School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom.
Adv Nutr. 2022 Oct 2;13(5):S1-S26. doi: 10.1093/advances/nmac052.
The immune system is key to host defense against pathogenic organisms. Aging is associated with changes in the immune system, with a decline in protective components (immunosenescence), increasing susceptibility to infectious disease, and a chronic elevation in low-grade inflammation (inflammaging), increasing the risk of multiple noncommunicable diseases. Nutrition is a determinant of immune cell function and of the gut microbiota. In turn, the gut microbiota shapes and controls the immune and inflammatory responses. Many older people show changes in the gut microbiota. Age-related changes in immune competence, low-grade inflammation, and gut dysbiosis may be interlinked and may relate, at least in part, to age-related changes in nutrition. A number of micronutrients (vitamins C, D, and E and zinc and selenium) play roles in supporting the function of many immune cell types. Some trials report that providing these micronutrients as individual supplements can reverse immune deficits in older people and/or in those with insufficient intakes. There is inconsistent evidence that this will reduce the risk or severity of infections including respiratory infections. Probiotic, prebiotic, or synbiotic strategies that modulate the gut microbiota, especially by promoting the colonization of lactobacilli and bifidobacteria, have been demonstrated to modulate some immune and inflammatory biomarkers in older people and, in some cases, to reduce the risk and severity of gastrointestinal and respiratory infections, although, again, the evidence is inconsistent. Further research with well-designed and well-powered trials in at-risk older populations is required to be more certain about the role of micronutrients and of strategies that modify the gut microbiota-host relationship in protecting against infection, especially respiratory infection.
免疫系统是宿主防御病原体的关键。衰老与免疫系统的变化有关,保护性成分下降(免疫衰老),易感染性增加,低度炎症持续升高(炎症衰老),多种非传染性疾病的风险增加。营养是免疫细胞功能和肠道微生物群的决定因素。反过来,肠道微生物群塑造和控制免疫和炎症反应。许多老年人的肠道微生物群发生变化。与年龄相关的免疫能力下降、低度炎症和肠道菌群失调可能相互关联,并且至少部分与与年龄相关的营养变化有关。许多微量营养素(维生素 C、D、E 和锌、硒)在支持多种免疫细胞类型的功能方面发挥作用。一些试验报告称,单独补充这些微量营养素可以逆转老年人和/或摄入不足者的免疫缺陷。有证据表明,这将降低感染(包括呼吸道感染)的风险或严重程度,但证据并不一致。调节肠道微生物群的益生菌、益生元和合生菌策略,特别是通过促进乳杆菌和双歧杆菌的定植,已被证明可以调节老年人的一些免疫和炎症生物标志物,并且在某些情况下可以降低胃肠道和呼吸道感染的风险和严重程度,但证据仍然不一致。需要在有风险的老年人群中进行设计良好、效能高的试验,以更确定微量营养素和改变肠道微生物群-宿主关系的策略在预防感染(特别是呼吸道感染)方面的作用。
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