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Molekulare und biologische Grundlage zum Einfluss von Sport auf die Krebsentstehung

Molecular and biological mechanism of physical exercise on carcinogenesis

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Der Gastroenterologe Aims and scope

Zusammenfassung

Körperliche Aktivität und gezielte sporttherapeutische Maßnahmen haben sich mittlerweile als Supportivtherapie in der Onkologie bewährt, um Nebenwirkungen der Erkrankung und der medizinischen Therapie zu reduzieren und die Lebensqualität der Betroffenen zu steigern. Eine immer besser werdende epidemiologische Datenlage weist ferner darauf hin, dass körperliche Aktivität und Sport das Erkrankungsrisiko reduzieren und die tumorspezifische Mortalität beispielsweise für Kolorektalkarzinome um bis zu 60 % senken. Diese Daten sind insbesondere im Vergleich zum relativ geringen Benefit einer adjuvanten Chemotherapie beachtlich und deuten auf den erheblichen immunologischen Effekt körperlicher Aktivität hin. Einschränkend ist zu sagen, dass hierzu noch keine Daten großer prospektiv-randomisierter Interventionsstudien vorliegen, wobei sich die Durchführung solcher Untersuchungen im Vergleich zu pharmakologischen Studien deutlich komplexer gestaltet. Um die Bewegungsempfehlungen jenseits der global empfohlenen 150 min moderater bis intensiver körperliche Aktivität pro Woche zu konkretisieren, sind weitere, v. a. mechanistische Studien notwendig. Vor diesem Hintergrund soll dieser Artikel eine Übersicht über potenzielle biologische Mechanismen geben, über die Bewegung und Sport der Entstehung und dem Fortschreiten von Tumorerkrankungen entgegenwirken können. Neben einer globalen Veränderung des systemischen Entzündungsgeschehens werden sportinduzierte Veränderungen von Immunzellfunktionen und direkte Effekte durch eine Veränderung des Tumormilieus diskutiert.

Abstract

General physical activity and physical exercise have become a meaningful supportive therapy in oncology, since they have proven to reduce several disease- and treatment-specific side effects and to increase patients’ quality of life. Ample evidence from epidemiological investigations suggests that regular physical activity significantly decreases cancer risk and mortality. However, prospective randomized controlled trials are still lacking. Of note, such trials have many trapdoors and are more complex than usual pharmaceutical trials. In order to improve general physical activity and exercise recommendations, more mechanistic research is urgently needed. Against this background, this article will provide an overview on mechanistic studies, investigating the impact of exercise interventions on tumorgenesis and the progress of disease. In addition to alterations in systemic inflammatory signaling, the activation of tumor-competetive lymphocytes as well direct effects on the tumor microenvironment will be discussed.

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Authors and Affiliations

  1. Institut für Kreislaufforschung und Sportmedizin, Abteilung für molekulare und zelluläre Sportmedizin, Deutsche Sporthochschule Köln, Am Sportpark Müngersdorf 6, 50933, Köln, Deutschland

    P. Zimmer & A. Schenk

  2. Klinik I für Innere Medizin, Centrum für Integrierte Onkologie Aachen Bonn Köln Düsseldorf, Universität zu Köln, Köln, Deutschland

    T. Elter

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  1. P. Zimmer
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Correspondence to P. Zimmer.

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Interessenkonflikt

P. Zimmer, A. Schenk und T. Elter geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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W. Fischbach, Aschaffenburg

J.F. Riemann, Ludwigshafen

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Zimmer, P., Schenk, A. & Elter, T. Molekulare und biologische Grundlage zum Einfluss von Sport auf die Krebsentstehung. Gastroenterologe 14, 332–339 (2019). https://doi.org/10.1007/s11377-019-0379-5

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