Objective: This narrative review gives an overview on the essential role of adequate nutrition
to an optimally functioning immune defence. Micronutrients act as regulators of the immune response,
with the focus of this review on the immunomodulatory effects of the trace elements iron, zinc
and selenium, and the vitamins A, D, E, C, B6 and B12 and folic acid.
Results: Iron deficiency especially impairs the Th1 cell-borne cellular immunity. T lymphocytes are
also most affected by a deficiency of zinc, needed for their maturation and the balance between the
different T cell subpopulations and acting as a redox signal in the regulation of many enzymes. Selenium
is also involved in redox reactions as the glutathione peroxidases and other redox enzymes are
selenoproteins. Selenium status has shown special effects on cellular immunity and resistance to viral
Vitamin A in the form of retinoic acid induces a humoral Th2 cell response via antigen-presenting cells
and is involved in maintaining intestinal immune defence and tolerance through its nuclear receptor
RAR and via kinase signalling cascades. Immune tolerance is particularly promoted by vitamin D acting
through dendritic cells to stimulate the differentiation of regulatory T cells. Vitamin E has antiinflammatory
effects and stimulates naïve T cells especially in the elderly. Besides its antioxidative
properties, vitamin C has effects on cell signalling and epigenetic regulation. The B vitamins are required
for cytotoxic cellular immunity and modulate T cell responses.
Conclusion: A diverse diet and regular exposure to sunlight are the best sources for a balanced nutrient
supply to maintain an optimal immune defence.