Effects of fasting on the immune system function and its positive effects on the chemotherapy of various types of cancer

authors:

avatar Sanam Nami , avatar Ali AghebatiMaleki , avatar Zohreh Babaloo , avatar leili Aghebati-Maleki , *

Koomesh: Vol.22, issue 3; 404-410
article type: issue_documents_importer
received: August 01, 2018
accepted: October 01, 2019

how to cite: Nami S, AghebatiMaleki A, Babaloo Z, Aghebati-Maleki L. Effects of fasting on the immune system function and its positive effects on the chemotherapy of various types of cancer. koomesh. 2020;22(3):e153195. 

Abstract

Fasting is one of the most basic religions in Islam. The body considers fasting as a stress and tries to cope with it through a path called self-regulating stress. The effects of fasting on various diseases and different physiological conditions have been evaluated and its positive effects have been shown in many diseases. The effects of fasting on the immune system of healthy people in general indicate the effect of fasting moderator on the chemokine network, oxidative stress and intrinsic and acquired immune system. Correspondingly, fasting reduces the pre-inflammatory cytokines, the chemokines, the antibodies, the CRP and the immune system cells, and increases IFN-γ, TNFα, iNOS, Endorphine and endocannabinoids. In addition, fasting does not have an effect on oxidative stress markers such as Malondialdehyde (MDA), glutathione (GSH), glutathione peroxidase, and catalase levels. Fasting also has beneficial effects on autoimmune diseases and, in most cases, moderates the disease. Various studies have shown that fasting with chemotherapy can reduce the adverse effects of chemotherapy without even reducing the anti-cancer effect of chemotherapy drugs, and even reduce the growth of some cancers in vitro. Although, chemotherapy with fasting is a better option for cancer treatment for prognosis, there are very precise clinical trials prior to using it as a standardized method. In this review article, we discuss the significance of fasting effects on various diseases and different physiological conditions and their physiological elements on the chemokine network, oxidative stress and intrinsic immune system in cancer development.  

References

  • 1.

    Yarahmadi S, Larijani B, Bastanhagh MH, Pajouhi M, Baradar Jalili R, Zahedi F, et al. Metabolic and clinical effects of Ramadan fasting in patients with type II diabetes. J Coll Physicians Surg Pak 2003; 13: 329-332.

  • 2.

    Latifynia A, Vojgani M, Gharagozlou MJ, Sharifian R. Neutrophil function (innate immunity) during Ramadan. J Ayub Med Coll Abbottabad 2009; 21: 111-115.

  • 3.

    Ibrahim WH, Habib HM, Jarrar AH, Al Baz SA. Effect of Ramadan fasting on markers of oxidative stress and serum biochemical markersof cellular damage in healthy subjects. Ann Nutr Metab 2008; 53: 175-181.

  • 4.

    Achmad Zainullah, Suhartono Taat Putra. sychoneuroimmunological Response Change in Ramadan Fasting Individuals A Case Study in Pesantren Hidayatullah Surabaya using PsychoneuroimmunoIogical Approach. Abstrac Disertation. 2005;1001-3542.

  • 5.

    Dhabhar FS, McEwen BS. Enhancing versus suppressive effects of stress hormones on skin immune function. Proc Natl Acad Sci U S A 1999; 96: 1059-1064.

  • 6.

    Esch T, Stefano GB. The neurobiologyof stress management. Neuro Endocrinol Lett 2010; 31: 19-39.

  • 7.

    Charmandari E, Tsigos C, Chrousos G. Endocrinology of the stress response. Annu Rev Physiol 2005; 67: 259-284.

  • 8.

    Bragazzi NL, Watad A. The Impact of Fasting on Rheumatic Diseases. Isr Med Assoc J 2017; 19: 378-379.

  • 9.

    Nematy M, Alinezhad-Namaghi M, Rashed MM, Mozhdehifard M, Sajjadi SS, Akhlaghi S, et al. Effects of Ramadan fasting on cardiovascular risk factors: a prospective observational study. Nutr J 2012; 11: 69.

  • 10.

    Adawi M, Watad A, Brown S, Aazza K, Aazza H, Zouhir M, et al. Ramadan fasting exerts immunomodulatory effects: insights from a systematic review. Front Immunol 2017; 8: 1144.

  • 11.

    Latifynia A, Vojgani M, Gharagozlou MJ, Sharifian R. Effect of Ramadan on neutrophil's respiratory burst (innate immunity) and circulating immune complex. J Ayub Med Coll Abbottabad 2008; 20: 128-131.

  • 12.

    Latifynia A, Vojgani M, Abofazeli T, Jafarieh H. Circulating immune complex during Ramadan. J Ayub Med Coll Abbottabad 2007; 19: 15-18.

  • 13.

    Faris MA, Kacimi S, Al-Kurd RA, Fararjeh MA, Bustanji YK, Mohammad MK, et al. Intermittent fasting during Ramadan attenuates proinflammatory cytokines and immune cells in healthy subjects. Nutr Res 2012; 32: 947-955.

  • 14.

    Mohammed K, Mahmood M. Effect of Ramadan fasting on the levels of IL-1, IL-2, IL-6 and IL-8 cytokines. Diyala J Pure Sci 2010; 6: 308-313.

  • 15.

    Develioglu ON, Kucur M, Ipek HD, Celebi S, Can G, Kulekci M. Effects of Ramadan fasting on serum immunoglobulin G and M, and salivary immunoglobulin A concentrations. J Int Med Res 2013; 41: 463-472.

  • 16.

    Chennaoui M, Desgorces F, Drogou C, Boudjemaa B, Tomaszewski A, Depiesse F, et al. Effects of Ramadan fasting on physical performance and metabolic, hormonal, and inflammatory parameters in middle-distance runners. Appl Physiol Nutr Metab 2009; 34: 587-594.

  • 17.

    Lahdimawan A, Handono K, Indra M, Prawiro S. Effect of Ramadan fasting on the ability of serum, PBMC and macrophages from healthy subjects to kill M. tuberculosis. IOSR J Pharm Biol Sci 2014; 9: 24-29.

  • 18.

    Lahdimawan A, Handono K, Indra M, Prawiro S. Effect of Ramadan fasting on classically activated, oxidative stress and inflammation of macrophage. IOSR J Pharm (IOSRPHR) 2013; 3: 14-22.

  • 19.

    Lahdimawan A, Handono K, Indra M, Prawiro S. Effect of Ramadan fasting on endorphin and endocannabinoid level in serum, PBMC and macrophage. Int J Pharm Sci Invent 2013; 2: 46-54.

  • 20.

    Fujita Y, Yoshioka N, Abe R, Murata J, Hoshina D, Mae H, et al. Rapid immunochromatographic test for serum granulysin is useful for the prediction of Stevens-Johnson syndrome and toxic epidermal necrolysis. J Am Acad Dermatol 2011; 65: 65-68.

  • 21.

    Gorjipour K, Yeganeh F, Haji Molla Hoseini M. The effect of fasting on the functioning of the immune system based on the measurement of plasma granulysin level. J Res Religion Health 2015; 1: 25-32.

  • 22.

    El-Dayem S, Zyton H. The effect of Ramadan fasting on multiple sclerosis. Egypt J Neurol Psychiatry Neurosurg 2012; 49: 341-345.

  • 23.

    Saadatnia M, Etemadifar M, Fatehi F, Ashtari F, Shaygannejad V, Chitsaz A, et al. Short-term effects of prolonged fasting on multiple sclerosis. Eur Neurol 2009; 61: 230-232.

  • 24.

    Tavakkoli H, Haghdani S, Emami MH, Adilipour H, Tavakkoli M, Tavakkoli M. Ramadan fasting and inflammatorybowel disease. Indian J Gastroenterol 2008; 27: 239-241.

  • 25.

    Sharma M, Veena S, Gupta M, Tailang M, Pathak A. Quantitative change in circulating immune complexes during Ramadan in rheumatoid arthritis patients. J Pharm Res 2011; 4: 1306.

  • 26.

    UgochukwuNH, Figgers CL. Caloric restriction inhibits up-regulation of inflammatory cytokines and TNF-alpha, and activates IL-10 and haptoglobin in the plasma of streptozotocin-induced diabetic rats. J Nutr Biochem 2007; 18: 120-126.

  • 27.

    Ajabnoor G, Bahijri S, Shaik NA, Borai A, Alamoudi AA, Al-Aama J. Ramadan fasting in Saudi Arabia is associated with altered expression of CLOCK, DUSP and IL-1alpha genes, as well as changes in cardiometabolic risk factors. PLoS One 2017; 12: e0174342.

  • 28.

    Nasiri J, Khoshdel A, Kheiri S, Jafari BA. The effect of Ramadan fasting on tuberculin skin test and leukocyte count. J Fast Health 2016; 5: 1-5.

  • 29.

    BaHammam AS, Pandi-Perumal SR, Alzoghaibi MA. The effect of Ramadan intermittent fasting on lipid peroxidation in healthy young menwhile controlling for diet and sleep: A pilot study. Ann Thorac Med 2016; 11: 43-48.

  • 30.

    Bahijri SM, Ajabnoor GM, Borai A, Al-Aama JY, Chrousos GP. Effect of Ramadan fasting in Saudi Arabia on serum bone profile and immunoglobulins. Ther Adv Endocrinol Metab 2015; 6: 223-232.

  • 31.

    Akrami Mohajeri F, Ahmadi Z, Hassanshahi G, Akrami Mohajeri E, Ravari A, Ghalebi SR. Dose Ramadan fasting affects inflammatory responses: evidences for modulatory roles of this unique nutritional status via chemokine network. Iran J Basic Med Sci 2013; 16: 1217-1222.

  • 32.

    Lahdimawan A, Handono K, Indra MR, Prawiro SR. Effect of Ramadan fasting on endorphin and endocannabinoid level in serum, PBMC and macrophage. Int J Pharm Sci Invent 2013; 2: 46-54.

  • 33.

    Latifynia A, Vojgani M, Abofazeli T, Jafarieh H. Circulating immune complex during Ramadan. J Ayub Med Coll Abbottabad 2007; 19. (Persian).

  • 34.

    GH. M, Dordi Q, Omran M, Habibi T. Effects of Ramadan fasting on complement components activities C3, C4, and CH50 of human serum. J Ilam Univ Med Sci 2006; 14. (Persian).

  • 35.

    Descamps O, Riondel J, Ducros V, Roussel AM. Mitochondrial production of reactive oxygen species and incidence of age-associated lymphoma in OF1 mice: effect of alternate-day fasting. Mech Ageing Dev 2005; 126: 1185-1191.

  • 36.

    Berrigan D, Perkins SN, Haines DC, Hursting SD. Adult-onset calorie restriction and fasting delay spontaneous tumorigenesis in p53-deficient mice. Carcinogenesis. 2002; 23: 817-822.

  • 37.

    Raffaghello L, Lee C, Safdie FM, Wei M, Madia F, Bianchi G, et al. Starvation-dependent differential stress resistance protects normal but not cancer cells against high-dose chemotherapy. Proc Natl Acad Sci U S A 2008; 105: 8215-8220.

  • 38.

    Lei S, Li Y, Yang X, Gao L, Yi C. Effect of fasting therapy in chemotherapy-protection and tumorsuppression: a systematic review. Transl Cancer Res 2016; 6: 354-365.

  • 39.

    D'Aronzo M, Vinciguerra M, Mazza T, Panebianco C, Saracino C, Pereira SP, et al. Fasting cycles potentiate the efficacy of gemcitabine treatment in in vitro andin vivo pancreatic cancer models. Oncotarget 2015; 6: 18545-18557.

  • 40.

    Lee C, Raffaghello L, Brandhorst S, Safdie FM, Bianchi G, Martin-Montalvo A, et al. Fasting cycles retard growth of tumors and sensitize a range of cancer cell types to chemotherapy. Sci Transl Med 2012; 4: 124ra27.

  • 41.

    Dorff TB, Groshen S, Garcia A, Shah M, Tsao-Wei D, Pham H, et al. Safety and feasibility of fasting in combination with platinum-based chemotherapy. BMC Cancer 2016; 16: 360.

  • 42.

    Lankelma J, Kooi B, Krab K, Dorsman JC, Joenje H, Westerhoff HV. A reason for intermittent fasting to suppress the awakening of dormant breast tumors. Biosystems 2015; 127: 1-6.

  • 43.

    Katsuya Y, Fujiwara Y, Sunami K, Utsumi H, Goto Y, Kanda S, et al. Comparison of the pharmacokinetics of erlotinib administered in complete fasting and 2 h after a meal in patients with lung cancer. Cancer Chemother Pharmacol 2015; 76: 125-132.

  • 44.

    Bianchi G, Martella R, Ravera S, Marini C, Capitanio S, Orengo A. Fasting induces anti-Warburg effect that increasesrespiration but reduces ATP-synthesis to promote apoptosis in colon cancer models. Oncotarget 2015; 6: 11806-11819.

  • 45.

    Thomas JA, 2nd, Antonelli JA, Lloyd JC, Masko EM, Poulton SH, Phillips TE, et al. Effect of intermittent fasting on prostate cancer tumor growth in a mouse model. Prostate Cancer Prostatic Dis 2010; 13: 350-355.

  • 46.

    Chen X, Lin X, Li M. Comprehensive modulation of tumor progression and regression with periodic fasting and refeeding circles via boosting IGFBP-3 loops and NK responses. Endocrinology 2012; 153: 4622-4632.

  • 47.

    Goldstein I, Hager GL. Transcriptional and chromatin regulation during fasting - the Genomic Era. Trends Endocrinol Metab 2015; 26: 699-710.

  • 48.

    Cheng CW, Adams GB, Perin L, Wei M, Zhou X, Lam BS, et al. Prolongedfasting reduces IGF-1/PKA to promote hematopoietic-stem-cell-based regeneration and reverse immunosuppression. Cell Stem Cell 2014; 14: 810-823.

  • 49.

    Fontana L, Partridge L, Longo VD. Extending healthy life span--from yeast to humans. Science 2010; 328: 321-326.

  • 50.

    Lee C, Safdie FM, Raffaghello L, Wei M, Madia F, Parrella E, et al. Reduced levels of IGF-I mediate differential protection of normal and cancer cells in response to fasting and improve chemotherapeutic index. Cancer Res 2010; 70: 1564-1572.

  • 51.

    Caffa I, D'Agostino V, Damonte P, Soncini D, Cea M, Monacelli F, et al. Fasting potentiates the anticancer activity of tyrosine kinase inhibitors by strengthening MAPK signaling inhibition. Oncotarget 2015; 6: 11820-11832.

  • 52.

    Hanahan D, Weinberg RA. The hallmarks of cancer. Cell 2000; 100: 57-70.