Immunonutrition, Metabolism, and Programmed Cell Death in Lung Cancer: Translating Bench to Bedside

Author:

Fedele Palma1ORCID,Santoro Anna Natalizia1,Pini Francesca1,Pellegrino Marcello2,Polito Giuseppe3,De Luca Maria Chiara4,Pignatelli Antonietta5,Tancredi Michele6,Lagattolla Valeria7,Anglani Alessandro8,Guarini Chiara1,Pinto Antonello19,Bracciale Pietro10

Affiliation:

1. Oncology Unit, Dario Camberlingo Hospital, 72021 Francavilla Fontana, Italy

2. Pathology Unit, Antonio Perrino Hospital, 72100 Brindisi, Italy

3. Nuclear Medicine Unit, Antonio Perrino Hospital, 72100 Brindisi, Italy

4. Radiotherapy Unit, Antonio Perrino Hospital, 72100 Brindisi, Italy

5. Palliative Care Unit, Antonio Perrino Hospital, 72100 Brindisi, Italy

6. Radiology Unit, Antonio Perrino Hospital, 72100 Brindisi, Italy

7. Clinic Nutrition Unit, Antonio Perrino Hospital, 72100 Brindisi, Italy

8. Radiology Unit, Dario Camberlingo Hospital, 72021 Francavilla Fontana, Italy

9. Course in Development and Production of Biotechnological Drugs, Faculty of Pharmaceutical Science, University of Milan, 20122 Milano, Italy

10. Pneumology Unit, Ostuni Hospital, 72017 Ostuni, Italy

Abstract

Lung cancer presents significant therapeutic challenges, motivating the exploration of novel treatment strategies. Programmed cell death (PCD) mechanisms, encompassing apoptosis, autophagy, and programmed necrosis, are pivotal in lung cancer pathogenesis and the treatment response. Dysregulation of these pathways contributes to tumor progression and therapy resistance. Immunonutrition, employing specific nutrients to modulate immune function, and metabolic reprogramming, a hallmark of cancer cells, offer promising avenues for intervention. Nutritional interventions, such as omega-3 fatty acids, exert modulatory effects on PCD pathways in cancer cells, while targeting metabolic pathways implicated in apoptosis regulation represents a compelling therapeutic approach. Clinical evidence supports the role of immunonutritional interventions, including omega-3 fatty acids, in augmenting PCD and enhancing treatment outcomes in patients with lung cancer. Furthermore, synthetic analogs of natural compounds, such as resveratrol, demonstrate promising anticancer properties by modulating apoptotic signaling pathways. This review underscores the convergence of immunonutrition, metabolism, and PCD pathways in lung cancer biology, emphasizing the potential for therapeutic exploration in this complex disease. Further elucidation of the specific molecular mechanisms governing these interactions is imperative for translating these findings into clinical practice and improving lung cancer management.

Publisher

MDPI AG

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