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Selected vitamins and trace elements support immune function by strengthening epithelial barriers and cellular and humoral immune responses


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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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Selected vitamins and trace elements support immune function by
strengthening epithelial barriers and cellular and humoral immune responses
Silvia Maggini
*, Eva S. Wintergerst
, Stephen Beveridge
and Dietrich H. Hornig
Bayer Consumer Care Ltd, Peter Merian-Strasse 84, P.O. Box, 4002 Basel
Bayer Diabetes Care Ltd, Peter Merian-Strasse 84, P.O. Box, 4002 Basel and
Reinach, Switzerland
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 lacta-
tion, 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, B
, 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.
Vitamins B
: Folate: B
: C: A: D: E: Trace elements Selenium: Zinc: Copper: Iron; Effects on immune response: Nutrient deficiency:
Excellent reviews on the immune system are available
. The
immune system is an intricate network of specialized tissues,
organs, cells, and chemicals protecting the host from infec-
tious agents and other noxious insults. The immune response
to invaders can be divided into two interactive systems:
innate and adaptive immunity. Innate immunity is present at
birth and provides the first barrier against “invaders” consist-
ing of e.g. skin, mucus secretions, and the acidity of the
stomach. Adaptive immunity is the second barrier to infection
and is acquired later in life, such as after an immunization or
successfully fighting off an infection. It retains a memory of
all the invaders it has faced and this accelerates antibody pro-
duction. Although defence mechanisms of innate and adaptive
immunity are very complex, they can be described as being
organized in three main clusters: physical barriers (e.g. skin,
mucosa, mucus secretions), immune cells and antibodies.
Inter-individual variations in many immune functions exist
within the normal healthy population and are due to genetics,
age, gender, smoking habits, habitual levels of exercise, alco-
hol consumption, diet, stage in the female menstrual cycle,
stress, etc
. Nutrient status is an important factor contributing
to immunocompetence and the profound interactions among
nutrition, infection, and health have been recognised
. In the
recent decade, substantial research has focused on the role of
nutrition and especially on the contribution of the role of
micronutrients to an optimum functioning of the immune
system. The objective of this overview is to demonstrate
that selected micronutrients work in synergy and support the
different components of the immune system such as physical
barriers, cellular response and antibody production. An
inadequate or deficient micronutrient status negatively influ-
ences the body’s defences and thus impairs the body’s overall
ability to combat infections (Table 1).
Vitamins and immune function
Vitamin A
Vitamin A, acting via all-trans retinoic acid, 9-cis retinoic
acid, or other metabolites and nuclear retinoic acid receptors,
plays an important role in the regulation of innate and cell-
mediated immunity and humoral antibody response
. In vita-
min A deficiency the integrity of mucosal epithelium is
altered. As a consequence, an increased susceptibility to var-
ious pathogens in the eye, and in the respiratory and gastroin-
testinal tracts is observed. Vitamin A deficient children have
an increased risk of developing respiratory disease
, and
increased severity of diarrhoeal disease
. The benefits of vita-
min A supplementation in reducing the morbidity and mor-
tality from acute measles in infants and children, diarrhoeal
diseases in pre-school children in developing countries,
acute respiratory infections, malaria, tuberculosis, and infec-
tions in pregnant and lactating women have been
12 14
* Corresponding author: Dr Silvia Maggini, fax þ 41 58 272 7502, email
British Journal of Nutrition (2007), 98, Suppl. 1, S29–S35 doi: 10.1017/S0007114507832971
q The Authors 2007
British Journal of Nutrition
Vitamin A deficiency is associated with diminished phago-
cytic and oxidative burst activity of macrophages activated
during inflammation
, and a reduced number and activity of
natural killer (NK) cells
. The increased production of IL-
12 (promoting T cell growth) and pro-inflammatory TNF-a
(activating microbicidal action of macrophages) in a vitamin
A deficient state may promote an excessive inflammatory
response, but supplementation with vitamin A can reverse
these effects
Lymphocyte proliferation is caused by activation of reti-
noic acid receptors and therefore vitamin A is playing an
essential role in the development and differentiation of Th1
and Th2 lymphocyte subsets
. Vitamin A maintains the
normal antibody mediated Th2 response by suppressing IL-
12, TNF-a, and IFN-g production of Th1 lymphocytes. As
a consequence, in vitamin A deficiency there is an impaired
ability to defend against extracellular pathogens
. Antibody-
mediated immunity is strongly impaired in vitamin A
. Oral vitamin A supplementation increases
delayed type hypersensitivity (DTH) in infants which may
reflect vitamin A-related up-regulation of lymphocyte func-
. In humans, vitamin A supplementation has been
shown to improve antibody titre response to various vac-
Vitamin D
Besides the effects in calcium and bone metabolism, vitamin
D and especially its biologically active metabolite 1,25-dihy-
droxycholecalciferol (1,25(OH)
D3) act as powerful immu-
24 26
. The discovery of significant quantities of
vitamin D receptors in monocytes, macrophages, and thymus
tissue suggests a specific role of vitamin D and its metabolites
in the immune system. Most cells of the immune system
except B cells express vitamin D receptors
There is evidence from human epidemiological and animal
studies that vitamin D status influences the occurrence of
Th1-mediated autoimmunity diseases which is in accordance
with the ability of 1,25(OH)
D3 to inhibit maturation of
dendritic cells (DC) and down-regulate production of the
immunostimulatory IL-12, and the observed increase in immu-
nosuppressive IL-10
. Human epidemiological studies
indicate supplementation with 1,25(OH)
D3 as an independent
protective factor influencing the occurrence of Th-1 mediated
D3 acts as an immune system modulator, pre-
venting excessive expression of inflammatory cytokines and
increasing the ’oxidative burst’ potential of macrophages. Per-
haps most importantly, it stimulates the expression of potent
anti-microbial peptides, which exist in neutrophils, monocytes,
NK cells, and in epithelial cells lining the respiratory tract
where they play a major role in protecting the lung from infec-
. Volunteers inoculated with live attenuated influenza
virus are more likely to develop fever and serological evi-
dence of an immune response in the winter, a period of the
year characterized by vitamin D insufficiency
. Vitamin D
deficiency predisposes children to respiratory infections.
Ultraviolet radiation (either from artificial sources or from
sunlight) reduces the incidence of viral respiratory infections,
as does cod liver oil (which contains vitamin D)
Vitamin E
Free radicals and lipid peroxidation are immunosuppressive and
due to its strong lipid-soluble antioxidant activity vitamin E is
able to optimise and enhance the immune response. Supplemen-
tation with vitamin E increases lymphocyte proliferation in
response to mitogens, production of IL-2, NK cell cytotoxic
activity, and phagocytic activity by alveolar macrophages, and
causes an increased resistance against infectious agents indicat-
ing that higher vitamin E intake is promoting a Th1 cytokine
mediated response and suppressing a Th2 response
Immune function in humans declines with age (immunose-
nescence). Alterations include impaired T cell-dependent
functions such as T-cell proliferation to mitogens, antibody
response after primary immunization with T-cell dependent
antigens, impaired DTH and IL-2 production, whereas IL-4
and IL-6 are elevated. These findings could indicate a shift
from a pro-inflammatory Th1 to a more anti-inflammatory
Th2 cytokine response due to ageing
34 36
. Since deregulation
of the responses with age is associated with a higher morbidity
and mortality from infections and neoplastic diseases, vitamin
E has been investigated in human studies with regard to its
potential to improve the overall immune response, especially
in the elderly
37 46
. Further support for a more specific role
of vitamin E is provided by the finding that vitamin E sup-
plementation increases IL-2 production of T cells and
enhances a Th1 response and decreased the expression of
IL-4, a stimulator of Th2 response. Other studies indicate
that vitamin E causes a shift toward greater proportions of
antigen-experienced memory T cells with fewer naive T
. Recent reviews comprehensively confirmed the
role of vitamin E and immunity in man, especially in the
Vitamin C
Reactive oxygen species (ROS), generated by activated immune
cells during the process of phagocytosis, can be scavenged by
non-enzymatic antioxidants, such as vitamin C or by enzyme
action. Whereas ROS play essential roles in intracellular killing
of bacteria and other invading organisms, the immune system
and other body’s molecules may be vulnerable to oxidative
attack. If ROS are produced in high concentrations, this fact
can cause oxidative stress and lead to impaired immune
response, loss of cell membrane integrity, altered membrane
Table 1. Summary of the sites of action of micronutrients on the
immune system
Epithelial barriers Cellular immunity Antibody production
Vitamin A Vitamin A Vitamin A
Vitamin C Vitamin B
Vitamin B
Vitamin E Vitamin B
Vitamin B
Zinc Vitamin C Vitamin D
Vitamin D Vitamin E
Vitamin E Folic acid
Folic acid Zinc
Iron Copper
Zinc Selenium
Silvia Maggini et al.S30
British Journal of Nutrition
fluidity, and alteration of cell-cell communication. These
alterations could contribute to degenerative disorders such as
cancer and cardiovascular disease
The immune-enhancing role of vitamin C has recently been
. Vitamin C is highly concentrated in leukocytes
and is used rapidly during infection. In fact, it has been
defined as a stimulant of leukocyte functions, especially of
neutrophil and monocyte movement. Vitamin C supplements
have been shown to enhance neutrophil chemotaxis in healthy
adults (1 3 g/day) and children (20 mg/kg/day)
. In addition,
supplementation with vitamin C has been demonstrated to
stimulate the immune system by enhancing T-lymphocyte pro-
liferation in response to infection increasing cytokine pro-
duction and synthesis of immunoglobulins
. Vitamin C may
also play a significant role in the regulation of the inflamma-
tory response
Administration of vitamin C results in improvement in
several components of human immune response such as
anti-microbicidal and NK cell activities, lymphocyte pro-
liferation, chemotaxis, and DTH response
54 57
. Based on
its immune-stimulating properties
, vitamin C was postu-
lated to be effective in ameliorating symptoms of upper res-
piratory tract infections, especially the common cold.
Further, plasma and leukocyte vitamin C concentrations
fall rapidly with the onset of the infection and return to
normal with the amelioration of the symptoms suggesting
dosage with vitamin C could be beneficial for the recovery
. A review of the large numbers of studies on a
potential effect of vitamin C on the common cold and res-
piratory infections concluded that administration of more
than 1 g/day had no consistent effect on the incidence of
common colds, but supported a moderate benefit on duration
and severity of symptoms which may also be of economic
Vitamin B
Vitamin B
is essential in nucleic acid and protein biosyn-
thesis, hence an effect on immune function is logical, since
antibodies and cytokines built up from amino acids and
require vitamin B
as coenzyme in their metabolism
Human studies demonstrate that vitamin B
impairs lymphocyte maturation and growth, and antibody pro-
duction and T-cell activity. Lymphocyte mitogenic response is
impaired by dietary vitamin B
depletion in elderly subjects
and restored by administration of vitamin B
. Effects of
deficiency were seen in a decreased antibody DTH response,
IL-1-b, IL-2, IL-2 receptor, NK cell activity, and in lympho-
cyte proliferation
62 64
Marginal vitamin B
deficiency alters the percentage of
T-helper cells and slightly decreased serum immunoglobulin
. Marginal vitamin B
deficiency in the elderly is associ-
ated with decreased numbers and function of circulating
T-lymphocytes which can be corrected by short-term
(6 weeks) supplementation with 50 mg of vitamin B
Decreased IL-2 production, T lymphocyte numbers, and T
lymphocyte proliferation is observed in subjects undergoing
vitamin B
depletion, indicating that vitamin B
suppresses a Th1 and promotes a Th2 cytokine mediated
activity, whereas repletion reverses it
Folate plays a crucial role in nucleic acid and protein synthesis
by supplying in concert with vitamins B
and B
units, and therefore inadequate folate significantly alters the
immune response. Folate deficiency modulates immune com-
petence and resistance to infections and affects cell-mediated
immunity by reducing the proportion of circulating T lympho-
cytes and their proliferation in response to mitogen activation.
This effect in turn decreases resistance to infections
In vitro data suggest that folate status may affect the
immune system by inhibiting the capacity of CD8
T lympho-
cytes cells to proliferate in response to mitogen activation.
This might explain the observation that folate deficiency
enhances carcinogenesis, next to increased damage to DNA
and altered methylation capacity
Folate supplementation of elderly individuals improves
overall immune function by altering the age-associated
decrease in NK cell activity supporting a Th1 response thus
providing protection against infections
. Large intakes of
folic acid (folate-rich diet and supplements . 400 mg/day)
were shown in one study to possibly impair NK cytotoxicity
whereas another study reported no correlation between total
plasma folate concentration and NK cell cytotoxicity in Italian
NK activity was followed in a trial with 60 healthy subjects
aged over 70 years who received over 4 months in addition to
the regular diet a special nutritional formula providing, among
other nutrients, 400 mg folic acid, 120 IU vitamin E and 3·8 mg
vitamin B
. NK cell cytotoxicity increased in supplemented
subjects and decreased in non-supplemented participants. Sup-
plemented subjects reported less infections, suggesting that
this nutritional supplement increased innate immunity and
provided protection against infections in elderly people
Vitamin B
Vitamin B
is involved in carbon-1 metabolism and there are
interactions with folate metabolism. In a vitamin B
state the irreversible reaction that forms 5-methyl tetrahydro-
folate (THF) results in an inactive form of folate if it is not
de-methylated by methionine synthase. The “trapping” of
5-methyl THF may result in a secondary folate deficiency
with impairments in thymidine and purine synthesis and sub-
sequently in DNA and RNA synthesis, leading to alterations in
immunoglobulin secretion
A human study in vitamin B
deficient patients evaluated
the alterations of immunological indicators following adminis-
tration of vitamin B
. In these patients, a significant decrease
was found in the number of lymphocytes and CD8
cells and
in the proportion of CD4
cells. In addition, findings showed
an abnormally high CD4
ratio, and suppressed NK
cell activity. Supplementation with vitamin B
these effects indicating that it may act as a modulatory
agent for cellular immunity, especially in relation to CD8
and NK cells
In elderly subjects (aged . 70 years) who received over
4 months in addition to the regular diet a special nutritional
formula providing, among other nutrients, 120 IU vitamin E,
8 mg vitamin B
, and 400 mg folic acid, NK cell cyto-
toxic activity increased in supplemented subjects, indicating
Vitamins and trace elements support immune function S31
British Journal of Nutrition
increased innate immunity in elderly people
. Immunocom-
petent adults (aged . 65 years) with low vitamin B
concentrations, had an impaired antibody response to pneumo-
coccal polysaccharide vaccine
. These few studies demon-
strate the importance of a sufficient vitamin B
status to
maintain an adequate immune response, especially in the
elderly who have a high percentage (up to 15 %) of low
serum vitamin B
Trace elements and immune function
The role of trace elements is covered by other authors in this
special issue and is only briefly sketched here.
Selenium is essential for optimum immune response and influ-
ences the innate and acquired immune systems. It plays a key
role in the redox regulation and antioxidant function through
glutathione peroxidases that remove excess of potentially
damaging radicals produced during oxidative stress. Thus, sel-
enium plays an important role in balancing the redox state,
and helping to protect the host from oxidative stress generated
by the microbicidal effects of macrophages and during inflam-
matory reactions. The selenoenzyme thioredoxin reductase
affects the redox regulation of several key enzymes, transcrip-
tion factors and receptors, including ribonucleotide reductase,
glucocorticoid receptors, anti-inflammatory protein AP-1, and
nuclear factor-kappa B (NFkB), which binds to DNA and acti-
vates expression of genes encoding proteins involved in
immune response (cytokines, adhesion molecules). Selenium
deficiency decreases immunoglobulin titres and aspects of
cell-mediated immunity. Selenium supplementation can coun-
teract these effects
4,76 79
The immune related functions of zinc have been reviewed in
the last few years
50,80 82
. Zinc is essential for highly prolifer-
ating cells, especially in the immune system and influences
both innate and acquired immune functions. It is involved in
the cytosolic defence against oxidative stress (superoxide dis-
mutase activity) and is an essential cofactor for thymulin
which modulates cytokine release and induces proliferation.
Adequate zinc intake supports a Th1 response, and helps to
maintain skin and mucosal membrane integrity and unbound
zinc ions exert a direct antiviral effect on rhinovirus replica-
tion. Zinc supplementation increases cellular components of
innate immunity (e.g. phagocytosis by macrophages and neu-
trophils, NK cell activity, generation of oxidative burst, DTH
activity), antibody responses, and the numbers of cytotoxic
T cells (Th1 response).
Copper has been shown to have a role in the development and
maintenance of the immune system and a large number of
experimental studies have demonstrated that copper status
alters several aspects of neutrophils, monocytes and superoxide
dismutase. Working together with catalase and glutathione
peroxidase in the cytosolic antioxidant defence against ROS,
copper is essential in the dismutation of superoxide anion to
oxygen and H
, and diminishes damage to lipids, proteins,
and DNA. Both copper deficiency and high intakes over
longer periods can modulate several aspects of the immune
79,83 87
The immune related functions of iron have been subject to
several reviews since 2001
88 91
. Iron is essential for electron
transfer reactions, gene regulation, binding and transport of
oxygen, and regulation of cell differentiation and cell
growth. Iron is a critical component of peroxide and nitrous
oxide generating enzymes. It is involved in the regulation of
cytokine production and mechanism of action, and in the acti-
vation of protein kinase C, which is essential for phosphoryl-
ation of factors regulating cell proliferation. In addition, iron
is necessary for myeloperoxidase activity which is involved
in the killing process of bacteria by neutrophils through the
formation of highly toxic hydroxyl radicals. Therefore, any
alteration in cellular iron homeostasis to either deficiency or
overload has unfavourable functional consequences on the
immune system. Since pathogens such as infectious microor-
ganisms and viruses require iron and other micronutrients
for replication and survival as well, it seems essential to
restrict access of the infecting microorganism to iron, but to
maintain a suitable concentration of iron that the host can
mount an optimum immune response and avoid the possibility
of excess amounts of iron which may induce free radical
mediated damage
Inadequate intake and status of vitamins and trace elements
may lead to suppressed immunity, which predisposes to infec-
tions and aggravates undernutrition. Evidence has accumu-
lated that in humans certain nutrients selectively influence
the immune response, induce dysregulation of a coordinated
host response to infections in cases of deficiency and oversup-
ply, and that deficiency may impact virulence of otherwise
harmless pathogens. Thus, micronutrients are required at
appropriate intakes for the immune system to function opti-
mally. Available data indicate a role of vitamins (A, D, E,
, folate, and C), and trace elements (selenium, zinc,
copper, and iron) on the immune response. They contribute
to the body’s natural defences on three levels by supporting
physical barriers (skin/mucosa), cellular immunity and anti-
body production. Vitamins A, C, E and the trace element
zinc assist in enhancing the skin barrier function. The vitamins
A, B
, C, D, E and folic acid and the trace elements iron,
zinc, copper and selenium work in synergy to support the pro-
tective activities of the immune cells. Finally, all these micro-
nutrients, with the exception of vitamin C and iron, are
essential for antibody production. Vitamin B
, selenium,
copper and zinc have a direct impact on antibody production
or B-cell proliferation, vitamins A, D and E stimulate Th2
response which in turn promotes humoral immunity, and the
remaining micronutrients act indirectly by their roles in pro-
tein synthesis / cell growth. Overall, inadequate intake and
status of these vitamins and trace elements may lead to
Silvia Maggini et al.S32
British Journal of Nutrition
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.
Conflict of interest statement
SB, SM and ESW are employees of Bayer Health Care, a
manufacturer of multivitamins. DHH is a consultant for
Bayer Consumer Care. SM, ESW, SB and DHH co-wrote
the manuscript.
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Vitamins and trace elements support immune function S35
British Journal of Nutrition
... They enable the body to produce enzymes, hormones and other substances that are required for energy production (e.g., in mitochondrial function), cell maintenance and repair (including division, replication, and growth), immune function and recovery from illness, blood formation, and maintenance and function of the brain, heart, lung, skin, bone, muscle, etc., Vitamins are key to the regulation and coordination of these homeostatic processes, mostly acting as coenzymes (as do minerals such as zinc) or hormones (e.g., vitamins A and D). Vitamins are essential to bone health [9], wound healing [10], the function, development and differentiation of the immune system [11][12][13], and microsomal drug metabolism and detoxification [14]. ...
... They are structural components of enzymes, neuropeptides, hormones and hormone receptors, with various roles in numerous enzymatic and metabolic reactions, nerve transmission, and maintaining the structure of bones and teeth [17]. Table 1 provides an outline of some of the main roles of essential micronutrients, where they can be sourced, and their storage within the body [7,11,18]. ...
... An inadequate intake of micronutrients is known to result in low energy and fatigue [7,27], and can weaken our immune system and reduce resistance to infections [11,12]. Thus, in everyday life it is essential that we consume sufficient amounts of micronutrients to maintain basic health. ...
... Vitamin A contributes to immune function through the restoration of the skin and respiratory and intestinal epithelium so contributing to the strength of these barriers which function to protect people against invading pathogens [20]. Vitamin A also plays a direct role in the growth and production of the different types of immune cells. ...
... Many pathogens require iron to function and grow but iron concentration in different Open Access Journal parts of the body is tightly regulated to limit pathogens being able to access it. This is achieved largely in the context of absorption, as in the presence of infection, iron absorption is reduced and also taken into immune cells, particularly macrophages [20]. Iron also promotes the growth of T cells whilst iron deficiency alters the numbers of T and B lymphocytes which can reduce the ability of the immune system to eradicate harmful organisms. ...
Full-text available
Almost all vitamins and minerals and essential fatty acids such as omega-3 fatty acids are essential for immune function. In the context of the COVID-19 pandemic, the importance of nutrition has been highlighted, but vitamins and minerals are often forgotten or intakes assumed to be adequate. Dietary surveys in the UK show that intakes of these essential micronutrients are below recommended intakes particularly in some population groups.
... Iron synergizes with vitamins and trace elements (selenium, copper, and zinc) to support cellular immunity. Maggini et al. (2007) Effect of iron on T cell proliferation. ...
... Iron is a micronutrient mineral that has an important role in responding to T-cell differentiation and proliferation. Iron can also encourage the formation or production of various cytokines, especially through hepcidin or directly (Maggini et al., 2007). However, iron can control or regulate the ratio between cytotoxic T cells and helpers to prevent excessive cytokine storms. ...
Iron is a mineral that plays an important role, especially to prevent anaemia through the production of red blood cells. Iron also plays a role in physiological processes, such as the activation of enzymes and hormones, as well as increasing the immune system in warding off various viral infections. Therefore, iron bioavailability needs to be considered to take the greatest benefit of iron. This review discussed the factors that can affect the bioavailability of iron, various technologies to increase the bioavailability, and its potential in enhancing the immune system. Iron bioavailability can be increased by fortification, fermentation, the addition of vitamin C, and iron encapsulation. Under conditions of adequate iron intake, iron plays an important role in enhancing the immune system through controlling lymphocytes and T cell proliferation. However, excess iron consumption can be at risk of weakening the host's immune response to viruses. Therefore, the appropriate level of iron intake must be maintained accurately to be used optimally and has the potential to ward off viral infections, including the Sars-CoV-2 virus as the cause of COVID-19.
... Over millions of years the human immune system (i.e., our defense arsenal) has co-evolved to meet various attackers and now ranges from simple physical barriers (skin, mucosa) to sophisticated cells as well as biological, chemical and nuclear weapons (antibodies, cytokines and free radicals respectively). Despite this complexity, the immune system can be described for educational purposes as consisting of three main layers, i.e., epithelial barriers (e.g., skin, mucosa); cellular defenses and humoral responses such as antibody production [1][2][3]. ...
... Adequate intakes of micronutrients are needed for the development of efficient immune system (23). There is a growing body of reports linking micronutrient deficiencies and malaria caused by P. falciparum in developing countries where certain micronutrient deficiencies may be predisposing factors (24,25,26,27). ...
... Efek 1,25 (OH) 2D pada sistem kekebalan termasuk penurunan sel Th1 / Th17 CD4 + T dan sitokin, peningkatan sel T regulator, regulasi turun produksi IgG yang digerakkan sel T, dan penghambatan diferensiasi sel dendritik (25). Suplemen zinc dapat membantu mempertahankan penghalang fisik dan integritas membran mukosa,meningkatkan komponen seluler dari imunitas bawaan (misalnya fagositosis oleh makrofag dan neutrofil, aktivitas sel pembunuh alami, dan pembentukan ledakan oksidatif) (26). Produk yang mengandung Echinacea menunjukkan aktivitas imunomodulasi dengan mekanisme umum stimulasi setidaknya satu sitokin antara IL-4, IL-6, IL-lO, TNF dan IFN-y (27). ...
Corona Virus Disease-19 (COVID-19) telah ditetapkan sebagai pandemi oleh World health Organization (WHO) pada 11 maret 2020, sebelumnya pada 2 Maret 2020 Indonesia telah melaporkan 2 kasus terkonfirmasi COVID-19. Imunomodulator diyakini dapat meningkatkan daya tahan tubuh terhadap serangan virus COVID-19 dengan menstimulasi sistem imun. Tujuan penelitian ini adalah untuk mengetahui adanya pengaruh COVID-19 terhadap penjualan produk suplemen kesehatan di salah satu apotek di Surakarta.Penelitian ini termasuk jenis penelitian observasional analitik. Pengambilan data didapat dari catatan penjualan di Apotek pada 3 bulan sebelum pandemi COVID-19 dan 3 bulan awal pandemi COVID-19. Analisa data menggunakan uji statistik.Penjualan produk suplemen kesehatan selama 6 bulan sebesar 17843 pcs. Produk suplemen kesehatan terjual sebanyak 4773 pcs sebelum pandemi, sedangkan saat pandemi sebesar 13070 pcs. Hasil uji normalitas menunjukkan data tidak terdistribusi normal. Hasil uji wilcoxon menunjukkan bahwa nilai signifikan 0.028 (<0.05) artinya ada perbedaan penjualan sebelum dan sesudah ditetapkannya pandemi. Kesimpulan dari penelitian ini adalah COVID-19 memberi pengaruh terhadap penjualan produk suplemen kesehatan di salah satu apotek di Surakarta.
... It is divided into congenital immunity and acquired immunity (2). For nearly fifty years, it has been stated that vitamin C has a very important role, especially in the function of immune system cells (3). The recommended daily intake of vitamin C is 110 mg/day for men and 95 mg/ day for women (4). ...
Full-text available
Per- and polyfluoroalkyl substances (PFAS) exposure has been associated with reduced antibody levels. Higher red blood cell (RBC) folate was previously associated with lower serum PFAS concentrations in adolescents. This study included 819 adolescents aged 12-19 years who had detectable rubella and measles antibody levels in serum from the U.S. National Health and Nutrition Examination Survey 2003-2004 and 2009-2010 cycles. We found inverse associations between serum PFOS and PFHxS and rubella antibodies, between PFOA and mumps antibodies, and between PFAS mixtures and rubella and mumps antibodies, only among adolescents with RBC folate concentrations <66th percentile (lower folate group) while not among adolescents with higher RBC folate levels (upper folate group). Specifically, per quartile increase in serum concentrations of the total PFAS mixture was associated with a 9.84% (95% CI: -15.57%, -3.74%) decrease in rubella antibody and an 8.79% (95% CI: -14.39%, -2.82%) decrease in the mumps antibody concentrations only in the lower folate group, while null associations were found for the upper folate group. If confirmed in mechanistic studies or prospective epidemiologic studies, these findings may have important implications for using folate as a mitigation measure against immune-related PFAS effects.
Aging and death remain a great mystery of biological science. Many processes associated with aging have been described. In general, the aging process is associated with inflammation. Inflammation is the cellular and vascular response of tissues to infection and tissue damage. Under normal conditions, it provides tissue healing with a controlled humoral and cellular response and prevents the development of infection. The presence of chronic, low-level inflammation without significant infection was termed “inflammaging.” The use of methods aimed at regulating or preventing inflammaging will prevent, at least reduce or delay the effects of both the prevention of symptoms that can occur with aging and the emergence of diseases that can be seen. The use of treatments and methods to regulate inflammation in the early period when signs of aging begin to appear will have a positive effect on aging by activating the body’s compensatory mechanism. Aging is strongly affected by metabolism. Research on drugs such as polyphenolic compounds, statins, and aspirin will increasingly continue, as they can delay the aging process, prolong lifespan, and reduce age-related degeneration and associated morbidity and mortality by targeting mTOR, NF-κβ, inflammatory cytokines, and related signal transduction pathways. Research on polyphenolic compounds, anti-aging pharmacologic agents will increasingly continue, as they can delay the aging process, prolong life, and reduce age-related degeneration and associated morbidity and mortality by targeting mTOR, NF-κb, inflammatory cytokines, and related signal transduction pathways.KeywordsNew updateAnti-aging strategiesLow-grade inflammation
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One hundred twenty infants were randomly assigned to receive either 15 mg vitamin A or placebo with each of three DPT/OPV (diphtheria, pertussis, tetanus/oral polio vaccine) immunizations at monthly intervals. Sixty-two received vitamin A and 58 received placebo. One month after the third supplementation dose, the response to the delayed cutaneous hypersensitivity test [multitest cell-mediated immunity (CMI) skin evaluation] for tetanus, diphtheria, and tuberculin (purified protein derivative, PPD) was the same in the vitamin A and placebo infants. The number of anergic infants was 17 (27%) and 19 (33%) in the vitamin A and placebo groups, respectively. The number of positive tests among well-nourished infants was significantly higher than that in malnourished infants irrespective of supplementation (P < 0.001). Among the infants with adequate serum retinol concentrations (> 0.7 mumol/L) after supplementation, the vitamin A-supplemented infants had a significantly higher proportion of positive CMI tests than the placebo infants (chi-square test: 8.99, P = 0.008). Among the infants with low serum retinol concentrations (< 0.7 mumol/L) after supplementation, vitamin A supplementation had no effect on CMI response. These results indicate that CMI in young infants was positively affected by vitamin A supplementation only in those infants whose vitamin A status was adequate (ie, serum retinol > 0.7 mumol/L) at the time of the CMI test. CMI was consistently better in well-nourished infants irrespective of supplementation.
This book contains 18 chapters discussing the roles of specific nutrients in maintaining the immune response and protection against infection and non-communicable diseases, and the influence of various factors, such as exercise and aging, on the interaction between nutrition and immune function. The contents include methods for studying nutrient-immune function interactions, the impact of undernutrition on immune function and infection, the influences of fatty acids, amino acids, antioxidant vitamins, various minerals and probiotics on immunity, food allergies, immunological effects of changes throughout the life cycle, and public health policy implications.
Preschool-age rural Indonesian children were reexamined every 3 months for 18 months. An average of 3135 children were free of respiratory disease and or diarrhea at the examination initiating each of the six, 3-month follow-up intervals. Children with mild xerophthalmia (night blindness and/or Bitot's spots) at the start and end of an interval developed respiratory disease and diarrhea at twice (p < 0.001) and three times (p < 0.001) the rate, respectively, of children with normal eyes during the same interval, independent of age and anthropometric status (weight for length). The risk of respiratory disease and diarrhea were more closely associated with vitamin A status than with general nutritional status. These results may explain much of the excess mortality recently reported for mildly vitamin A-deficient children.
Vitamin B-12 deficiency is present in up to 15% of the elderly population as documented by elevated methylmalonic acid with or without elevated total homocysteine concentrations in combination with low or low-normal vitamin B-12 concentrations. Clinical signs and symptoms of vitamin B-12 deficiency are insensitive in elderly subjects and comorbidity in these subjects makes responses to therapy difficult to interpret. Many elderly subjects with hyperhomocysteinemia have undiagnosed vitamin B-12 deficiency with elevated serum methylmalonic acid concentrations. Therefore, such elderly subjects should not receive folic acid supplementation before their vitamin B-12 status is diagnosed. Oral vitamin B-12 supplementation may be effective in lowering serum methylmalonic acid values in the elderly. However, the dose of vitamin B-12 in most common multivitamin preparations is too low for this purpose. Research efforts should be directed toward determining practical methods for diagnosing and treating vitamin B-12 deficiency in the millions of elderly subjects with undiagnosed deficiency.
Vitamin A deficiency is one of the leading causes of immunodeficiency among infants, children, and women worldwide. The consequences of vitamin A deficiency include higher morbidity and mortality from many infectious diseases. In developing countries, an estimated 253 million children are at risk for vitamin A deficiency (1) and an estimated 6 million women have clinical manifestations of vitamin A deficiency during pregnancy (2). Vitamin A deficiency also causes night blindness, xerophthalmia, growth retardation, impaired reproductive capacity, and anemia, and it permanently blinds an estimated 350,000 children worldwide each year (3). The constellation of adverse health problems ascribed to vitamin A deficiency has been termed the vitamin A deficiency disorders (VADD) (4). Among all the micronutrients, the role of vitamin A in immune function has probably been the most extensively characterized, and these studies show a multifaceted role of vitamin A in many functional aspects of immunity. Vitamin A plays a role in the maintenance of mucosal surfaces, the generation of antibody responses, normal hematopoiesis, and the function of T and B lymphocytes, natural killer (NK) cells, monocyte/macrophages, and neutrophils. The essential nature of vitamin A to different aspects of immune function is likely attributed to the action of vitamin A and related metabolites as modulators of gene transcription on the molecular level. The purpose of this chapter is to provide a current overview of the role that vitamin A plays in immune function and resistance to infectious diseases and to highlight knowledge gaps and future areas for investigation.
Conference Paper
Selenium as an essential component of selenocysteine-containing protein is involved in most aspects of cell biochemistry and function. As such, there is much potential for selenium to influence the immune system. For example, the antioxidant glutathione peroxidases are likely to protect neutrophils from oxygen-derived radicals that are produced to kill ingested foreign organisms. When the functions of all selenoproteins are described, only then will it be possible to fully understand their role in maintaining optimal immune function.
This paper presents a summary of the main findings, and their interpretation, of a review of controlled studies on the effect of vitamin A supplementation on young child morbidity and mortality. In presenting interpretations, special emphasis has been placed on findings and interpretations that appear particularly relevant to policy development and programme design. -from Authors