Pharmaceutical Sciences 藥物科學大豆食物對乳癌荷爾蒙療法的影響 英國 RNP 國際醫學營養研究中心研究員彭建彰 小太陽藥局藥師黃泰卿 摘要 (World Cancer Research Fund) 10 109.2 2 3 46 1995 2009 110% 11% 50-60% 60-75% (estrogen receptor, ER) 1 ER 2 ER (selective estrogen receptor modulators, SERMs) (aromatase inhibitors, AIs) SERMs tamoxifen ( ) tamoxifen 41% 34% 3 70% (ER+) 2/3 tamoxifen (ER-) 5-10% 30% ( ) ER tamoxifen 2009 28 THE JOURNAL OF TAIWAN PHARMACY Vol.32 No.2 Jun. 30 2016
4 ER 2003 1980 12.7 1995 28.68 2005 49.19 5 2013 10 10 2010 9,600 2012 1,900 1997 tamoxifen 6,7 4.3% 8,9 tamoxifen (American Society of Clinical Oncology, ASCO) bisphosphonate 藥物科 學壹 前言 10 貳 營養概論 (soybean, Glycine max Merrial) 38% 30% 18% 14% 10 (lecithin) (isoflavones) (saponin) (Phytic acid) (trypsin inhibitors) 32 2 藥學雜誌 127 29 Jun. 30 2016
藥Pharmaceutical Sciences 物科學 參 大豆與乳癌相關爭議一 大豆異黃酮結構 17 -estradiol 2-phenylnaphthalene isoflavonoids isoflavones coumestans prenylflavonoids lignans stilbenes isoflavones 12 (Peñalvo and Adlercreutz, 2004) 6 daidzin (D)23% genistin (G)64% glycitin (Gly) 13% daidzein (De) genistein (Ge) glycitein (Glye) D G Gly (glucoside form) 20% De Ge Glye (aglycones form) 90% 6 97-98% -glucosidase (Hendrich, 2002) 2-3% daidzin daidzein (equol) equol 17 -estradiol 11 二 大豆異黃酮誘發乳癌疑慮 58% 三 大豆類食品預防乳癌實驗 Choi (2009) equol caspase-3 caspase-9 MDA-MB-453 1 10 100 µm equol 24 48 72 100 µm equol 72 59% equol 11 Charalambous 30 THE JOURNAL OF TAIWAN PHARMACY Vol.32 No.2 Jun. 30 2016
equol 10 µm MCF-7 100 µm equol 10 µm tamoxifen MCF-7 tamoxifen ER- ER- equol ER- ER- ER- 595 (66Kda) 530 (54Kda) ER- ER- 12 ER- 2009 (JAMA) Soy Food Intake and Breast Cancer Survival (The Shanghai Breast Cancer Survival Study) 2002 3 2006 4 20 75 5,024 2009 6 18 36 60 7.4% 藥物科學Constantinou (2012) equol tamoxifen 10.3% 8.0% 11.2% (ER+) (ER-) tamoxifen 13 肆 食用大豆與預防乳癌建議 ER- tamoxifen 14 2011 1-3 藥學雜誌 127 31 32 2 Jun. 30 2016
Pharmaceutical Sciences 藥物科學Study of the Effect of Soy-Based Food on Hormone Therapy for Breast Cancer Rudy Peng 1, Tai-Ching Huang 2 Research of RNP International Research Center On Medical Nutrition 1 Pharmacist of Junior Sun Drug Store 2 Abstract Breast cancer is one of the biggest threats to women health globally. Clinical data indicated that 50-60% of breast cancer in premenopausal women and 60-75% of breast cancer in postmenopausal women are positive for estrogen receptor (ER). Hence, hormone therapy takes advantage of reducing the amount of estrogen or interrupting the cellular signaling via the ER pathway. There are two types of hormone therapies including selective estrogen receptor modulators (SERMs) and aromatase inhibitors (AIs). Tamoxifen is the most widely used of SERMs. Continuous therapy with tamoxifen for 5 years reduced the recurrence rate by 41% and mortality by 34%, and if tamoxifen is not effective for postmenopausal women, AIs can be considered. Clinical data suggests that the efficacy of AIs likely extends beyond 5 years. Previous studies showed that soy beans are excellent natural products; however, several studies indicated that isoflavones in soy beans and soy-based products mimic hormoneassociated signaling pathways and occupy ER, hindering the effects of tamoxifen. Since 2009, studies on the safety of soy bean and soy bean-based products in breast cancer patients showed that intake of moderate amount of soy bean-based products does not increase the risk of recurrence of breast cancer and to the contrary higher intake of soy bean-based products leads to lower recurrence rate and mortality rate of breast cancer. A long term follow up study also showed that intake of soy bean-based products are beneficial to the health of breast cancer patients. The current study intends to investigate whether intake of soy bean-based products exerted effects as generally predicted in the prevention and treatment of breast cancer patients. The study will offer guidance to physicians and dieticians in providing nutritional advice or support to breast cancer patients. 32 THE JOURNAL OF TAIWAN PHARMACY Vol.32 No.2 Jun. 30 2016
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