Genotypic Influences on Metabolic Alterations during Inflammation and the Nutritional Outcome

摘要

Inflammation is part of the immune response, whose function is to combat pathogens and restore health following injury and surgery. Inflammation also occurs in a less helpful role during cancer, exposure to environmental pollutants, radiation, and allergens, and during chronic inflammatory disease. This latter group of inflammatory conditions includes diseases such as rheumatoid arthritis, Crohn's disease, asthma and psoriasis. During the inflammatory response metabolites are released from endogenous sources to supply the immune system with substrate to support its activity. Key features of the inflammatory response are: (i) immunonutrition from endogenous sources; (ii) loss of lean tissue components; (iii) creation of a hostile environment for pathogens, and (iv) ultimate inhibition of the process by endogenous systems (Fig. 1). The strength and duration of the response are modulated by pro-inflammatory and anti-inflammatory cytokine production, from the immune system. Interleukin-l(IL-l) and tumor necrosis factor-alpha (TNF-alpha) fall into this first category and interleukin-10 (IL-10) into the second. In addition to pro- and anti-inflammatory cytokines, a wide range of immunomodulatory cytokines (e.g. IL-2, IL-4) are produced.