Symposium on ‘Evidence-based nutrition’. Nutritional modulation of immune function
Grimble, R.F. (2001) Symposium on ‘Evidence-based nutrition’. Nutritional modulation of immune function. Proceedings of the Nutrition Society, 60, (3), 389-397. (doi:10.1079/PNS2001102).
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The inflammatory response to injury and infection, although an essential part of immune function, carries the risk of severe tissue depletion and immunosuppression. These outcomes increase morbidity and delay recovery. Evidence is accumulating that single-nucleotide polymorphisms in the genes controlling pro-inflammatory cytokine production adversely influence the response.
Immunonutrition provides a means of modulating the inflammatory response to injury and infection, and thereby improves clinical outcome. n-3 Polyunsaturated fatty acids (n-3 PUFA), glutamine, arginine, S amino acids and nucleotides are important components of immunonutrient mixes. While animal model studies suggest that all these components may exert a beneficial effect in patients, the number of large randomized placebo-controlled trials utilizing immunonutrition is fairly limited and the observed effects are relatively small. Meta-analyses suggest that while immunonutrition may not reduce mortality rates, a reduction in hospital length of stay, decreased requirements for ventilation and lower infection rates are achieved by this mode of nutrition.
The present paper discusses some underlying reasons for the difficulty in demonstrating the clinical efficacy of immunonutrition. Paramount among these reasons is the antioxidant status and genetic background of the patient. A number of studies suggest that there is an inverse relationship between inflammation and T-cell function. Immuno-enhancive effects have been shown in a number of studies in which n-3 PUFA, glutamine and N-acetyl cysteine have been employed. All these nutrients may exert their effects by suppressing inflammation; n-3 PUFA by direct suppression of the process and glutamine and N-acetyl cysteine by acting indirectly on antioxidant status. Glutamine and nucleotides exert a direct effect on lymphocyte proliferation. Preliminary data suggests that not all genotypes are equally sensitive to the effects of immunonutrition. When further studies have been conducted to discern the precise interaction between each individual’s genotype of relevance to the response to injury and infection, and immunonutrients, the level of precision in the application of immunonutrition will undoubtedly improve.
|Digital Object Identifier (DOI):||doi:10.1079/PNS2001102|
|Additional Information:||A joint meeting of the Clinical Nutrition and Metabolism Group of the Nutrition Society and the British Association for Parenteral and Enteral Nutrition was held at the Harrogate International Centre, Harrogate on 28–30 November 2000|
|Keywords:||immunonutrition, immune function, single-nucleotide polymorphisms, n-3 polyunsaturated fatty acids, n-acetyl cysteine|
|Subjects:||Q Science > QR Microbiology > QR180 Immunology
Q Science > QP Physiology
|Divisions:||University Structure - Pre August 2011 > School of Medicine > Developmental Origins of Health and Disease
|Date Deposited:||20 Apr 2006|
|Last Modified:||06 Aug 2015 02:25|
|RDF:||RDF+N-Triples, RDF+N3, RDF+XML, Browse.|
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