Nutrition is seen as vital in helping to manage both acute and chronic diseases via the body’s response to pathogenic organisms. In the case of TB, macro- and micro-nutrients and vitamins can boost immune responses to the intracellular pathogens mycobacterium tuberculosis (M.tb) by modulating the immune system.
This aids in controlling infection, inflammation, and any nutritional deficiency, including malnutrition that may result in immunodeficiency syndrome, which makes one more vulnerable to infection leading to disease.
As such, researchers from India’s National Institute for Research in Tuberculosis set out to assess how nutritional deficiency influences impaired cell mediated and humoral immune responses, which weakens the body’s ability to fight TB.
They also sought to determine if nutritional food or supplementation could help to improve immune response to TB in malnourished patients.
The narrative review said malnutrition compromised two mechanisms by which the body fights infection: phagocytosis and complement cascade.
The former is able to “mediate capture of pathogens”, while the latter can destroy microorganisms
The researchers stated that “micronutrient deficiency leads to altered immune-homeostasis, which greatly increases an individual’s susceptibility to infections or progression of infection to disease”.
They added that the most prevalent cause of immunodeficiency was malnutrition, with both macro- and micro-nutrient deficiency compromising the immune system, thereby increasing the risk of TB.
The researchers noted that “supplementation of micro- / macro-nutrients to TB patients not only improves the body weight and BMI but also has an effect on T-cell function, sputum conversion, relapse, physical activity, and mortality”.
In addition, studies have shown that nutrient supplementation can increase the bioavailability of anti-TB drugs, thereby improving treatment outcome.
However, they said previous studies and trials of nutritional or food supplementation among TB patients had shown “varied results in various settings”, and that “there is no documented evidence that any specific food on its own or a specific quantity can alter the course of TB disease or can, for that matter, be effective in the treatment of malnutrition”.
They concluded: “There is experimental evidence that some nutrients may be helpful, but further clinical studies and randomised clinical trials will be needed for them to be recommended, and to better understand the link between malnutrition, TB and impaired immunity.”
Source: Frontiers in Immunology
“Malnutrition: Modulator of Immune Responses in Tuberculosis”
Authors: Padmapriyadarsini Chandrasekaran, et al.