ID GROWTH-FACTOR-I; LIFE-SPAN EXTENSION; CALORIC RESTRICTION; STRESS
RESISTANCE; OXIDATIVE STRESS; CAENORHABDITIS-ELEGANS; BINDING-PROTEINS;
GENE-EXPRESSION; IGF-I; THERAPEUTIC STARVATION
AB The dietary recommendation for cancer patients receiving chemotherapy, as described by the American Cancer Society, is to increase calorie and protein intake. Yet, in simple organisms, mice, and humans, fasting-no calorie intake-induces a wide range of changes associated with cellular protection, which would be difficult to achieve even with a cocktail of potent drugs. In mammals, the protective effect of fasting is mediated, in part, by an over 50% reduction in glucose and insulin-like growth factor 1 (IGF-I) levels. Because proto-oncogenes function as key negative regulators of the protective changes induced by fasting, cells expressing oncogenes, and therefore the great majority of cancer cells, should not respond to the protective signals generated by fasting, promoting the differential protection (differential stress resistance) of normal and cancer cells. Preliminary reports indicate that fasting for up to 5 days followed by a normal diet, may also protect patients against chemotherapy without causing chronic weight loss. By contrast, the long-term 20 to 40% restriction in calorie intake (dietary restriction, DR), whose effects on cancer progression have been studied extensively for decades, requires weeks-months to be effective, causes much more modest changes in glucose and/or IGF-I levels, and promotes chronic weight loss in both rodents and humans. In this study, we review the basic as well as clinical studies on fasting, cellular protection and chemotherapy resistance, and compare them to those on DR and cancer treatment. Although additional pre-clinical and clinical studies are necessary, fasting has the potential to be translated into effective clinical interventions for the protection of patients and the improvement of therapeutic index. Oncogene (2011) 30, 3305-3316; doi:10.1038/onc.2011.91; published online 25 April 2011
C1 Univ So Calif, Andrus Gerontol Ctr, Dept Biol Sci, Los Angeles, CA 90089 USA.
Univ So Calif, Norris Canc Ctr, Los Angeles, CA 90089 USA.
RP Longo, VD (reprint author), Univ So Calif, Andrus Gerontol Ctr, Dept Biol Sci, 3715 McClintock Ave, Los Angeles, CA 90089 USA.
EM vlongo@usc.edu
NR 175

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