PRESENTATION OF THE EXPERT GROUP

Transcription

1 Workshop Monitoring immune modulation by nutrition in the general population PRESENTATION OF THE EXPERT GROUP Prof. Dr. Ulrich Sack Chair of the Expert Group 1

2 Expert Group Experts Prof. Ulrich Sack - Chair - Universität Leipzig DE Dr. Phoukham Phothirath - Co-chair- Nestlé CH Dr. Ruud Albers NutriLeads NL Dr. Raphaëlle Bourdet-Sicard Danone FR Prof. Philip Calder University of Southampton UK Dr. Udo Herz Mead Johnson Nutrition NL Prof. Claude Lambert CHU Saint-Etienne FR Dr. Irene Lenoir-Wijnkoop IDF ILSI Liaison Officer FR Prof. Jean-François Nicolas CHU Lyon-Sud FR Dr. Arthur Ouwehand DuPont Nutrition and Health FI Dr. Tomoyuki Sako Yakult Europe NL Prof. Seppo Salminen University of Turku FI Dr. André Siemensma Royal FrieslandCampina NL Prof. Henk van Loveren National Institute of Public Health and the Environment RIVM Ms. Agnès Méheust ILSI Europe BE Dr. Lena Jönsson/ Ms. Marie Latulippe ILSI Europe BE NL 2

3 Expert Group..from companies Prof. Ulrich Sack - Chair - Universität Leipzig DE Dr. Phoukham Phothirath - Co-chair- Nestlé CH Dr. Ruud Albers NutriLeads NL Dr. Raphaëlle Bourdet-Sicard Danone FR Prof. Philip Calder University of Southampton UK Dr. Udo Herz Mead Johnson Nutrition NL Prof. Claude Lambert CHU Saint-Etienne FR Dr. Irene Lenoir-Wijnkoop IDF ILSI Liaison Officer FR Prof. Jean-François Nicolas CHU Lyon-Sud FR Dr. Arthur Ouwehand DuPont Nutrition and Health FI Dr. Tomoyuki Sako Yakult Europe NL Prof. Seppo Salminen University of Turku FI Dr. André Siemensma Royal FrieslandCampina NL Prof. Henk van Loveren National Institute of Public Health and the Environment RIVM Ms. Agnès Méheust ILSI Europe BE Dr. Lena Jönsson/ Ms. Marie Latulippe ILSI Europe BE NL 3

4 Expert Group Prof. Ulrich Sack - Chair - Universität Leipzig DE Dr. Phoukham Phothirath - Co-chair- Nestlé CH Dr. Ruud Albers NutriLeads NL Dr. Raphaëlle Bourdet-Sicard Danone FR Prof. Philip Calder University of Southampton UK Dr. Udo Herz Mead Johnson Nutrition NL Prof. Claude Lambert CHU Saint-Etienne FR Dr. Irene Lenoir-Wijnkoop IDF ILSI Liaison Officer FR Prof. Jean-François Nicolas CHU Lyon-Sud FR Dr. Arthur Ouwehand DuPont Nutrition and Health FI Dr. Tomoyuki Sako Yakult Europe NL Prof. Seppo Salminen University of Turku FI Dr. André Siemensma Royal FrieslandCampina NL Prof. Henk van Loveren and from public institutions. National Institute of Public Health and the Environment RIVM Ms. Agnès Méheust ILSI Europe BE Dr. Lena Jönsson/ Ms. Marie Latulippe ILSI Europe BE NL 4

5 History of the Expert Group on Immune Modulation Started with a very broad work programme (minutes PR/85/OC09) 1. Find some data (by literature review) concerning all food (botanicals, micronutrients, etc ) having an impact/effect on the immune system All vitamins listed in the Annex I of the DIRECTIVE 2002/46/EC (at least one short term and one with long term action like lipid soluble vitamins) All minerals and Zinc in the Annex I of the DIRECTIVE 2002/46/EC Amino acids (also to include the clinical nutrition in this work) Already a lot of literature existing on these ingredients The work would be a copy of existing conclusion. 5

6 History of the Expert Group on Immune Modulation Started with a very broad work programme (minutes PR/85/OC09) 1. Find some data (by literature review) concerning all food (botanicals, micronutrients, etc ) having an impact/effect on the immune system Gram+ cell wall and envelop Echoic acids Lipopolysaccharides (LPS) Long chain fatty acids (n-3, n-6) Update on state of the art - not so much is known on the safety of these ingredients. 6

7 History of the Expert Group on Immune Modulation Started with a very broad work programme (minutes PR/85/OC09) 1. Find some data (by literature review) concerning all food (botanicals, micronutrients, etc ) having an impact/effect on the immune system Bacteria Fibres For this category, very little is known about their immune safety: the Expert Group would have to write everything following a literature review. 7

8 2. For each of these ingredients, what is the action reported on the immune system and how was it assessed: restoring it (from a suboptimal immune function after malnutrition, or weakening conditions) stimulating it (from an average immune function for healthy people) suppressing it? To be discussed with the scenarios : Is there a threshold between restoring/stimulating? How should we handle changes within normal ranges? Does normal mean healthy for the individuum? Careful: we do not speak about a level of nutrient intake but we look at the efficacy/the immune safety of commonly accepted servings. We exclude food allergy that can be induced by an ingredient A but we still look at the effect an ingredient B can have on the food allergy induced by ingredient A. 8

9 3. Determine the different clusters of population to be considered: people with immune system in development: 0-6 months, 6 months to 3 years, 3-12 years, years healthy adults (18-? years) Elderly (>50? years) people with diseases (multimorbidity of the aged) people at risk (look at specific risk factors) Low birth weight children Breast feeding mothers Sleep deprivation, stress, job loss Comorbidity 9

10 3. Example: age dependency of NK cells Sack et al., Transfus Med Hemother 2007;34:

11 4. What are the efficacy and potentially deleterious effects of these ingredients on the immune system? Examples found in humans? How can such effects be observed/investigated? Explanations for described effects? Consequences of unintended use? 11

12 5. What is the impact: clinical, biological, other? Technical efficacy 6 levels to evaluate diagnostic tests Diagnostic validity Influence on differential diagnosis Influence on therapy Patients benefit Social consequences Fryback & Thornbury Med Decis Making 1991; 11:

13 Aim of the Expert Group (1/2) Finally: scope was narrowed down: Not looking at the ingredients effects anymore Not giving detailed reference ranges but indicating key references and laboratory examples But: Focus on what are the adequate markers Try to cluster the markers according to the functional domains proposed by EFSA in their Guidance on scientific requirements related to gut and immune function (Apr 2011) Find a rationale to rank/prioritize/evaluate the markers Find a rationale to interpret the change of this marker after a dietary intervention/by nutrition 13

14 Aim of the Expert Group (2/2) Draft has been prepared by the working group; to be presented by Ruud Albers During this meeting, we intend to Check it for content and scope Add specific information Evaluate the markers for use in nutritional studies Find a rationale to interpret the change of this marker Thank you for participating and have an interesting workshop. 14