Science: Chinese scientists led the way in revealing that the ketogenic diet is expected to become a potentially life-saving therapy for cancer patients to combat low platelets

In a new preliminary study, researchers from research institutions such as Fudan University in China and Longyan First Hospital affiliated to Fujian Medical University suggest that a high-fat diet may combat low platelet counts in the blood caused by chemotherapy, suggesting that the ketogenic diet plan may be a non-toxic, low-cost, high-benefit cancer treatment option
。 The results were published in the Nov.
30, 2022 issue of Science Translational Medicine as "Dietary ketone body–escalated histone acetylation in megakaryocytes alleviates chemotherapy-induced thrombocytopenia"
。

Low platelets can lead to thrombocytopenia
.
Chemotherapy-induced thrombocytopenia is a serious complication in cancer patients that can lead to poor treatment outcomes and threaten survival
.
According to these authors, it is estimated that 1 in 10 patients undergoing chemotherapy develop thrombocytopenia
.

Dr.
Sisi Xie, co-first author and researcher in the Department of Cellular and Genetic Medicine at Fudan University's School of Basic Medical Sciences, said, "Treatment options for chemotherapy-induced thrombocytopenia are limited
by serious adverse effects and high economic burden.
Dr.
Xie emphasized that chemotherapy-induced thrombocytopenia is a major problem
for oncologists and cancer patients worldwide.

Dr.
Xie added, "We have shown that the ketogenic diet can alleviate chemotherapy-induced thrombocytopenia in animals and humans without causing thrombocytosis"
.
Thrombocytosis refers to the complete opposite of
thrombocytopenia.
In thrombocytosis, the body produces too many platelets
.

Platelets are tiny sticky disc-shaped cells that are part of the blood supply that clump together to form blood clots
.
When chemotherapy destroys platelets, the result is thrombocytopenia, which can be dangerous
.
This complication complicates cancer surgery by increasing the risk of bleeding, forcing doctors to reduce or stop chemotherapy
altogether.

Based on a series of elegant experimental and clinical studies conducted by these authors, Dr.
Xie and colleagues found that the ketogenic diet promotes the production of ketone bodies in the liver, which have multiple biological effects, one of which is to fight thrombocytopenia
.

Ketone bodies are an alternative energy source
when glucose is not readily available.
The ketogenic diet emphasizes foods high in fat and protein, greatly reducing calories
from carbohydrate sources.
There are three types of ketone bodies
.
The two main ketone bodies are acetoacetic acid and β-hydroxybutyric acid; Acetone is the third ketone body and is also the least abundant
.

Dr.
Xie and his colleagues were almost striking: They noticed that the diet caused changes in the bone marrow, which led to an increase
in circulating platelets.
If these findings, obtained in animal models and a small subset of human volunteers, stand up to further scrutiny, the ketogenic diet could become a potential thrombocytopenia prevention measure
in patients undergoing chemotherapy in the near future.

After switching to a ketogenic diet for 7 days, platelet counts in 5 healthy volunteers increased to safe levels
.
Dr.
Xie and colleagues also examined retrospective data from 28 cancer patients who received chemotherapy and observed that 17 patients who received the ketogenic diet had higher platelet counts and lower rates
of chemotherapy-induced thrombocytopenia.

Dr.
Xie wrote in the new study, "Mechanistically, the ketogenic diet induces a rise in β-hydroxybutyric acid in the blood [and] increases histone H3 acetylation
in bone marrow megakaryocytes.
" A ketogenic diet alleviated chemotherapy-induced thrombocytopenia
in a mouse model.
In addition, the ketogenic diet modestly increased platelet count in healthy [human] volunteers, but did not cause thrombocytosis
.
”

While far from hitting a home run at this point, Dr.
Xie and his colleagues envision the prospect of reducing healthcare costs if --- diet is a treatment option
.
Current treatments for thrombocytopenia, such as platelet transfusions or recombinant therapy, are either expensive or carry a high risk of
side effects.

The ketogenic diet promotes megakaryocyte and platelet production
through β-hydroxybutyric acid.
Image from Science Translational Medicine, 2022, doi:10.
1126/scitranslmed.
abn9061
.

By taking a dietary approach, the authors suggest that the prevention of chemically induced thrombocytopenia may eventually be added to the roster of medical diseases that are being explored or clinically recommended on high-fat
diets.
The ketogenic diet has been tested
in people with diabetes and cancer.
Epilepsy, especially severe forms of childhood epilepsy, is a medical condition
in which ketogenic eating plans have been used for a long time.

Basically, the ketogenic diet is a high-fat, high-protein, and low-carb or no-carbohydrate nutritional therapy
.
They are commonly used as weight loss regimens
.
But this dietary approach has had the greatest success
in hard-to-control epilepsy.

This dietary method forces the body to burn fat instead of using carbohydrates for energy
.
Dr.
Xie and colleagues speculate that this form of nutrition may help prevent chemotherapy-induced thrombocytopenia because activity in the bone marrow stimulates the production
of healthy new platelets.

In contrast, this diet works on epilepsy because it greatly reduces glucose, the main source of energy in cells and the preferred source
of energy in the brain.
Glucose has been linked
to severe seizures in some people who are susceptible to epilepsy.

Now, Dr.
Xie and colleagues believe that high-fat diet regimens may help cancer patients avoid chemotherapy-induced thrombocytopenia
.
However, they are quick to caution that large-scale prospective clinical studies are needed to validate the therapeutic potential
of ketogenic regimens against thrombocytopenia.
(Biovalley Bioon.
com)

Resources:

1.
Sisi Xie et al.
 Dietary ketone body–escalated histone acetylation in megakaryocytes alleviates chemotherapy-induced thrombocytopenia.
Science Translational Medicine, 2022, doi:10.
1126/scitranslmed.
abn9061.

2.
High fat ketogenic diet envisioned as potential life-saving therapy to combat low platelets in cancer patients

https://medicalxpress.
com/news/2022-12-high-fat-ketogenic-diet-envisioned.
html