Oleh Admin Kalbe Medical pada February 09, 2017 08:00

Manfaat Preventif dan Terapeutik Minyak Krill pada Kanker Kolorektal

Kanker kolorektal menempati urutan ketiga penyebab utama kanker pada pria dan wanita, dengan mortalitas mendekati 9% dari keseluruhan mortalitas akibat kanker setiap tahunnya. Di antara faktor-faktor yang berperan dalam berkembangnya kanker kolorektal, lebih dari 70% pasien yang terdiagnosis kanker kolorektal bersifat sporadis dan faktor lingkungan telah menjadi penyebab utama dari mayoritas insidens. Diet merupakan faktor lingkungan utama, dengan 90% kasus kanker kolorektal dilaporkan berhubungan dengan asupan tinggi lemak jenuh, daging merah, serta asupan rendah serat dan vitamin.

Beberapa studi epidemiologis menunjukkan bahwa peningkatan konsumsi long chain n-3 (LC n-3) PUFA berkorelasi terbalik dengan insidens kanker kolorektal. Sumber kaya LC n-3 PUFA yang dapat kita jumpai di pasaran di antaranya minyak ikan dan minyak krill. Kandungan LC n-3 PUFA utama dalam kedua minyak ini adalah eicosapentaenoic acid (EPA, C20:5n-3) dan docosahexaenoic acid (DHA, C22:6n-3). Berbeda dari minyak ikan, EPA dan DHA pada minyak krill berikatan dengan fosfolipid, sedangkan pada minyak ikan berikatan dengan trigliserida. Studi-studi telah menunjukkan bahwa ikatan n-3 PUFA dengan fosfolipid dapat menembus membran sel secara efisien dibandingkan yang berikatan dengan gliserol pada trigliserida, sehingga memberikan manfaat kesehatan yang lebih baik.

EPA dan DHA memiliki efek preventif dan terapeutik terhadap kanker kolorektal. Berbagai hipotesis terkait mekanisme manfaat n-3 PUFA terhadap pencegahan dan tatalaksana kanker kolorektal telah dipublikasikan. Jayathilake, et al, pada studinya mendapati bahwa LC n-3 PUFA mempunyai efek inhibisi pertumbuhan dan pro-apoptosis pada sel-sel kanker, seperti HT-29, HCT-116, SW-480 dan Caco. Sedangkan Cockbain AJ, et al, yang mempelajari manfaat pemberian n-3 PUFA pada pasien dengan familial adenimatous polyposis (FAP), mengemukakan 3 aktivitas antineoplastik utama dari n-3 PUFA, yaitu modulasi aktivitas COX, alterasi fungsi dinamis membran dan reseptor permukaan sel, serta peningkatan stres oksidatif seluler.
Mediator lipid anti-iflamasi utama didapatkan dari EPA dan DHA, meliputi resolvins, protectins, dan maresins, yang mewakili mekanisme aksi antineoplastik keempat dari n-3 PUFA. Sintesis prostaglandins (PGs) yang COX-2-dependent pada mukosa kolorektal, khususnya PGE2, memiliki peranan penting pada tahap-tahap awal karsinogenesis kolorektal. EPA dapat berperan sebagai substrat alternatif untuk COX-2, selain arachidonic acid (AA), yang menurunkan pembentukan ’2series’ PGs pro-tumor serta membentuk ’three-series’ PGs (PGE3). PGE3 memiliki aktivitas anti-tumorigenik dan bersifat less proinflammatory. Mekanisme kemopreventatif EPA melalui penghambatan selektif terhadap COX-2 pada pasien dengan FAP ini juga dikemukakan pada kesimpulan studi yang dilakukan oleh West NJ, et al.

Simpulan:
Omega-3 (n-3) PUFA yang terkandung dalam minyak krill memiliki peranan dalam pencegahan ataupun tatalaksana kanker kolorektal. Mekanisme anti-tumor dari n-3 PUFA diduga diperantarai oleh kandungan EPA. Studi lebih lanjut diperlukan untuk mengetahui mekanisme kompleks yang mendasari manfaat anti-kanker dari minyak krill. (JCH)

Image : Ilustrasi
Referensi:    
1.Jayathilake AG, Senior PV, Su XQ. Krill oil extract suppresses cell growth and induces apoptosis of human colorectal    cancer cells. BMC Complement Altern Med. 2016;16:328. doi: 10.1186/s12906-016-1311-x.

Cockbain AJ, Toogood GJ, Hull MA. Omega-3 polyunsaturated fatty acids for the treatment and prevention of colorectal cancer. Gut 2012;61:135-49.
West NJ, Clark SK, Phillips RK, Hutchinson JM, Leicester RJ, Belluzzi A, et al. Eicosapentaenoic acid reduces rectal polyp number and size in familial adenomatous polyposis. Gut 2010;59:918-25.

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