Peroni Diego G, Hufnagl Karin, Comberiati Pasquale, Roth-Walter Franziska
Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University of Vienna and University of Vienna, Vienna, Austria.
Front Nutr. 2023 Jan 9;9:1032481. doi: 10.3389/fnut.2022.1032481. eCollection 2022.
Micronutritional deficiencies are common in atopic children suffering from atopic dermatitis, food allergy, rhinitis, and asthma. A lack of iron, in particular, may impact immune activation with prolonged deficiencies of iron, zinc, vitamin A, and vitamin D associated with a Th2 signature, maturation of macrophages and dendritic cells (DCs), and the generation of IgE antibodies. In contrast, the sufficiency of these micronutrients establishes immune resilience, promotion of regulatory cells, and tolerance induction. As micronutritional deficiencies mimic an infection, the body's innate response is to limit access to these nutrients and also impede their dietary uptake. Here, we summarize our current understanding of the physiological function of iron, zinc, and vitamins A and D in relation to immune cells and the clinical consequences of deficiencies in these important nutrients, especially in the perinatal period. Improved dietary uptake of iron is achieved by vitamin C, vitamin A, and whey compounds, whereas zinc bioavailability improves through citrates and proteins. The addition of oil is essential for the dietary uptake of beta-carotene and vitamin D. As for vitamin D, the major source comes sun exposure and only a small amount is consumed diet, which should be factored into clinical nutritional studies. We summarize the prevalence of micronutritional deficiencies of iron, zinc, and vitamins in the pediatric population as well as nutritional intervention studies on atopic diseases with whole food, food components, and micronutrients. Dietary uptake the lymphatic route seems promising and is associated with a lower atopy risk and symptom amelioration. This review provides useful information for clinical studies and concludes/emphasizes that a healthy, varied diet containing dairy products, fish, nuts, fruits, and vegetables as well as supplementing foods or supplementation with micronutrients as needed is essential to combat the atopic march.
微量营养素缺乏在患有特应性皮炎、食物过敏、鼻炎和哮喘的特应性儿童中很常见。特别是缺铁，可能会影响免疫激活，长期缺乏铁、锌、维生素A和维生素D与Th2特征、巨噬细胞和树突状细胞（DCs）的成熟以及IgE抗体的产生有关。相反，这些微量营养素的充足可建立免疫弹性、促进调节性细胞并诱导耐受性。由于微量营养素缺乏类似于感染，身体的固有反应是限制对这些营养素的获取，并阻碍它们的膳食摄取。在这里，我们总结了目前对铁、锌以及维生素A和D与免疫细胞相关的生理功能的理解，以及这些重要营养素缺乏的临床后果，特别是在围产期。维生素C、维生素A和乳清化合物可提高铁的膳食摄取，而柠檬酸盐和蛋白质可提高锌的生物利用度。添加油脂对于β-胡萝卜素和维生素D的膳食摄取至关重要。至于维生素D，主要来源是阳光照射，只有少量通过饮食摄入，这一点在临床营养研究中应予以考虑。我们总结了儿科人群中铁、锌和维生素微量营养素缺乏的患病率，以及关于全食物、食物成分和微量营养素对特应性疾病的营养干预研究。通过淋巴途径进行膳食摄取似乎很有前景，并且与较低的特应性风险和症状改善有关。本综述为临床研究提供了有用的信息，并得出结论/强调，包含乳制品、鱼类、坚果、水果和蔬菜的健康、多样化饮食，以及根据需要补充食物或微量营养素，对于对抗特应性进程至关重要。
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