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Background: Autoimmune diseases (AIDs) are characterized by chronic inflammation and tissue damage resulting from abnormal immune responses. While genetic and environmental factors play significant roles in disease development, essential micronutrient deficiencies (MNDs) represent a critical and often overlooked contributor. Methods: This review examines the interactions between micronutrients and immune cells, focusing on vitamin D, vitamin B12, folate (FA), and iron, and their roles in AIDs, such as rheumatoid arthritis, autoimmune thyroid disorders, multiple sclerosis, systemic lupus erythematosus, and other connective tissue diseases. We explore the immunomodulatory effects of these micronutrients, their impact on immune tolerance, and the mechanisms by which MNDs contribute to disease progression. Results: MNDs are commonly observed in patients with AIDs and are associated with worsening immune dysregulation, increased inflammation, and disease severity. Vitamin D plays a pivotal role in modulating immune responses and attenuating inflammation, while iron and FA are essential for immune cell proliferation and function. Vitamin B12 supports methylation processes and genomic stability. Conclusions: MNDs significantly influence the pathogenesis and progression of AIDs. Routine micronutrient screening and targeted supplementation should be considered as part of clinical management, offering potential adjunctive benefits alongside conventional therapies. Further research is needed to define optimal dosing strategies and to identify patient subgroups most likely to benefit from nutrition-based interventions.

8 February 2026

Micronutrients, including trace elements (yellow boxes) and ultra-trace elements (blue boxes), along with other elemental moieties (green boxes), are involved in multiple crucial aspects of immunity, such as steady-state immune surveillance, acute-phase responses, and chronic maladaptive inflammation. Mucosal barrier stability depends on efficient repair and renewal responses, which, in turn, rely on the availability of nutrients, such as zinc or vitamin C. Trimming of mucosal permeability to exogenous moieties, including microorganisms, toxins, and nutrients, is crucial to prevent unsolicited inflammation and facilitated triggering of autoimmunity. In this setting, the expression of defensins and mediators of intercellular communication might be modulated by vitamin D and vitamin A, with the latter also affecting membrane fluidity. Variations in the microbiome also modulate the bioavailability of nutrients such as B12. Inflammation can affect the efficiency of absorption of some micronutrients, such as iron, hindering microbial proliferation but also impairing defensive functions, including the generation of oxidative stress by phagocytes and even regulatory anti- inflammatory responses. By affecting the properties of interface tissues, micronutrients are also involved in leukocyte extravasation (vitamin B6), along with skin (vitamin D) or gut (vitamin A) homing. Phagocytosis and the generation of reactive oxygen species (ROS) to perform the oxidative burst play a crucial role in pathogen and cell death debris neutralization and disposal. In this setting, buffering of ROS is also crucial to prevent tissue damage and uncontrolled inflammation. These functions depend on highly reactive elements such as iron or moieties with intrinsic bactericidal properties such as copper. Rarer elements such as selenium, chromium, arsenate, and maybe vanadium have been hypothesized to potentially substitute at least part of the iron/copper function. Iron has also been shown to participate in the shift between pro-inflammatory (M1) and anti-inflammatory (M2) macrophages. Dampening of M1 functions has also been attributed to vitamin E. Vitamin C can act upstream by reducing the rates of formation of neutrophil extracellular traps (NET), a major source of autoantigens along with necroptotic debris, potentially fueling autoimmunity. DNA plasticity and effective access to DNA are crucial for the expansion and maturation of immune cells. In this setting, Zn-dependent enzymes, along with Mg, are required for chromatin physiology. Folic acid and vitamin B6 are also crucial to ensure effective cell replication. Other micronutrients contribute to modulating T- and B-lymphocyte differentiation and function. Vitamin D has an important role in favoring T-regulatory responses and dampening antibody-mediated responses, while sodium overload or deprivation and downstream alterations in intracellular calcium promote conventional T-cell differentiation and pro-inflammatory responses. Zn and vitamin A affect T-helper cell polarization, with Zn inhibiting Th19/Th17 differentiation and vitamin A promoting both Th1- and Th2-biased responses. Magnesium concurs with efficient antibody–antigen interactions. In this and other functions, a potential backup role has been proposed for manganese.

Background/Objectives: This study examined the relationship between adherence to the Mediterranean diet (MD), dietary and vitamin intake, physical activity, and body composition in young adults. Methods: A total of 145 Spanish university students (34 women and 111 men) were included in this cross-sectional study, with a mean body mass index (BMI) of 23 kg/m2. MD adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS). Dietary intake was evaluated through a three-day food record, physical activity using the International Physical Activity Questionnaire (IPAQ), and body composition by bioelectrical impedance analysis. Results: Overall adherence to the MD was moderate. Participants with high MD adherence showed significantly lower body weight (p < 0.05; d = 0.4), BMI (p < 0.01; d = 0.52), fat mass (p < 0.05; d = 0.44), and fat mass percentage (p < 0.05; d = 0.38) compared with those with low adherence. Energy (p < 0.05; d = 0.41), protein (p < 0.05; d = 0.65), and carbohydrate (p < 0.05; d = 0.37) intake per kilogram of body weight were higher in the high-adherence group. Fiber intake was greater (p < 0.001; d = 0.82) among those with higher MD adherence. Adherence to the MD was also associated with higher intakes of vitamins C (p < 0.05; d = 0.39) and E (p < 0.05; d = 0.62), retinol equivalents (p < 0.05; d = 0.28), and carotenoids (p < 0.001; d = 0.79). MD adherence was inversely correlated with body weight (rs = −0.32; p < 0.01; r = 0.46) and BMI (rs = −0.34; p < 0.01; r = 0.32). Fiber intake showed positive correlations with several water-soluble vitamins, particularly folate (HAG: rs = 0.68; p < 0.001; r = 0.81 and LAG: rs = 0.61; p < 0.001; r = 0.69). Conclusions: In conclusion, higher adherence to the MD among university students was associated with healthier body composition and improved vitamin intake adequacy. These findings support the promotion of the MD as an effective nutritional strategy to enhance micronutrient intake and overall diet quality in young adults.

8 February 2026

Background/Objectives: Zinc is an essential trace element involved in multiple aspects of immune function, including epithelial barrier integrity, innate and adaptive immune responses, regulation of inflammation and oxidative stress. Zinc deficiency has been associated with increased susceptibility to infections, particularly in the pediatric population. This narrative review aims to summarize and discuss current evidence on the role of zinc in the prevention and management of pediatric respiratory infections. Methods: A comprehensive literature review was conducted including randomized controlled trials, real-world studies, and international guidelines published in recent years. Both zinc monotherapy and multicomponent dietary supplements containing zinc were considered. Results: Evidence consistently supports a preventive role of zinc supplementation in reducing the incidence and burden of respiratory infections, particularly in children with recurrent disease and in zinc-deficient populations. Zinc-containing multicomponent supplements demonstrated significant reductions in infection frequency and duration, alongside improved patient and parent-reported outcomes, with a favorable safety profile. In contrast, data on zinc as an adjunctive treatment during acute infections, especially severe pneumonia, are less consistent, with limited impact on major clinical outcomes. The effectiveness of zinc appears to be influenced by treatment duration, baseline nutritional status, and formulation. Conclusions: In conclusion, zinc may represent a valuable component of preventive immune-nutritional strategies for pediatric respiratory infections, especially when administered as part of multicomponent formulations and over prolonged periods. While its role in acute disease management remains uncertain, optimizing zinc status may contribute to reducing infection recurrence and overall disease burden. Further well-designed trials are warranted to clarify optimal dosing, timing, and target populations.

7 February 2026

Objective: To systematically evaluate the potential of Saussurea involucrata cultures (SICs) against high-altitude illness under hypobaric hypoxia and establish a progressive experimental evidence chain covering acute hypoxia tolerance enhancement and acute/chronic hypoxic injury protection. Methods: A tiered experimental strategy was employed. Key findings were derived from primary rat models of acute (5500 m, 8 h) and chronic intermittent (5500 m, 8 h/d, 4–8 weeks) hypobaric hypoxia. A mouse acute tolerance model (10,000 m lethality, closed-system endurance) provided supplementary verification. Comprehensive analyses included survival, hemorheology, multi-organ function, and core mechanistic indicators of endothelial function and oxidative stress. Diamox, Rhodiola, and Compound Danshen Dripping Pills served as positive controls. Normoxic/hypoxic blank groups served as negative controls. Results: SICs significantly enhanced acute hypoxia tolerance in mice. In the rat models, SICs demonstrated dose-dependent and selective regulation of the endothelial–oxidative stress/hemorheology axis. Specifically, it downregulated endothelin-1, upregulated nitric oxide, enhanced total antioxidant capacity, and improved chronic hypoxia-induced blood hyperviscosity. Medium doses showed consistent optimal efficacy. SICs had limited effects on macroscopic organ remodeling. Conclusions: The core protective effect of SICs lies in enhancing hypoxic tolerance and selectively modulating the interconnected pathways of endothelial function, oxidative stress, and microcirculatory health. This mechanistic profile supports its potential as a preventive or early adjuvant intervention for high-altitude illness, providing a systematic preclinical foundation for translational development.

7 February 2026

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Editors: Silvia V. Conde, Fatima O. Martins

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Nutrients - ISSN 2072-6643