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Immune-enhancing role of vitamin C and zinc and effect on clinical conditions

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S Beveridge
S Beveridge
S Beveridge
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E S Wintergerst
E S Wintergerst
E S Wintergerst
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Silvia Maggini at Bayer
Silvia Maggini
D.H. Hornig
D.H. Hornig
D.H. Hornig
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Abstract

Vitamin C concentrations in the plasma and leukocytes rapidly decline during infections and stress. Supplementation of vitamin C was found to improve components of the human immune system such as antimicrobial and natural killer cell activities, lymphocyte proliferation, chemotaxis, and delayed-type hypersensitivity. Vitamin C contributes to maintaining the redox integrity of cells and thereby protects them against reactive oxygen species generated during the respiratory burst and in the inflammatory response. Likewise, zinc undernutrition or deficiency was shown to impair cellular mediators of innate immunity such as phagocytosis, natural killer cell activity, and the generation of oxidative burst. Therefore, both nutrients play important roles in immune function and the modulation of host resistance to infectious agents, reducing the risk, severity, and duration of infectious diseases. This is of special importance in populations in which insufficient intake of these nutrients is prevalent. In the developing world, this is the case in low- and middle-income countries, but also in subpopulations in industrialized countries, e.g. in the elderly. A large number of randomized controlled intervention trials with intakes of up to 1 g of vitamin C and up to 30 mg of zinc are available. These trials document that adequate intakes of vitamin C and zinc ameliorate symptoms and shorten the duration of respiratory tract infections including the common cold. Furthermore, vitamin C and zinc reduce the incidence and improve the outcome of pneumonia, malaria, and diarrhea infections, especially in children in developing countries.
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1
st
International Immunonutrition Workshop, Valencia, 3–5 October 2007, Valencia, Spain
Immune-enhancing role of vitamin C and zinc and effect on
clinical conditions
S. Beveridge
1
, E. S. Wintergerst
2
, S. Maggini
1
and D. Hornig
3
1
Bayer Consumer Care, Basel,
2
Bayer Diabetes Care, Basel, Switzerland and
3
Bayer Diabetes Care, Reinach, Switzerland
The present paper is intended to give an overview on the roles of vitamin C and Zn in immune functions. Vitamin C concentrations in the
plasma and leucocytes rapidly decline during infections and stress. Supplementation of vitamin C improves components of the human
immune system such as antimicrobial and natural killer (NK) cell activities, lymphocyte proliferation, chemotaxis and delayed-type
hypersensitivity. Vitamin C contributes to maintaining the redox integrity of cells and thereby protects them against reactive oxygen
species generated during the respiratory burst and in the inflammatory response. Similarly, Zn deficiency impairs cellular mediators of
innate immunity such as phagocytosis, NK cell activity, and the generation of oxidative burst. Thus, both nutrients play important and
complementary roles in immune function and the modulation of host resistance to infectious agents, reducing the risk, severity and
duration of infectious diseases. A deficiency in one of these essential nutrients weakens immunity since vitamin C is crucial for cellular
immunity and Zn for the production of antibodies.A large number of randomized controlled intervention trials with intakes of £1g
vitamin C and £30 mg Zn are available. These trials show that adequate intakes of vitamin C and Zn ameliorate symptoms and shorten the
duration of respiratory tract infections including the common cold. Natural defences can only provide full protection when the body has
sufficient Zn, as well as high levels of vitamin C.The physiological effects of vitamin C provide clear evidence and rationale for a number
of ways in which it might help to protect against infection. This evidence is termed mechanistic evidence because it stems from
knowledge of the chemical reactions and biochemical processes in which vitamin C is known to play an important role (Table). The
actions of Zn not only complement the actions of vitamin C to provide ‘double protection’ (Table), but may even have a synergistic effect.
Like vitamin C, in recent years research has proved that Zn is essential for effective immune defence at several different levels.
Table. Summary of the role of vitamin C and Zn in body defences
(1,2,3)
Defence Vitamin C Zn
Skin and mucosal barriers Collagen synthesis
Improved strength
Cellular proliferation
Maintains thickness
Neutrophils and macrophages Improved motility and chemotaxis
Enhanced killing
Overall improvement in phagocytosis
Lymphocytes Proliferation of stem cells
B- and T-cell differentiation
B- and T-cell interaction
B lymphocytes Antibody production
T lymphocytes Proliferation Proliferation and appropriate response
Destruction of infected tissue cells and tumours
Interferon Production enhanced
Adequate intakes of vitamin C and Zn are essential for health.This is of special importance in populations in which insufficient intake of
these nutrients is prevalent. The current belief is that regular prophylactic intakes of vitamin C at doses of ‡ 200 mg daily have no effect
on the incidence of the common cold, but may be beneficial in the reduction of the severity and duration of the symptoms, suggesting that
vitamin C plays some role in the respiratory defence mechanisms. However, the elderly, who have been shown to have a lowered vitamin
C status and may therefore be more prone to infections, individuals exposed to continuous oxidative stress, such as chronic smokers, and
individuals exposed to heavy physical exercise and/or cold environment may benefit from a moderate continuous vitamin C intake. Other
vulnerable population groups include children. As a result of the high prevalence of Zn deficiency, especially in children in developing
countries, and the impaired immune status, susceptibility to infectious diarrhoea, malaria and pneumonia is found to be substantially
increased. Large intervention trials with daily intakes of 10–30 mg Zn have shown that Zn supplementation could be an important
adjuvant therapy for treating these infectious diseases in children in developing countries. Given that both vitamin C and Zn have
an important and synergistic effect on immune function and the modulation of host resistance to infectious agents it is hence appropriate
and beneficial to combine the trace element Zn with a high dose of vitamin C in one supplement.
1. Wintergerst ES, Maggini S & Hornig DH (2006) Ann Nutr Met 50, 85–94.
2. Wintergerst ES, Maggini S & Hornig DH (2007) Ann Nutr Met 51, 301–323.
3. Maggini S, Wintergerst ES, Beveridge S & Hornig DH (2007) Br J Nutr 98, Suppl. 1, S29–S35.
Proceedings of the Nutrition Society (2008), 67 (OCE), E83 doi:10.1017/S0029665108006927
... In this review, It could be concluded that the intake of this important nutrient through diet or as a pharmaceutical supplement can reverse many of these harmful effects. It can accelerate wound healing (9), modulate immunity (14), stabilize mood (15), enhance cognitive function (16), and decrease the attack rate in schizophrenic (12) and epileptic patients (13). Also, many studies have revealed its beneficial role in cancer (17). ...
... It is well known that VC plays a crucial role in the host defense system, and supplementing with VC can improve immunity (14). Several studies have shown that VC deficiency can inhibit cellular and humoral immunity (14,34). ...
... It is well known that VC plays a crucial role in the host defense system, and supplementing with VC can improve immunity (14). Several studies have shown that VC deficiency can inhibit cellular and humoral immunity (14,34). VC is essential in proliferation and differentiation of immune cells; its presence in these cells, which is 10 to 100 times greater than its quantity in plasma, demonstrates its function in immunity (35). ...
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... Vitamin C acts as a cofactor for some enzymes, as an antioxidant and enhancing agent for the immune system (54)(55)(56). In the innate immune system, vitamin C maintains the integrity of the epithelial barriers by enhancing collagen synthesis, enhancing fibroblast proliferation, and differentiating keratinocytes (39,57,58). It also boosts the chemotaxis of neutrophils and macrophages, increases their antimicrobial activity (57,59). ...
Vitamins and Immunity in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)
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Currently, the novel coronavirus disease (COVID-19) is one of the global challenges that remains inade-quately addressed and is not being treated effectively. It is essential to acknowledge the role of supplementsin strengthening the immune system to reduce the risk of infection. Food provides a well-established sourceof adequate macronutrients and micronutrients, all essential for the proper functioning of the immunesystem. Among the micronutrients, vitamins A, C, D, E, and B play crucial roles in the immune system'seffective response to infections. This study explores the role of vitamins in the immune system and theirimpact on defense against COVID-19.
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... Furthermore, vitamin C promotes the production of antibodies and stimulates the activity of natural killer cells, which are essential for targeting infected or cancerous cells [15]. A deficiency in vitamin C can impair these immune processes, leading to an increased risk of infections, particularly respiratory illnesses such as the common cold and pneumonia [16]. ...
International Digital Organization for Scientific Research The Impact of Diet and Nutrition on Immune Function: Implications for Health and Disease
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The relationship between diet, nutrition, and immune function is crucial for maintaining health and preventing disease. This review explores how key nutrients and dietary patterns influence immune responses, highlighting the role of vitamins, minerals, and macronutrients in supporting both innate and adaptive immunity. Micronutrients such as vitamins C, D, A, and minerals like zinc, selenium, and iron are essential for the production of immune cells, antibodies, and regulating inflammation. Macronutrients, including proteins and omega-3 fatty acids, contribute to the immune system by supporting the synthesis of immune cells and modulating inflammatory responses. Dietary patterns also significantly affect immune function. The Mediterranean diet, rich in antioxidants, healthy fats, and fiber, enhances immune regulation and reduces chronic inflammation, while the Western diet, characterized by high sugar, refined carbohydrates, and unhealthy fats, can suppress immune activity and promote inflammation, increasing susceptibility to infections and chronic diseases. Malnutrition, whether through undernutrition or overnutrition, impairs immune function, increasing vulnerability to infections and hindering recovery. Gut health, closely linked to nutrition, also plays a vital role in immune regulation through the gut microbiome. This review underscores the importance of a balanced, nutrient-rich diet in supporting optimal immune function and preventing disease, with implications for both individual health and broader public health strategies.
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... Recent research suggests vitamin C consumption for managing lower respiratory tract infections, with supplementation emerging as a compelling therapeutic approach for COVID-19 (Matthay et al., 2020;. In the immune response against infections, vitamin C primarily functions as a potent antioxidant, serving as a cofactor for various enzymes involved in biosynthesis and gene regulation processes (Wintergerst et al., 2006). ...
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Amidst the relentless battle against Coronaviridae, vaccines stand as our beacon of hope, illuminating a path towards an eventual triumph over the pandemic. Through tireless collaboration and scientific ingenuity, researchers have forged ahead, developing a diverse array of vaccines to combat COVID-19 and its variants. Yet, alongside these remarkable achievements, formidable challenges persist. Vaccine hesitancy, fueled by misinformation and cultural complexities, threatens to impede progress, underscoring the need for comprehensive strategies to foster trust and understanding. Moreover, the imperative of global cooperation looms large, demanding equitable vaccine distribution to ensure that no community is left behind in our shared pursuit of health and resilience. As we navigate these uncharted waters, let us draw inspiration from the resilience and compassion that define our collective humanity, forging ahead with determination and unity to overcome this unprecedented crisis.
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... This work studied the efficacy of Vitamin C in the treatment of malaria and its protective activity on the liver of rat infected with plasmodium berghei. Vitamin C (Ascorbic Acid) is a watersoluble vitamin that acts as an antioxidant, especially protecting the immune system cells from free radicals generated during their assault on invaders [15]. It has, therefore been suggested that vitamin C supplementation may have a role in case management of malaria [16]. ...
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... In our findings too, subjects consuming Vitamin C + Zinc gummies exhibited a shift from frequent sickness to excellent health. (Beveridge, Wintergerst, Maggini, & Hornig, 2008) Furthermore, the examination of organoleptic properties demonstrated a positive reception among subjects for taste, smell, texture, handling, and packaging across all three gummy formulations. This positive response emphasizes the crucial role of palatability in supplement compliance, particularly in paediatric populations. ...
A CLINICAL INVESTIGATION ON THE SAFETY AND EFFECTIVENESS OF DIETARY SUPPLEMENTS: CURCUMIN, VITAMIN C, AND VITAMIN B COMPLEX GUMMIES IN PAEDIATRIC HEALTH
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... Additionally, AA regulates synaptic transmission by inhibiting the interaction between neurotransmitters and receptors [15], in uencing receptor release and uptake [16], and serving as a co-factor in neurotransmitter synthesis [17]. In addition to its effects on the nervous system, as an immune cell modulator, AA enhances immune cell activities [18,19]. The decline of the immune system plays a role in the aging process of bodily organs, presenting a considerable threat to the host [20]. ...
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... In this work for determination of vitamin C in fruits, fruits were fresh and collected from local market. Black current shows maximum amount of vitamin C and grapes shows minimum amount of vitamin C [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] (Table 1, Figure 2). ...
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Immune-Enhancing Role of Vitamin C and Zinc and Effect on Clinical Conditions
Article
Full-text available
  • Feb 2006
Vitamin C concentrations in the plasma and leukocytes rapidly decline during infections and stress. Supplementation of vitamin C was found to improve components of the human immune system such as antimicrobial and natural killer cell activities, lymphocyte proliferation, chemotaxis, and delayed-type hypersensitivity. Vitamin C contributes to maintaining the redox integrity of cells and thereby protects them against reactive oxygen species generated during the respiratory burst and in the inflammatory response. Likewise, zinc undernutrition or deficiency was shown to impair cellular mediators of innate immunity such as phagocytosis, natural killer cell activity, and the generation of oxidative burst. Therefore, both nutrients play important roles in immune function and the modulation of host resistance to infectious agents, reducing the risk, severity, and duration of infectious diseases. This is of special importance in populations in which insufficient intake of these nutrients is prevalent. In the developing world, this is the case in low- and middle-income countries, but also in subpopulations in industrialized countries, e.g. in the elderly. A large number of randomized controlled intervention trials with intakes of up to 1 g of vitamin C and up to 30 mg of zinc are available. These trials document that adequate intakes of vitamin C and zinc ameliorate symptoms and shorten the duration of respiratory tract infections including the common cold. Furthermore, vitamin C and zinc reduce the incidence and improve the outcome of pneumonia, malaria, and diarrhea infections, especially in children in developing countries.
View
Selected vitamins and trace elements support immune function by strengthening epithelial barriers and cellular and humoral immune responses
Article
Full-text available
  • Nov 2007
Adequate intakes of micronutrients are required for the immune system to function efficiently. Micronutrient deficiency suppresses immunity by affecting innate, T cell mediated and adaptive antibody responses, leading to dysregulation of the balanced host response. This situation increases susceptibility to infections, with increased morbidity and mortality. In turn, infections aggravate micronutrient deficiencies by reducing nutrient intake, increasing losses, and interfering with utilization by altering metabolic pathways. Insufficient intake of micronutrients occurs in people with eating disorders, in smokers (active and passive), in individuals with chronic alcohol abuse, in certain diseases, during pregnancy and lactation, and in the elderly. This paper summarises the roles of selected vitamins and trace elements in immune function. Micronutrients contribute to the body's natural defences on three levels by supporting physical barriers (skin/mucosa), cellular immunity and antibody production. Vitamins A, C, E and the trace element zinc assist in enhancing the skin barrier function. The vitamins A, B6, B12, C, D, E and folic acid and the trace elements iron, zinc, copper and selenium work in synergy to support the protective activities of the immune cells. Finally, all these micronutrients, with the exception of vitamin C and iron, are essential for antibody production. Overall, inadequate intake and status of these vitamins and trace elements may lead to suppressed immunity, which predisposes to infections and aggravates malnutrition. Therefore, supplementation with these selected micronutrients can support the body's natural defence system by enhancing all three levels of immunity.
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Contribution of Selected Vitamins and Trace Elements to Immune Function
Article
  • Feb 2007
  • ANN NUTR METAB
Adequate intakes of vitamins and trace elements are required for the immune system to function efficiently. Micronutrient deficiency suppresses immune functions by affecting the innate T-cell-mediated immune response and adaptive antibody response, and leads to dysregulation of the balanced host response. This increases the susceptibility to infections, with increased morbidity and mortality. In turn, infections aggravate micronutrient deficiencies by reducing nutrient intake, increasing losses, and interfering with utilization by altering metabolic pathways. Insufficient intake of micronutrients occurs in people with eating disorders, in smokers (both active and passive), in individuals with chronic alcohol abuse, in patients with certain diseases, during pregnancy and lactation, and in the elderly. With aging a variety of changes are observed in the immune system, which translate into less effective innate and adaptive immune responses and increased susceptibility to infections. Antioxidant vitamins and trace elements (vitamins C, E, selenium, copper, and zinc) counteract potential damage caused by reactive oxygen species to cellular tissues and modulate immune cell function through regulation of redox-sensitive transcription factors and affect production of cytokines and prostaglandins. Adequate intake of vitamins B(6), folate, B(12), C, E, and of selenium, zinc, copper, and iron supports a Th1 cytokine-mediated immune response with sufficient production of proinflammatory cytokines, which maintains an effective immune response and avoids a shift to an anti-inflammatory Th2 cell-mediated immune response and an increased risk of extracellular infections. Supplementation with these micronutrients reverses the Th2 cell-mediated immune response to a proinflammatory Th1 cytokine-regulated response with enhanced innate immunity. Vitamins A and D play important roles in both cell-mediated and humoral antibody response and support a Th2-mediated anti-inflammatory cytokine profile. Vitamin A deficiency impairs both innate immunity (mucosal epithelial regeneration) and adaptive immune response to infection resulting in an impaired ability to counteract extracellular pathogens. Vitamin D deficiency is correlated with a higher susceptibility to infections due to impaired localized innate immunity and defects in antigen-specific cellular immune response. Overall, inadequate intake and status of these vitamins and minerals may lead to suppressed immunity, which predisposes to infections and aggravates malnutrition.
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  • Jan 2007
  • 301-323
  • E S Wintergerst
  • S Maggini
  • D H Hornig
Wintergerst ES, Maggini S & Hornig DH (2007) Ann Nutr Met 51, 301-323.
  • Jan 2006
  • 85-94
  • E S Wintergerst
  • S Maggini
  • D H Hornig
Wintergerst ES, Maggini S & Hornig DH (2006) Ann Nutr Met 50, 85-94.