AUTOIMMUNITY&FOOD<br />Are we missing something? <br />PUMC2006 陈朗<br />
Autoimmune diseases: a brief introduction<br />Systemic<br />Lupus(SLE)<br />Sclerodermia<br />Vasculitis<br />Organ-speci...
Many autoimmune diseases are difficult or impossible to cure for the obvious reason that the focus of the immune response ...
Unclear mechenisms<br />
Epidemiology[2]<br />Diseases affecting young adults<br />Female &gt; male<br />Triggering and / or evolution often influe...
Epidemiology<br />Environmental factors(Food & nutrition)<br />Genetic factors<br />Psychological factors<br />……<br />
Evidences suggest that:<br />
Evidences suggest that:<br />
Evidences suggest that[18-23]:<br />Vitamin D and vitamin D receptor(VDR) deficiency resulted in accelerated IBD. <br />Vi...
Autoimmune diseases: a brief introduction<br />Systemic<br />Lupus(SLE)<br />Sclerodermia<br />Vasculitis<br />Organ-speci...
Why?<br />Common<br />Severity<br />most studied & resent achievement<br />Significance<br />The type of food is common!<b...
Food    autoimmune?!<br />Molecular mimicry<br />T cell regulation<br />Other possible mechanisms<br />
MS &vitamin D[1,12-17]<br />Nutrition<br />Exercise<br />Stress<br />Social <br />
vitamin D<br />
VDR<br />Gene regulator<br />Many tissues<br />Skin<br />Bone<br />Activated monocytesand B and T lymphocytes<br />Central...
Epidemiological conclusions <br />25(OH)D3 level : high in summer, low in winter<br />MS severity: spring<br />Latitude , ...
Experimental and immunological studies<br />Vitamin D<br />Protective<br />Curative<br />Immunomodulatory effect<br />Anti...
Immunomodulatory effectof vitamin D<br />VDR & gene transcription<br />Th1 development <br />Th2 and Treg restoration<br /...
Immunomodulatory  effectof vitamin D<br />In Th2cells<br />Number : unknown<br />IL-10:Production of IL-4<br />Overall<br ...
Prevention & treatment<br />Vitamin D has a preventive effect on MS<br />The treatment of vit D is currently under clinica...
Food containing vitamin D:for the normal majority<br />
Managing MS:are we forgetting something?<br />conventional medicines<br />only modestly effective<br />may have significan...
Unclear mechenisms<br />
Type 1 diabetes &cow’s milk[1,3-7]<br />Bad gene(s) +<br />Environmental factors <br />=Danger!<br />
Importance?<br />
Possible machenisms<br />Molecular mimicry<br />
Who are gonna be happy?<br />
References<br />T. COLIN CAMPBELL, PHD and THOMAS M. CAMPBELL II, “The China Study The Most Comprehensive Study of Nutriti...
References<br />Michael F Holick, ”Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, ...
References<br />Margherita T Cantorna, Yan Zhu, Monica Froicu, and AnjaWittke, ” Vitamin D status, 1,25-dihydroxyvitamin D...
Thank you very much!<br />PUMC2006<br />           陈朗<br />
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Autoimmunity&amp;Food

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Autoimmunity&amp;Food

  1. 1. AUTOIMMUNITY&FOOD<br />Are we missing something? <br />PUMC2006 陈朗<br />
  2. 2. Autoimmune diseases: a brief introduction<br />Systemic<br />Lupus(SLE)<br />Sclerodermia<br />Vasculitis<br />Organ-specific<br />Type 1 diabetes endocrine pancreas<br />Asthma lung<br />Rhumatoid arthritis joints<br />Myositis muscle<br />Thyroiditis (Graves, Hashimoto) thyroid<br />APECED endocrine glands<br />Multiple sclerosis nervous tissue<br />Anemia, thrombopenia, neutropenia blood cells<br />Psoriasis, eczema skin<br />Gastritis stomach<br />Colitis (Crohn, UC) colon<br />Uveitis eye<br />…..<br />
  3. 3. Many autoimmune diseases are difficult or impossible to cure for the obvious reason that the focus of the immune response – self antigens - cannot be eliminatedThe ultimate mechanism involve a failure of tolerance and the accumulation of irreversible damage in the target tissues<br />
  4. 4. Unclear mechenisms<br />
  5. 5. Epidemiology[2]<br />Diseases affecting young adults<br />Female &gt; male<br />Triggering and / or evolution often influenced by infectious diseases, pregnancy, traumatisms<br />Familial trends<br />North-South gradient<br />Higher prevalence in nordic countries[1,2]<br />
  6. 6. Epidemiology<br />Environmental factors(Food & nutrition)<br />Genetic factors<br />Psychological factors<br />……<br />
  7. 7. Evidences suggest that:<br />
  8. 8. Evidences suggest that:<br />
  9. 9.
  10. 10. Evidences suggest that[18-23]:<br />Vitamin D and vitamin D receptor(VDR) deficiency resulted in accelerated IBD. <br />Vitamin D decreases the risk of RA<br />And that of type 1 diabetes<br />Fat increases the risk of hemolytic anemia<br />Gluten(wheat) increases the risk of coeliac disease(CD) <br />Food restriction lowers the risk of SLE, and vitamin A can help treat it<br />……<br />
  11. 11. Autoimmune diseases: a brief introduction<br />Systemic<br />Lupus(SLE)<br />Sclerodermia<br />Vasculitis<br />Organ-specific<br />Type 1 diabetes endocrine pancreas<br />Asthma lung<br />Rhumatoid arthritis joints<br />Myositis muscle<br />Thyroiditis (Graves, Hashimoto) thyroid<br />APECED endocrine glands<br />Multiple sclerosis nervous tissue<br />Anemia, thrombopenia, neutropenia blood cells<br />Psoriasis, eczema skin<br />Gastritis stomach<br />Colitis (Crohn, UC) colon<br />Uveitis eye<br />…..<br />
  12. 12. Why?<br />Common<br />Severity<br />most studied & resent achievement<br />Significance<br />The type of food is common!<br />Good potential in prevention & treatment<br />
  13. 13. Food autoimmune?!<br />Molecular mimicry<br />T cell regulation<br />Other possible mechanisms<br />
  14. 14. MS &vitamin D[1,12-17]<br />Nutrition<br />Exercise<br />Stress<br />Social <br />
  15. 15. vitamin D<br />
  16. 16. VDR<br />Gene regulator<br />Many tissues<br />Skin<br />Bone<br />Activated monocytesand B and T lymphocytes<br />Central nervous system (CNS)<br />Muscles<br />Gonads<br />Intestine <br />Microglia<br />
  17. 17. Epidemiological conclusions <br />25(OH)D3 level : high in summer, low in winter<br />MS severity: spring<br />Latitude , past exposure to sun and the serum level of vitamin D influence the risk of MS<br />HypovitaminosisD?<br />
  18. 18.
  19. 19. Experimental and immunological studies<br />Vitamin D<br />Protective<br />Curative<br />Immunomodulatory effect<br />Anti-inflammatory effect<br />reducing macrophages<br />increasing TGF- β1 and IL-4<br />Induction of apoptosis<br />a protective effect on myelin by activating oligodendrocytes<br />
  20. 20. Immunomodulatory effectof vitamin D<br />VDR & gene transcription<br />Th1 development <br />Th2 and Treg restoration<br />Cytokines:<br />Th1:IFN-γ,IL-2,TNF-α<br />Th2:IL-4 & IL-5<br />Vitamin D In Th1 cells:<br />IL-12:Th1 number & function<br />JAK-STAT signaling pathway<br />
  21. 21.
  22. 22. Immunomodulatory effectof vitamin D<br />In Th2cells<br />Number : unknown<br />IL-10:Production of IL-4<br />Overall<br />Autoimmunity(EAE)<br />Reduction of severity<br />
  23. 23.
  24. 24. Prevention & treatment<br />Vitamin D has a preventive effect on MS<br />The treatment of vit D is currently under clinical trial phase 1, which has gained positive results<br />
  25. 25. Food containing vitamin D:for the normal majority<br />
  26. 26. Managing MS:are we forgetting something?<br />conventional medicines<br />only modestly effective<br />may have significant side-effects<br />Diet(low saturated fat, vitamin D)<br />stress management <br />Exercise<br />the best of medical management<br />
  27. 27. Unclear mechenisms<br />
  28. 28. Type 1 diabetes &cow’s milk[1,3-7]<br />Bad gene(s) +<br />Environmental factors <br />=Danger!<br />
  29. 29. Importance?<br />
  30. 30.
  31. 31. Possible machenisms<br />Molecular mimicry<br />
  32. 32. Who are gonna be happy?<br />
  33. 33. References<br />T. COLIN CAMPBELL, PHD and THOMAS M. CAMPBELL II, “The China Study The Most Comprehensive Study of Nutrition Ever Conducted”, BENBELLA BOOKS,2006<br />Arthur Rabson,”Really Essential Medical Immunology”,blackwell publishing,2005<br />Savilahti E, Akerblom HK, Tainio V-M, et al. &quot;Children with newly diagnosed insulin dependent diabetes mellitus have increased levels of cow&apos;s milk antibodies.&quot; Diabetes Res. 7 (1988): 137-140.Asdfasdf<br />Akerblom HK, Vaarala 0, Hyoty H, et al. &quot;Environmental factors in the etiology of Type 1 diabetes.&quot; Am. ]. Med. Genet. (Semin. Med. Genet.) 115 (2002): 18-29.<br />KostrabaJN, Cruickshanks KJ, Lawler-Heavner J, et al. &quot;Early exposure to cow&apos;s milk and solid foods in infancy; genetic predisposition, and risk of lODM.&quot; Diabetes 42 (1993): 288-295.<br />Gerstein He. &quot;Cow&apos;s milk exposure and Type 1 diabetes mellitus: a critical overview of the clinical literature.&quot; Diabetes Care 17 (1994): 13-19.<br />Virtanen SM, Laara E, Hypponen E, et al. &quot;Cow&apos;s milk consumption, HLA-DQB1 genotype,and Type 1 diabetes.&quot; Diabetes 49 (2000): 912-917.<br />Charles Pierrot-Deseilligny, ”Clinical implications of a possible role of vitamin D in multiple sclerosis”, J Neurol (2009) 256:1468–1479<br />
  34. 34. References<br />Michael F Holick, ”Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease”, Am J ClinNutr2004;80(suppl)<br />George A Jelinek,” Managing multiple sclerosis in primary care: are we forgetting something?”, Quality in Primary Care 2009;17:55–61<br />A. Payne. &quot;Nutrition and diet in the clinical management of multiple sclerosis”,2001 J Hum Nutr Dietet, 14, pp. 349±357<br />GladsonMuthian. &quot;1,25 Dihydroxyvitamin-D3 Modulates JAK–STAT pathway in IL-12/IFNc Axis Leading to Th1 Response in Experimental Allergic Encephalomyelitis.&quot; Journal of Neuroscience Research 83:1299–1309 (2006)<br />Frank Mattner1, Simona,“Inhibitionof Th1 development and treatment of chronic-relapsing experimental allergic encephalomyelitis by a non-hypercalcemic analogue of 1,25-dihydroxyvitamin D3.&quot; Eur. J. Immunol. 2000. 30: 498–508<br />MARGHERITA T. CANTORNA. &quot;Mounting Evidence for Vitamin D as an Environmental Factor Affecting Autoimmune Disease Prevalence”, Exp Biol Med 229:1136–1142, 2004<br />P. Szodoray. &quot;The Complex Role of Vitamin D in Autoimmune Diseases.&quot; 2008 Blackwell Publishing Ltd. Scandinavian Journal of Immunology 68, 261–269<br />Sarah A. Stechschulte, ” Vitamin D: Bone and Beyond, Rationale and Recommendations for Supplementation”, The American Journal of Medicine, Vol 122, No 9, September 2009<br />
  35. 35. References<br />Margherita T Cantorna, Yan Zhu, Monica Froicu, and AnjaWittke, ” Vitamin D status, 1,25-dihydroxyvitamin D3, and the immune system”, Am J ClinNutr 2004;80(suppl):1717S–20S<br />MASAHIKO ÃoeRAO, Food Restriction Inhibits an Autoimmune Disease Resembling Systemic Lupus Erythematosus in (NZB x NZW) Fl Mice”, J. Nutr. 125: 2316-2324, 1995.<br />Tom Patavino ,&quot; Natural Medicine and Nutritional Therapy as an Alternative Treatment in Systemic Lupus Erythematosus”, Alternative Medicine Review Volume 6, Number 5 2001<br />J. HOMSY, W. J. W. MORROW & J. A. LEVY. &quot; Nutrition and autoimmunity: a review.&quot; Clin. exp. Immunol. (1986), 65, 473-488<br />Abraham R Eliakim,“Nutritional status and nutritional therapy in inflammatory bowel diseases.&quot; World J Gastroenterol 2009 June 7; 15(21): 2570-2578<br />Gabriel Fernandes. &quot; Progress in nutritional immunology Immunol Res (2008) 40:244–261<br />GABRIEL FERNANDES. &quot; Influence of diet on vascular lesions in autoimmune-prone B/W mice”, Proc. Nati Acad. Sci. USA 80 (1983)<br />
  36. 36. Thank you very much!<br />PUMC2006<br /> 陈朗<br />

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