Table 1.
Role of macro- and micro-nutrients over immunomodulation during TB.
| Nutrient deficiencies | Impact of the deficiency on immunomodulation | Reference |
|---|---|---|
| Macro-nutrients | ||
| Proteins | ||
| Total protein | ↓ CD4/CD8 ratio | (14–16) |
| ↓ Expression of CD 25 and CD 27 | ||
| ↓ Production of IL-2 and IFN-γ | ||
| Albumin | ↓ Associated with death due to TB | (17) |
| Lipids | ||
| n6PUFA | ↓ Actin filament assembly and phagosome maturation in vitro | (19) |
| n3PUFA | ↑ Actin filament assembly and phagosome maturation in vitro | (19) |
| n6 and n3 PUFA | Contrasting observation in animal model | (20) |
| Eicosanoids | Differentially regulated by Mycobacterium tuberculosis (M.tb) to avoid apoptosis | (21) |
| Sphingosine-1-phosphate (S1P) | M.tb dephosphorylate S1P and thereby prevents phagosome maturation | (22) |
| Micro-nutrients | ||
| Vitamins | ||
| Vitamin A | ↓ Cell-mediated responses and lympho-proliferative responses | (24, 25) |
| Vitamin B6 | ↓ Lymphocyte and natural killer cell activities | (26, 27) |
| Vitamin C | ↑Reactive oxygen species and tissue injury due to inflammation caused by M.tb | (28) |
| Vitamin E | ↑Oxidative stress and suppressed T-cell function | (29, 30) |
| Vitamin D | ↓ Macrophage differentiation and phagocytosis | (31–39) |
| ↓ Levels of cathelicidins, β-defensin, hepcidin antibacterial protein, and hCAP18 | ||
| ↑ Proinflamatory cytokines and ↓ anti-inflammatory cytokines | ||
| ↑ MMP 7, 9, and 10 | ||
| Metals | ||
| Copper and zinc | Decreased killing of mycobacteria in phagosomes | (45–48) |
| Iron and manganese | Overload of TB bacilli affects TB diseases progression and clinical outcome | (45–48) |
| NOS2 and TNFα pathways affected | ||
| Minerals | ||
| Ca2+ | Decreased phagocytosis | (49, 50) |
| Generation of reactive oxygen molecules | ||
| Phagosome lysosome fusion | ||