Beveridge, S.

Hornig, D.

Maggini, S.

Wintergerst, E.S.

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1st International Immunonutrition Workshop, Valencia, 3–5 October 2007, Valencia, SpainContribution of selected vitamins and trace elements to immune functionS. Maggini1, E. S. Wintergerst2, S. Beveridge1 and D. Hornig31Bayer Consumer Care, Basel, Switzerland, 2Bayer Diabetes Care, Basel, Switzerland and 3Bayer Diabetes Care,Reinach, SwitzerlandThe immune system requires essential nutrients to function efficiently. Inadequate intake and status of vitamins and trace elements maylead to suppressed immunity, which predisposes to infections and aggravates undernutrition. Available data indicate a role for vitamins A,B6, B12, C, D and E and folate and for the trace elements Se, Zn, Cu and Fe in the immune response. Evidence has accumulated that inhuman subjects these nutrients selectively influence the immune response, induce dysregulation of a coordinated host response to infec-tions in the case of deficiency and oversupply, and that deficiency may impact on the virulence of otherwise harmless pathogens. Thus,micronutrients are required at appropriate intakes for the immune system to function optimally and contribute to the body’s naturaldefences on three levels by supporting the physical barriers (skin and mucosa), cellular and humoral immunity. Vitamins A, C and E andthe trace element Zn assist in enhancing the skin barrier function. The vitamins A, B6, B12, C, D and E and folic acid and the traceelements Fe, Zn, Cu and Se work in synergy to support the protective activities of immune cells. Finally, all these micronutrients, exceptvitamin C and Fe, are essential for antibody production.The table summarises the most important roles of selected vitamins and trace elements in immune function(1–3).Micronutrient Main roles in the immune systemVitamin A Normal differentiation of epithelial tissue and gene expressionImportant role both in humoral antibody response and cell-mediated immunityDeficiency impairs innate immunity, induces inflammation, potentiates existing inflammatory conditions and impairs abilityto defend against extracellular pathogensSupplementation is of benefit in reducing the morbidity and mortality from infectious diseases (especially children)Vitamin D Potent immune system modulator when metabolized to 1,25-dihydroxycholecalciferol, is involved in cell proliferation and enhancesinnate immunity by increasing the differentiation of monocytes to macrophagesDeficiency correlates with higher susceptibility to infections as a result of impaired localized innate immunity and defects in antigenspecific cellular immune responseSupplementation together with a high-Ca diet inhibits progression of autoimmune disordersVitamin E Optimizes and enhances immune response (T-helper (Th) 1 response)Supplementation in healthy adults increases T-cell proliferation, improves the CD4 + :CD8 + , and decreases indices of oxidative stressSupplementation of elderly individuals improves overall immune functionVitamins B6 and B12and folic acidInterfere with immune function through involvement in nucleic acid and protein biosynthesisMaintain Th1 immune response (vitamin B6), innate immunity (natural killer (NK) cell activity; folate) and act asimmunomodulatory for cellular immunity, especially with effects on cytotoxic cells (NK; CD8 + T lymphocytes; vitamin B12)Vitamin C Maintains redox integrity of cells and protection against reactive oxygen species (ROS) generated during respiratory burst and inflammatory responseStimulates leucocyte functions (neutrophil, monocytes movement)Role in antimicrobial and NK cell activities, lymphocyte proliferation, chemotaxis and delayed-type hypersensitivity responseDecreases duration and severity of common coldSe Antioxidant essential for optimal immune response, influencing both the innate and the acquired immunityDeficiency impairs antibody production and causes viruses to undergo mutations to more virulent formsSupplementation normalizes age-related decline in immune responseZn Influences both innate and acquired immunity, supports Th1 response, helps to maintain skin and mucosal integrityDeficiency leads to thymic atrophy, decreased cell-mediated cytotoxicity, helper T-cell and NK cell activitiesCu Part of Cu/Zn-superoxide dismutase, a key enzyme in the defence against ROSMaintains intracellular antioxidant balance, suggesting an important role in inflammatory responseAdequate intake supports a Th1 response and both deficiency and oversupply modulate the immune responseFe Essential for cell differentiation and growth, component of enzymes critical for functioning of immune cellsInvolved in the regulation of cytokine production and actionInsufficient intake of micronutrients occurs in individuals with eating disorders, in smokers (both active and passive), in individualswith chronic alcohol abuse, in patients with certain diseases, during pregnancy and lactation, and in the elderly. With aging a variety ofchanges are observed in the immune system, which translate to less-effective innate and adaptive immune responses and increasesusceptibility to infections. Overall, inadequate intake and status of vitamins A, B6, B12, C, D and E and folate and of the trace elementsSe, Zn, Cu and Fe may lead to suppressed immunity, which predisposes to infections and aggravates malnutrition. Thus, supplementationwith a combination of these selected micronutrients can support the body’s natural defence system by enhancing all three levels ofimmunity: epithelial barriers; cellular immunity; antibody production.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), E84 doi:10.1017/S0029665108006939https:/www.cambridge.org/core/terms. https://doi.org/10.1017/S0029665108006939Downloaded from https:/www.cambridge.org/core. University of Basel Library, on 11 Jul 2017 at 09:32:40, subject to the Cambridge Core terms of use, available at

Contribution of selected vitamins and trace elements to immune function

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