Review and feature articleMechanisms of nutrient modulation of the immune response
Section snippets
Primary malnutrition
PCM is a major common cause of secondary immune deficiency in the world. Deficiencies are usually complex, frequently involving both protein calorie and varying degrees of micronutrient deficiency of vitamin A, vitamin E, vitamin B6, folate, zinc, iron, copper, and selenium.2, 27, 28 On the basis of severity and features at presentation, PCM is defined as marasmus, a chronic wasting condition, or kwashiorkor, which is distinguished by edema and anemia. Marasmus occurs when there is
Micronutrient deficiencies
Micronutrient deficiencies are a major complication of PCM and promote infectious processes. Oxidative stress is worsened in infection if micronutrients are deficient. Vitamin A, β-carotene, folic acid, vitamin B12, vitamin C, riboflavin, iron, zinc, and selenium have immunomodulating functions and influence both the susceptibility of the host to infectious diseases and the course and outcome of these diseases.54 Many apparently healthy looking children have subclinical deficiencies of vitamin
Secondary malnutrition
When malnutrition presents in association with an underlying genetic disorder, chronic infection, or other illness that affect the metabolism, such as congenital heart disease, cystic fibrosis, or renal insufficiency, resolution cannot be obtained by nutritional means unless the underlying cause is treated. A more extensive discussion of secondary malnutrition is provided elsewhere.3 Parenteral nutrition might be required in some conditions, and this has been associated with nutrient deficiency
Chronic infection
Proinflammatory cytokines initiated during the acute-phase response to infection act to elicit cellular responses throughout the body, and nutrients are lost during any generalized febrile infections. This response is affected by malnutrition.127, 128, 129 Energy expenditure increases at the same time that the infected host experiences a decrease in intake, and diarrhea might result in decreased intestinal absorption of nutrients.4
Summary
PCM is the major common cause of secondary immune deficiency in the world. In most cases PCM involves both protein calorie and micronutrient deficiency of vitamin A, vitamin E, vitamin B6, folate, zinc, iron, copper, and selenium. PCM is defined as marasmus, a chronic wasting condition, or kwashiorkor, which is distinguished by edema and anemia. Marasmus occurs with caloric insufficiency, whereas kwashiorkor develops from protein deficiency. PCM leads to atrophy of lymphoid organs, profound
References (137)
Historical concepts of interactions, synergism and antagonism between nutrition and infection
J Nutr
(2003)The history of nutrition: malnutrition, infection and immunity
J Nutr
(2003)- et al.
Prenatal undernutrition and postnatal growth are associated with adolescent thymic function
J Nutr
(2001) - et al.
Titers of antibody to common pathogens: relation to food-based interventions in rural Kenyan schoolchildren
Am J Clin Nutr
(2003) - et al.
Serum IgE level in malnutrition
Allergol Immunopathol (Madr)
(2003) - et al.
Serum leptin concentrations during severe protein-energy malnutrition: correlation with growth parameters and endocrine function
Metabolism
(2000) - et al.
Helicobacter pylori is not a determinant factor of persistent diarrhoea or malnutrition in Peruvian children
Trans R Soc Trop Med Hyg
(1999) - et al.
Metabolic effects of acute measles in chronically malnourished Nigerian children
J Nutr Biochem
(2004) - et al.
Nutritional support with nucleotide addition favors immune response in severely malnourished infants
Arch Med Res
(2004) Roles for cell death in zinc deficiency
J Nutr
(2005)
The dynamic link between the integrity of the immune system and zinc status
J Nutr
Effect of zinc supplementation on immune and inflammatory responses in pediatric patients with shigellosis
Am J Clin Nutr
Acrodermatitis enteropathica: a lethal inherited human zinc-deficiency disorder
Lancet
Effect of a zinc-fortified formula on immunocompetence and growth of malnourished infants
Am J Clin Nutr
Copper and immunity
Am J Clin Nutr
Selenium deficiency and viral infection
J Nutr
Assessment and control of vitamin A deficiency: the Annecy Accords
J Nutr
Vitamin A supplements and diarrheal and respiratory tract infections among children in Dar es Salaam, Tanzania
J Pediatr
Micronutrient and cytokine interaction in congenital pediatric HIV infection
J Nutr
Vitamin A deficiency leads to severe functional disturbance of the intestinal epithelium enzymes associated with diarrhoea and increased bacterial translocation in gnotobiotic rats
Microbes Infect
Vitamin A deficiency increases the in vivo development of IL-10-positive Th2 cells and decreases development of Th1 cells in mice
J Nutr
Effect of vitamin A supplementation on morbidity due to Plasmodium falciparum in young children in Papua New Guinea: a randomised trial
Lancet
alpha-tocopherol supplementation decreases production of superoxide and cytokines by leukocytes ex vivo in both normolipidemic and hypertriglyceridemic individuals
Am J Clin Nutr
Child nutrition in developing countries
Pediatr Ann
Immune response in malnutrition
The thymus gland is a target in malnutrition
Eur J Clin Nutr
CD45RA and CD45RO isoforms in infected malnourished and infected well-nourished children
Clin Exp Immunol
Pro-inflammatory cytokines in Turkish children with protein-energy malnutrition
Mediators Inflamm
Leukotrienes: underappreciated mediators of innate immune responses
J Immunol
Early Helicobacter pylori colonisation: the association with growth faltering in The Gambia
Arch Dis Child
Malnutrition is an independent factor associated with nosocomial infections
Br J Nutr
Immunobiology of gestational zinc deficiency
Br J Nutr
Immunobiology of mild micronutrient deficiencies
Br J Nutr
Trace elements, innate immune response and parasites
Clin Chem Lab Med
Cellular immune changes in undernourished children
Prog Clin Biol Res
Nutrition and immune responses
Can J Physiol Pharmacol
Humoral immunity in malnutrition
Fed Proc
Impact of nutritional status on antibody responses to different vaccines in undernourished Gambian children
Acta Paediatr
The many roles of apoptosis in immunity as modified by aging and nutritional status
J Nutr Health Aging
Cryptosporidiosis stimulates an inflammatory intestinal response in malnourished Haitian children
J Infect Dis
Micronutrients and infection: interactions and implications with enteric and other infections and future priorities
J Infect Dis
Exercise, stress, and inflammation in the growing child: from the bench to the playground
Curr Opin Pediatr
Ghrelin: integrative neuroendocrine peptide in health and disease
Ann Surg
Leptin regulation of the immune response and the immunodeficiency of malnutrition
FASEB J
Changes in the immune system are conditioned by nutrition
Eur J Clin Nutr
Golan memorial lecture. Nutritional regulation of immunity and infection: from epidemiology to phenomenology to clinical practice
J Pediatr Gastroenterol Nutr
Serum copper and zinc concentrations and their relation to superoxide dismutase in severe malnutrition
Eur J Pediatr
Severe nutritional deficiencies in toddlers resulting from health food milk alternatives
Pediatrics
Selenium serum concentrations in malnourished Ecuadorian children: a case-control study
Int J Vitam Nutr Res
A new classification of acute protein-energy malnutrition
J Trop Pediatr
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Series editors: William T. Shearer, MD, PhD, Lanny J. Rosenwasser, MD, and Bruce S. Bochner, MD
Disclosure of potential conflict of interest: S. Cunningham-Rundles has received grants–research support from Probi and Lund and is on the Board of Scientific Advisors for Probi. A. Moon has received grants–research support from Probi and Lund. There are no other potential conflicts of interest to disclose.