Nutrition and the Immune System
Prof Renuka Silva
Department of Nutrition & Dietetics
• Understand the key
components of the immune
system.
• Explore the role of macro and
micronutrients in immune
Learning
function.
Objectives • Discuss the impact of
malnutrition and
overnutrition on immunity.
• Analyze the effect of specific
nutrients on immunity.
Immune System
• The immune system is the body natural
defense mechanism
• The immune system protects the body against
foreign substances (antigens) – bacteria,
viruses, toxins, food proteins that cause
allergies, etc.
• If the immune system fails, the body becomes
vulnerable to disease
Immune System
Physical barriers: Organs • Tissues
body’s first line of
– Mucus membranes
defense against Thymus gland (make T
cells) – Lymphoid tissue
foreign
substances: Bone marrow (make B • Lymphatic vessels
cells)
• Cells
Spleen
Skin – Defense proteins
Tonsils
Mucous membranes
Adenoids – Leukocytes
Gastrointestinal tract
Lymph nodes • Phagocytes
– Neutrophils
Gastrointestinal tract
– Macrophages
• Lymphocytes
– Natural killer cells
– B-cells
– T-cells
The amount and type of nutrients
consumed are tightly linked to the
metabolic stage and the immune health.
Inappropriate nutrient consumption is
associated with development of major
human diseases due to an immune
system not properly functioning
Overview of the
Immune System
Definition and Purpose
Types of Immunity:
• Innate
• Adaptive
• Key Components (e.g., cells,
organs, and signaling molecules)
Saliva
Stomach acid & enzymes Bile
Multiple
Factors
Protect Water and electrolyte secretion
Mucosa! products (mucus, defensins)
Against GI
Pathogens Epithelial barrier
Peristalsis
Bacterial flora
• Rapidly
Compr colonises
ises more gut
than 1014 after birth ,---
• organisms
• More tti an 400 species
• Symbiotic relati onship with host
(commensals)
• Weighs 1-2 kg
Th e Im m un e Sy s t em of Th e Gu t
• The gut is the major site of contact in the body
for foreign antigens
• Gastrointestinal diseases kill more than 2
million people every year
• Non-specif ic (innate) immunity
• Specif ic immunity
• What types of immune responses protect
individuals from infections?
• What are the important characteristics of
immunity, and what mechanisms are responsible
for these characteristics?
• How are the cells and tissues of the immune
system organized to find and respond to
microbes in ways that lead to their elimination?
Physiologic functions of the immune system
and its role in disease
Immune system
Innate Adaptive
Immune
Respons Immune
e Response
Non-specific Highly specific
Distinguishes between human cells and pathogens Distinguishes between different pathogens based on
But not between different types of pathogen shapes on the surface – called antigens
Fast Can take weeks
But no memory But cells remember
?
?
?
?
?
Immune system
Innate Adaptive
Immune
Respons Immune
e Response
Non-specific Highly specific
Distinguishes between human cells and pathogens Distinguishes between different pathogens based on
But not between different types of pathogen shapes on the surface – called antigens
Fast Can take weeks
But no memory But cells remember
antigen
s
How does the immune system fight?
White
blood
cells
Innate Immune Response Adaptive Immune
Response
How does the immune system fight?
White
blood
cells
Innate Immune Response Adaptive Immune
Response
Myeloid cells
(Identifies My cells from not My cells)
Swallows the pathogen whole to kill it
and shows antigens
Called Phagocytosis
How does the immune system fight?
White
blood
cells
Innate Immune Response Adaptive Immune
Response
Myeloid cells Lymphoid cells
(Identifies My cells from not My cells)
Swallows the pathogen whole to kill it
and shows antigens
antigen
How does the immune system fight?
White
blood
cells
Innate Immune Response Adaptive Immune
Response
Myeloid cells Lymphoid cells
(Identifies My cells from not My cells)
Makes specific antibodies which fit
Swallows the pathogen whole to kill it onto specific pathogen antigens
and shows antigens and signal
for
destruction
How does the immune system fight?
White
blood
cells
Innate Immune Response Adaptive Immune
Response
Myeloid cells Lymphoid cells
(Identifies My cells from not My cells)
Makes specific antibodies which fit
Swallows the pathogen whole to kill it onto specific pathogen antigens
and shows antigens
Some form memory cells to protect
you in the future
Principal mechanisms of innate and adaptive
immunity
Innate immunity
• Provide the initial defense against infections.
• Some mechanisms (e.g., epithelial barriers) prevent infections
• Other mechanisms (e.g., phagocytes, natural killer [NK] cells and other
innate lymphoid cells [ILCs] , the complement system) eliminate
microbes.
Adaptive immune responses
• Develop later and are mediated by lymphocytes and their products.
• Antibodies block infections and eliminate microbes
• T lymphocytes eradicate intracellular microbes.
The kinetics of the innate and adaptive immune responses are approximations and
may vary in different infections.
In innate immunity, the first line of defense is provided by
epithelial barriers of the skin and mucosal tissues and by cells
and natural antibiotics present in epithelia, all of which
function to block the entry of microbes.
If microbes do breach epithelia and enter the tissues or
circulation
Several other components of the
innate immune system defend Innate immune responses are
against them, including phagocytes required to initiate adaptive immune
and innate lymphoid cells, and responses against the infectious
several plasma proteins, such as the agents.
complement system. I
Adaptive immune system
• Lymphocytes with highly diverse and variable receptors
for foreign substances, and the products of these cells,
such as antibodies .
• Adaptive immune responses - essential for defense against
infectious microbes that are pathogenic for humans (i.e.,
capable of causing disease) and may have evolved to resist
innate immunity.
• Cells and molecules of innate immunity - recognize structures
shared by classes of microbes
• Lymphocytes of adaptive immunity express receptors that
specifically recognize a much wider variety of molecules
produced by microbes, as well as noninfectious molecules.
• Any molecule that is specifically recognized by lymphocytes or
Two systems work together
• Adaptive immune responses often use the
cells and molecules of the innate immune
system to eliminate microbes.
• For example, antibodies (a component of
adaptive immunity) bind to microbes, and these
coated microbes avidly bind to and activate
phagocytes (a component of innate immunity),
which ingest and destroy the microbes.
Cells of the immune system
• Located in different tissues and serve different roles in host defense.
• Most of these cells are derived from bone marrow precursors that
circulate in the blood and are called leukocytes (white blood cells).
• Others are present in tissues at all times. Some of these cells
function mainly in innate immunity, others in adaptive immunity,
and some function in both types of responses.
• 2 broad categories:
– Lymphoid cells (most of which are the mediators of adaptive
immune responses)
– Nonlymphoid cells (myeloid cells) - play diverse roles, including
in innate immune responses.
• Tissue-resident dendritic cells, macrophages, and
mast cells
– serve as sentinels to detect the presence of microbes in tissues and
initiate immune responses.
– Dendritic cells (DCs) - many protruding membrane extensions, also
have the specialized function of capturing microbial antigens and
displaying them to T lymphocytes to initiate adaptive immune
responses and are therefore called antigen-presenting cells (APCs).
– Phagocytes - ingest and destroy microbes.
• Myeloid cells – neutrophils, eosinophils, macrophages, natural killer (NK) cells.
• Macrophages (can develop from circulating monocytes and live in tissues much longer
than neutrophils do).
• Macrophages are not only sentinels and destroyers of microbes, but they also help to
repair damaged tissues.
• Lymphocytes - B and T cells, circulate through
lymphoid organs and nonlymphoid tissues.
– Recognize foreign antigens and carry out adaptive immune
responses. They are described further later in this chapter.
Types of Adaptive Immunity
1. Humoral immunity
• mediated by proteins called antibodies, which are produced by cells called
B lymphocytes.
• antibodies enter the circulation, extracellular tissue fluids, and the lumens
of mucosal organs such as the gastrointestinal and respiratory tracts.
• preventing them from invading tissue cells and neutralizing toxins made by
the microbes.
2. Cell-mediated immunity
• Activation of specific immune cells - T lymphocytes
• Defend against intracellular organisms that can survive and replicate
inside cells.
• Some T lymphocytes activate phagocytes to destroy microbes
• Other T lymphocytes kill any type of host cells (including non-phagocytic
cells)recognize only peptide fragments of protein antigens presented on
Most T cells
cell surfaces, whereas B cells and antibodies are able to recognize many
different types of molecules, including proteins, carbohydrates, nucleic acids, and
lipids.
Properties
of adaptive
immune
responses
Mature lymphocytes
with receptors for
many antigens
develop before
encountering these
antigens.
A clone refers to a
population of
lymphocytes with
identical antigen
receptors and
therefore specificities;
all of these cells are
presumably derived
from one precursor
cell.
Quiz
• Which of the following is NOT a component of
the immune system?
A. Lymph nodes
B. Spleen
C. Liver
D. Bone marrow
• Which characteristic is unique to adaptive
immunity?
A. Rapid response to pathogens
B. Recognition of specific antigens
C. Involvement of physical barriers
D. Lack of immunological memory
• What type of immune cell is primarily
responsible for producing antibodies?
A. T cells
B. B cells
C. Macrophages
D. Natural killer cells
Study Qs
1. What is the primary function of the immune system,
and how does it distinguish between self and non-self?
2. Identify the major components of the immune system
and briefly describe their roles in immunity.
3. Which types of immune cells are involved in both
innate and adaptive immunity, and what are their
specific functions?
4. Describe the concepts of antigen recognition and
immunological memory and their importance in
vaccine development.
Inflammation and nutrition
• The inflammatory mechanisms that compose
the innate immunity are strongly influenced
by nutrition.
• This interaction, when disturbed, can
profoundly affect disease development.
• The immune system is able to destroy
antigens through both innate and adaptive
immune cells and finally through antibodies
that are specific .for each pathogen
Inflammation
• Inflammation is a set of symptoms that include pain,
swelling, heat, and redness of an affected organ or
tissue
– It is the natural way the body’s immune system
responds to injury, infection or attack
• Another form of inflammation that is not aligned with
pain and is referred to as chronic low-grade
inflammation or “silent inflammation”
– The links between diet, inflammatory processes,
and diseases are the topics of intense current
research
Acute and Chronic Inflammation
• Acute inflammation - beneficial
– Immune system responses to infection or injuring resulting in
inflammation, fighting infection or injury, and then stops
• Immune system responses and get recovery
• Chronic inflammation – harmful
– Low grade inflammation that persists
– Chronically inflamed tissues produce bioactive compounds that
sustain the inflammatory response
– Low grade inflammation can suppress immune response
• If constantly turned on at a low level the immune system get
used to it and is not responsive (flies under the radar)
• Immune system responds but no recovery
Chronic Diseases and Inflammation
• Many diseases, especially chronic diseases, reflect an
underlying inflammatory process such as:
– Obesity
– Metabolic syndrome
– Atherosclerosis
– Type 2 diabetes
– Hypertension
– Certain types of cancer
– Rheumatoid arthritis
– Others
Obesity and Inflammation
• Chronic inflammation accompanies obesity
– Adipose (fat) tissue is metabolically active and produces
compounds that promote inflammation
–As adipose tissue fills up, fat migrates to other tissues -
muscles and liver (ectopic fat)
–The combination of increased ectopic fat and inflammation
disrupts normal glucose and lipid metabolism leading to:
• Insulin resistance
• Elevated blood lipids (also promotes inflammation)
• High blood pressure (also promotes inflammation)
–This cluster of symptoms is known as metabolic syndrome –
which increases the risk for type 2 diabetes, atherosclerosis,
and cardiovascular disease (heart disease and hypertension).
Atherosclerosis and
Inflammation
– Atherosclerosis initiated by minor but chronic damage to the blood vessel
wall
– Blood vessel damage increases permeability of the blood vessel wall and
initiates an inflammatory response.
– The immune system responds by sending in macrophages.
– LDL cholesterol becomes trapped inside the blood vessel wall.
• Free radicals produced during inflammatory response oxidize LDL cholesterol.
– Macrophages take up the oxidized LDL cholesterol.
• Swell up with oxidized LDL cholesterol and eventually become plaque.
– Blood vessel damage and inflammation also favor formation of blood
clots
– As damage progresses, inflammatory response intensifies
• Plaque instability and weakens the blood vessel wall
Challenge is to Maintain Beneficial Effects of
Inflammation Yet Limit Harmful Consequences
• The fact that many diseases reflect an
underlying inflammatory process yet
inflammation is critical to immune
system response presents a challenge
to identify factors that will both
protect the beneficial effects and
limit the harmful consequences
Nutrition and Immunity
• Nutritional deficiencies are closely associated with
impaired immune response and loss of the host
resistance to infection.
• Less developed regions malnutrition continues to be a
major health problem - associated with a higher
incidence of morbidity and mortality usually linked with
the higher prevalence of bacterial and parasitic infection
diseases in these regions
• Developed countries – poor diets / inadequate diet
consumption, with no real nutritional value,
accompanied by excess calories
Malnutrition mainly affects: Cell-
mediated immunity Phagocyte
function Complement activity
Nutrient
Deficiencies lgA production Cytokine
& Immune production
Responses
Lymphoid tissue - 'nutritional
thymectomy'
Proteins:
• Role in antibody production
Macronutrients • Structural components of
and Immune immune cells
Function
Carbohydrates and
Lipids:
• Energy sources for immune
response
Proteins
• Amino acids such as L-arginine and L-tryptophan are responsible
and critical for macrophages’ appropriate immune activity.
• L-arginine - associated with a well-known immunoregulatory
mechanism exploited by M2 macrophages.
• The mechanism involves arginase 1, which consumes L-arginine
and the genes responsible for M1 inhibition, concomitantly with
M2 promotion.
• Arginine and methionine together, are in charge of the synthesis
of polyamines. Due to their ability to maintain cell membrane
stability and keep DNA homeostasis, they stimulate cell
proliferation
• Tumor cell growth metabolic pathways as well as in immune
antitumor response
Micronutrients: Vitamins
• Vitamin A:
– Role in mucosal immunity
– Deficiency effects
• Vitamin D:
– Immune modulation
– Link to autoimmunity
• Vitamin C:
– Antioxidant properties
– Influence on infection resistance
Vitamin Deficiency
Alters epithelial structure -7 metaplasia &
Vitamin A increased bacterial binding
deficiency
Reduced T cell numbers and CMI
Vitamin B6 and Reduced CMI
folate
Reduced antibody production
deficiencies
Micronutrients: Minerals
• Zinc:
- Enzyme activation and cell signaling
- Impact of deficiency
• Iron:
– Role in microbial growth and host defense
– Risks of imbalance
• Selenium:
– Antioxidant effects
– Immune cell function
• Impairs cell-mediated immunity (T-
helper 1) & phagocyte function
Reduced CD4/CD8 ratios
– A lower ratio of CD4 (helper T cells)
to CD8 (cytotoxic T cells) often
Magnesium, signifies immune system
Iron and Zinc dysfunction.
• Post-operative patients, athletes,
Deficiency elderly
• Chronic deficiency seems to be
associated with acute lymphoblastic
leukemia and malignant lymphoma
(Mg & Zn)
• Altered NK and macrophage
cytotoxicity (may affect tumor
surveillance)
Gut Microbiota and Immunity
Relationship Role of probiotics Dietary fibers and
between diet, gut and prebiotics short-chain fatty
microbiota, and acids (SCFAs)
immune function
Key Roles of Gut Microbiota in
Immunity
Immune Shapes the maturation of the immune system, particularly in early life.
System
Influences the development of gut-associated lymphoid tissues (GALT).
Development
Enhances the gut’s physical barrier by promoting mucus production and
Barrier tight junction integrity in epithelial cells.
Protection: Competes with pathogens for resources, preventing their colonization.
Maintains a balance between pro-inflammatory and anti-inflammatory
Regulation of signals.
Inflammatory
Produces short-chain fatty acids (SCFAs), like butyrate, which have anti-
Responses: inflammatory effects.
Modulation Influences the activity of T cells (e.g., Tregs, TH1, TH17) and B cells.
of Immune Promotes the production of immunoglobulin A (IgA), which neutralizes
Cells: pathogens in the gut lumen.
Imbalance in Gut Microbiota
(Dysbiosis)
Effects on Immunity:
Overgrowth of harmful bacteria triggers chronic inflammation.
Reduced microbial diversity is linked to autoimmune diseases and allergies.
Associated Diseases:
Inflammatory Bowel Disease (IBD)
Obesity and metabolic syndrome
Infections and weakened immunity
Dietary Choices:
• High-fiber diets (prebiotics) to
promote beneficial bacteria.
• Fermented foods (probiotics)
like yogurt, kefir, and
sauerkraut.
Ways to
Lifestyle Modifications:
Maintain a • Regular physical activity and
Healthy Gut stress management.
• Avoidance of unnecessary
Microbiota antibiotics.
Therapeutic Approaches:
• Probiotic and prebiotic
supplements.
• Fecal microbiota
transplantation (FMT) in severe
cases of dysbiosis.
Pr o tein-en ergy M a lnutri tion
Associated with reduced
• Numbers of CD4 helper T cells
CD4/CD8 ratios
• Macrophage activation
• Levels of C3,C5 and Factor B opsonisation
phagocytosis
• Intracellular killing of bacteria by phagocytes Lysosyme
levels
• TNF &IL2
• Wound healing
Obesity and chronic
inflammation
Impact of excess sugar
and fats on immunity
Overnutrition
signals nutritional
and Immune Risks of metabolic
syndromes
status to the
hypothalamus
Dysfunction
Loss of fat cells results
modifies pro-
in low leptin (adipose
inflammatory immune
tissue-derived
responses
hormone) levels:
provides a key link
between nutritional
de iciency and
immune dysfunction
Role of Antioxidants
OXIDATIVE STRESS AND SOURCES OF DIETARY EXAMPLES: VITAMINS
IMMUNE RESPONSE ANTIOXIDANTS E, C, AND SELENIUM
Nutrition and Autoimmune Diseases
Links between diet Role of anti- Examples:
and autoimmunity inflammatory diets Mediterranean
diet, gluten-free
diet for celiac
disease
Special Populations
Nutrition for the elderly and immune aging
Child nutrition and immune development
Immune considerations for athletes
Nutritional Interventions
Public health Fortification Supplementation
strategies programs guidelines
Practical Applications
DIETARY ROLE OF EXAMPLES OF
RECOMMENDATIO BALANCED MEALS IMMUNE-
NS FOR IMMUNE SUPPORTING MEAL
HEALTH PLANS
Diet and Inflammation
Research suggests that certain Research is still currently being
dietary components may modulate conducted investigating the effects
key inflammatory pathways of dietary components on
inflammation
Diet and Inflammation
• Possible pro-inflammatory dietary factors
– Excess calories
– Saturated and trans fats
– Highly processed foods
• Highly processed meats
• Highly refined carbohydrates
Diet and Inflammation
• Possible anti-inflammatory dietary factors: found in fruits, vegetables,
whole grains, lean protein foods (lean meat, poultry, pork and fish;
beans, peas and lentils; nuts and seeds), low-fat or fat-free dairy, and
healthy fats)
–Healthy fats
• Omega-3 fatty acids
• Monounsaturated fats
–Vitamins and minerals (vitamin C, E, selenium, magnesium, zinc)
–Fiber
–Phytonutrients
• Polyphenols
• Carotenoids
–Probiotics and prebiotics
Diet and Inflammation
• However, at the present lime, the research to
support specific dietary recommendations
regarding inflammation is lacking
– More research is needed
• What foods/food components
• How much
• How often
Diet and Inflammation
• Currently, the best advice is to adopt a healthy dietary
pattern including a variety of nutritious foods
– Make fruits and vegetables half your plate
• Choose a variety of brightly colored fruits and
vegetables
– Make half your grains whole grains
– Vary your protein routine
• Choose lean protein foods
• Include fish; beans, peas and lentils; nuts and seeds
– Move to low-fat or fat-free milk or yogurt
– Choose healthy fats
• Choose those high in omega 3 and
monounsaturated fats
– Limit foods and beverages higher in added sugars,
saturated and trans fat, and sodium
Diet and Immune
System Health
• A healthy dietary pattern also provides the nutrients
needed to support a healthy immune system
Calories Vitamin A
Zinc
Protein Vitamin C
Selenium
Omega 3 Vitamin E
Iron Vitamin D
Magnesium
Vitamin B6
Copper
Vitamin B12
Prebiotics
Folate
Probiotics
Other Lifestyle Factors and Inflammation
REGULAR PHYSICAL ADEQUATE SLEEP MANAGE STRESS
ACTIVITY
