营养、免疫与新冠病毒病

Nutrition, immunity and COVID-19.

作者信息

Calder Philip C

机构信息

School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.

出版信息

BMJ Nutr Prev Health. 2020 May 20;3(1):74-92. doi: 10.1136/bmjnph-2020-000085. eCollection 2020.

Abstract

The immune system protects the host from pathogenic organisms (bacteria, viruses, fungi, parasites). To deal with this array of threats, the immune system has evolved to include a myriad of specialised cell types, communicating molecules and functional responses. The immune system is always active, carrying out surveillance, but its activity is enhanced if an individual becomes infected. This heightened activity is accompanied by an increased rate of metabolism, requiring energy sources, substrates for biosynthesis and regulatory molecules, which are all ultimately derived from the diet. A number of vitamins (A, B, B, folate, C, D and E) and trace elements (zinc, copper, selenium, iron) have been demonstrated to have key roles in supporting the human immune system and reducing risk of infections. Other essential nutrients including other vitamins and trace elements, amino acids and fatty acids are also important. Each of the nutrients named above has roles in supporting antibacterial and antiviral defence, but zinc and selenium seem to be particularly important for the latter. It would seem prudent for individuals to consume sufficient amounts of essential nutrients to support their immune system to help them deal with pathogens should they become infected. The gut microbiota plays a role in educating and regulating the immune system. Gut dysbiosis is a feature of disease including many infectious diseases and has been described in COVID-19. Dietary approaches to achieve a healthy microbiota can also benefit the immune system. Severe infection of the respiratory epithelium can lead to acute respiratory distress syndrome (ARDS), characterised by excessive and damaging host inflammation, termed a cytokine storm. This is seen in cases of severe COVID-19. There is evidence from ARDS in other settings that the cytokine storm can be controlled by n-3 fatty acids, possibly through their metabolism to specialised pro-resolving mediators.

摘要

免疫系统保护宿主免受病原生物(细菌、病毒、真菌、寄生虫)的侵害。为应对这一系列威胁,免疫系统不断进化,包含了无数种特殊的细胞类型、信号分子和功能反应。免疫系统始终处于活跃状态,进行着监测,但如果个体受到感染,其活性会增强。这种增强的活性伴随着代谢率的提高,需要能量来源、生物合成的底物和调节分子,而这些最终都来自饮食。已证实多种维生素(维生素A、B族、叶酸、C、D和E)和微量元素(锌、铜、硒、铁)在支持人体免疫系统和降低感染风险方面发挥着关键作用。其他必需营养素,包括其他维生素和微量元素、氨基酸和脂肪酸也很重要。上述每种营养素在支持抗菌和抗病毒防御方面都发挥着作用,但锌和硒对后者似乎尤为重要。个人摄入足够量的必需营养素以支持其免疫系统,以便在感染病原体时帮助应对,这似乎是明智的做法。肠道微生物群在教育和调节免疫系统方面发挥作用。肠道微生物群失调是包括许多传染病在内的疾病的一个特征,在新冠肺炎中也有描述。实现健康微生物群的饮食方法也有益于免疫系统。呼吸道上皮的严重感染可导致急性呼吸窘迫综合征(ARDS),其特征是宿主炎症过度且具有破坏性,称为细胞因子风暴。在严重的新冠肺炎病例中可见这种情况。在其他情况下ARDS的证据表明,细胞因子风暴可以由n-3脂肪酸控制,可能是通过它们代谢为特殊的促解决介质。

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