Review
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World J Diabetes. Aug 15, 2014; 5(4): 527-535
Published online Aug 15, 2014. doi: 10.4239/wjd.v5.i4.527
Domino effect of hypomagnesemia on the innate immunity of Crohn’s disease patients
Saleh A Naser, Almatmed Abdelsalam, Saisathya Thanigachalam, Abed S Naser, Karel Alcedo
Saleh A Naser, Almatmed Abdelsalam, Saisathya Thanigachalam, Abed S Naser, Karel Alcedo, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32816, United States
Author contributions: All authors contributed equally to the preparation and revision of the manuscript.
Correspondence to: Saleh A Naser, PhD, Professor, Graduate Coordinator, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Building 20, BMS 136, 4110 Libra Drive, Orlando, FL 32816, United States. saleh.naser@ucf.edu
Telephone: +1-407-8230955 Fax: +1-407-8230956
Received: May 15, 2014
Revised: May 28, 2014
Accepted: May 29, 2014
Published online: August 15, 2014
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.

Keywords: Diabetes, Crohn’s disease, Hypomagnesemia, Inflammatory bowel disease, Mycobacterium paratuberculosis

Core tip: Magnesium is an essential trace mineral, which plays key role as an immunomodulator in many pathways leading to homeostasis. Hypomagnesemia is common in patients with Crohn’s disease (CD) and may be the cause of upregulation of pro-inflammatory factors leading to aggravating symptoms. Therefore, understanding the role of magnesium in maintaining a healthy immune response is important for effective treatment of patients with CD.