JP6093300B2 - がんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物 - Google Patents
がんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物 Download PDFInfo
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- JP6093300B2 JP6093300B2 JP2013518060A JP2013518060A JP6093300B2 JP 6093300 B2 JP6093300 B2 JP 6093300B2 JP 2013518060 A JP2013518060 A JP 2013518060A JP 2013518060 A JP2013518060 A JP 2013518060A JP 6093300 B2 JP6093300 B2 JP 6093300B2
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Description
がん患者の多くは、栄養不良を引き起こしやすく、がん患者の60〜80%に栄養不良による体重減少が認められている。その原因として、がん病変による経口摂取不良、精神・神経的変化、外科的手術・化学療法・放射線治療、不適切な栄養管理、不可逆性の代謝障害等が知られている(非特許文献1)。がんによる不可逆性の代謝障害に陥ると、がんの進展に伴って、著しい代謝亢進が惹起される。そのため、十分な熱量を摂取しても、たんぱく崩壊等が進み、骨格筋・内臓たんぱくの減少や浮腫等が発生する。結果として、体重減少、制御不能の全身浮腫・腹水・胸水等がおこる(非特許文献2)。これらの原因として近年有力視されているのは、腫瘍が産生する蛋白質分解誘導因子(PIF)、腫瘍組織をとりまくマクロファージや末梢血の単球等が分泌する各種サイトカインである。がんに起因する体重減少等には、代謝の改善が必須であり、従来の栄養管理では体重等の改善および維持は困難と言われている。そこで近年、がんに起因する代謝障害、栄養不良状態の患者に対する栄養管理が重要視されている。
[1] タンパク質として乳タンパク質の加水分解物および発酵乳タンパク質、脂質としてオレイン酸を含有する油脂ならびに乳リン脂質及び/又は大豆レシチン、および糖質としてパラチノースを含む、がんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物、
[2] 前記乳タンパク質が、カゼイン、乳タンパク質濃縮物(MPC)、ホエイタンパク質濃縮物(WPC)、ホエイタンパク質分離物(WPI)、α-ラクトアルブミン、β-ラクトグロブリンおよびラクトフェリンからなる群より選択される、前記[1]記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物、
[3] 前記乳タンパク質が、組成物100mLあたり0.9〜3.0g含まれる、前記[1]記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物、
[4] 前記発酵乳タンパク質が、発酵乳よりホエイを減少させた組成物に由来する、前記[1]記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物、
[5] 発酵乳タンパク質がフレッシュチーズに由来する、前記[1]記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物、
[6] フレッシュチーズがクワルクである、請求項5記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物、
[7] 前記発酵乳タンパク質が、組成物100mLあたり2〜6g含まれる、前記[1]記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物、
[8] 前記乳タンパク質の加水分解物が、ホエイタンパク質分離物(WPI)をバシラス・リシェニフォルムス(Bacillus licheniformus)由来のアルカラーゼで加水分解およびブタ膵臓由来のトリプシンで加水分解して得られうる、前記[1]記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物、
[9] 前記乳タンパク質の加水分解物が、分画分子量10,000の限外濾過膜でさらに処理して得られる透過画分(パーミエイト)である、前記[8]記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物、
[10] 前記パラチノースが、組成物100mLあたり4〜15g含まれる、前記[1]記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物、
[11] 前記脂質中、オレイン酸が全脂肪酸組成の30%以上含まれる、前記[1]記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物、からなる。
1-1 乳タンパク質加水分解物
原料タンパク質として、カゼイン、ホエイタンパク質(ホエイタンパク質濃縮物(WPC)、ホエイタンパク質分離物(WPI)、α-ラクトアルブミン(α-La)、β-ラクトグロブリン(β-Lg))、乳タンパク質濃縮物(MPC、総乳タンパク質=TMPともいう)等を用いることができる。
例えば、乳タンパク質加水分解物は、in vivoにおけるLPS誘導性TNF-αおよびIL-6産生を抑制する作用を有することが見出されている(WO2004/047566公報)。乳タンパク質から派生するペプチドのサイトカイン産生に対する影響に関しては、ウシカゼイン由来のペプチドが、ネズミ骨髄マクロファージからのLPS誘導性TNF-αおよびIL-6産生を増加させるという報告(J. Sci. Food Agric., 81: 300-304, 2000)やプロバイオティック(probiotic)乳酸菌による発酵乳の上清中に、LPS刺激によるIL-6産生を誘導するペプチドが存在するという報告(Milchwissenschaft, 57(2): 66-70, 2002)がある。
(1)乾燥物として約90%のタンパク質含量のホエイタンパク質分離物(WPI、ダビスコ社)を、8%(w/v)のタンパク質含有量で蒸留水に溶解した。(2)溶液は85℃2分間の加熱処理しタンパク質を変性させた。この加熱後の溶液のpHは約7.5であった。(3)加水分解は、アルカラーゼ2.4L(酵素、ノボザイムス社)を基質に対して2.0%の濃度で添加し3時間55℃で反応させた。(4)次に、豚由来のトリプシンである PTN 6.0S(ノボザイムズジャパン)を基質に対して3.0%の濃度で添加し3時間55℃で反応させた。全加水分解時間は6時間であった。反応終了時のpHは約7.0であった。(5)ホエイタンパク質加水分解物は、遠心処理(20,000×g、10分)後、分画分子量10,000のUF膜処理(ミリポア社ウルトラフリー-MC)を行った。
予備加熱:65〜90℃
E/S:0.01〜0.2
pH:2〜10
加水分解温度:30〜65℃
加水分解時間:3〜20時間未満
1)エンド型プロテアーゼ
バシラス・リシェニフォルムス由来:アルカラーゼ(Alcalase)
B. レントゥス(B. lentus)由来:エスペラーゼ
枯草菌由来:ニュートラーゼ(Neutrase)
バクテリア由来:プロタメックス
豚膵臓由来:PTN(トリプシン)
2)エキソ型プロテアーゼ
アスペルギルス・オリゼ(Aspergillus oryzae)由来:フレーバーザイム
豚あるいはウシ内臓由来:カルボキシペプチダーゼ
本発明において、発酵乳タンパク質の原料に、ヨーグルト、チーズ(ナチュラルチーズ、フレッシュチーズ)、チーズ様食品、乳の乳酸菌及び/又はビフィズス菌発酵物等の発酵乳を用いることができる。
ヨーグルトは、アミノ酸スコアが100で、発酵によりタンパク質の消化吸収性が高められており栄養価が高い。本発明で使用する発酵乳タンパク質の例として、ヨーグルトから水分(ホエイ)を減少させたもの(例えば、日本特許第3,179,555号)をあげることができる。
一方、フレッシュチーズはカッテージ、クワルク、ストリング、ヌーシャテル、クリームチーズ、モツァレラ、リコッタ、マスカルポーネなど多くの種類があるが、原料としてクワルクを好適に使用することができる。クワルクの製造方法は公知(例えば、特開平6-228013)である。
2-1 リン脂質
リン脂質として乳リン脂質と大豆由来レシチンあるいは卵黄レシチンの組み合わせを用いる。乳リン脂質単独でもよい。レシチンという用語は、生化学、医学、薬学などの分野ではホスファチジルコリンだけに使用しているが、商業的あるいは工業的には、ホスファチジルコリン、ホスファチジルエタノールアミン、ホスファチジルイノシトール、ホスファチジン酸および他のリン脂質の混合物の総称として使われている。食品添加物公定書第7版(1999)では、レシチンは、「油糧種子又は動物原料から得られたもので、その主成分は、リン脂質である」、と定義されている。
乳リン脂質は、スフィンゴミエリン(SM)、ホスファチジルコリン(PC)、ホスファチジルエタノールアミン(PE)、ホスファチジルイノシトール(PI)、ホスファチジルセリン(PS)、リゾホスファチジルコリン(LPC)からなり、乳脂肪球皮膜(MFGM)のみに局在している。
大豆レシチンは天然の食品添加物として、食品分野で広く使われる一方、ポリエンホスファチジルコリンは医薬品(適応:慢性肝疾患における肝機能の改善、脂肪肝、高脂質血症)としても使われている。大豆レシチンの生理作用として、(1)生体膜の形態と機能の調整、(2)肺機能改善、(3)動脈硬化症の改善、(4)脂質代謝の改善、(5)肝臓脂質代謝の改善および(6)神経機能の改善・向上、があげられている(食品と開発, Vol. 29(3):18-21, 1994)。
本発明において、脂質としてオレイン酸を含有する油脂を使用することができる。厚生省(厚生労働省)は、飽和脂肪酸(SFA:パルミチン酸、ステアリン酸等):一価不飽和脂肪酸(MUFA:オレイン酸等):多価不飽和脂肪酸(PUFA:リノール酸、リノレン酸等)の望ましい摂取比率を従来の1:1.5:1から3:4:3となるよう、また、n-6系脂肪酸:n-3系脂肪酸の比率が4:1となるよう勧告している。わが国において、MUFAの摂取比を1.5倍まで高めた食生活の実施は難しいということが理由の一つである。そこで、脂質の脂肪酸組成中一価不飽和脂肪酸(MUFA)の含量を高めることが考えられる。そのために一価不飽和脂肪酸であるオレイン酸を本発明の組成物に含有せしめることができる。オレイン酸を多く含む脂質源としては、例えば、高オレイン酸のハイオレイックヒマワリ油、ナタネ油、オリーブ油、高オレイン酸ベニバナ油、大豆油、コーン油、パーム油などが挙げられる。またオレイン酸を含む脂質源として栄養調製油脂(日本油脂(株))が挙げられる。ヒマワリ油、ナタネ油、オリーブ油、およびオリーブ油との混合物も用いることができる。
糖質としては、主にパラチノースを使用することができる。その他の糖質としては、糖アルコール(ソルビトール、キシリトール、マルチトールなど)、ハチミツ、グラニュー糖、ブドウ糖、果糖、転化糖などがあげられる。
また、本発明の組成物における、タンパク質、脂質および糖質の組成物全体に対するエネルギー比率は、第六次改定日本人の栄養所要量にほぼ準ずるが、タンパク質15〜25%、脂質20〜30%、糖質45〜65 %を例示することができるが、この範囲に限定されない。
また、液状の組成物を予め加熱滅菌した後、無菌的に容器に充填する方法(例えば、UHT滅菌法とアセプティック包装法を併用した方法)、液状の組成物を容器に充填した後、容器とともに加熱滅菌する方法(例えば、オートクレーブ法)、缶容器や流動食や経口・経管栄養に用いる各種容器(いわゆるソフトバッグ、栄養バック等)に充填しレトルト殺菌を行う方法、缶容器や流動食や経口・経管栄養に用いる各種容器(いわゆるソフトバッグ、栄養バック等)に充填しレトルト殺菌した後に約140〜145℃で約5〜8秒間加熱殺菌後、冷却し、無菌充填を行う方法を例示することができる。
従って、本発明の組成物は、がん患者の栄養管理および代謝管理に有用である。
また、従来知られるがんに伴う不可逆性の代謝障害の予防及び/又は改善効果を有する医薬品や食品と併用して用いてもよい。具体的には、ω-3脂肪酸等を挙げることができるが、これらの例に限定されない。
(動物実験)
6週齢雄性CDF1マウスを、1週間馴化の後に、体重を指標に対照群、および癌細胞移植群に群分けした(N=8)。癌細胞移植群は、Colon26細胞株(マウスの結腸癌細胞株、財団法人癌研究会)を1×106cell、各個体の脇の皮下に移植した。Colon26細胞移植後から21日間飼育後、解剖および採血を行い、体重、腫瘍重量、除腫瘍重量、脂肪量(精巣周囲脂肪)、筋肉量(長指伸筋)、空体量、血漿中の各種マーカー(プロスタグランジンE2(PGE2)、インターロイキン−6(IL-6))、白血球数、白血球分画を測定した。
Colon26細胞移植後から剖検までは、動物用精製飼料AIN-93M自由摂取させた。また、Colon26細胞移植後から剖検の期間中の体重を測定した。
なお、AIN-93Mは、米国国立栄養研究所(American Institute of Nutrition)から1993年に発表されたマウス・ラット用の栄養研究のための標準精製飼料組成である。
・腫瘍重量:マウスを屠殺後、腫瘍を摘出し、腫瘍の重量を測定した。
・除腫瘍重量:マウスを屠殺後、腫瘍を摘出した後の体重を測定した。
・脂肪量(精巣周囲脂肪):精巣周囲脂肪を摘出し、重量を測定した。
・筋肉量(長指伸筋):長指伸筋を摘出し、重量を測定した。
・空体量:マウスを屠殺後、各種臓器(肝臓、脾臓、膵臓、腎臓、小腸、大腸、盲腸、内臓脂肪、精巣、肺)を摘出した後の体重を測定した。
・腫瘍体積:腫瘍の長径(a)と短径(b)を測定し、a×b2/2を体積(cm3)として算出した。
図1に、試験期間中の体重、および腫瘍容積の推移および解剖時(Colon26細胞移植後21日目)の腫瘍重量、脂肪量、筋肉量、空体量を示す。表3に、解剖時(Colon26細胞移植後21日目)の腫瘍重量、除腫瘍重量を示す。図2に、血漿中のIL-6、PGE2濃度を示す。図3に、全血中の白血球数、白血球分画を示す。
脂肪量については、癌細胞移植群で対照群に対し有意に減少した。また、癌細胞移植群では、筋肉量の有意な減少が見られた。空体についても、癌細胞移植群で顕著な減少が観察された。
血漿中のIL-6濃度およびPGE2濃度については、癌細胞移植群では、有意なIL-6値およびPGE2値の上昇が認められた。
好中球数は癌細胞移植群で有意に増加し、リンパ球数は逆に減少した。また、白血球の割合に関しても同様に、癌細胞移植群で、白血球中の好中球の割合が有意に増加し、リンパ球、単球の割合が有意に減少した。
以上より、Colon26細胞株を移植することで、がんに伴う不可逆性の代謝障害を誘導し、体重減少や筋肉、脂肪の減少、血中の炎症マーカー(IL-6、PGE2)の上昇をもたらすことが示唆された。また、血中の白血球、および白血球分画の数や割合にも異常をきたした。
前記試験例1で作成した癌細胞移植モデル動物を用いて、本発明の組成物の有効性試験を行った。
(動物実験)
6週齢雄性BALB/cマウスを、1週間馴化の後に、体重を指標に表4記載の群構成で群分けした(N=8)。
Colon26細胞移植後から剖検までは、凍結乾燥した表5および表6に記載の組成物(一般流動食、または本発明の組成物(栄養組成物と表記))を自由摂取させた。抗がん剤投与群には、5−フルオロウラシル(5-FU)を0.5%カルボキシメチルセルロース水溶液に懸濁し、5mL/kgの容量、60mg/kg、または30mg/kgの用量にて、Colon26細胞移植後1日目から13日目まで週に3回経口投与した(Colon26細胞移植後1、4、6、8、11、13日目)。対照群には、0.5%カルボキシメチルセルロース水溶液5mL/kgを抗がん剤投与と同じスケジュールで投与した。さらに、Colon26細胞移植後から解剖までの期間中の体重、および腫瘍体積を測定した。
・腫瘍重量:マウスを屠殺後、腫瘍を摘出し、腫瘍の重量を測定した。
・除腫瘍重量:マウスを屠殺後、腫瘍を摘出した後の体重を測定した(除腫瘍体重ともいう)。
・脂肪量(精巣周囲脂肪):精巣周囲脂肪を摘出し、重量を測定した。
・筋肉量(長指伸筋):長指伸筋を摘出し、重量を測定した。
・空体量:マウスを屠殺後、各種臓器(肝臓、脾臓、膵臓、腎臓、小腸、大腸、盲腸、内臓脂肪、精巣、肺)を摘出した後の体重を測定した。
・腫瘍体積:腫瘍の長径(a)と短径(b)を測定し、a×b2/2を体積(cm3)として算出した。
図4に、解剖時(Colon26細胞移植後21日目)の体重、腫瘍重量、除腫瘍重量、脂肪量(精巣周囲脂肪)、筋肉量(長指伸筋)、空体量を示す。図5に、血漿中のPGE2、IL-6濃度を示す。図6に、試験期間中の体重、および腫瘍容積の推移を示す。図7に、全血中の白血球数、白血球分画を示す。
腫瘍重量は、TB群、FU30群、MFU30群の間に差を認めなかった。また、5-FU投与量の高いFU60群、MFU60群の間にも差を認めなかった。MFU群(MFU30およびMFU60)で腫瘍重量が増加していないことから、5-FUの抗がん剤治療時に本発明の組成物による栄養管理によって、5-FUのがん治療効果が阻害されることはないことが確認された。
筋肉量は、MFU群(MFU30およびMFU60)で対照と比較して有意に高い値を示した。MFU群はFU群(FU30およびFU60)と比較しても有意に高い筋肉量であった。5-FUの抗がん剤治療 時に本発明の組成物を用いた栄養管理によって、がんの進展に伴う筋肉の減少が抑制されたことから、体重、除腫瘍体重の減少を防止できる可能性が示唆された。
PGE2、IL-6濃度は、MFU群はFU群と比較して有意に低い値を示した。5-FUの抗がん剤治療時に本発明の組成物による栄養管理によって、がんの進展に伴う血中の炎症マーカー(PGE2やIL-6)の亢進が抑制され、それによって、筋肉の減少、さらには体重、除腫瘍体重の減少も防止されることが示唆された。
5-FUの抗がん剤治療時に本発明の組成物による栄養管理を行うことで、がんの進展に伴う単球の減少が抑制された。同時に好中球の増加も抑制する傾向にあった。
Claims (10)
- タンパク質として乳タンパク質の加水分解物および発酵乳タンパク質、脂質としてオレイン酸を含有する油脂ならびに乳リン脂質及び/又は大豆レシチン、および糖質としてパラチノースを含み、
前記乳タンパク質の加水分解物が、ホエイタンパク質分離物(WPI)をバシラス・リシェニフォルムス(Bacillus licheniformus)由来のアルカラーゼで加水分解およびブタ膵臓由来のトリプシンで加水分解して得られうることと、分画分子量10,000の限外濾過膜でさらに処理して得られる透過画分(パーミエイト)であることとの特徴を有する、
がんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物。 - 前記乳タンパク質の加水分解物が、組成物100mLあたり0.9〜3.0g含まれる、請求項1記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物。
- 前記発酵乳タンパク質が、発酵乳よりホエイを減少させた組成物に由来する、請求項1記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物。
- 発酵乳タンパク質がフレッシュチーズに由来する、請求項1記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物。
- フレッシュチーズがクワルクである、請求項4記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物。
- 前記発酵乳タンパク質が、組成物100mLあたり2〜6g含まれる、請求項1記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物。
- 前記パラチノースが、組成物100mLあたり4〜15g含まれる、請求項1記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物。
- 前記脂質中、オレイン酸が全脂肪酸組成の30%以上含まれる、請求項1記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物。
- 抗がん剤の作用を損なわないことを特徴とする、請求項1記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物。
- 抗がん剤の代謝障害を抑制することを特徴とする、請求項1記載のがんに伴う不可逆性の代謝障害の予防及び/又は改善のための組成物。
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