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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Immunology".

Deadline for manuscript submissions: 15 December 2024 | Viewed by 15005

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Prof. Dr. Noriyuki Inaki

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Guest Editor

Department of Gastrointestinal Surgery/Breast Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8641, Ishikawa, Japan
Interests: esophageal cancer; gastric cancer; minimally invasive surgery; laparoscopic surgery; postoperative complications; upper gastrointestinal surgery; nutrition

Dr. Ryota Matsui

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Co-Guest Editor

Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
Interests: gastric cancer; malnutrition; nutrition; postoperative complication; prognosis; sarcopenia; visceral fat

Special Issue Information

Dear Colleagues,

Nutrition guidelines have recommended that patients diagnosed with malnutrition be asked to determine whether their malnutrition is due to inflammation or not. The Global Leadership Initiative on malnutrition (GLIM) criteria, published in 2019, incorporate the presence of inflammation into the diagnosis of malnutrition. However, not many reports of malnutrition focus on inflammation.

It has been reported that the intensity of inflammation makes a difference in the effectiveness of nutritional therapy. In cancer patients, we should distinguish between acute inflammation, such as pneumonia, and chronic inflammation, such as cachexia. In addition, cut-off values for the intensity of inflammation have rarely been investigated.

Immunonutrition is an option for nutritional therapy in the presence of inflammation. Immunonutrition contains nutrients to optimize inflammation. However, this may lead to different outcomes in patients undergoing elective surgery as opposed to patients with sepsis. Therefore, further studies with defined patient backgrounds are needed.

This Special Issue on inflammation and nutritional therapy aims to clarify whether nutritional therapy for inflammation improves outcomes. We welcome studies focused on changing the daily clinical practice of the readers of this Special Issue.

Prof. Dr. Noriyuki Inaki
Dr. Ryota Matsui
Guest Editors

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Keywords

cachexia
immunonutrition
inflammation
nutritional therapy
sepsis
surgery

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Research

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19 pages, 1414 KiB

Open AccessArticle

Efficacy and Mechanism of Schisandra chinensis Fructus Water Extract in Alzheimer’s Disease: Insights from Network Pharmacology and Validation in an Amyloid-β Infused Animal Model

by Hye-Jeong Yang, Ting Zhang, Min-Jung Kim, Haeng-Jeon Hur, Xuangao Wu, Dai-Ja Jang and Sunmin Park

Nutrients 2024, 16(21), 3751; https://doi.org/10.3390/nu16213751 - 31 Oct 2024

Viewed by 667

Abstract

Background/Objectives: Schisandra chinensis Fructus (SCF) is a traditional medicinal herb containing lignans that improves glucose metabolism by mitigating insulin resistance. We aimed to investigate the therapeutic potential and action mechanism of SCF for Alzheimer’s disease (AD) using a network pharmacology analysis, followed by experimental validation in an AD rat model. Methods: The biological activities of SCF’s bioactive compounds were assessed through a network pharmacology analysis. An AD rat model was generated by infusing amyloid-β peptide (Aβ) (25–35) into the hippocampus to induce Aβ accumulation. The AD rats were fed either 0.5% dextrin (AD-Con) or 0.5% SCF (AD-SCF group) in a high-fat diet for seven weeks. The rats in the normal/control group received an Aβ (35–25) infusion (no Aβ deposition) and were fed a control diet (Normal-C). Aβ deposition, memory function, inflammation, and glucose/lipid metabolism were evaluated. Results: The network analysis revealed significant intersections between AD-related targets and bioactive SCF compounds, like gomisin A, schisandrin, and longikaurin A. Key AD genes prostaglandin-endoperoxide synthase-2 (PTGS2, cyclooxygenase-2) and acetylcholinesterase (AChE) were linked to SCF compounds. In the rats with AD induced by bilaterally infusing amyloid-β (25–35) into the hippocampus, the 0.5% SCF intake mitigated hippocampal amyloid-β deposition, neuroinflammation, memory deficits, and dysregulated glucose and lipid metabolism versus the AD controls. SCF reduced hippocampal AChE activity, inflammatory cytokine expression related to PTGS2, and malondialdehyde contents and preserved neuronal cell survival-related factors such as brain-derived neurotrophic factor and ciliary neurotrophic factor similar to normal rats. The neuroprotective effects validated the network analysis findings. Conclusions: SCF could be a potential AD therapeutic agent by activating the parasympathetic nervous system to reduce hippocampal oxidative stress and inflammation, warranting further clinical investigations of its efficacy. Full article

(This article belongs to the Special Issue Inflammation and Nutritional Therapy)

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18 pages, 5531 KiB

Open AccessArticle

Protective Effect of IgY Embedded in W/O/W Emulsion on LPS Enteritis-Induced Colonic Injury in Mice

by Zhaohui Wang, Ruihua Ye, Zijian Xu, Shidi Zhang, Chuanming Liu, Kongdi Zhu, Pengjie Wang and Jiaqiang Huang

Nutrients 2024, 16(19), 3361; https://doi.org/10.3390/nu16193361 - 3 Oct 2024

Viewed by 786

Abstract

Chicken yolk immunoglobulin (IgY), an immunologically active component, is used as an alternative to antibiotics for the treatment of enteritis. In this study, IgY was embedded in a W/O/W emulsion to overcome the digestive barrier and to investigate the protective effect of IgY against LPS-induced enteritis in mice. Four different hydrophilic emulsifiers (T80, PC, SC, and WPI) were selected to prepare separate W/O/W emulsions for encapsulating IgY. The results showed that the IgY-embedded double emulsion in the WPI group was the most effective. IgY embedded in the W/O/W emulsion could reduce the damage of LPS to the mouse intestine and prevent LPS-induced intestinal mucosal damage in mice. It increased the number of cup cells, promoted the expression of Muc2, and increased the mRNA expression levels of KLF3, TFF3, Itln1, and Ang4 (p < 0.05). It also enhanced the antioxidant capacity of the colon tissue, reduced the level of inflammatory factors in the colon tissue, and protected the integrity of the colon tissue. Stable embedding of IgY could be achieved using the W/O/W emulsion. In addition, the IgY-embedded W/O/W emulsion can be used as a dietary supplement to protect against LPS-induced enteritis in mice. Full article

(This article belongs to the Special Issue Inflammation and Nutritional Therapy)

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12 pages, 1656 KiB

Open AccessArticle

Correlation between the Quantity and Type of Dietary Fiber with the Activity in Mexican Patients with Ulcerative Colitis (UC)

by Sophia Eugenia Martínez-Vázquez, José Miguel Corral-Ceballos and Jesús K. Yamamoto-Furusho

Nutrients 2024, 16(18), 3198; https://doi.org/10.3390/nu16183198 - 21 Sep 2024

Viewed by 959

Abstract

Background/Objective: Ingestion of dietary fiber can influence in the remission of patients with ulcerative colitis (UC). There are no current recommendations for fiber intake in UC; therefore, we evaluate the association between dietary fiber and the activity of the disease. Methods: Ours is a cross-sectional study in patients with a confirmed diagnosis of UC to whom a 24 h recall was applied; this allowed for the estimation and classification of type of dietary fiber. The patients were divided into two groups: (1) remission and (2) active UC. We analyzed the quantity and type of fiber with the grades of disease activity through Spearman correlation and logistic regression. Results: A total of 152 patients were included; it was found that those with clinically active UC consumed less total fiber (p = 0.016) and insoluble fiber (p = 0.018). Meanwhile, in endoscopic grade, the difference was for insoluble fiber (p = 0.038). Insoluble fiber had an inversely significant correlation with fecal calprotectin levels (r = −0.204; p = 0.018). Logistic regression showed that less than 11 g of insoluble fiber was a risk factor for clinical activity (OR = 2.37; 95% CI 1.107–5.019; p = 0.026). Conclusions: Consumption below the current recommendation of total and insoluble dietary fiber is associated with clinical activity of UC. Full article

(This article belongs to the Special Issue Inflammation and Nutritional Therapy)

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11 pages, 780 KiB

Open AccessArticle

Influence of Body Composition Assessed by Computed Tomography on Mortality Risk in Young Women with Breast Cancer

by Agnes Denise de Lima Bezerra, Jarson Pedro da Costa Pereira, Ingryd Fernandes de Macedo Soares, Glaucia Mardrini Cassiano Ferreira, Ana Lúcia Miranda, Galtieri Otávio Cunha de Medeiros, Sara Maria Moreira Lima Verde and Ana Paula Trussardi Fayh

Nutrients 2024, 16(18), 3175; https://doi.org/10.3390/nu16183175 - 19 Sep 2024

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Abstract

Background/Objectives: Increasing evidence indicates that body composition can significantly influence prognosis in women with breast cancer. However, alterations in body composition, particularly among young women (<40 years), remain largely unknown and underexplored. This study aimed to investigate the relationship of computed tomography (CT)-derived body composition with mortality rates among young women recently diagnosed with breast cancer, identifying the best-correlated cutoff value. Methods: This is a bi-set cohort study with retrospective data collection. Women newly diagnosed with ductal invasive breast cancer, aged 20 to 40 years, treated in reference oncology units were included. Body composition was assessed using CT scans at the third lumbar vertebra (L3) level, including muscle and adipose compartments. The outcome of interest was the incidence of overall mortality. A maximally selected log-rank Cox-derived analysis was employed to assess the cutoffs associated with mortality. Results: A total of 192 women were included before any form of treatment (median age of 35 years, IQ range: 31–37). Overall mortality occurred in 12% of the females. Stages III–IV were the most frequent (69.5%). Patients who died had a significantly lower muscle area index. CT-derived muscle area was inversely associated with mortality. Each 1 cm²/m² decrease in skeletal muscle index increased the mortality hazard by 9%. Higher values of adiposity compartments were independently associated with higher mortality. Conclusions: Our study highlights the predictive significance of skeletal muscle area and adipose tissue in predicting survival among young women recently diagnosed with breast cancer. Full article

(This article belongs to the Special Issue Inflammation and Nutritional Therapy)

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12 pages, 762 KiB

Open AccessArticle

Impact of Omega-3 Fatty Acid Supplementation in Parenteral Nutrition on Inflammatory Markers and Clinical Outcomes in Critically Ill COVID-19 Patients: A Randomized Controlled Trial

by David Berlana, Raquel Albertos, Raquel Barquin, Alba Pau-Parra, Monica Díez-Poch, Rocío López-Martínez, Cristina Cea, Sergi Cantenys-Molina and Roser Ferrer-Costa

Nutrients 2024, 16(18), 3046; https://doi.org/10.3390/nu16183046 - 10 Sep 2024

Viewed by 2273

Abstract

The heightened inflammatory response observed in COVID-19 patients suggests that omega-3 fatty acids (O3FA) may confer anti-inflammatory benefits. This randomized, double-blind, single-center clinical trial aimed to evaluate the effect of O3FA supplementation in parenteral nutrition (PN) on inflammatory markers in COVID-19 patients admitted to the intensive care unit (ICU). A total of 69 patients were randomized into three groups: one received standard lipid emulsion, and two received O3FA (Omegaven^®) at doses of 0.1 g/kg/day and 0.2 g/kg/day, respectively, in addition to Smoflipid^®. The primary outcomes measured were serum levels of C-reactive protein (CRP) and interleukin-6 (IL-6) on days 1, 5, and 10 of PN initiation. Secondary outcomes included additional inflammatory markers (TNF-α, IFN-γ, IL-1Ra, CXCL10), hepatic function, triglyceride levels, and clinical outcomes such as mortality and length of ICU and hospital stay. Results indicated a significant reduction in CRP, IL-6, and CXCL10 levels in the group receiving 0.1 g/kg/day O3FA compared to the control. Additionally, the higher O3FA dose was associated with a shorter ICU and hospital stay. These findings suggest that O3FA supplementation in PN may reduce inflammation and improve clinical outcomes in critically ill COVID-19 patients. Full article

(This article belongs to the Special Issue Inflammation and Nutritional Therapy)

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13 pages, 298 KiB

Open AccessArticle

Usefulness of Perioperative Nutritional Therapy with the Glutamine/Arginine/Calcium β-Hydroxy-β-Methylbutyrate Product in Esophageal Cancer Surgery: A Single-Center Retrospective Study

by Koichi Okamoto, Hiroyuki Takamura, Taigo Nagayama, Yuta Sannomiya, Akifumi Hashimoto, Hisashi Nishiki, Daisuke Kaida, Takashi Miyata, Toshikatsu Tsuji, Hideto Fujita, Shinichi Kinami, Itasu Ninomiya and Noriyuki Inaki

Nutrients 2024, 16(13), 2126; https://doi.org/10.3390/nu16132126 - 3 Jul 2024

Viewed by 1533

Abstract

A useful perioperative nutritional therapy for highly invasive esophageal cancer surgical cases needs to be developed. We clarified the usefulness of amino-acid-enriched nutritional therapy using glutamine (Gln)/arginine (Arg)/calcium β-hydroxy-β-methylbutyrate (HMB) products on the short-term postoperative outcomes of minimally invasive esophagectomy for esophageal cancer. Altogether, 114 patients (Gln/Arg/HMB group) received perioperative nutritional therapy with Gln/Arg/HMB products, and we retrospectively investigated the change in nutritional parameters including skeletal muscle mass, occurrence of postoperative complications, and short-term postoperative outcomes in this group. The results were compared between the Gln/Arg/HMB and control groups (79 patients not receiving the Gln/Arg/HMB products). The incidence of all postoperative complications, sputum expectoration disorder, and pleural effusion of grade ≥ III was significantly lower in the Gln/Arg/HMB group (62.0% vs. 38.6%, p = 0.001; 44.3% vs. 28.1%, p = 0.020; 27.8% vs. 13.2%, p = 0.011, respectively). The psoas muscle area and postoperative body weight were significantly higher at 1 month and 1 year after surgery in the Gln/Arg/HMB group than in the control group (93.5% vs. 99.9%, p < 0.001; 92.0% vs. 95.4%, p = 0.006). Perioperative amino-acid-enriched nutritional therapy may improve the short-term postoperative outcomes, nutritional status, and skeletal muscle mass of esophageal cancer surgical patients. Full article

(This article belongs to the Special Issue Inflammation and Nutritional Therapy)

14 pages, 1706 KiB

Open AccessArticle

Nutritional Support Reduces Circulating Cytokines in Patients with Heart Failure

by Aura D. Herrera-Martínez, Concepción Muñoz Jiménez, Ana Navas Romo, José López Aguilera, Manuel Crespin Crespin, Bárbara Torrecillas Baena, Antonio Casado-Díaz, María Ángeles Gálvez Moreno, María José Molina Puerta and Aurora Jurado Roger

Nutrients 2024, 16(11), 1637; https://doi.org/10.3390/nu16111637 - 27 May 2024

Cited by 1 | Viewed by 1203

Abstract

Increased inflammation is associated with the pathogenesis of heart failure (HF). Increased circulating levels of cytokines have been previously reported and generally associated with worse clinical outcomes. In this context, the modulation of inflammation-related parameters seems to be a reasonable therapeutic option for improving the clinical course of the disease. Based on this, we aimed to compare changes in circulating cytokines when Mediterranean diet alone or in combination with hypercaloric, hyperproteic oral nutritional supplements (ONS), enriched with omega−3 (n−3) polyunsaturated fatty acids were administered to patients with HF. Briefly, patients were randomly assigned to receive Mediterranean Diet (control group) vs. Mediterranean Diet plus ONS (intervention group). We observed increased circulating levels of IL-6, IL-8, MCP-1 and IP-10. MCP-1 and IL-6 were associated with overweight and obesity (p = 0.01–0.01–0.04, respectively); IL-6 and IL-8 were positively correlated with fat mass and CRP serum levels (p = 0.02–0.04, respectively). Circulating levels of IL-8 significantly decreased in all patients treated with the Mediterranean diet, while IL-6 and IP-10 only significantly decreased in patients that received plus ONS. In the univariate analysis, MCP-1 and its combination with IL-6 were associated with increased mortality (p = 0.02), while the multivariate analysis confirmed that MCP-1 was an independent factor for mortality (OR 1.01, 95%ci 1.01–1.02). In conclusion, nutritional support using hypercaloric, hyperproteic, n-3 enriched ONS in combination with Mediterranean Diet was associated with decreased circulating levels of some cytokines and could represent an interesting step for improving heart functionality of patients with HF. Full article

(This article belongs to the Special Issue Inflammation and Nutritional Therapy)

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14 pages, 3644 KiB

Open AccessArticle

Mycobacterium avium paratuberculosis Infection Suppresses Vitamin D Activation and Cathelicidin Production in Macrophages through Modulation of the TLR2-Dependent p38/MAPK-CYP27B1-VDR-CAMP Axis

by Muna M. Talafha, Ahmad Qasem and Saleh A. Naser

Nutrients 2024, 16(9), 1358; https://doi.org/10.3390/nu16091358 - 30 Apr 2024

Viewed by 1467

Abstract

Background: Vitamin D plays a vital role in modulating both innate and adaptive immune systems. Therefore, vitamin D deficiency has been associated with higher levels of autoimmune response and increased susceptibility to infections. CYP27B1 encodes a member of the cytochrome P450 superfamily of enzymes. It is instrumental in the conversion of circulating vitamin D (calcifediol) to active vitamin D (calcitriol). This is a crucial step for macrophages to express Cathelicidin Anti-microbial Peptide (CAMP), an anti-bacterial factor released during the immune response. Our recent study indicated that a Crohn’s disease (CD)-associated pathogen known as Mycobacterium avium paratuberculosis (MAP) decreases vitamin D activation in macrophages, thereby impeding cathelicidin production and MAP infection clearance. The mechanism by which MAP infection exerts these effects on the vitamin D metabolic axis remains elusive. Methods: We used two cell culture models of THP-1 macrophages and Caco-2 monolayers to establish the effects of MAP infection on the vitamin D metabolic axis. We also tested the effects of Calcifediol, Calcitriol, and SB203580 treatments on the relative expression of the vitamin D metabolic genes, oxidative stress biomarkers, and inflammatory cytokines profile. Results: In this study, we found that MAP infection interferes with vitamin D activation inside THP-1 macrophages by reducing levels of CYP27B1 and vitamin D receptor (VDR) gene expression via interaction with the TLR2-dependent p38/MAPK pathway. MAP infection exerts its effects in a time-dependent manner, with the maximal inhibition observed at 24 h post-infection. We also demonstrated the necessity to have toll-like receptor 2 (TLR2) for MAP infection to influence CYP27B1 and CAMP expression, as TLR2 gene knockdown resulted in an average increase of 7.78 ± 0.88 and 13.90 ± 3.5 folds in their expression, respectively. MAP infection also clearly decreased the levels of p38 phosphorylation and showed dependency on the p38/MAPK pathway to influence the expression of CYP27B1, VDR, and CAMP which was evident by the average fold increase of 1.93 ± 0.28, 1.86 ± 0.27, and 6.34 ± 0.51 in their expression, respectively, following p38 antagonism. Finally, we showed that calcitriol treatment and p38/MAPK blockade reduce cellular oxidative stress and inflammatory markers in Caco-2 monolayers following macrophage-mediated MAP infection. Conclusions: This study characterized the primary mechanism by which MAP infection leads to diminished levels of active vitamin D and cathelicidin in CD patients, which may explain the exacerbated vitamin D deficiency state in these cases. Full article

(This article belongs to the Special Issue Inflammation and Nutritional Therapy)

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17 pages, 4319 KiB

Open AccessArticle

Ser9p-GSK3β Modulation Contributes to the Protective Effects of Vitamin C in Neuroinflammation

by Melania Ruggiero, Antonia Cianciulli, Rosa Calvello, Chiara Porro, Francesco De Nuccio, Marianna Kashyrina, Alessandro Miraglia, Dario Domenico Lofrumento and Maria Antonietta Panaro

Nutrients 2024, 16(8), 1121; https://doi.org/10.3390/nu16081121 - 10 Apr 2024

Cited by 1 | Viewed by 1760

Abstract

Background. The prolonged activation of microglia and excessive production of pro-inflammatory cytokines can lead to chronic neuroinflammation, which is an important pathological feature of Parkinson’s disease (PD). We have previously reported the protective effect of Vitamin C (Vit C) on a mouse model of PD. However, its effect on microglial functions in neuroinflammation remains to be clarified. Glycogen synthase kinase 3β (GSK3β) is a serine/threonine kinase having a role in driving inflammatory responses, making GSK3β inhibitors a promising target for anti-inflammatory research. Methods. In this study, we investigated the possible involvement of GSK3β in Vit C neuroprotective effects by using a well-known 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced animal model of PD and a cellular model of neuroinflammation, represented by Lipopolysaccharide (LPS)-activated BV-2 microglial cells. Results. We demonstrated the ability of Vit C to decrease the expression of different mediators involved in the inflammatory responses, such as TLR4, p-IKBα, and the phosphorylated forms of p38 and AKT. In addition, we demonstrated for the first time that Vit C promotes the GSK3β inhibition by stimulating its phosphorylation at Ser9. Conclusion. This study evidenced that Vit C exerts an anti-inflammatory function in microglia, promoting the upregulation of the M2 phenotype through the activation of the Wnt/β-catenin signaling pathway. Full article

(This article belongs to the Special Issue Inflammation and Nutritional Therapy)

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Open AccessReview

Measures for Identifying Malnutrition in Geriatric Rehabilitation: A Scoping Review

by Shinta Nishioka, Yoji Kokura, Ryo Momosaki and Yutaka Taketani

Nutrients 2024, 16(2), 223; https://doi.org/10.3390/nu16020223 - 10 Jan 2024

Cited by 1 | Viewed by 2803

Abstract

Malnutrition is a common condition in geriatric rehabilitation settings; however, the accuracy and predictive validity of the measures to identify malnutrition have not been established. The current scoping review followed the Joanna Briggs Institute’s evidence synthesis manual and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews checklist. Literature published through September 2023 was searched using MEDLINE and CINAHL. The inclusion criteria selected studies reporting malnutrition measures, which include static body weight and weight loss. Identified tools were classified as nutritional screening tools, nutritional assessment tools, or diagnostic criteria. The domains of each tool/criterion and their accuracy and predictive validity were extracted. Fifty-six articles fulfilled the inclusion criteria, and six nutritional screening tools, three nutritional assessment tools, and three diagnostic criteria for malnutrition were identified. These measures consisted of various phenotypes, e.g., weight loss, causes such as inflammation/disease, and risk factors of malnutrition, e.g., functional impairment. The predictive validity of nutritional screening tools (n = 6) and malnutrition diagnostic criteria (n = 5) were inconsistently reported, whereas those for nutritional assessment tools were scarce (n = 1). These findings highlight the need to distinguish the functional impairment of nutritional origin from that of non-nutritional origin in nutritional assessment procedures, and the need to study the accuracy and the predictive validity of these measures in geriatric rehabilitation patients. Full article

(This article belongs to the Special Issue Inflammation and Nutritional Therapy)

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