Diet and Hygiene in Modulating Autoimmunity During the Pandemic Era

Abstract

The immune system is an efficiently toned machinery that discriminates between friends and foes for achieving both host defense and homeostasis. Deviation of immune recognition from foreign to self and/or long-lasting inflammatory responses results in the breakdown of tolerance. Meanwhile, educating the immune system and developing immunological memory are crucial for mounting defensive immune responses while protecting against autoimmunity. Still to elucidate is how diverse environmental factors could shape autoimmunity. The emergence of a world pandemic such as SARS-CoV-2 (COVID-19) not only threatens the more vulnerable individuals including those with autoimmune conditions but also promotes an unprecedented shift in people’s dietary approaches while urging for extraordinary hygiene measures that likely contribute to the development or exacerbation of autoimmunity. Thus, there is an urgent need to understand how environmental factors modulate systemic autoimmunity to better mitigate the incidence and or severity of COVID-19 among the more vulnerable populations. Here, we discuss the effects of diet (macronutrients and micronutrients) and hygiene (the use of disinfectants) on autoimmunity with a focus on systemic lupus erythematosus.

Megamonas funiformis, Plasma Zonulin, and Sodium Intake Affect C3 Complement Levels in Inactive Systemic Lupus Erythematosus

“…Dietary components, both micronutrients, and macronutrients, have been shown to affect various innate physical defenses, such as epithelial barrier integrity, antimicrobial peptides, pro/anti-inflammatory cytokines, and immune cell functionality [41][42][43]. In vitro studies have demonstrated that certain dietary components can impair human epithelial barrier function, leading to increased intestinal permeability across tight junctions.…”

Vitamin D Supplementation in Neonatal and Infant MIS-C Following COVID-19 Infection

“…The observed lack of a specific therapeutic strategy for this emerging disease fostered the research of effective add-on approaches to improve currently available drug treatments' effectiveness. To reach such objectives, many researchers have focused their attention on patients' nutritional needs, as there is growing evidence supporting the role of a balanced nutrition in supporting immune functions in both adults and children [47][48][49][50][51][52][53][54][55][56].…”

“…Furthermore, there is evidence supporting the role of nutrient intake (intended as directly derived from the diet or acquired through dietary supplements) in modulating both immune cells' maturation and response to inflammation by acting through epigenetic mechanisms and by affecting the host's intestinal and pulmonary microbiota composition [47,51,54,56,60]. A key role in this context is played by vitamins (i.e., vitamin A, vitamin C, and vitamin D) and oligoelements (i.e., zinc, selenium), which deficiency has been shown to affect, to a various extent, immune functions.…”

“…A key role in this context is played by vitamins (i.e., vitamin A, vitamin C, and vitamin D) and oligoelements (i.e., zinc, selenium), which deficiency has been shown to affect, to a various extent, immune functions. Moreover, also dietary supplements, such prebiotics and probiotics, are known to be important in supporting immune defenses, as they directly affect microbiota composition and functions [19,47,50,53,54,56,[59][60][61].…”

Cardiovascular health worsening in patients with autoimmune rheumatological diseases during the COVID-19 pandemic

“…There is evidence of the association between diet, both micro- and macronutrients, and immunity regulation and how disturbances in the nutritional status of people can lead to autoimmunity [ 45 ]. The COVID-19 pandemic had many, mainly, negative consequences on feeding and dietary habits and could have an important impact on health, including mental health.…”