Nutrition in chronic inflammatory conditions: Bypassing the mucosal block for micronutrients.

Franziska Roth-Walter, Roberto Berni Canani, Liam O'Mahony, Diego Peroni, Milena Sokolowska, Emilia Vassilopoulou, Carina Venter

Journal: Allergy 2024;79(2):353-383

PMID: 38084827

Abstract

Nutritional Immunity is one of the most ancient innate immune responses, during which the body can restrict nutrients availability to pathogens and restricts their uptake by the gut mucosa (mucosal block). Though this can be a beneficial strategy during infection, it also is associated with non-communicable diseases-where the pathogen is missing; leading to increased morbidity and mortality as micronutritional uptake and distribution in the body is hindered. Here, we discuss the acute immune response in respect to nutrients, the opposing nutritional demands of regulatory and inflammatory cells and particularly focus on some nutrients linked with inflammation such as iron, vitamins A, Bs, C, and other antioxidants. We propose that while the absorption of certain micronutrients is hindered during inflammation, the dietary lymph path remains available. As such, several clinical trials investigated the role of the lymphatic system during protein absorption, following a ketogenic diet and an increased intake of antioxidants, vitamins, and minerals, in reducing inflammation and ameliorating disease.

© 2023 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.

Address: Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria.; Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.; Department of Translational Medical Science and ImmunoNutritionLab at CEINGE-Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy.; Department of Medicine, School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland.; Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.; Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland.; Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.; Pediatric Area, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy.; Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece.; Children's Hospital Colorado, University of Colorado, Aurora, Colorado, USA.

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