Interactions of micronutrient deficiencies, infection, and inflammation

Authors: PALMER, AMANDA - Johns Hopkins School Of Public Health; BEDSAUL-FRYER, JACQUELYNE - Johns Hopkins School Of Public Health; Stephensen, Charles

Submitted to: Annual Review of Nutrition
Publication Type: Review Article
Publication Acceptance Date: 2/29/2024
Publication Date: N/A
Citation: N/A

Interpretive Summary: Approximately five million children die each year from preventable causes such as respiratory infections, diarrhea, and malaria. Roughly half of those deaths are attributable to undernutrition, including micronutrient deficiencies. The influence of childhood infectious diseases on micronutrient status has been well established: the inflammatory response to infection triggers anorexia, while pathogens or the immune response to them can both alter nutrient absorption and cause nutrient losses. This article reviews the roles of selected micronutrients in the immune system, particularly vitamin A, vitamin D, iron, zinc and selenium. It further summarizes evidence regarding the synergistic or antagonistic interactions between micronutrient deficiencies, the ability of pathogens to infect and survive in human hosts, and the related morbidity and mortality among children in low- and middle-income countries. The review concludes with a discussion of gaps in the literature and future directions for multi-disciplinary research on the interactions of micronutrients, infection, and inflammation.

Technical Abstract: Approximately five million children die each year from preventable causes such as respiratory infections, diarrhea, and malaria. Roughly half of those deaths are attributable to undernutrition, including micronutrient deficiencies (MNDs). The influence of infection on micronutrient status has been well established: the inflammatory response to pathogens triggers anorexia, while pathogens or the immune response to them can both alter nutrient absorption and cause nutrient losses. We review the roles of individual micronutrients in the immune system, acting in the regulation of molecular- or cellular-level responses, directly affecting pathogens, or protecting against oxidative stress or inflammation. We further summarize high-quality evidence regarding the synergistic or antagonistic interactions between MNDs, pathogens, and related morbidity or mortality among children in low- and middle-income countries. We conclude with a discussion of gaps in the literature and future directions for multi-disciplinary research on the interactions of MNDs, infection, and inflammation.