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Raadpleeg altijd een complementair arts voor gebruik van voedingssupplementen - anti-oxidanten

En bekijk de literatuurlijsten niet-toxische middelen en behandelingen van arts-bioloog drs. Engelbert Valstar

12 augustus 2019: Bron: . 2018 Feb; 26(2): 177–190. Published online 2017 Dec 19. Elsevier Science. Met dank aan Rob die mij dit toestuurde.

Heel vaak krijgen kankerpatienten van hun behandelende artsen te horen dat bepaalde anti-oxidanten wellicht schadelijk zouden kunnen zijn om die te gebruiken naast bv. chemo. Uit een grote meta-analyse van maar liefst 174 peer-reviewed originele artikelen van 1967 tot moment van opmaken van deze meta-analyse (2017) bestaande uit 93 klinische studies met een totaal aantal van 18.208 kankerpatiënten, 56 dierstudies en 35 in vitro studies blijkt dat dit vaak onterecht is.  

Uit deze meta-analyse blijkt dat antioxidanten een grote potentie hebben om door chemotherapie veroorzaakte bijwerkingen - toxiciteit te verbeteren. Voedingssuppletie met antioxidanten tijdens chemotherapie geeft ook betere effectiviteit van de behandelingen en nog belangrijker, soms ook beduidend langere overlevingstijd bij kankerpatiënten.

De conclusie:

Van de 130 artikelen rapporteren 91 artikelen (70%) dat de therapeutische efficiëntie van chemotherapie toeneemt door het gebruik van antioxidanten. Conjugaat-antioxidantsuppletie bleek ook de overlevingstijd bij de patiënten te verhogen volgens 26 rapporten (63%) van de 41 onderzoeksartikelen. Onze uitgebreide gegevens suggereren daarom dat antioxidanten niet interfereren met chemotherapie en tijdens de klinische setting kunnen worden voorgeschreven om de levensstandaard te verhogen.

Een zo goed als letterlijke vertaling via google translate van de introductie van deze meta-analyse:

Antioxidanten voorkomen cellulaire schade door te reageren en oxiderende vrije radicalen te elimineren, waardoor relevantie voor adjuvante chemotherapie wordt gevonden. Het gebruik van antioxidantensupplementen door patiënten met kanker wordt geschat op 13 tot 87% ().

Een dergelijk groot verschil in percentage kan worden toegeschreven aan het verschil in vormen van kanker, leeftijd, opleiding, aanvullende geneesmiddelen en etniciteit in de groep die voor de studie is uitgevoerd. Het gebruik van supra-dieet doses antioxidant heeft steeds meer belangstelling gekregen als een mogelijke primaire en secundaire strategie ter bestrijding van kanker.
Hogere niveaus van endogene antioxidanten kunnen beschermen tegen door chemotherapie veroorzaakte oxidatieve stress, vooral bij sommige kankerpatiënten met een verminderd vermogen om met oxidatieve belasting om te gaan

().

Bij chemotherapie bij kanker veroorzaakt een werkingsmechanisme van bepaalde antineoplastische middelen het genereren van vrije radicalen die verder leiden tot cellulaire schade en necrose van kwaadaardige cellen. Daarom wordt het gebruik van antioxidanten tijdens chemotherapie bekritiseerd vanwege de angst om de werkzaamheid van het medicijn te verstoren. 

Echter veel complementair werkende artsen stimuleren het gebruik van antioxidantensupplementen waardoor patiënten mogelijk hogere effectieve doses chemotherapie kunnen verdragen, waardoor de kans op een betere tumorrespons en een verbeterde overlevingskans wordt vergroot. Daarom is gelijktijdig gebruik van antioxidanten tijdens chemotherapie een zeer controversieel onderwerp.

De herhaaldelijk gestelde vragen zijn: "Verhogen antioxidanten de werkzaamheid van een middel tegen kanker? Beschermen antioxidanten normaal weefsel en verbeteren ze de toxiciteit of beschermen ze kankercellen tegen het effect van chemotherapie? 

Deze meta-analyse is bedoeld om een idee te geven van door chemotherapie veroorzaakte toxiciteit; ROS en oxidatieve schade worden beoordeeld met opheldering over de belangrijkste kwesties rond deze controverse door de huidige staat van inzicht te evalueren over mogelijke en bewezen interactie tussen antioxidanten en conventionele oncologische therapieën.

Hier een paar grafieken van bepaalde anti-oxidanten uit het studierapport: Antioxidants as precision weapons in war against cancer chemotherapy induced toxicity – Exploring the armoury of obscurity dat gratis is in te zien. Daaronder het abstract plus referentielijst.

Klik op de bold gemaakte table 1,2, 3 en 4 dan krijgt u de grafieken volledig op uw scherm te zien.  

Table 1 

vertegenwoordigt gegevens verzameld uit in totaal 75 peer-reviewed onderzoeksartikelen waarin het gelijktijdig gebruik van vet en in water oplosbare antioxidanten met chemotherapie werd onderzocht. Onder hen is het totale aantal klinische onderzoeken 36 waarbij 8047 patiënten betrokken waren (zowel mannen als vrouwen). Totaal aantal artikelen over in vitro en diermodel zijn respectievelijk 19 en 28. Tabel geeft het gebruik weer van 5 verschillende vitamines in hun verschillende vormen samen met 34 verschillende chemotherapeutische middelen in een specifieke combinatie.

Table 2 

vertegenwoordigt gegevens verzameld uit een totaal van 46 peer-reviewed onderzoeksartikelen waarin de gevolgen van antioxidanten zoals GSH, melatonine en NAC in chemotherapeutica werden onderzocht. Onder hen is het totale aantal klinische proeven 32 waaraan 1415 proefpersonen, zowel mannen als vrouwen, deelnamen. Totaal aantal artikelen over in vitro en diermodel zijn respectievelijk 5 en 8. Deze 3 antioxidanten worden gebruikt in specifieke combinatie met 22 verschillende chemotherapeutische middelen.

Table 3

vertegenwoordigt gegevens verzameld uit 26 peer-reviewed onderzoeksartikelen die zich richten op het begrijpen van de rol van antioxidanten zoals Quercetin, Selenium en Co-enzym Q10 tijdens chemotherapie. Deze gegevens bestaan ​​uit 6 klinische studies met 270 proefpersonen (zowel mannelijke als vrouwelijke), 15 dierstudies en 8 studies in in vitro-model. 10 verschillende chemotherapeutische middelen werden afzonderlijk of in combinatie met alle hierboven genoemde drie antioxidanten gebruikt. 5 onderzoeksartikelen verklaren het effect van quercetine in chemotherapie, waarvan alle 5 onderzoeksresultaten wijzen op een hogere therapeutische respons in aanwezigheid van een antioxidant. Van de 10 rapporten over selenium ontvouwden 8 artikelen (80%) het feit dat gelijktijdige toediening van selenium samen met verschillende chemotherapeutica leidt tot een superieure vermindering van de toxiciteit die tijdens therapieën wordt veroorzaakt. Evenzo ondersteunen van 11 meldingen 9 artikelen (81%) antioxidantensuppletie om door geneesmiddelen veroorzaakte toxiciteit te verlichten. Van de in totaal 26 meldingen bevestigen 18 artikelen (69%) het feit van door antioxidanten gemedieerde toxiciteitsbeperking en nog eens 8 artikelen publiceerden geen wijziging in de gegevens of de studie was niet van toepassing. 15 artikelen (57%) toonden aan dat antioxidantensuppletie de therapeutische efficiëntie van het kankermedicijn verhoogt, mogelijk door een synergistisch effect, terwijl er geen rapporten waren over een langere overlevingstijd bij proefpersonen of modellen die in studies werden gebruikt.

Table 4

In deze grafiek gegevens van 22 onderzoeksinzendingen die de uitkomst van een combinatie van antioxidanten samen met geneesmiddelen voor de behandeling van kanker analyseren. Veel onderzoeksartikelen stellen dat een combinatie van antioxidanten voordeliger kan zijn dan deze antioxidanten afzonderlijk te gebruiken. Een totaal van 15 antioxidanten in een specifieke combinatie bij een bepaalde dosis werden gecombineerd met een goed gepland chemotherapieregime inclusief 17 verschillende soorten chemotherapeutische middelen. Deze gegevens vertegenwoordigen 15 klinische onderzoeken, waaronder 571 proefpersonen, 4 dierstudies en 3 experimenten met een in vitro model. Van de 22, gaven 16 artikelen (72%) nadruk op verbetering van de toxiciteit door antioxidant combinatie tijdens therapie, melden 15 onderzoeksrapporten een verhoogde therapeutische respons en in 5 studies was er een toename in de overlevingstijd na toediening van antioxidanten.

Het volledige studierapport: Antioxidants as precision weapons in war against cancer chemotherapy induced toxicity – Exploring the armoury of obscurity is gratis in te zien.

Hier het abstract plus referentielijst.

The clinical cancer research community should cooperate and focus new studies on the use of a specific combination of antioxidant in chemotherapy, and determine optimal doses of antioxidant for a specific cancer setting. Mechanistic studies on the interaction between antioxidants and conventional cancer therapy could also lead to novel biomarkers for assessing dose adequacy.

. 2018 Feb; 26(2): 177–190.
Published online 2017 Dec 19. doi: 10.1016/j.jsps.2017.12.013
PMCID: PMC6111235
PMID: 30166914

Antioxidants as precision weapons in war against cancer chemotherapy induced toxicity – Exploring the armoury of obscurity

Abstract

Cancer is the leading cause of mortality worldwide, accounting for almost 13% of deaths in the world. Among the conventional cancer treatments, chemotherapy is most frequently carried out to treat malignant cancer rather than localised lesions which is amenable to surgery and radiotherapy. However, anticancer drugs are associated with a plethora of side effects. Each drug, within every class, has its own set of adverse reactions which may cause patient incompliance and deterioration of the quality of life. One of the major causes of adverse reactions, especially for drugs targeting DNA, is the excessive production of reactive oxygen species (ROS) and subsequent build up of oxidative stress. To curb these undesired side effects, several dietary supplements have been tested, amongst which antioxidants have gained increasing popularity as adjuvant in chemotherapy. However, many oncologists discourage the use of antioxidant rich food supplements because these may interfere with the modalities which kill cancer by generating free radicals. In the present review, all studies reporting concomitant use of several antioxidants with chemotherapy are indiscriminately included and discussed impartially.

The effect of supplementation of thirteen different antioxidants and their analogues as a single agent or in combination with chemotherapy has been compiled in this article. The present review encompasses a total of 174 peer-reviewed original articles from 1967 till date comprising 93 clinical trials with a cumulative number of 18,208 patients, 56 animal studies and 35 in vitro

Conflict of interest

Authors declare no conflict of interest. Authors declare full control of all primary data.

Acknowledgment

Authors acknowledge Late Dr. J. Nadkarni for her support.

Footnotes

Peer review under responsibility of King Saud University.

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Articles from Saudi Pharmaceutical Journal : SPJ are provided here courtesy of Elsevier

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  • e.valstar :
    En dan is het wel zo dat een aantal van deze middelen los van pro- of antioxydatie nog andere gunstige effecten hebben! deze middelen kunnen dus niet over een kam geschoren worden en er zijn soms uitzonderingen.

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