nutrition and health

immunonutrition

What is immunosuppression?

" Immunonutrition or pharmaconutrition is a term that indicates the supplementary administration of specific nutrients able to modulate the inflammatory response and increase the immune response of a subject " (Dott.ssa Eliana Siciliano, freelancer).

In summary, immunonutrition means using the nutritive principles to favor the decrease of the state of hyper-inflammation and / or to favor the action of the immune system; immunonutrition can be applied in different clinical conditions, in acute or chronic forms, orally (os), enteral (nasogastric tube) or parenteral (intravenous).

Usefulness of the immunology

Immunonutrition can contribute to the significant reduction of risks related to the complications of acute post-operative inflammation. Surgery (in oncology, traumatology, etc.) often leads to an IPERmetabolic response - CATABOLIC responsible for:

  • Weight loss
  • Reduction of mass and muscle tone
  • Impaired immune system
  • Slow down of healing processes
  • Difficulty in weaning from mechanical respiration (when applied)
  • Increased risk of infections
  • In the worst case scenario, multi-organ failure and increased mortality risk.

In such cases, the MINIMUM administration of nutrients by ENTERALE is able to prevent the atrophy of intestinal villi and mucosal atrophy, to increase the intestinal immune barrier and to reduce bacterial translocation. However, we recall that an ADEQUATE (and not least) nutritional support is able to prevent both malnutrition and the various repercussions on the immune system.

Immunonutrition is based on these assumptions and aims to optimize the organism's own resources.

Immunonutrition molecules - immunonutrients

In immunology the most useful and employed molecules are:

  • L-arginine
  • L-glutamine (amino acid)
  • Omega-3 fatty acids (ω3 - essential fatty acid)
  • Nucleotides
  • Taurine (amino acid)
  • Tocopherols (vitamin E)
  • Inulin and fructo-oligosaccharides (FOS - water-soluble dietary fiber)

Arginine has a stimulating action on the secretion of some hormones, including somatotropin [GH] and this is particularly valid (and demonstrated) precisely for those who are debilitated and / or poly-traumatized. It is also a precursor of nitric oxide (NO) and contributes to enhancing the activation of T lymphocytes and macrophages (white blood cells).

Glutamine, among its many functions, constitutes 60-70% of the energy used by enterocytes (cells of the intestinal mucosa) and has a primary action on lymphocyte activation and macrophages. Its administration proves useful in healing wounds and reducing hospitalization times.

Taurine is a derived amino acid that contributes to the regulation of osmotic equilibrium, to intracellular calcium homeostasis, to the composition and stabilization of cell membranes, to antioxidant protection, to the regulation of blood glucose, etc. Its administration allows to maintain normal concentrations of platelets, erythrocytes (red blood cells), granulocytes (white blood cells) and lymphocytes.

The ω3 fatty acids are typically anti-inflammatory; they also act on lipid metabolism favoring the increase of HDL and the reduction of LDL and triglycerides. They also act positively on reducing blood pressure and the immune response and have no side effects.

The FOS favor the selection of the correct intestinal bacterial flora, reduce the transit time of food, modulate the absorption of glucose and reduce that of cholesterol; not least, they favor the maintenance of the integrity of the intestinal moss.

Immunonutrition: yes or no?

Concluding, although the therapeutic effects of immunonutrition are by now established, there is still a scarce utilization of this nutritional practice among doctors and within the clinical hospitalization facilities. Obviously, even the immunonutption has some very specific limits:

  • It is possible to derive a significant advantage as long as the basic nutritional needs are met first
  • It is not advisable to administer the immunonutrients indiscriminately and each case should include a separate formulation.

These are secondary aspects and easily manageable through the intervention of a specialized professional, the latter indispensable figure in clinical nutrition and an integral part of medical therapy.

Bibliography :

  • Magazine of the National Dietitians Association (ANDID) - 21st year, sixth issue, bimonthly period Sixth bi-monthly 2011 - page 25:28.