Nutritional Interventions to Improve Asthma-Related Outcomes through Immunomodulation: A Systematic Review

Area of Science:

• Immunology
• Nutrition Science
• Respiratory Medicine

Background:

• Asthma is a chronic airway inflammatory disease driven by T-helper 2 inflammation.
• Current recommendations include a diet rich in fruits/vegetables and healthy weight maintenance.
• The potential for other nutritional interventions to modulate immune responses in asthma remains underexplored.

Purpose of the Study:

• To systematically review studies examining nutritional interventions for asthma.
• To investigate the impact of these interventions on asthma-related outcomes and immunological parameters.
• To identify potential immunomodulatory mechanisms linking nutrition and asthma.

Main Methods:

• Systematic literature search identifying 808 studies, with 28 meeting inclusion criteria.
• Categorization of studies into six nutritional clusters: herbs, supplements, weight loss, vitamin D3, omega-3 fatty acids, and whole-food approaches.
• Analysis of studies reporting both asthma outcomes and immunological data.

Main Results:

• Fifteen studies reported improvements in either asthma outcomes or immunological parameters.
• Eight studies demonstrated simultaneous improvements in both asthma outcomes and immunological parameters.
• Herbs, herbal mixtures/extracts, and omega-3 long-chain polyunsaturated fatty acids (LCPUFAs) emerged as promising interventions, though clinical relevance was limited.

Conclusions:

• Certain nutritional interventions, particularly herbs and omega-3 LCPUFAs, show potential for improving asthma management.
• While some studies indicate positive effects on immune function and asthma symptoms, clinically significant results are limited.
• Future research should focus on optimizing nutritional strategies by considering asthma phenotypes and endotypes for personalized interventions.