Department of Internal Medicine and Medical Specialties, Rheumatology, Sapienza University of Rome, Rome 00185, Italy.
Nutrients. 2019 May 5;11(5):1013. doi: 10.3390/nu11051013.
The incidence and prevalence of autoimmune diseases have increased in Western countries over the last years. The pathogenesis of these disorders is multifactorial, with a combination of genetic and environmental factors involved. Since the epidemiological changes cannot be related to genetic background, which did not change significantly in that time, the role of environmental factors has been reconsidered. Among these, dietary habits, and especially an excessive salt, typical of processed foods, has been implicated in the development of autoimmune diseases. In this review, we summarize current evidence, deriving both from experimental models and clinical studies, on the capability of excessive salt intake to exacerbate proinflammatory responses affecting the pathogenesis of immune-mediated diseases. Data on several diseases are presented, including rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, and Crohn's disease, with many of them supporting a proinflammatory effect of salt. Likewise, a hypertonic microenvironment showed similar effects in experimental models both in vivo and in vitro. However, murine models of spontaneous autoimmune polyneuropathy exposed to high salt diet suggest opposite outcomes. These results dictate the need to further analyse the role of cooking salt in the treatment and prevention of autoimmune diseases, trying to shape a fine tuning between the possible advantages of a restricted salt intake and the changes in circulating metabolites, mediators, and hormones which come along salt consumption and could in turn influence autoimmunity.
近年来，自身免疫性疾病在西方国家的发病率和患病率有所上升。这些疾病的发病机制是多因素的，涉及遗传和环境因素的结合。由于流行病学的变化不能与遗传背景相关，而遗传背景在那段时间并没有显著改变，因此环境因素的作用再次受到了关注。在这些因素中，饮食习惯，尤其是加工食品中过量的盐，被认为与自身免疫性疾病的发展有关。在这篇综述中，我们总结了目前来自实验模型和临床研究的证据，表明过量盐摄入可加重影响免疫介导性疾病发病机制的促炎反应。介绍了几种疾病的数据，包括类风湿关节炎、系统性红斑狼疮、多发性硬化症和克罗恩病，其中许多疾病都支持盐的促炎作用。同样，高渗微环境在体内和体外的实验模型中也表现出类似的作用。然而，暴露于高盐饮食的自发性自身免疫性多发性神经病的小鼠模型表明了相反的结果。这些结果表明，需要进一步分析烹饪盐在自身免疫性疾病的治疗和预防中的作用，试图在限制盐摄入的可能优势和盐消费带来的循环代谢物、介质和激素的变化之间取得平衡，这些变化反过来又可能影响自身免疫。
