探索生酮饮食在减轻神经炎症和调节免疫反应中的潜力
Exploring the ketogenic diet's potential in reducing neuroinflammation and modulating immune responses
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影响因子:5.9
分区:医学2区 / 免疫学2区
发表日期:2024
作者:
Antonietta Monda, Maria Ester La Torre, Antonietta Messina, Girolamo Di Maio, Vincenzo Monda, Fiorenzo Moscatelli, Marida De Stefano, Marco La Marra, Marilena Di Padova, Anna Dipace, Pierpaolo Limone, Maria Casillo, Marcellino Monda, Giovanni Messina, Rita Polito
DOI:
10.3389/fimmu.2024.1425816
摘要
生酮饮食（KD）以大量减少碳水化合物摄入、增加脂肪和蛋白质摄入为特征，导致代谢状态被称为“酮症”，在此状态下脂肪成为主要能量来源。近年来的研究强调KD在降低多种疾病风险中的潜在优势，包括2型糖尿病、高脂血症、心脏病和癌症。KD的宏量营养素分布通常为高脂肪、中等蛋白质和低碳水化合物。限制碳水化合物摄入至每日至少50克，诱发分解代谢状态，促使糖异生和酮体生成。酮体生成减少脂肪和葡萄糖的积累，作为能量储备，促进脂肪酸的生成。神经退行性疾病如阿尔茨海默病、帕金森病等，其特征是持续的神经炎症。不断增加的证据表明，免疫激活和神经炎症在这些疾病的发病机制中发挥重要作用。KD的保护作用与酮体的产生密切相关，酮体在此饮食方案中起关键作用。鉴于这些发现，本文旨在探讨KD通过调节免疫反应对神经炎症的潜在影响。理解KD对中枢神经系统的免疫调节作用，有望为这些致残疾病提供创新的治疗策略。
Abstract
The ketogenic diet (KD) is marked by a substantial decrease in carbohydrate intake and an elevated consumption of fats and proteins, leading to a metabolic state referred to as "ketosis," where fats become the primary source of energy. Recent research has underscored the potential advantages of the KD in mitigating the risk of various illnesses, including type 2 diabetes, hyperlipidemia, heart disease, and cancer. The macronutrient distribution in the KD typically entails high lipid intake, moderate protein consumption, and low carbohydrate intake. Restricting carbohydrates to below 50 g/day induces a catabolic state, prompting metabolic alterations such as gluconeogenesis and ketogenesis. Ketogenesis diminishes fat and glucose accumulation as energy reserves, stimulating the production of fatty acids. Neurodegenerative diseases, encompassing Alzheimer's disease, Parkinson's disease are hallmarked by persistent neuroinflammation. Evolving evidence indicates that immune activation and neuroinflammation play a significant role in the pathogenesis of these diseases. The protective effects of the KD are linked to the generation of ketone bodies (KB), which play a pivotal role in this dietary protocol. Considering these findings, this narrative review seeks to delve into the potential effects of the KD in neuroinflammation by modulating the immune response. Grasping the immunomodulatory effects of the KD on the central nervous system could offer valuable insights into innovative therapeutic approaches for these incapacitating conditions.