Danieli M G, Candela M
Istituto Clinica medica generale e Terapia medica, Università, Ancona.
Recenti Prog Med. 1990 Jul-Aug;81(7-8):532-8.
New data emphasize the importance of nutritional factors in autoimmune diseases. Dietary alterations can be linked to autoimmune disorders as a specific pathogenetic mechanism and also for the malnutrition conditions frequently documented in these patients. The precise function of different nutrients is not completely known as they can be primary pathogenetic agents or causes of acute reacerbations or, finally, simply accompanying phenomena. It is also difficult to modify the intake of a single dietary component and to clarify its metabolic importance for the complexity of metabolic events in the human body and for the possible appearance of cascade-mechanisms. In lipid metabolism the multiple interactions between fatty acids, prostaglandins and leukotrienes are linked to alterations in inflammatory parameters. The exact role of modifications of proteins or of a single amino acid on immune function, also for the possible interference in protein restricted diet of the caloric component, is still unknown. Trace elements and vitamins are certainly important for the control of inflammation and of susceptibility in infections, albeit their role is not clear. More studies are necessary to clarify the link between dietary component and autoimmune diseases. However, study in experimental models and in human Systemic Lupus Erythematosus and Rheumatoid Arthritis demonstrated that a good nutritional homeostasis can contribute to decrease the severity of these disorders and to modify the clinical course with a physiological treatment that is free of side effects.
新数据强调了营养因素在自身免疫性疾病中的重要性。饮食改变可与自身免疫性疾病相关联,这既是一种特定的发病机制,也是这些患者中经常记录到的营养不良状况的原因。不同营养素的确切功能尚未完全明确,因为它们可能是主要的致病因素、急性加重的原因,或者最终仅仅是伴随现象。由于人体代谢事件的复杂性以及可能出现的级联机制,改变单一饮食成分的摄入量并阐明其代谢重要性也很困难。在脂质代谢中,脂肪酸、前列腺素和白三烯之间的多种相互作用与炎症参数的改变有关。蛋白质或单一氨基酸的修饰对免疫功能的确切作用,以及热量成分对蛋白质限制饮食可能产生的干扰,仍然未知。微量元素和维生素对控制炎症和感染易感性肯定很重要,尽管它们的作用尚不清楚。需要更多研究来阐明饮食成分与自身免疫性疾病之间的联系。然而,在实验模型以及人类系统性红斑狼疮和类风湿关节炎中的研究表明,良好的营养稳态有助于降低这些疾病的严重程度,并通过无副作用的生理治疗来改变临床病程。