营养素对人体免疫功能的影响

Influence of nutrients on human immunity

目的:系统回顾人体必需营养素中主要的宏量营养素和微量营养素对人体免疫功能及疾病结局的影响。方法:数据库包括万方数据库、中国知网、PubMed、Web of Science;以营养素、食物、膳食结构、膳食模式、蛋白质、脂肪、维生素、矿质元素等作为营养相关中文检索词,炎症、炎性、氧化应激、免疫力、免疫等作为免疫相关中文检索词;相应的以nutrients、food、diet、protein、fat、vitamin、minerals等作为营养相关英文检索词,inflammatory、inflammation、oxidative stress、immune、immunity等作为免疫相关英文检索词,检索截至2020年1月10日的文献。结果:共纳入53篇文献,其中中文18篇,英文35篇。研究内容集中在铁、锌、维生素A、维生素D、维生素E和脂肪酸同免疫功能的关系。总体来看,营养素的不充足或缺乏会影响人体细胞免疫和体液免疫,主要表现在免疫指标CD3 +、CD4 +、CD4 +/CD8 +比值,以及IgA和IgG水平的变化。营养素摄入量或血清含量与疾病结局如疾病发生率或患病风险、疾病严重程度存在相关关系,而干预实验验证了补充一些营养素如n-3多不饱和脂肪酸、锌、维生素A等对免疫功能及疾病结局的有益影响。 结论:营养素摄入量或血液营养素水平同细胞免疫和体液免疫存在关系,充足的营养状态对提高免疫力和抵抗疾病具有重要作用。

Objective To systematically review the studies on impact of macronutrients and micronutrients on human′s immunity including cell-meditated immunity and humoral immunity as well as disease outcome.Methods The database searched included Wan Fang Data,China National Knowledge Infrastructure,PubMed and Web of Science."Nutrients","food","diet structure","diet pattern","protein","fat","vitamin","mineral"etc.were searched in Chinese and English for nutrition related terms,and"inflammation","inflammatory","oxidative stress","immune","immunity"etc.were searched for immunity related terms in Chinese and English respectively for published articles till Jan.10th,2020.Results A total of 53 articles including 18 Chinese articles and 35 English articles were included in this review.Studies mainly focused on the relationship between nutrients such as iron,zinc,vitamin A,vitamin D,vitamin E and fatty acids and immunity.In a summary,insufficiency or deficiency of nutrients would impact immunity of humans which was mostly reflected in changes of CD3+,CD4+,CD4+/CD8+,IgA and IgG levels.Furthermore,nutrient intake level or serum level was associated with disease outcomes such as prevalence,occurring risk or severity of symptoms.Interventions studies on n-3 polyunsaturated fatty acid(n-3 PUFA),zinc and vitamin A confirmed the positive effects of such nutrients on immunity and disease outcome.Conclusions The intake level or serum level of nutrients is associated with cell-meditated immunity and humoral immunity.Optimal status of nutrients plays an important role in effectively strengthening immune system and disease defense of humans.