Domino effect of hypomagnesemia on the innate immunity of Crohn’s disease patients

Abstract

Digestive diseases play major role in development and complications of other disorders including diabetes. For example, Crohn's disease (CD) is an inflammatory bowel disease associated with Mycobacterium avium subspecies paratuberculosis. The inflammation is a complex process that involves the activity of both innate and adaptive immune responses. CD lesions are primarily due to T cell response, however; innate immune response has a significant role in initiating its pathogenesis. Toll-like receptors and NOD-like receptors promote the activity of nuclear factor (NF)-κB pathway for cytokines production. This results in the production of high levels of tumor necrosis factor-α, interleukin (IL)-1β and IL-6. Moreover, intestinal inflammation of CD is related to increased activity of NMDA receptors and the release of substance P. Imbalanced magnesium homeostasis in CD is a frequent finding in CD, Diabetes and others. The loss of such a major mineral affects many physiological processes in the body including its role as an immunomodulator. This review aims to (1) describe the significance of hypomagnesemia in the release of pro-inflammatory mediators in CD; (2) demonstrate effects of magnesium on pathways like NF-κB; (3) address the role of hypomagnesemia in the activity of CD; and (4) examine possible future research to establish a standard magnesium supplementation strategy; helping patients with CD or other disorders to maintain a sustained remission.

Low gut microbiota diversity and dietary magnesium intake are associated with the development of PPI‐induced hypomagnesemia

“…This is relevant because low microbial diversity is generally associated with poor health (28,29). Furthermore, low microbial diversity can cause defects in mucus formation and tight junction permeability, contributing to disturbances in ion reabsorption (30)(31)(32). Indeed, stimulating the gut microbiota with prebiotic inulin fibers (20 g/d) improved Mg 2+ absorption to the low-normomagnesemic range in 11 patients with PPI-induced hypomagnesemia (15).…”

The Influence of Nutrients on Inflammatory Bowel Diseases

“…After the introduction of magnesium supplementation, a reduction in inflammation was obtained by decreasing the effect of TNF-α [100]. Naser et al also indicate the possible role of hypomagnesaemia in the pathogenesis of IBD [101]. Taylor et al in their study aimed at assessing the intake of selected food components; they assessed that patients with IBD showed a lower intake of magnesium compared to a control group [102].…”

Magnesium: Biochemistry, Nutrition, Detection, and Social Impact of Diseases Linked to Its Deficiency

“…Chronic magnesium deficiency is indeed common in the elderly, usually due to a decrease both in diet assumption and intestinal absorption, and it is probably exacerbated by estrogen deficit, which occurs in aging women and men and cause hypermagnesuria [ 132 ]. In a very recent and comprehensive review [ 34 ], Lo Piano and colleagues highlight the risk and consequences of the reduce intake and absorption of magnesium by elderly people; People affected by gastrointestinal diseases with consequent general malabsorption, such as Crohn’s disease [ 117 , 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 ], inflammatory bowel diseases [ 135 , 138 , 140 , 141 ], and celiac disease [ 142 , 143 , 144 , 145 , 146 , 147 , 148 , 149 , 150 ]. In particular, besides the absorption inefficiency due to celiac disease, a gluten free-diet was found to be poor in fiber and micronutrients, such as magnesium [ 151 , 152 ].…”

“…In particular, besides the absorption inefficiency due to celiac disease, a gluten free-diet was found to be poor in fiber and micronutrients, such as magnesium [ 151 , 152 ]. Therefore, people suffering from celiac disease are a typical example of subjects particularly susceptible to magnesium deficiency as they are simultaneously exposed to two risk factors; People affected by type 2 diabetes, although it still remains unclear if magnesium deficiency represents a cause or a consequences of this pathology [ 3 , 21 , 135 , 153 , 154 , 155 , 156 ]; People who used to drink alcohol/alcoholics or are affected by long-term alcoholism [ 3 , 157 , 158 , 159 , 160 ] and are therefore affected by intestinal malabsorption. Spirits (such as brandy, cognac, gin, rum, vodka, and whisky) do not contain significant traces of magnesium.…”