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Right-
Victoria Dimitriades, MD
Clinical Assistant Professor of Pediatrics
Divisions of Allergy/Immunology and Rheumatology
Louisiana State University Health Sciences Center
Disclosures
I
Sistem imun
Diakuisisi
Asli
Sel T
Sel B
Antigen
Antigen
Complement
System
T cell
Immunity
Phagocytes
Immune
Function
Mucous
Membranes
B cell
Immunity
Nutrition-Immunity link
Macronutrient deficiency
Protein, Calories
Malnutrition is the most common cause of
immune deficiency world-wide
Micronutrient
deficiency
Elements, Vitamins
Overnutrition
Excess of macronutrients
Protein-energy malnutrition
Causes
Limited food access
Chronic disease
Chronic Pain
Dental/Feeding issues
Medications
Severe dieting
Protein-energy malnutrition
Innate Immunity
Impaired phagocyte function
Adaptive Immunity
T cells
Decreased numbers and function
Increased susceptibility to opportunistic
infections
Micronutrients
Iron
Zinc
Copper
Selenium
Vitamins
Micronutrients- Iron
Aids in
T cell development
Generates some reactive oxygen
species to kill pathogens
Micronutrients- Iron
Deficiency
associated with:
issues
Micronutrients- Iron
Supplementation
Recommended: 7-18mg/day
Micronutrients- Zinc
Stimulates T cell production and
subtype switching
Stimulates complement system
Stimulates phagocytes
Antioxidant/Inflammatory Control
Micronutrients- Zinc
Deficiency
associated with:
issues
Micronutrients- Zinc
Supplementation
Recommended daily
dose: 3-11 mg/day of
elemental zinc
Micronutrients- Copper
Promotes
IL-2 production
Promotes
phagocyte function
Micronutrients- Copper
Deficiency
associated with:
Neutropenia, anemia
Neurologic issues
Immune
issues
Micronutrients- Copper
Supplementation
Micronutrients- Selenium
Antioxidant effects
general immune
responsiveness
Micronutrients- Selenium
Deficiency
associated with:
issues
Micronutrients- Selenium
Supplementation
Vitamin A
Supports
Vitamin A
Deficiency
associated with:
Vitamin A
Immune
issues:
Vitamin A
Supplementation
Vitamin B
B1-
thiamin
B2- riboflavin
B3- niacin
B5- pantothenic acid
B6- pyridoxine
B7- biotin
B9- folic acid
B12- cyanocobalmin
Vitamin B- all
B1-
thiamin
acid
acid
cyanocobalamin
Vitamin B- all
Supplement
Vitamin C
Antioxidant effects
Protects cells from reactive oxygen species (ROS)
made by the body to control infections
May have anti-viral activity
May aid in symptoms of common cold because of ROS
function on surface of airway and lung epithelium
Vitamin C
Deficiency
associated with:
Purpura/petechiae
Poor wound healing (scurvy)
Immune
issues:
Vitamin C
Supplementation
Vitamin D
Necessary
Vitamin D
Deficiency associated with:
Rickets
Autoimmune diseases
Diabetes, type I
Atopic diseases
Vitamin D
Immune issues:
B cells
Decreased proliferation
Decreased immune globulin production
Vitamin D
Supplementation
Vitamin E
Antioxidant
Vitamin E
Deficiency
associated with:
Neurologic symptoms
Atopic disease
Immune
issues:
Vitamin E
Supplementation
fats (PUFA)
Omega-3/Omega-6 Ratio
Goal is to
Garlic
Used
Probiotics
Lactobacilli,
Bifidobacteria species
fermentation
inflammation
Promotion of immune system
stimulation causing autoimmunity
Poor wound healing
Increased susceptibility to respiratory,
gastrointestinal, and liver infections
Summary
The
Oversupplementation
detrimental:
can be
Toxicity (Vitamin A)
Inhibition of phagocytes (zinc, iron,
copper)
Obesity in relation to food excess
References
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2008. 4(2): 80-90
Bruns H et al. Anti-TNF immunotherapy reduces CD8+ T cellmediated antimicrobial activity
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Chasapis C et al. Zinc and human health: an update. Archives of Toxicology 2011. in print
Chinen J and Shearer W. Secondary immunodeficiencies, including HIV infection. J All Clin
Immunol. 125(2): S195-203
Cunningham-Rundles S, McNeeley DF, and Moon A. Mechanisms of nutrient modulation of the
immune response. J All Clin Immunol 2005. 115(6): 1119-1128
Dorshkind K et al. The ageing immune system: is it ever too old to become young again? Nature
Reviews: Immunology 2009. Vol 9: 57-62
Elefteriadis T et al. Basic Science and Dialysis: Disturbances of Acquired Immunity in
Hemodialysis Patients. Seminars in Dialysis 2007. 20(5): 440-451
Fairweather-Tait S. Selenium in Human Health and Disease. Antioxidants and Redox signalling
2011. 14(7): 1337-1383
Geerlings S and Hoelpelman A. Immune dysfunction in patients with Diabetes Mellitus. FEMS
Immunology and Medical Microbiology 1999. 26: 259-265
Gomez C et al. Innate immunity and aging. Experimental Gerontology 2008. Vol 43: 718-728
Haute Autorite de Sante. Nutritional Support Strategy in protein-energy malnutrition in the
elderly. HAS Clinical guildelines 2007.
References