Non-coeliac gluten sensitivity and the spectrum of gluten-related disorders: an updated overview.

The spectrum of gluten-related disorders includes coeliac disease (CD), wheat allergy (WA) and the suggested entity of non-coeliac gluten sensitivity (NCGS). An increasing number of the world's population are avoiding gluten due to the assumption of health benefits and self-diagnosed gastrointestinal and/or extra-intestinal symptoms. Unlike CD and WA, NCGS is a relatively new entity with an unknown prevalence and mechanisms, complicated by recent literature suggesting that gluten is not the only food component that may trigger symptoms experienced by this group of patients. The term 'non-coeliac wheat sensitivity' has been proposed as a more accurate term, allowing inclusion of other non-gluten wheat components such as fructans and amylase-trypsin inhibitors. There is inconsistent evidence when evaluating the effects of a gluten challenge in patients with suspected NCGS and there is a need for a standardised procedure to confirm the diagnosis, ultimately enabling the optimisation of clinical care. The present review will give an overview of the different gluten-related disorders and discuss the most recent scientific evidence investigating NCGS.

Effect of Extra Virgin Olive Oil and Table Olives on the ImmuneInflammatory Responses: Potential Clinical Applications.

BACKGROUND AND OBJECTIVE: Extra virgin olive oil (EVOO) is the common element among the Mediterranean countries. It can be considered a nutraceutical and functional food, thanks to its bioactive compounds. It can act and modulate different processes linked to ageing and age-related diseases related to a common chronic low grade inflammation. Depending on the cultivar, the growth conditions, the period of harvesting, the productive process and time of product storage, EVOO could contain different amount of vegetal components. Of course, the same is for table olives. METHODS: The aim of our review is to summarize the effects of EVOO and table olives on the immunemediated inflammatory response, focusing our attention on human studies. RESULTS: Our report highlights the effect of specific molecules obtained from EVOO on the modulation of specific cytokines and anti-oxidants suggesting the importance of the daily consumption of both EVOO and table olives in the context of a Mediterranean dietary pattern. In addition, the different action on immune-inflammatory biomarkers, are depending on the olive tree cultivar. CONCLUSION: Thanks to their bioactive compounds, EVOO and table olive can be considered as nutraceutical and functional foods. The beneficial effects analysed in this review will help to understand the potential application of specific olive components as therapeutic adjuvant, supplements or drugs.

Anti-inflammatory Activity of Extra Virgin Olive Oil Polyphenols: Which Role in the Prevention and Treatment of Immune-Mediated Inflammatory Diseases?

BACKGROUND AND OBJECTIVE: Altered inflammatory response characterizes chronic immunemediated inflammatory diseases (IMID) such as rheumatoid arthritis, inflammatory bowel disease, multiple sclerosis, systemic lupus erythematosus, and psoriasis. Accumulating evidence indicates that regular consumption of extra virgin olive oil (EVOO), the main source of fat in the Mediterranean diet, is associated with a reduced risk of developing chronic degenerative disorders such as cardiovascular diseases, type 2 diabetes and cancer. The beneficial effects on health of EVOO have been attributed, besides to the monounsaturated fats content, to the presence of phenolic compounds that have antioxidant, anti-inflammatory and immunomodulatory properties. The purpose of this review is to provide an overview of the effects of EVOO polyphenols on IMID highlighting the potential mechanisms of action. METHODS: Scientific papers were found by searching in PubMed up to May 2017 using the following key words: rheumatoid arthritis, inflammatory bowel disease, multiple sclerosis, systemic lupus erythematosus, and psoriasis also in combination with EVOO, phenolic compounds, oleuropein, oleocantal, hydroxytyrosol,tyrosol and oleochantal. RESULTS: In vitro and in vivo studies indicate that EVOO and its polyphenols can improve diseases symptoms in IMID, by acting both at local and systemic levels and by modulating several molecular pathways. Nevertheless, there are not sufficient data to achieve specific nutritional guidelines. CONCLUSION: Further research is needed to evaluate the real contribution of EVOO and its phenolic compounds in modulating the IMID-associated inflammatory perturbations, in order to develop appropriate nutritional recommendations.

The Protective Effects of Extra Virgin Olive Oil on Immune-mediated Inflammatory Responses.

BACKGROUND AND OBJECTIVE: The increasing interest in the Mediterranean diet (MeDiet) hinges on the relevant role it plays in inflammatory diseases. Several clinical, epidemiological and experimental evidences suggest that consumption of the MeDiet reduces the incidence of certain pathologies related to oxidative stress, chronic inflammation and immune system diseases such as cancer, atherosclerosis and cardiovascular disease (CVD). These reductions can be partially attributed to extra virgin olive oil (EVOO) consumption which has been described as a key bioactive food because of its high nutritional quality and its particular composition of fatty acids, vitamins and polyphenols. Indeed, the beneficial effects of EVOO have been linked to its fatty acid composition, which is very rich in monounsaturated fatty acids (MUFA), and has moderate saturated and polyunsaturated fatty acids (PUFA). The current knowledge available on the beneficial effects of EVOO and its phenolic compounds, specifically its biological properties and antioxidant capacity against immune-mediated inflammatory responses (atherosclerosis, rheumatoid arthritis, diabetes, obesity, cancer, inflammatory bowel disease or neurodegenerative disease, among others) in addition to its potential clinical applications. CONCLUSION: The increasing body of studies carried out provides compelling evidence that olive polyphenols are potential candidates to combat chronic inflammatory states.

Nutrición y trastornos del sistema inmune / Nutrition and immune system disorders

Introducción: la energía y los nutrientes que obtenemos a través de la alimentación ejercen un papel importante en el desarrollo y preservación del sistema inmune, por lo que cualquier desequilibrio nutricional en el individuo afecta a su competencia e integridad. Objetivos: conocer el abordaje nutricional sobre diferentes trastornos del sistema inmune. Métodos: se ha realizado una revisión sobre los trastornos inmunológicos de mayor prevalencia en países desarrollados, las características nutricionales a los que se encuentran asociados y su abordaje nutricional. Resultados: el abordaje nutricional de los trastornos inmunológicos se ha centrado en los últimos años en los AGP-ω3 y la vitamina D. Mantener el peso corporal, evitar estados de desnutrición y catabolismo proteico, son estrategias clave del tratamiento nutricional. Este debe adecuarse a cada fase de la enfermedad, por lo que se trata de un proceso dinámico. Conclusiones: el abordaje nutricional de los trastornos inmunológicos, sobre todo en las enfermedades autoinmunes, no siempre es del todo claro, debido a los estados agudos y de remisión que presentan. La anorexia es uno de los síntomas más característicos, derivada del tratamiento farmacológico y el proceso inflamatorio. La dieta debe contener una elevada densidad en nutrientes que eviten el deterioro. El abordaje nutricional de los trastornos inmunológicos debe tener como objetivo mantener un estado óptimo de nutrición durante los periodos sintomáticos, prevenir su deterioro durante los episodios agudos y mejorarlo durante los periodos estables libres de sintomatología (AU)

Introduction: Energy and nutrients obtained through food play an important role in the development and preservation of the immune system therefore any nutritional imbalance affects its competence and integrity. Objectives: knowing the nutritional approach on different disorders of the immune system. Methods: A review has been carried out on the most prevalent immunological disorders in developed countries, the nutritional characteristics to which they are associated and their nutritional approach. Results: Nutritional treatment for immune disorders has focused in recent years on the role of PUFA-ω3 and vitamin D. Maintaining body weight, preventing malnutrition and protein catabolism are key strategies for nutritional treatment. This should be adapted to each disease stage because it is a dynamic process. Conclusions: Nutritional treatment for immunological disorders, especially in autoimmune diseases, is not always clear because they present acute and remission states. Anorexia is one of the most characteristic symptoms derived mainly from pharmacological treatment and inflammatory processes. Diet should be dense in nutrients that prevent deterioration. Nutritional treatment of immunological disorders should aim to maintain an optimal state of nutrition during symptomatic periods, prevent their deterioration during acute episodes and improve during stable periods free of symptoms (AU)

Sesión de Inmunonutrición: Comunicaciones orales / Immunonutrition

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Food-derived oligosaccharides exhibit pharmaceutical properties.

Breast feeding is considered as the best nutrition for growth and development of an infant. Human milk consists of a unique combination of nutritional components each with different characteristics. Oligosaccharides or non-digestible carbohydrates as one of these components, are generally accepted to have a beneficial effect by selectively stimulating the growth and/or activity of one or a limited number of bacterial species. Recently more evidence is rising for direct effects of oligosaccharides on the immune system. Oligosaccharides often used as dietary supplements for their beneficial effects on the host and its immune system, are derived from nutritional sources. In this review we aim to summarize the pharmaceutical properties of these food-borne oligosaccharides early in life.

Vitamin E and immunity.

Vitamin E is the most important chain-breaking, lipid-soluble antioxidant present in body tissues of all cells and is considered the first line of defense against lipid peroxidation and it is important for normal function of the immune cells. However, vitamin E deficiency is rare in well-nourished healthy subjects and is not a problem, even among people living on relatively poor diets, both T- and B-cell functions are impaired by vitamin E deficiency. While immune cells are particularly enriched in vitamin E because of their high polyunsaturated fatty acid content, this point puts them at especially high risk for oxidative damage. Besides its immunomodulatory effects, vitamin E also plays an important role in carcinogenesis with its antioxidant properties against cancer, and ischemic heart disease with limiting the progression of atherosclerosis. Supplementation of vitamin E significantly enhances both cell mediated and humoral immune functions in humans, especially in the elderly and animals.

Emerging paradigms in immunonutrition.

Nutritional immunology is the study of the relationship between food and the immune system. It evolved with the study of immune deficiencies caused by malnutrition. However, because of technological advances made over the past few decades, malnutrition is no longer the main cause of lowered immune status in otherwise healthy people/animals. Rather, life stage (neonate or old age) and natural stressors have taken over as the primary cause for immune deficiency. Unlike malnutrition, immune deficiency due to life stage or natural stress cannot be addressed by correcting underlying nutritional problems. Lowered immune status because of life stage or naturally occurring stress is characterized by reduced capacity to process and present foreign antigens to immune cells, resulting in a less efficient or altered immune response that leads to increased susceptibility to infections and an increase in autoimmunity and cancers. Beyond providing essential nutrients, diet can actively influence the immune system. Over 65% of the immune cells in the body are present in the gut, making the gut the "largest immune organ." Receptors present on the immune cells in the gut are the primary targets for immunomodulation via diet. Diet interacts with the immune system at multiple levels, starting with providing basic nutrients, then moving on to providing higher levels of key nutrients such as protein, vitamins, and minerals, and leading to a more focused modulation of the immune system. A framework outlining this interaction, along with relevant examples, will be discussed.

A mixture of Lactobacillus plantarum CECT 7315 and CECT 7316 enhances systemic immunity in elderly subjects. A dose-response,double-blind, placebo-controlled, randomized pilot trial / Una mezcla de Lactobacillus plantarum CECT 7315 y CECT 7316 mejora la inmunidad sistémica en ancianos. Un ensayo aleatorio piloto, de dosis-respuesta, doble ciego y controlado con placebo

Background & aim: Immunosenescence can increase morbi-mortality. Lactic acid producing bacteria may improve immunity and reduce morbidity and mortality in the elderly. We aimed to investigate the effects of a mixture of two new probiotic strains of Lactobacillus plantarum-CECT 7315 and 7316- on systemic immunity in elderly. Methods: 50 institutionalized elderly subjects were randomized, in a double-blind fashion, to receive for 12 weeks 1) 5·108 cfu/day of L. plantarum CECT7315/7316 ("low probiotic dose") (n = 13), 2) 5·109 cfu/day of the probiotic mixture ("high probiotic dose") (n = 19), or 3) placebo (n = 15). Leukocyte subpopulations, and cytokine levels (IL-1 , IL-10, TGF-β1) were measured in venous blood at baseline, end of treatment (week 12), and end of follow-up (week 24). Infection and survival rates were recorded. Results: After treatment, high probiotic dose resulted in significant increases in the percentages of activated potentially T-suppressor (CD8+CD25+) and NK (CD56+ CD16+) cells, while low probiotic dose increased activated T-helper lymphocytes (CD4+CD25+), B lymphocytes (CD19+), and antigen presenting cells (HLA-DR+). Also, plasma TGF-β1 concentration significantly decreased after treatment with both probiotic doses. Most of these changes remained 12 weeks after probiotic discontinuation. Incidence of infections during treatment showed a significant trend to be lower in the high probiotic dose group. In addition, there was a significant trend for mortality to be greater in the placebo group vs. both probiotic groups. Conclusions: Depending on the dose, L. plantarum CECT7315/7316 have different immune-enhancing effects in elderly subjects. These effects might result in a better clinical outcome (AU)

Introducción y objetivos: La inmunosenescencia puede aumentar la morbi-mortalidad. Las bacterias productoras de ácido láctico pueden mejorar la inmunidad y disminuir la morbilidad y mortalidad en los ancianos. Nuestro objetivo fue investigar los efectos de una mezcla de dos nuevas cepas probióticas de Lactobacillus plantarum -CECT 7315 y 7316- sobre la inmunidad sistémica en ancianos. Métodos: 50 ancianos institucionalizados se aleatorizaron, en un diseño a doble-ciego, para recibir durante 12 semanas 1) 5·108 ufc/día de L. plantarum CECT7315/ 7316 ("dosis baja de probiótico") (n = 13), 2) 5·109 ufc/día de la mezcla probiótica ("dosis alta de probiótico") (n = 19), o 3) placebo (n = 15). Se determinaron las subpoblaciones leucocitarias y los niveles de citokinas (IL-1 , IL-10, TGF-β1) en sangre venosa periférica basalmente, al final del tratamiento (sem. 12) y al final del seguimiento (sem. 24). Se registró la tasa de infecciones y la mortalidad. Resultados: Tras el tratamiento, la dosis alta de probiótico indujo aumentos significativos en los porcentajes de células potencialmente T-supresoras (CD8+CD25+) y NK (CD56+CD16+) activadas, en tanto que la dosis baja aumento los linfocitos T-colaboradores activados (CD4+CD25+), los linfocitos B (CD19+), y las células presentadoras de antígeno (HLA-DR+). Asimismo, la concentración plasmática de TGF-β1 disminuyó tras el tratamiento con ambas dosis de probiótico. La mayor parte de estos cambios se mantuvieron 12 semanas después de suspender el tratamiento. La incidencia de infecciones durante el tratamiento mostró una tendencia significativa a ser menor con la dosis alta de probiótico, mientras que se observó una tendencia significativa a que la mortalidad fuera mayor el grupo placebo vs. ambos grupos tratados con probiótico. Conclusiones: Dependiendo de la dosis, L. plantarum CECT7315/7316 tiene distintos efectos inmunoestimulantes en ancianos. Dichos efectos podrían contribuir a una mejor evolución clínica (AU)

Zinc supplementation for the treatment or prevention of disease: current status and future perspectives.

Zinc is a nutritionally essential trace element, and thus zinc deficiency may severely affect human health. Many studies were published in which the effect of nutritional zinc supplementation on the incidence or severity of a certain disease was investigated. This review summarizes the main observations and aims to evaluate the use of nutritional zinc supplementation for prevention and treatment of human disease.

[Experimental research on the effects of Chinese herb drugs on immune dysfunction in severely scalded rats].

OBJECTIVE: To observe the modulation effect of a concoction of Chinese herb drugs on immune dysfunction in severely burned rats. METHODS: One hundred healthy Wistar rats were randomly divided into A group (n = 30, with Chinese herb drug feeding after burns), B group (n = 30, with bouillon feeding after burns), C group (n = 30, with ordinary feeding after burns), and D group (n = 10, with sham burns as normal controls). The rats in A, B and C groups were subjected to 30% TBSA full-thickness burns and received conventional treatment. The rats in A group received 2 ml of Chinese herbal drug at 37 degrees C by gavage two times a day beginning from 2 postburn-hours(PBH). The rats in B group received 2 ml bouillon by gavage instead, and otherwise treatment was the same as A group, while the rats in C group were not fed by gavage. The activity of natural killer cell and T lymphocyte, and the levels of IgA, IgG, IgM, C3, C4 in A, B, C groups were examined on 3, 7, 14 PBD, and these indices were also determined in D group. RESULTS: Compared with D group, the amount of the CD3+, CD4+ lymphocyte, the ratio of the CD4+/CD8+, the level of IgA, IgG, IgM, C3, C4, the activity of NK cells, and the density of the sIgA in A, B, C groups were obviously decreased, but the amount of the CD8+ were obviously increased (P < 0.05 or P < 0.01). Furthermore, the above indices in A group improved more quickly when compared with B and C groups. CONCLUSION: The concoction of Chinese herb drugs can improve the distribution of T lymphocyte subsets, increase the activity of NK cells, promote the secretion of sIgA in intestinal mucous membrane and promote recovery of IgM, IgG, C3, C4 levels, thereby improves the immune function of the body.

Bioecological and nutritional control of disease: prebiotics, probiotics and synbiotics.

A growing number of patients worlwide suffer acute and chronic diseases. Evidence supports the association of chronic diseases to modern lifestyle habits and malfunction of the immune system. Morbidity and mortality for patients affected of chronic diseases is unacceptably high despite advanced surgical and medical treatments. Nowadays there is an increasing interest in the bioecological and nutritional control of diseases. The use of prebiotics, probiotics and synbiotics, e.g. antioxidants, anti-inflammatory omega-3 lipid emulsions, bioactive fibers, lactic acid bacteria (LAB), etc, appears as a new tool for the treatment of disease. The effects of antioxidants and omega-3 lipid emulsions remain largely unexplored, but significant modulatory effects on neutrophils and morbidity have been observed. It is burning that these compounds are tried in patients including surgically and critically ill patients. Some bioactive fibers and some probiotic bacteria have demonstrated extraordinary efficacy to restore and maintain immunity and prevent complications. Lactic acid bacteria (LAB) have demonstrated ability to reduce or eliminate potential pathogen micro-organisms, as well as various toxins, mutagens and carcinogens; they also promote apoptosis, synthesize and release numerous nutrients, antioxidants, growth-factors, coagulation and other bioactive compounds, and modulate the innate and adaptive immune defence mechanisms. More recent studies suggest that LAB promote and maintain gastrointestinal (GI) motility and prevent GI paralysis and postoperative ileus and have the ability to inhibit inflammation. Further studies are needed to ascertain the molecular mechanisms by which pre-, pro- and synbiotics influence the outcome in a variety of acute and chronic diseases.

Probiotics and medical nutrition therapy.

Probiotics have been defined by The Food Agricultural Organization/World Health Organization (FAO/WHO) as "live microorganisms which when administered in adequate amounts confer a health benefit to the host." They have been used for centuries in the form of dairy-based fermented products, but the potential use of probiotics as a form of medical nutrition therapy has not received formal recognition. A detailed literature review (from 1950 through February 2004) of English-language articles was undertaken to find articles showing a relationship between probiotic use and medical conditions. Medical conditions that have been reportedly treated or have the potential to be treated with probiotics include diarrhea, gastroenteritis, irritable bowel syndrome, and inflammatory bowel disease (Crohn's disease and ulcerative colitis), cancer, depressed immune function, inadequate lactase digestion, infant allergies, failure-to-thrive, hyperlipidemia, hepatic diseases, Helicobacter pylori infections, genitourinary tract infections, and others. The use of probiotics should be further investigated for possible benefits and side-effects in patients affected by these medical conditions.

[Reducing diet therapy in the correction of the immune disorders in patients with primary osteoarthrosis]. / Razgruzochno-dieticheskaia terapiia v korrektsii immunnykh narushenii u bol'nykh s pervichnym osteoartrozom.

Effects of 14-21-day courses of reducing diet on function of T- and B-system immunity were studied in 35 patients with primary osteoarthrosis, while effects of food deprivation on nonspecific effector system of immune defense and local immune reactions were studied in experiment on R. Altman arthrosis model. It was proved that due to the above fasting the articular syndrome by clinical and laboratory criteria was much relieved. This positive effect is explained by modulating action of diet therapy on T- and B-immunity in combination with stimulation of activity of nonspecific effector system of immune defense. The dependence of the above changes on the treatment period are determined.

Potential of parenteral and enteral nutrition in inflammation and immune dysfunction: a new challenge for dietitians.

Advances in the understanding of the interrelationship between immunology and nutrition indicate that immune dysfunction in critically ill patients is linked with nutrient deficiency and abnormal acute-phase response to illness. Immune dysfunction requires special nutrition therapy and metabolic support; immunoregulation by nutrition manipulation may lead to specific immunotherapies for defined groups of patients. The success of dietary strategies must be measured not only by metabolic indexes but also by effects on immune function. The health profession must combat immune dysfunction and inflammation for the sick and frail patients under its care.