have a nutrient profile which matches most closely to what Black Americans are inadequately consuming (e.g., vitamin A, vitamin D, calcium, magnesium). However, Black adults tend to consume less than half the recommended daily servings of dairy foods, in part, due to issues with lactose intolerance, making higher intake of dairy foods an ideal target for improving diet quality and health in this population. This review examines the current body of evidence exploring the links between dairy intake, obesity, cardiometabolic disease risk, chronic kidney disease, and the most common types of cancer, with a special focus on health and disparities among Black adults. Overall, the evidence from most systematic reviews and/or meta-analyses published in the last decade on dairy intake and health outcomes has been conducted on White populations and largely excluded research on Black populations. The findings from this extensive body of research indicate that when teamed with an energy-restricted diet, meeting or exceeding the DGA recommended 3 daily servings of dairy foods is associated with better body weight and composition outcomes and lower rates of most common chronic diseases than lower intake (<2 servings per day). In addition to the number of daily servings consumed, the specific types (e.g., milk, yogurt, cheese) and subtypes (e.g., low-fat, fermented, fortified) consumed have also been shown to play major roles in how these foods impact health. For example, higher intake of fermented dairy foods (e.g., yogurt) and vitamin D fortified dairy products appear to have the most protective effects for reducing chronic disease risk. Along with lactose-free milk and cheese, yogurt is also generally low in lactose, making it an excellent option for individuals with lactose intolerance, who are trying to meet the DGA recommendations for dairy food intake.

2024-02-19·Journal of the National Medical Association

The role of dairy food intake for improving health among black Americans across the life continuum: A summary of the evidence.

Article

作者: Kevin Comerford ; Yolanda Lawson ; Michal Young ; Michael Knight ; Kevin McKinney ; Priscilla Mpasi ; Edith Mitchell

Decades of health data show major health disparities occurring at every life stage between Black and White Americans. These disparities include greater mortality rates among Black mothers and their offspring, higher levels of malnutrition and obesity among Black children and adolescents, and a higher burden of chronic disease and lower life expectancy for Black adults. Although nutrition is only one of many factors that influence human health and well-being across the life continuum, a growing body of research continues to demonstrate that consuming a healthy dietary pattern is one of the most dominant factors associated with increased longevity, improved mental health, improved immunity, and decreased risk for obesity and chronic disease. Unfortunately, large percentages of Black Americans tend to consume inadequate amounts of several essential nutrients such as vitamin A, vitamin D, calcium, and magnesium; and simultaneously consume excessive amounts of fast foods and sugar-sweetened beverages to a greater degree than other racial/ethnic groups. Therefore, strategies that can help improve dietary patterns for Black Americans could make up a major public health opportunity for reducing nutrition-related diseases and health disparities across the life course. A key intervention strategy to improve diet quality among Black Americans is to focus on increasing the intake of nutrient-rich dairy foods, which are significantly underconsumed by most Black Americans. Compared to other food group, dairy foods are some of the most accessible and affordable sources of essential nutrients like vitamin A, D, and B12, calcium, magnesium, potassium, selenium, and zinc in the food supply, as well as being some of the primary sources of several health-promoting bioactive compounds, including polar lipids, bioactive proteins and peptides, oligosaccharides, and live and active cultures in fermented products. Given the complex relationships that many Black Americans have with dairy foods, due to issues with lactose intolerance, and/or negative perceptions about the health effects of dairy foods, there is still a need to examine the role that dairy foods play in the health and well-being of Black Americans of all ages and life stages. Therefore, the National Medical Association and its partners have produced multiple reports on the value of including adequate dairy in the diet of Black Americans. This present summary paper and its associated series of evidence reviews provide an examination of an immense amount of research focused on dairy intake and health outcomes, with an emphasis on evidence-based strategies for improving the health of Black Americans. Overall, the findings and conclusions from this body of research continue to indicate that higher dairy intake is associated with reduced risk for many of the most commonly occurring deficiencies and diseases impacting each life stage, and that Black Americans would receive significantly greater health benefits by increasing their daily dairy intake levels to meet the national recommendations than they would from continuing to fall short of these recommendations. However, these recommendations must be considered with appropriate context and nuance as the intake of different dairy products can have different impacts on health outcomes. For instance, vitamin D fortified dairy products and fermented dairy products like yogurt - which are low in lactose and rich in live and active cultures - tend to show the greatest benefits for improved health. Importantly, there are significant limitations to these research findings for Black Americans, especially as they relate to reproductive and child health, since most of the research on dairy intake and health has failed to include adequate representation of Black populations or to sufficiently address the role of dairy intake during the most vulnerable life stages, such as pregancy, lactation, fetal development, early childhood, and older age. This population and these life stages require considerably more research and policy attention if health equity is ever to be achieved for Black Americans. Sharing and applying the learnings from this summary paper and its associated series of evidence reviews will help inform and empower nutrition and health practitioners to provide more evidence-based dietary recommendations for improving the health and well-being of Black Americans across the life course.

2024-02-16·Journal of the National Medical Association

Executive summary: The role of dairy food intake for improving health among Black Americans across the life continuum.

Article

作者: Kevin Comerford ; Yolanda Lawson ; Michal Young ; Michael Knight ; Kevin McKinney ; Priscilla Mpasi ; Edith Mitchell

Given the complex relationships that many Black individuals have with dairy foods, due to issues with lactose intolerance or other cultural factors, the National Medical Association has made considerable efforts to examine the role that dairy foods play in the health and well-being of Black Americans. Over the last two decades, the National Medical Association and its partners have produced multiple reports on the value of including adequate milk and dairy foods in the diets of Black Americans. These publications have highlighted the impact that inadequate consumption of dairy foods and nutrients have on chronic disease risks. Past publications have also provided evidence-based recommendations for the proper diagnosis and management of lactose intolerance. This new series of evidence reviews focuses on dairy's role in improving nutrition and health among Black Americans across the life course and covers an extensive amount of new research that highlights additional health disparities and provides further evidence-based strategies for the management of lactose intolerance. Much like the 2020-2025 Dietary Guidelines for Americans, this work utilizes a life course approach to better address dairy intake on health outcomes for different ages and life stages: 1) pregnancy, fetal development, and lactation, 2) infants, toddlers, and young children, 3) older children and adolescents, 4) adults, and 5) geriatric populations. Overall, the findings and conclusions from this series of evidence reviews continue to indicate that higher dairy intake is associated with reduced risk for many of the most commonly occurring deficiencies and diseases impacting each life stage, and that Black Americans would receive significantly greater health benefits by increasing their daily dairy intake levels to meet the national dietary recommendations than they would from continuing to fall short of these recommendations. However, these recommendations must be considered with appropriate context and nuance as the intake of different dairy products can have different impacts on health outcomes. For instance, vitamin D fortified dairy products and fermented dairy products like yogurt - which are low in lactose and rich in live and active cultures - tend to show the greatest impacts for reducing disease risk across the life continuum, while whole-fat dairy foods may be most beneficial in early life for optimal brain development, and more protein-rich options may be most beneficial in later life to help maintain muscle mass and function.

项与乳糖不耐症相关的新闻（医药）

2024-02-19

·FierceBiotech

How pharma and healthcare will benefit from the adoption of ePI standards

None Author: Philippe Michiels, Principal Architect at Datapharm With improved digital standards for healthcare information now being adopted in the UK and elsewhere around the world, the discussion now turns to how the pharma and healthcare sectors will respond. What do they need to consider when onboarding these new standards and, crucially, what value can they build for patients and HCPs from doing so? If standards are implemented correctly, digital interoperability can then facilitate the free flow of information between healthcare settings. This is vital for not only understanding how best to treat a patient, but also how to administer medicines safely and effectively. Furthermore, through a wide adoption of modern digital standards, pharmaceutical companies, healthcare providers (HCPs) and patients can unlock the value that interoperability offers. To enable this to happen, adopting an ePI (electronic Product Information) standard is absolutely necessary. Without it, interoperability and its benefits will not be realized. Thankfully, promising steps are being taken. The global life science and healthcare markets are in the process of adopting HL7 FHIR for the digitization of medicines information, and the reasons behind this framework being adopted are already well defined and accepted. In the UK, Datapharm is embracing these standards with emc (www.medicines.org.uk). This is a global resource of UK regulated medicines information for patients and industry professionals that is being built on FHIR structured data. It helps HCPs to remain up to date and prescribe medicines safely. It can also be used by patients and their carers to check information about their medicines, as well as the general public seeking guidance about medicines they are taking or thinking about taking. What can pharma gain from adopting ePI? Pharma stands to benefit in many ways by adopting ePI for their medicines information, including: Cost savings and process efficiencies Ability to use AI and NLP technologies to harness insight currently locked within existing medicines information content Improved interoperability with future regulator and industry systems in the UK and internationally, streamlining update and approval processes Up-to-date distribution of information and flexible access via any user device Being able to present medicines information in a multi-language region in the patient’s local language Customer insight and engagement mechanisms Pharmacovigilance – sourcing alternative medicines in the case of an adverse event, regardless of region. Furthermore, creating product packages with digital medicine information (and paper being optional), will allow innovation yielding more viewing options, increasing safety and making for a more intuitive experience. Paper-based leaflets not only are often out of date and difficult for patients to read, but also have an environmental impact. How can healthcare benefit from ePI? Similarly, healthcare providers can gain a considerable amount from onboarding ePI. Motivated by enhanced patient safety and improving the effectiveness of their treatment delivery, ePI can help open up ways of consuming safety information taking into account the patient’s personal requirements. For instance, this could factor in a patient’s lactose intolerance or vegan preference to highlight this information to the patient about their medicines. Empowering patients to better understand their conditions is a universally acknowledged and crucial goal, especially given the budgetary constraints and limited public funds available in many countries. By combining structured medicines information with the patient’s own health data, they could be given more context with which to make more informed decisions for their own health management. Better informed patients may then lessen demand for healthcare services. Providing a sufficient level of ePI is reached, another major advantage for patients is that it would allow them to travel safe in the knowledge that they can replace or locate equivalent medicines when they are abroad. At the same time, HCPs will be able to accurately engage with foreign patients’ prescriptions or medications. How can pharma and healthcare realize the benefits of ePI? To fully realize these benefits, pharma and healthcare organizations need to invest resources and energy into understanding and engaging with ePI and digital interoperability. As is the case with any new technology, adoption is the key to realizing the full benefits. What’s more, in these early stages of development, there are still opportunities for improvements to be incorporated. This makes early preparation and movement even more important. It is pharma companies’ product information that will be transformed by these standards, therefore they should get involved in the adoption of this technology. Engagement with key stakeholders such as regulators and solution providers is imperative as they seek to help develop and evolve the technology by collaborating in industry working groups. Likewise, HCPs need to be at the forefront of collective engagement, gaining a firm grasp of the innovation that is being developed and how this will impact their provision of patient care. They should also work closely with pharma partners to provide feedback which will optimize the way ePI is developed and delivered. The time to move is now, not least because major international stakeholders are already beginning to adopt the new standard. Datapharm is a leading technology provider committed to ensuring that medicines information on emc (www.medicines.org.uk) is available using harmonized ePI standards, as well as driving wider ePI adoption across the UK and internationally. Would you like to find out more about ePI and its benefits? Ø Visit Datapharm's resource hub or contact one of our experts to discuss the development and implementation of modern medicines information standards.

2023-12-02

·今日头条

战肠癌：聚焦筛查和治疗方法新进展

12月02日的《热心肠日报》，我们解读了 10 篇文献，关注：结直肠癌，个性化医疗，ctDNA，癌症干细胞，3D打印，液体活检，饮食，肝癌，胃癌，工程菌。 JAMA子刊：液体活检筛查大肠癌，成本效益如何？ JAMA Network Open——[13.8] ① 建立马尔可夫模型比较液体活检与现有筛查策略的成本效益，当某策略增量成本效果比（ICER）低于$100000/获得寿命年（LYG）阈值时，认为其有成本效益；② 结肠镜检查是最具成本效益的策略，FIT和粪便DNA检测LYG略低，但其费用明显降低；③ 结肠镜-液体活检混检早期诊断出癌症比例更高，但费用明显较高不具有成本效益；④ 液体活检与未进行筛查相比，液体活检费用降低至$56.16可具有成本效益，而与结肠镜检查相比，降低至$260.95具有成本效益。【主编评语】目前正在开发利用液体活检检测DNA循环肿瘤标志物用于单癌或多癌早期筛查的方法，液体活检的应用可能为未参与常规筛查的人群提供新的筛查策略，但尚不清楚其是否具有成本效益。近日，哥伦比亚大学欧文医学中心研究人员在JAMA Network Open发表最新研究，建立马尔可夫模型比较液体活检与现有筛查策略的成本效益。目前结肠镜检查虽依从性偏低，但仍是筛查中最具成本效益的策略。将液体活检作为主流筛查策略不具有成本效益，未来若能实现液体活检的成本的大幅下降，其有望成为结直肠癌筛查的新选择，值得关注。（@九卿臣）【原文信息】 Cost-Effectiveness of Liquid Biopsy for Colorectal Cancer Screening in Patients Who Are Unscreened 2023-11-16, doi: 10.1001/jamanetworkopen.2023.43392 ctDNA检测大肠癌的临床应用价值 Annals of Oncology——[50.5] ① 招募851名以治愈为目的的II-III期CRC患者，探究术后风险评估和系列监测的潜力，以及转移部位如何影响ctDNA检测；② 术后和连续的ctDNA检测均可预测复发，复发患者样本采集结束时累积ctDNA检出率为87%；③ 观察到治疗结束后的提前期为3个月，其中ctDNA增长率是生存的预后指标；④ 在复发患者中，术后ctDNA检测对于肺转移和腹膜转移具有挑战性，检测率较低；⑤ 通过修改ctDNA阳性样本的截止值，能够根据不同的临床情况调整检测的敏感性和特异性。【主编评语】循环肿瘤DNA常被提议作为最小残留病评估的工具，ddPCR可提供低分析成本和不到一天的周转时间，使其展现出成熟的临床应用。近日，丹麦奥尔胡斯大学医院研究人员在Annals of Oncology发表最新研究，招募851名以治愈为目的的II-III期CRC患者，探究术后风险评估和系列监测的潜力，以及转移部位如何影响ctDNA检测。发现个性化dPCR方法可有效地检测手术后的MRD，并显示了用于复发监测的连续ctDNA检测的前景，值得关注。（@九卿臣）【原文信息】 Unraveling the potential clinical utility of circulating tumor DNA detection in colorectal cancer – evaluation in a nationwide Danish cohort 2023-11-21, doi: 10.1016/j.annonc.2023.11.009 Nature Reviews：大肠癌的个体化辅助治疗（观点） Nature Reviews Clinical Oncology——[78.8] ① 对结直肠癌（CRC）患者的分层应该能够区分复发风险的高低和化疗绝对获益大的患者；② 为此目的，遗传分析发现了氟嘧啶毒性的生殖系决定因素，确定了危及生命的毒性高风险患者，并实现了剂量调节以提高安全性；③ 而通过对切除组织的分析来识别具有预后生物标志物价值的突变或转录组特征的结果相当令人失望；④ 近些年人工智能驱动的模型可将患者分为不同的预后组，此外，术后循环肿瘤DNA的液体活检方法也是识别肿瘤复发风险的有用工具。【主编评语】目前，结直肠癌（CRC）患者的标准辅助治疗包括氟嘧啶（5-氟尿嘧啶或卡培他滨）作为单一药物或与奥沙利铂联合使用，疗程为3或6个月。目前治疗的选择取决于传统的组织病理学分期程序，这是患者分层的粗略工具。考虑到结直肠癌（CRC）患者从辅助治疗中获得的相对边际的生存益处，提高化疗方案的安全性并确定最有可能从中受益的患者是一个未满足需求的领域。近期发表于Nature Reviews Clinical Oncology的一篇观点论文概述了当前CRC患者辅助治疗的概况，并讨论了新技术如何在这种情况下实现更好的个性化治疗。（@注册营养师陈彬林）【原文信息】 Personalizing adjuvant therapy for patients with colorectal cancer 2023-11-24, doi: 10.1038/s41571-023-00834-2 贝伐珠单抗+FOLFOX4，改善治疗过的晚期大肠癌患者生存期 Journal of Clinical Oncology——[45.3] ① 纳入829名接受过治疗的转移性结直肠癌患者，随机分配到FOLFOX4+贝伐珠单抗，仅FOLFOX4或仅贝伐珠单抗组；② 联合治疗、仅FOLFOX4和仅贝伐珠单抗中位生存期分别为12.9、10.8和10.2个月，联合治疗降低25%死亡率；③ 联合治疗、仅FOLFOX4和仅贝伐珠单抗中位无进展生存期分别为7.3、4.7和2.7个月，联合治疗降低39%进展风险；④ 治疗总体响应率为22.7%（联合治疗）、8.6%（仅FOLFOX4）和3.3%（仅贝伐珠单抗）；⑤ 联合治疗出现副作用更频繁。【主编评语】结直肠癌是美国癌症致死的第二大原因，贝伐珠单抗联合化疗的抗血管生成治疗提高了先前未经治疗的转移性结直肠癌的生存率，但对于贝伐珠单抗联合奥沙利铂、氟尿嘧啶和亚叶酸 (FOLFOX4) 治疗既往治疗过的转移性结直肠癌效果如何仍不清楚。Journal of Clinical Oncology上发表的一项临床试验，探究了贝伐珠单抗对先前用氟嘧啶和伊立替康治疗过的转移性结直肠癌患者的生存时间的影响。结果表明，贝伐珠单抗+FOLFOX4疗法确实改善了既往治疗过的转移性结直肠癌患者的生存期，但是出现高血压、出血、恶心呕吐等副作用也更频繁。（@RZN）【原文信息】 Bevacizumab in Combination With Oxaliplatin, Fluorouracil, and Leucovorin (FOLFOX4) for Previously Treated Metastatic Colorectal Cancer: Results From the Eastern Cooperative Oncology Group Study E3200 2023-07-17, doi: 10.1200/JCO.22.02761 国内团队Nature子刊：靶向ID1或可改善大肠癌治疗 Nature Communications——[16.6] ① 肿瘤微环境会赋予肿瘤相关巨噬细胞高表达分化抑制因子1（ID1）导致CRC患者预后差，对化疗或免疫治疗的易感性低；② 高ID1表达的巨噬细胞通过抑制其分泌CCL4来排除CD8+ T细胞浸润，而髓源性抑制细胞中ID1的缺失对CD8+ T细胞的迁移没有影响；③ 巨噬细胞中ID1通过破坏STAT1介导的CCL4和SerpinB2转录，在癌细胞中发挥支架作用，阻碍CD8+ T细胞募集并激活FAK-YAP级联；④ 减少ID1表达可改善CRC进展，增强肿瘤对免疫治疗和化疗的敏感性。【主编评语】消除癌症干细胞（CSCs）和恢复抗肿瘤免疫仍然是癌症治疗尚未解决的挑战。近日，中国医学科学院北京协和医学院花芳、张海增及团队在Nature Communications发表最新研究，确定了肿瘤相关巨噬细胞表达的分化抑制因子1（ID1）作为中心分子节点，双重控制癌症启动能力和诱导肿瘤免疫逃逸。证据表明靶向ID1稳定性可以提高CRC患者的免疫治疗和化疗敏感性，值得关注。（@九卿臣）【原文信息】 ID1 expressing macrophages support cancer cell stemness and limit CD8+ T cell infiltration in colorectal cancer 2023-11-23, doi: 10.1038/s41467-023-43548-w 国内团队：3D打印肿瘤模型预测患者的化疗效果 Advanced Science——[15.1] ① 通过利用患者来源的原发肿瘤细胞和生物墨水的3D生物打印，可有效构建结直肠癌（CRC）和结直肠癌肝转移（CRLM）的体外3D模型；② 基因组学和组织学分析证实，CRC/CRLM 3D打印肿瘤模型有效地保留了亲本肿瘤生物标志物和突变谱；③ 体外评估化疗药物敏感性，CRC/CRLM 3D打印肿瘤模型对化疗的响应具有肿瘤异质性；④ CRLM 3D打印模型中的药物反应与新辅助化疗的临床结果之间存在明显的强相关性。【主编评语】由于肿瘤的异质性，目前没有方法可以准确预测结直肠癌（CRC）和结直肠癌肝转移（CRLM）对个性化化疗的反应。北京协和医学院的毛一雷、黄鹏羽、杨华瑜和南京医科大学的Lejia Sun与团队在Advanced Science发表文章，利用患者来源的原发肿瘤细胞可构建出CRC和CRLM 3D打印肿瘤模型，可用于预测患者对化疗的反应，在临床前研究具有重要应用潜力。（@章台柳）【原文信息】 Prediction of Clinical Precision Chemotherapy by Patient-Derived 3D Bioprinting Models of Colorectal Cancer and Its Liver Metastases 2023-11-16, doi: 10.1002/advs.202304460 EAT-Lancet参考饮食或可降低癌症和全因死亡风险 One Earth——[16.2] ① 纳入英国生物库数据，调查EAT-Lancet参考饮食与癌症事件、主要心血管事件和全因死亡率之间的关系；② 更高的EAT-Lancet参考饮食依从性与更低的癌症发病风险和更低的全因死亡率相关，而主要心血管事件风险大多为零关联；③ 使用潜在可改变风险因素的分层分析得出了类似的结果；④ 研究结果结合现有文献，支持采用EAT-Lancet参考饮食可能有利于预防非传染性疾病。【主编评语】 EAT-Lancet参考饮食模式，是兼顾人类健康和环境可持续的膳食模式：蔬菜、水果合计占膳食的50%，全谷物、植物蛋白、不饱和植物油、适量的动物蛋白等合计占另外的50%。EAT-Lancet膳食模式实质上可视为一种“弹性素食”或少肉膳食。One Earth近期发表的文章，发现EAT-Lancet膳食模式与英国成年人发生癌症和全因死亡率的风险降低相关，与心血管疾病风险不相关。（@章台柳）【原文信息】 Adherence to the EAT-Lancet reference diet is associated with a reduced risk of incident cancer and all-cause mortality in UK adults 2023-11-21, doi: 10.1016/j.oneear.2023.11.002 国家层面的癌症筛查项目，有效降低韩国胃癌死亡率 Gastroenterology——[29.4] ① 采用对照方法估计筛查对40岁及以上人群的胃癌（GC）死亡率和其他上消化道（UGI）疾病（食道癌和消化性溃疡）的影响；② 分析韩国和日本的GC死亡率，干预前的拟合结果较好，但日本其他UGI疾病的死亡率拟合结果较差；③ 韩国平均干预后发病率比（RR）为0.83，其他UGI疾病死亡率为0.72，全国性筛查启动15年后，RR为0.59，表明筛查具有明显的益处；④ 日本GC和其他UGI疾病死亡率的平均RR分别为0.97和0.93，结果可能存在偏倚，筛查效果尚不确定。【主编评语】韩国和日本在全国范围内组织的胃癌筛查项目已经开展了数十年，Gastroenterology最新文章评估这些计划对胃癌死亡率的影响，结果表明韩国全国性胃癌筛查有明显的好处，在第15年死亡率降低了41%，而日本项目的有效性尚不确定，该数据将为其他国家的胃癌筛查项目提供宝贵的参考。（@RZN）【原文信息】 The Effect of Nationwide Organized Cancer Screening Programs on Gastric Cancer Mortality: a Synthetic Control Study 2023-11-24, doi: 10.1053/j.gastro.2023.11.286 昼夜节律紊乱或促脂肪肝相关肝癌 Journal of Hepatology——[25.7] ① 通过生物标志物、代谢组学等分析探究慢性昼夜节律失调是否会促进人类NAFLD相关性肝细胞癌（HCC）的进展；② 昼夜节律失调小鼠表现出显著肝脏脂肪堆积，加速了NAFLD的形成；③ 昼夜节律失调会促进NAFLD诱导的人肝细胞癌变，改变非酒精性脂肪性肝炎和HCC转录组，激活癌症标志物，干扰对HCC的诊断；④ 通过对昼夜节律失调小鼠肝脏进行转录组和代谢组分析，识别到多个与细胞增殖、凋亡和代谢调控相关的信号通路发生改变，进而推动了肝癌的形成。【主编评语】非酒精性脂肪性肝病（NAFLD）是一种与酒精无关的肝疾病，通常与肥胖、2型糖尿病等代谢性疾病相关。慢性昼夜节律紊乱会增加NAFLD相关性肝细胞癌（HCC）的风险，但其潜在机制和与人类肝细胞癌的直接相关性尚未确定。近日，美国德克萨斯州休斯敦贝勒医学院医学系研究人员在Journal of Hepatology发表最新研究，通过生物标志物、代谢组学等分析探究人源化HCC的临床相关性，发现慢性昼夜节律紊乱是人类肝细胞的独立致癌因素，值得关注。（@九卿臣）【原文信息】 Circadian dysfunction induces NAFLD-related human liver cancer in a mouse model 2023-10-25, doi: 10.1016/j.jhep.2023.10.018 Cell子刊：用工程菌研究硫化氢对肠上皮细胞的浓度依赖性作用 Cell Reports——[8.8] ① 使用合成生物学方法开发了一个小型大肠杆菌菌株库，在支持微生物和宿主细胞共培养的肠道微生理系统（GMPS）中滴定硫化氢（H2S）；② GMPS维持挥发性气体递质H2S的气体张力，并使宿主-微生物相互作用可视化；③ 工程菌株在GMPS上定植，代谢活性为2天，产生16倍范围的H2S，并以H2S浓度依赖的方式诱导Caco-2细胞基因表达和代谢的改变；④ 通过实现当前动物和体外模型无法实现的实验，提供了一个研究微生物-宿主相互作用机制的平台。【主编评语】硫化氢（H2S）是一种由宿主细胞和菌群产生的代谢物，其在肠道疾病中的作用存在争议，取决于H2S的浓度、使用的模型系统和给药途径。因此，一种精准控制肠道微环境中的H2S浓度有助于阐明其在人体组织中的浓度依赖性作用。Cell Reports上近期发表的文章，设计大肠杆菌来滴定H2S水平，诱导对宿主基因表达和代谢的剂量依赖效应。文章向我们展示了气态微生物代谢物在低气透性、人源化肠道微生理系统中的因果作用，从而实现了宿主-微生物相互作用的高分辨率分析。（@RZN）【原文信息】 Engineered bacteria titrate hydrogen sulfide and induce concentration-dependent effects on the host in a gut microphysiological system 2023-11-18, doi: 10.1016/j.celrep.2023.113481 感谢本期日报的创作者：九卿臣，注册营养师陈彬林，DM，章台柳，圆滑的铁勺点击阅读过去10天的日报： 12-01 | 11月，最值得看的30篇肠道健康文献！ 11-30 | 《自然·综述》年度回顾：肠神经系统研究的三大进展 11-29 | 菌群寻宝：2篇Nature子刊深挖菌群中的抗菌肽 11-28 | 2篇高分研究，挖掘调节免疫的潜在益生菌 11-27 | 20年大队列新证：吃阿司匹林能否降低癌症风险？ 11-26 | Nature子刊：中年开始健康饮食，对寿命的影响有多大？ 11-25 | 善事利器：10文一览菌群研究的新方法和新工具 11-24 | 张发明团队：17页综述讲透粪菌移植前沿进展 11-23 | 今日Nature：两文揭示免疫调控中的饮食和肠道新知 11-22 | 翟齐啸/张家超/黄适Cell子刊突破：改善便秘的关键肠菌遗传因子

临床3期

2023-08-10

·MedCity News

Personalized Nutrition: Tomorrow’s Approach to Nutrition

Personalized nutrition has made remarkable progress, moving from a concept to a tangible reality with significant potential to improve individual health and well-being. This innovative approach focuses on tailoring nutritional strategies to the unique needs and preferences of each individual, moving away from the traditional one-size-fits-all approach. This article explores the significance of the innovative personalized nutrition approach and its ability to successfully implement personalized nutrition principles on a widespread scale. Understanding personalized nutrition Personalized nutrition incorporates factors such as physical activity, habits and behaviors, environmental exposures, continuous metabolite monitoring (continuous glucose monitoring), and continuous health-parameter monitoring (like heart rate and blood pressure). The overarching goal is to mitigate the risk of diet-related diseases by providing tailored dietary recommendations based on comprehensive data analysis, as well as managing existing chronic conditions. The additional elements involved in the personalized nutrition approach can be analyzed using machine learning algorithms and artificial intelligence to propose precise diets most suitable for individuals at specific stages and circumstances of their lives. However, it is worth noting that manual analysis is still prevalent, posing challenges in terms of scalability and application to the wider population. By leveraging algorithms to process information about the relationships between various factors and metabolic responses, medical doctors (MDs) and registered dietitian nutritionists (RDNs) can uncover predictions and correlations that traditional methods of analysis may not. This exciting new wave of personalized nutrition represents the convergence of nutrition science and data science. Personalized nutrition algorithms act as roadmaps in the form of decision trees. They guide nutritionists through a logical sequence of steps, starting from specific physical and genetic traits, and help them make clear suggestions on adjusting our nutrient intake. By taking into account individual traits and genetic differences, these algorithms can offer personalized recommendations that are specifically designed for our unique requirements and how our bodies respond. The idea of personalized nutrition has been on the surface for some time and has been recognized to be effective. For instance, in 1908, Sir Archibald Garrod classified alkaptonuria as a “hereditary error of metabolism,” paving the way for a groundbreaking concept in personalized medicine. This important milestone demonstrated the connection between genetic factors and metabolic disorders, opening new avenues for targeted dietary interventions. In addition, the discovery of phenylketonuria (PKU) in 1934, a condition that affects how the body processes phenylalanine, has provided valuable insights into the complex connection between nutrients, diet, and human well-being. Precision nutrition vs. personalized nutrition Although personalized nutrition and precision nutrition are two closely related concepts, they do differ in the assessed factors. Precision nutrition focuses on using scientific data, biomarkers, and genetic information to provide targeted and precise nutritional recommendations. It emphasizes tailoring nutrition based on individual genetic variations and biological markers. Personalized nutrition, on the other hand, focuses on data collected from clients. Customized plans for specific dietary needs can be created by considering specific genetic traits related to how nutrients are processed in the body. For example, someone can have a predisposition to lactose intolerance and may benefit from avoiding or reducing lactose intake. Moreover, nutrigenomics and epigenetics are important areas of precision nutrition that explore how our genes and their interactions with the environment, including diet, can influence our health and well-being. Meanwhile, personalized nutrition encompasses a broader range of factors beyond genetics. It integrates multiple sources of information, such as age, gender, body composition, medical history, dietary habits, and cultural background, to develop tailored nutrition plans. Personalized nutrition survey If we truly want to get the most out of our nutrition, we need to consider nutritionists’ work and if they do turn to personalized nutrition recommendations. To review how personalized nutrition is used by nutritionists today, I conducted a survey involving 500+ nutritionists and healthcare professionals. The data showed that 46.5% of dietitians most often use personalized nutrition principles in their daily practice. In addition, 42.72% of them have created at least one nutrition program based on advanced phenotypic and epigenetic data, and 43.09% are very confident in their knowledge of personalized or precision nutrition. The survey also revealed that when creating a personalized nutrition program, the most used patient data includes: Food allergy test (56.34%) Other health conditions (such as hypercholesterolemia, hypertension, gout, etc.) (53.73%) Current nutrition habits, including hydration (71.08%) Lifestyle factors (58.20%) Fitness levels (62.50%) The least used patient data includes: Social behavior (27.05%) Data from personal lifestyle devices (27.61%) Genetics and genomic data (30.22%) Questionnaires (30.59%) Phenotypic information on anthropometry (31.15%) Screening for genetic disease (32.27%) Personalized digital health platforms and tools The primary goal of personalized digital health platforms is to empower individuals to take an active role in managing their nutrition. These platforms provide personalized guidance, educational resources, and monitoring tools to support this process. By leveraging technology, data analytics, and user-friendly interfaces, including AI-powered solutions, these platforms deliver personalized health information, dietary recommendations, and tracking capabilities. This integration of AI enables individuals to make well-informed choices, accurately monitor their progress, and actively participate in managing their nutrition. According to the personalized nutrition survey, nutritionists, on the other hand, utilize advanced/specialized data analysis tools (such as Nutritics, NutriAdmin, and similar) for analyzing the data. The survey revealed that 60.82% of nutritionists mostly rely on these tools for data analysis. Challenges While personalized nutrition shows promising results and is an advanced approach to diet and nutrition, it still faces certain challenges. One challenge is accessibility, as it often requires specialized healthcare professionals, which may limit its availability. Additionally, the cost of personalized nutrition services can be competitive, and potential customers need to be open to understanding and accepting new approaches to nutrition. The biggest challenge in nutrition, however, is how to effectively apply healthy eating and lifestyle habits to improve the health of each individual on a larger scale. It becomes time-consuming. Moreover, using machine learning to analyze patient data can raise privacy concerns. Machine learning strategies involve the analysis of large amounts of personal data and can raise questions about how personal information is stored and used. Summary In the future, research in personalized nutrition needs to focus on understanding the role of nutrition throughout the entire lifespan and address diet-related conditions through comprehensive interventions that go beyond simply choosing healthy foods. This means considering various aspects of an individual’s life and implementing multifaceted approaches to promote overall well-being. The next step would be to incorporate the precision nutrition approach, which would enhance our understanding of patient data and enable us to create a personalized approach with even greater efficiency. Personalized and precision nutrition is the future of nutrition science. The integration of AI and machine learning techniques will provide opportunities we have never had before. Given the immense potential, it’s crucial to direct attention and investments toward the field of personalized and precision nutrition. This will foster innovation and drive progress in healthcare.