Immunonutrition: A nutritional concept with potential immune module activity

Running head: IMMUNONUTRITION
IMMUNONUTRITION
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Introduction:
With the growing prevalence of chronic diseases, the research on immunonutrition has
gained increased attention. The immunonutrition is defined as the nutrition with potential
immune module activity. Prieto et al. (2017), suggested that the concept of nutrition is applied
for the situation such as vascular health, infection, cancer to modulate the immune system. Koch
and Radtke (2018), highlighted that in the immunology, glutamine, arginine, omega three fatty
acid, vitamins like B12, zinc are commonly used as immunonutrition to module the immune
system. This essay aims to focus on omega-three fatty acid as immunonutrition therapy for the
cancer patient. Omega-three fatty acid reduce the inflammatory response, modulate molecular
pathway which in turn increase the efficacy of chemotherapy. This essay will provide the
aetiology, pathogenesis and genetic mechanism of cancer, treatment option and the role of
immunonutritions in following paragraphs.
Discussion:
Mechanism of cancer:
Cancer is defined as a condition that exhibits abnormal cell growth with the possiblity to
spread throughout the body. Considering the clinical manifestations of cancer include a lump,
abnormal bleeding, cough, and sudden weight loss and altered bowel movement (Koundouros
and Poulogiannis 2019). The cancer statistics of the United Kingdom suggested that
approximately 363,000 new cases informed in the UK every year with approximately 990 every
day. Approximately 178,000 new cases in female were reported in 2016 where around
185,000 cancer cases in male were reported (Www.cancerresearchuk.org. 2020). Every two
minutes someone in the UK is diagnosed with cancer, highlighting an intense need for

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appropriate therapy. Considering the aetiology, tobacco, obesity, deprived diet, lack of physical
activity with a sedentary lifestyle, stress exposure to infection and radiation and environmental
pollutants.
Cancer is fundamentally a condition of tissue growth regulation and for normal cells to
transform into cancer, the genes must be altered. Koch and Radtke (2018), suggested that
oncogenes such as epidermal growth factor receptor, vascular endothelial growth factor receptor
as well as platelet-derived growth factor receptor tend to involve in cancer initiation and
progression when they mutated, especially dominant mutation. Tumour suppressor genes usually
inhibit the fast cell division through DNA and one such example is TP53 (Bykov et al. 2018) .
The abnormalities in this gene resulted in overexpression of oncogenes followed by cancer
progression.
T lymphocyte-mediated cellular immunity plays an essential role in an anti-tumour
immune response. The specific ration between T cell subsets such as CD3+, CD4+ and CD8 +
are responsible for the sensitive index for the cell immunity since CD3+ reflect cellular
immunity, CD4+ promote b cell differentiation and CD8+ represents cytotoxic T cells. Xia et al.
(2019), suggested that in cancer, T cell become dysfunctional due to continuous exposure of
antigen and dysfunctional T cells are regarded as decreased effector function, reduced
proliferative activity and overexpression of multiple inhibitory receptors (Li et al. 2017). The
researchers suggested that T cell dysfunctions usually associated with sustained expression of
multiple inhibitory receptors such as CTLA-4, Tim-3, and LAG-3 and due to constant
suboptimal stimulation ( anergic T cells), ( persistent stimulation) exhausted T cells and
repetitive stimulation senescent T cells (Lobo 2019). Hence, the patients exhibit a range of
clinical manifestations such as unusual, lump, change in the skin colour, swallowing depending

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on the type of cancer metastatic (Zakiryanova, Wheeler and Shurin 2018). In this case,
immunonutrition is a novel approach with chemotherapy to improve the immune system of
cancer patients.
Figure: exhaustion of T cells
Source: (Li et al. 2017).
Role of immunonutrition in cancer:
The critically ill patients such as cancer patients are at high risk of obtaining adverse
outcome compared to the patients who have undergone surgeries (Fazio et al. 2016). In this case,
immunonutrition is effective in modulating immune responses and facilitating the undergoing
therapy (Jones et al. 2017). One of the prominent instances is the efficacy of this nutrition in the
cancer patient who undergone gastrointestinal surgery (Lobo 2019). A range of researchers
suggested that potential targets exist for immunonutrition amongst patients include cellular
defence, local or systemic inflammation and mucosal barrier function. Prieto et al. (2017),
suggested that patients with cancer usually experience severe immune inflammation after
exposure to radiation treatment or chemotherapy which accompanied by a range of side effects.