Lack of iron, zinc, and vitamins as a contributor to the etiology of atopic diseases

Abstract

Micronutritional deficiencies are common in atopic children suffering from atopic dermatitis, food allergy, rhinitis, and asthma. A lack of iron, in particular, may impact immune activation with prolonged deficiencies of iron, zinc, vitamin A, and vitamin D associated with a Th2 signature, maturation of macrophages and dendritic cells (DCs), and the generation of IgE antibodies. In contrast, the sufficiency of these micronutrients establishes immune resilience, promotion of regulatory cells, and tolerance induction. As micronutritional deficiencies mimic an infection, the body’s innate response is to limit access to these nutrients and also impede their dietary uptake. Here, we summarize our current understanding of the physiological function of iron, zinc, and vitamins A and D in relation to immune cells and the clinical consequences of deficiencies in these important nutrients, especially in the perinatal period. Improved dietary uptake of iron is achieved by vitamin C, vitamin A, and whey compounds, whereas zinc bioavailability improves through citrates and proteins. The addition of oil is essential for the dietary uptake of beta-carotene and vitamin D. As for vitamin D, the major source comes via sun exposure and only a small amount is consumed via diet, which should be factored into clinical nutritional studies. We summarize the prevalence of micronutritional deficiencies of iron, zinc, and vitamins in the pediatric population as well as nutritional intervention studies on atopic diseases with whole food, food components, and micronutrients. Dietary uptake via the lymphatic route seems promising and is associated with a lower atopy risk and symptom amelioration. This review provides useful information for clinical studies and concludes/emphasizes that a healthy, varied diet containing dairy products, fish, nuts, fruits, and vegetables as well as supplementing foods or supplementation with micronutrients as needed is essential to combat the atopic march.

Nutrition in chronic inflammatory conditions: Bypassing the mucosal block for micronutrients

“…The human body adapts by altering the transport and distribution of micronutrients by blocking their mobilization 45 and inhibiting absorption 46–48 by organs like the liver, spleen, and macrophages, 49–52 all as part of the acute phase response.…”

The Role of Diet and Nutrition in Allergic Diseases

“…CD4 + Th2 cells, B cells, mast cells, neutrophils, and macrophages are observed in the nasal lining infiltrate [47]. Many epidemiological and clinical studies supported the role of diet and nutrition in the etiology, prevention, and treatment of AR [6,46,[48][49][50][51].…”

“…Dietary factors not only affect the development of allergic diseases [5,6,46,50] but also influence disease course and severity [50,58]. Different dietary components are related to differential allergy outcomes.…”

The holo beta‐lactoglobulin lozenge reduces symptoms in cat allergy—Evaluation in an allergen exposure chamber and by titrated nasal allergen challenge

“…Despite all the above academic excitement, it is essential to focus on the group at risk, that is, i) atopic families with a strong desire to keep or acquire pets, and ii) individuals who have no cats at home but severe reactions when visiting cat households or having contact with a cat holder. It is well documented that atopic patients have micronutritional deficiencies in innate immune cells, 28 especially ferric iron (Fe 3+ ) complexed with siderophores, 29 vitamins, 30 and zinc 31,32 . These deficiencies especially drive regulatory cells into an inflammatory state, and negatively affect Th1 cell survival, all resulting in Th2 hypersensitivity.…”