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特定维生素和微量元素对免疫功能的作用。

Contribution of selected vitamins and trace elements to immune function.

作者信息

Wintergerst Eva S, Maggini Silvia, Hornig Dietrich H

机构信息

Bayer Consumer Care Ltd, Basel, Switzerland.

出版信息

Ann Nutr Metab. 2007;51(4):301-23. doi: 10.1159/000107673. Epub 2007 Aug 28.

Abstract

Adequate intakes of vitamins and trace elements are required for the immune system to function efficiently. Micronutrient deficiency suppresses immune functions by affecting the innate T-cell-mediated immune response and adaptive antibody response, and leads to dysregulation of the balanced host response. This increases the susceptibility to infections, with increased morbidity and mortality. In turn, infections aggravate micronutrient deficiencies by reducing nutrient intake, increasing losses, and interfering with utilization by altering metabolic pathways. Insufficient intake of micronutrients occurs in people with eating disorders, in smokers (both active and passive), in individuals with chronic alcohol abuse, in patients with certain diseases, during pregnancy and lactation, and in the elderly. With aging a variety of changes are observed in the immune system, which translate into less effective innate and adaptive immune responses and increased susceptibility to infections. Antioxidant vitamins and trace elements (vitamins C, E, selenium, copper, and zinc) counteract potential damage caused by reactive oxygen species to cellular tissues and modulate immune cell function through regulation of redox-sensitive transcription factors and affect production of cytokines and prostaglandins. Adequate intake of vitamins B(6), folate, B(12), C, E, and of selenium, zinc, copper, and iron supports a Th1 cytokine-mediated immune response with sufficient production of proinflammatory cytokines, which maintains an effective immune response and avoids a shift to an anti-inflammatory Th2 cell-mediated immune response and an increased risk of extracellular infections. Supplementation with these micronutrients reverses the Th2 cell-mediated immune response to a proinflammatory Th1 cytokine-regulated response with enhanced innate immunity. Vitamins A and D play important roles in both cell-mediated and humoral antibody response and support a Th2-mediated anti-inflammatory cytokine profile. Vitamin A deficiency impairs both innate immunity (mucosal epithelial regeneration) and adaptive immune response to infection resulting in an impaired ability to counteract extracellular pathogens. Vitamin D deficiency is correlated with a higher susceptibility to infections due to impaired localized innate immunity and defects in antigen-specific cellular immune response. Overall, inadequate intake and status of these vitamins and minerals may lead to suppressed immunity, which predisposes to infections and aggravates malnutrition.

摘要

免疫系统要有效发挥功能,需要充足摄入维生素和微量元素。微量营养素缺乏会通过影响先天性T细胞介导的免疫反应和适应性抗体反应来抑制免疫功能,并导致宿主平衡反应失调。这会增加感染易感性,导致发病率和死亡率上升。反过来,感染会通过减少营养摄入、增加营养流失以及通过改变代谢途径干扰营养利用,从而加重微量营养素缺乏。饮食失调者、吸烟者(包括主动吸烟者和被动吸烟者)、长期酗酒者、患有某些疾病的患者、孕妇和哺乳期妇女以及老年人,都存在微量营养素摄入不足的情况。随着年龄增长,免疫系统会出现各种变化,这会导致先天性和适应性免疫反应效率降低,感染易感性增加。抗氧化维生素和微量元素(维生素C、E、硒、铜和锌)可抵消活性氧对细胞组织造成的潜在损害,并通过调节氧化还原敏感转录因子来调节免疫细胞功能,影响细胞因子和前列腺素的产生。充足摄入维生素B6、叶酸、B12、C、E以及硒、锌、铜和铁,可支持由Th1细胞因子介导的免疫反应,并产生足够的促炎细胞因子,从而维持有效的免疫反应,避免转向抗炎性Th2细胞介导的免疫反应以及增加细胞外感染风险。补充这些微量营养素可将Th2细胞介导的免疫反应逆转至由促炎性Th1细胞因子调节的反应,并增强先天性免疫力。维生素A和D在细胞介导和体液抗体反应中均发挥重要作用,并支持由Th2介导的抗炎细胞因子谱。维生素A缺乏会损害先天性免疫(黏膜上皮再生)和对感染的适应性免疫反应,导致抵抗细胞外病原体的能力受损。维生素D缺乏与感染易感性较高相关,原因是局部先天性免疫受损以及抗原特异性细胞免疫反应存在缺陷。总体而言,这些维生素和矿物质摄入不足及状态不佳可能导致免疫力低下,从而易引发感染并加重营养不良。

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