Raiten Daniel J, Sakr Ashour Fayrouz A, Ross A Catharine, Meydani Simin N, Dawson Harry D, Stephensen Charles B, Brabin Bernard J, Suchdev Parminder S, van Ommen Ben
Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD;
Departments of Nutritional Sciences and Veterinary and Biomedical Science and Center for Molecular Immunology and Infectious Disease, Pennsylvania State University, University Park, PA;
J Nutr. 2015 May;145(5):1039S-1108S. doi: 10.3945/jn.114.194571. Epub 2015 Apr 1.
An increasing recognition has emerged of the complexities of the global health agenda—specifically, the collision of infections and noncommunicable diseases and the dual burden of over- and undernutrition. Of particular practical concern are both 1) the need for a better understanding of the bidirectional relations between nutritional status and the development and function of the immune and inflammatory response and 2) the specific impact of the inflammatory response on the selection, use, and interpretation of nutrient biomarkers. The goal of the Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE) is to provide guidance for those users represented by the global food and nutrition enterprise. These include researchers (bench and clinical), clinicians providing care/treatment, those developing and evaluating programs/interventions at scale, and those responsible for generating evidence-based policy. The INSPIRE process included convening 5 thematic working groups (WGs) charged with developing summary reports around the following issues: 1) basic overview of the interactions between nutrition, immune function, and the inflammatory response; 2) examination of the evidence regarding the impact of nutrition on immune function and inflammation; 3) evaluation of the impact of inflammation and clinical conditions (acute and chronic) on nutrition; 4) examination of existing and potential new approaches to account for the impact of inflammation on biomarker interpretation and use; and 5) the presentation of new approaches to the study of these relations. Each WG was tasked with synthesizing a summary of the evidence for each of these topics and delineating the remaining gaps in our knowledge. This review consists of a summary of the INSPIRE workshop and the WG deliberations.
人们越来越认识到全球卫生议程的复杂性，特别是感染与非传染性疾病的碰撞以及营养过剩和营养不良的双重负担。特别值得实际关注的是：1）需要更好地理解营养状况与免疫和炎症反应的发育及功能之间的双向关系；2）炎症反应对营养生物标志物的选择、使用和解释的具体影响。炎症与项目/政策营养科学及研究证据解读（INSPIRE）的目标是为全球食品和营养企业所代表的那些用户提供指导。这些用户包括研究人员（基础研究和临床研究）、提供护理/治疗的临床医生、大规模开展和评估项目/干预措施的人员以及负责制定循证政策的人员。INSPIRE过程包括召集5个主题工作组（WG），负责围绕以下问题编写总结报告：1）营养、免疫功能和炎症反应之间相互作用的基本概述；2）审查关于营养对免疫功能和炎症影响的证据；3）评估炎症和临床状况（急性和慢性）对营养的影响；4）审查现有和潜在的新方法，以说明炎症对生物标志物解释和使用的影响；5）介绍研究这些关系的新方法。每个工作组的任务是综合这些主题中每个主题的证据总结，并勾勒出我们知识中仍然存在的差距。本综述包括INSPIRE研讨会和工作组讨论的总结。
