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Immune Function Healthy Function 
January 29, 2018 (2 min read)

Part 10: Immune System Series | Implications for Clinicians in Support of a Healthy Immune System

WholisticMatters

Summary

The benefits of a healthy immune system are extensive and applicable to everyone, thus the enhancement of patients’ immune function is a great clinical implication.

The clinical implications of a healthy immune system are extensive. There is growing evidence to promote the role of nutrition and healthy lifestyle to enhance and protect the immune system for people of all ages. While the specific level of nutrients needed across the lifespan to enhance outcomes is yet to be defined. However, the goal to enhance immune system development and bolster protection against pathogens is a good goal for clinicians to advance in their patients.

Epigenetic signaling and control of disease processes is becoming better understood and may soon provide clinical tools to support patient evaluation and treatment. The clinical implications of exogenous microRNA (miRNA) from a therapeutic perspective is likely just a few years away, but research has already established that dietary miRNA can be absorbed by the body. Additional research will identify modalities for clinical support of epigenetic factors that may enhance immune system development and provide clinicians with tools for intervention of health and wellness.

Who Benefits from Supporting the Immune System?

Everyone can benefit from a strong immune system to prevent illness and disease, and morbidity and mortality. Nutritional components can enhance the immune system, particularly with age, as processes are not as efficient as they were in the younger years.

Individuals with compromised nutritional intakes due to physical illness or poor dietary choices may benefit from nutritional interventions and supplementation, in order to enhance outcomes and support immune health. Older individuals who are cared for in nursing homes, or the very young exposed to second hand smoke or life-long poor nutritional choices and unhealthy lifestyle, may have special needs that clinicians may recognize as candidates for nutritional intervention and support.1-6

How are Special Dietary Needs Addressed?

Awareness of special needs across the life span is a critical component of nutritional evaluation by clinicians in supporting a healthy immune system. In otherwise healthy infants, a deficiency of zinc or iron may predispose children to increased morbidity, despite having normal growth. Children with picky eating behaviors may also be predisposed to deficiencies early in life that can have negative consequences when the immune system needs to mount a robust response.7-10 A Mediterranean-style diet rich in omega-3 fatty acids may benefit individuals that are predisposed to metabolic syndrome and reduce the symptoms associated with being overweight, such as diabetes and cardiovascular disease.11-12

Patients who are immunocompromised due to health challenges such as the Herpes symplex virus one (HSV-1), or are on medications that may cause immunosuppression, such as acyclovir, corticosteroids, or chemotherapy drugs, may benefit from nutritional support with nutrients shown to support a healthy immune system. Individuals who are in active treatment for various cancers in which cellular immunity may be compromised would be good candidates for nutritional support. This may be particularly useful for drugs that target depletion of B cells, via monoclonal antibodies, as part of the immunotherapy for multiple sclerosis, cancer, and other conditions.13-16

Individuals with compromised microbiomes or digestive disorders may find themselves more prone to immune system challenges due to an impaired epithelial/mucosal barrier, or limited absorption combined with chronic inflammation. Knowledge regarding the use of antibiotic therapy and digestive health may be an important factor to capture when developing an interventional approach with nutritional support and therapy. Patients recovering from surgical intervention or those with chronic wounds may benefit from a diet rich in omega-3 fatty acids, antioxidants, such as vitamin A, and nutrients, such as arginine, zinc, and vitamin D.17-21

WholisticMatters

References
  1. Meydani, M. (2002). The Boyd Orr lecture. Nutrition interventions in aging and age-associated disease. Proc Nutr Soc 61(2): 165-171.
  2. Meydani, S. N., Leka, L.S., et al. (2004). Vitamin E and respiratory tract infections in elderly nursing home residents: a randomized controlled trial. JAMA 292(7): 828-836.
  3. Meydani, S. N., Barnett, J.B., et al. (2007). Serum zinc and pneumonia in nursing home elderly. Am J Clin Nutr 86(4): 1167-1173.
  4. Wu, D., Meydani, S.N. (2008). Age-associated changes in immune and inflammatory responses: impact of vitamin E intervention. Journal of leukocyte biology 84(4): 900-914.
  5. Meydani, S. N., Hamer, D.H. (2009). Zinc supplementation in elderly nursing home residents. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 49(3): 479; author reply 479.
  6. Barnett, J. B., Hamer, D.H., et al. (2010). Low zinc status: a new risk factor for pneumonia in the elderly? Nutr Rev 68(1): 30-37.
  7. Brotanek, J. M., Gosz, J., et al. (2007). Iron deficiency in early childhood in the United States: risk factors and racial/ethnic disparities. Pediatrics 120(3): 568-575.
  8. Suskind, D. L. (2009). Nutritional deficiencies during normal growth. Pediatr Clin North Am 56(5): 1035-1053.
  9. Haimi, M., Lerner, M. (2014). Nutritional deficiencies in the pediatric age group in a multicultural developed country, Israel. World Journal of Clinical Cases : WJCC 2(5): 120-125.
  10. Taylor, C. M., Northstone, K., et al. (2016). Macro- and micronutrient intakes in picky eaters: a cause for concern? The American Journal of Clinical Nutrition 104(6): 1647-1656.
  11. Meydani, M. (2005). A Mediterranean-style diet and metabolic syndrome. Nutr Rev 63(9): 312-314.
  12. Meydani, M., Azzi, A. (2009). Diabetes risk: antioxidants or lifestyle? Am J Clin Nutr 90(2): 253-254
  13. Baker, D., Marta, M., et al. Memory B cells are major targets for effective immunotherapy in relapsing multiple sclerosis. EBioMedicine 16: 41-50.
  14. Lehmann-Horn, K., Kronsbein, H.C., et al. (2013). Targeting B cells in the treatment of multiple sclerosis: recent advances and remaining challenges. Therapeutic advances in neurological disorders 6(3): 161-173.
  15. Pennock, G. K., Chow, L.Q. (2015). The evolving role of immune checkpoint inhibitors in cancer treatment. The oncologist 20(7): 812-822.
  16. Calabresi, P. A. (2017). B-Cell depletion — a frontier in monoclonal antibodies for multiple sclerosis. New England Journal of Medicine 376(3): 280-282.
  17. Ellinger, S. (2014). Micronutrients, arginine, and glutamine: does supplementation provide an efficient tool for prevention and treatment of different kinds of wounds? Adv Wound Care (New Rochelle) 3(11): 691-707.
  18. Cereda, E., Klersy, C., et al. (2015). A nutritional formula enriched with arginine, zinc, and antioxidants for the healing of pressure ulcers: a randomized trial. Annals of internal medicine 162(3): 167-174.
  19. Chiang, N., de la Rosa, X., et al. (2017). Novel resolvin D2 receptor axis in infectious inflammation. The Journal of Immunology 198(2): 842-851.
  20. Serhan, C. N. (2017). Discovery of specialized pro-resolving mediators marks the dawn of resolution physiology and pharmacology. Mol Aspects Med Article in Press.
  21. Serhan, C. N. (2017). Treating inflammation and infection in the 21st century: new hints from decoding resolution mediators and mechanisms. The FASEB Journal 31(4): 1273-1288.

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