编者按
(1)抗病毒;
(2)抗病毒DNA/RNA复制;
(3)免疫调控;
(4)支持细胞和全身系统。
图1
膳食中的核苷酸:
图2 核苷酸对免疫细胞的影响
这项研究的作者对相关文献进行了综述,并总结仅卡路里和蛋白质就不足以使免疫功能恢复正常的情况下,给于需要维持免疫功能的饮食RNA,能在蛋白质剥夺后恢复失去的免疫功能。作者指出:膳食核苷酸即使在蛋白质缺乏或体重减轻期间也可以恢复失去的免疫功能。在两项独立的双盲临床研究中,与不含核苷酸饮食的患者相比,喂食含有核苷酸的饮食的患者的免疫功能得到了改善。此外,与对照组相比,接受核苷酸的免疫营养配方的术后癌症患者的感染并发症和住院时间减少了。
乳清蛋白:
褪黑激素:
图3 褪黑素与免疫
水飞蓟宾:
常常应用于病毒性肝炎中,大多数中医师和自然疗法医师很容易将水飞蓟素与肝脏疾病(从肝硬化到胆汁淤积症)联系起来。草药制剂可支持一般排毒,癌症治疗和肾脏保护。
▲ 随机、安慰剂对照试验:一项随机对照试验,用于评估水飞蓟素对急性肝炎的症状、体征和生物标志物的安全性和有效性:该研究招募了105例有症状的患者,患有急性临床肝炎,且血清丙氨酸氨基转移酶(ALT)水平>正常上限的2.5倍。作者指出:“干预措施包括每天三次摄入标准建议剂量140mg的水飞蓟素,或服用维生素安慰剂4周,再服用4周跟进。”没有发现不良事件。结果表明:“随机分组的服用水飞蓟素患者更快缓解与胆汁潴留有关的症状:深色尿(p=0.013)、黄疸(p=0.02)和巩膜黄疸(p = 0.043)。水飞蓟素中的间接胆红素减少(p=0.012),但其他变量(包括直接胆红素,ALT和天冬氨酸转氨酶(AST))没有明显减少。”
▲ 综述:在非肝炎病毒感染中使用水飞蓟素的注意事项:水飞蓟宾在实验性自身免疫性脑脊髓炎中的免疫抑制作用,水飞蓟宾通过抑制树突状细胞的免疫活性来来极化Th1/Th2免疫应答。(Arch Pharm Res.477 Oct):水飞蓟素对肝病模型(包括人类临床试验)具有有益作用;新的研究正在促进其在抗癌方案中的使用。水飞蓟素能抑制NFkB,这可以解释其抗炎和抗纤维化作用。但是,部分文章(例如Min等人的文章)显示:水飞蓟素可能会削弱抗病毒Th-1的免疫反应。他们写道:“…水飞蓟宾抗原非特异性下调促炎性Th1细胞因子,并上调抗炎性Th2细胞因子。这些结果表明水飞蓟宾既具有免疫抑制作用又具有免疫调节作用。”同样,Lee等人在一项涉及树突状细胞(DC)的实验中发现,水飞蓟宾处理的树突细胞证明Th1应答的诱导受损以及正常的细胞介导的免疫应答。”
Melhem等人在研究中使用的口服抗氧化剂营养物质和抗病毒植物药
★ 北五味子:500毫克bid *
★ 抗坏血酸:2,000毫克tid
★ 谷胱甘肽:150毫克bid
★ 水飞蓟素:250毫克tid*
★ 硫辛酸:150毫克bid
★ D-α-生育酚:800 IU / d
* Melhem et al. Treatment of chronic hepatitis C virus infection via antioxidants: results of a phase I clinical trial. J Clin Gastroenterol. 475 Sep;39(8):737-42
胰腺腺体和蛋白水解酶:
▲ 在慢性荨麻疹患者中进行的初步研究:菠萝蛋白酶在慢性荨麻疹患者(PLC)中的作用:“所有患者均在治疗后表现出完全的临床康复。…结论:总之,菠萝蛋白酶可以被认为是PLC的有效治疗选择。其功效可能与其抗炎,免疫调节和/或抗病毒特性有关。”
图4 菠萝蛋白酶作用
▲ 双盲、随机、对照III期研究:蛋白酶制剂对儿童败血症的致病原酶的功效和安全性:该研究的作者假设口服蛋白水解酶可以调节宿主的免疫系统并促进败血症的早期恢复。本研究使用含菠萝蛋白酶90 mg,胰蛋白酶48 mg和芦丁100 mg的肠溶片作为辅助疗法,对60例脓毒症儿童(1个月至12岁)进行了治疗;给予患者1片/10 kg体重,每天最多服用6片,分两次或三次服用,持续14-21天,并给予适当的抗生素和支持治疗。结果如下:“ [酶]治疗组中,发烧消退的中位时间为3天,而安慰剂组为4天。[酶]组需要2天的血液动力学支持,而安慰剂组则需要3天。改良的格拉斯哥昏迷量表评分在[酶]组中为3天,而在安慰剂组中为5.5天。[酶]组可以在四天内开始口服食物,而安慰剂组可以在五天内开始口服食物。安慰剂组有2例患者死亡。结论:[口服酶治疗]作为抗生素的辅助佐剂和支持性治疗可有效改善小儿败血症患者的病情。”
总结
参考文献
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作者简介
李淼
心血管内科副主任
美国功能医学研究院(IFM)会员及认证医生
美国功能医学大学FMU认证医生
美国抗衰老协会(A4M)会员
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