Volume 34, Issue 1, March 2023

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Mediterr J Rheumatol 2023;34(1):30-6
Fly Me to the Immune: Immunonutrition in Rheumatic Diseases
Authors Information

1Immunonutrition Unit, Department of Rheumatology and Clinical immunology, General University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece

2Nutrition and Food Standards Unit, Directorate of Risk Assessment and Nutrition, Hellenic Food Authority, Athens, Greece

3Department of Nutrition and Dietetics, School of Health Sciences, Hellenic Mediterranean University, Crete, Greece


Immunonutrition is the maintenance and induction of immune homeostasis with the use of nutritional factors, the so called, immunonutrients. Immunonutrition focuses on four “Is” representing an equal number of systemic responses with regards to: a) Immunity, b) Infection, c) Inflammation and d) Injury. Although at the early stages of the development of immunonutrition, its application was focused on malnourished patients, with a latter extension in the intensive care unit setting, today we acknowledge the great importance of immunonutrients in rheumatology. In rheumatic diseases (RDs), all the “Is” representing the four aims and targets of immunonutrition are fulfilled. Impaired Immunity is the hallmark of RDs, with both innate and adaptive immunity contributing to the development and course of each disease entity, representing distinct immunoregulation abnormalities, often paired with micronutrient deficiencies. Infections are both drivers and a frequent epiphenomenon of systemic RDs. Subclinical inflammation is propagated long before the first signs or symptoms of RDs and musculoskeletal conditions (injury) are apparent in all patients with RDs, accompanied by pain, underlying connective tissue disease and the consequent reduction in the function of musculoskeletal. Herein, the role of probiotics, curcumin, vitamins, Selenium, Zinc and n-3 fatty acids as immunonutrients is discussed.

Cite this article as: Grammatikopoulou MG, Marakis G, Gkiouras K, Athanatou D, Maraki MI, Bogdanos DP. Fly Me to the Immune: Immunonutrition in Rheumatic Diseases. Mediterr J Rheumatol 2023;34(1):30-6.

Article Submitted: 10 Apr 2022; Article Accepted: 20 Apr 2022; Available Online: 21 Feb 2023



This work is licensed under a Creative Commons Attribution 4.0 International License.

©Grammatikopoulou MG, Marakis G, Gkiouras K, Athanatou D, Maraki MI, Bogdanos DP.