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THE IMMUNE SYSTEM – THE MASTER DEFENDER
The immune system is a complex system of defence that
includes cells, proteins, enzymes, tissues and organs.
Its role is to protect our bodies from harmful substances
that abound in the environment in which we live. These
substances are recognised by the body as foreign or
“non-self” and may disrupt homeostasis by causing
infection or disease.
Our immune system protects us from such challenges
through a number of defensive systems designed to
recognise, destroy and eliminate harmful substances,
heal the damage caused and then protect us from future
infection. These harmful substances can include microbes
such as bacteria, viruses, fungi and parasites. They can
also include toxic substances from the environment and
endogenously generated tissue or cell changes like cancer.1
The environment can also present situations whereby we
can fall victim to accident or physical injury.
In these cases, the immune system also has a role to
play in transporting nutrients to the injury/wound site
for cleaning, preventing infection and healing.
Very often, the substances that trigger an “immune
response” are known as antigens. Antigens are
compounds that can be classified as proteins, peptides,
polysaccharides, lipids or nucleic acids. Antigens can be
attached to pathogens, toxins, allergens, foods, drugs,
vaccines and transplanted tissues.6
IMMUNE SYSTEM ANATOMY AND PHYSIOLOGY 101
Cells of the Immune System
All cells in the blood including the platelets, red blood
cells and white blood cells of the immune system develop
from progenitor cells in the bone marrow known as
pluripotent hematopoietic stem cells.3 This process is
known as haematopoiesis. Two types of progenitor cells
develop from stem cells: common lymphoid progenitor
cells and common myeloid progenitor cells.9

Diagram 1: Haematopoiesis – Blood Cell Genesis.

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White blood cells are divided into three main types:
granulocytes, monocytes and lymphocytes. Lymphocytes
originate from differentiation of the lymphoid progenitor
cells whilst the myeloid progenitor cells differentiate into
granulocytes and monocytes.9
Granulocytes are immune cells that contain granules
(tiny particles). These granules contain enzymes
and other compounds that are released during infections
or allergies. The granulocytic cells are neutrophils,
mast cells, eosinophils and basophils (lymphocytes
and monocytes are agranular, i.e., they do not contain
granules). Granulocytes activate the inflammatory
response by a process called “degranulation” whereby
they release their granules into the extracellular matrix.6
Lymphoid progenitor cells develop into immune
cells that make up the “adaptive” and mostly antigen
driven immune system which are known as T- &
B-cells. The T-cells differentiate in the thymus (T),
the B-cells differentiate in the bone marrow (B).
Mature T- & B-cells circulate in the blood stream and
the peripheral lymphatic system. Further differentiation
of the B-cells to plasma cells occurs when they encounter
an antigen. T-cells will further differentiate into different
types of effector T-cells which have various functions.
T- & B-cells are involved in the adaptive immune
response and are marked by their antigen specificity
and ability to recognise an invading pathogen from
previous infections.3
Lymphoid progenitor cells are also the precursor cells
for Natural Killer (NK) cells. These cells display traits
that put them into both the innate and adaptive immune
system, although they are generally classified as cells
of the innate immune system as they do not have the
ability to respond in an antigen specific way which is
the hallmark of the adaptive immune response.3
Myeloid progenitor cells develop into myeloblasts which
go on to develop into leukocytes/granulocytes (white
blood cells), mast cells, megakaryocytes which develop
into platelets, or erythroblasts which ultimately become
red blood cells.3
Immune cells that derive from myeloid progenitor
cells include monocytes, dendritic cells, basophils,
eosinophils and neutrophils. These cells circulate in
the blood and only become active if they are recruited
to sites of infection, inflammation or allergy.3
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IMMUNE SYSTEM CLASSIFICATION
The immune system has two divisions: the innate/natural/
non-specific immune system and the adaptive/acquired/
specific immune system.1,2
The Innate Immune System
The innate/natural immune system is considered our
primary and general (non-specific) system of defence and
contains physical, chemical, and genetic features that are
present at birth. It provides the initial immune defence
responses to and offers protection against injurious
pathogens or chemicals, foreign bodies, and injuries via
the utilisation of:
1. Physical features such as the skin, epithelial linings and
mucous membranes of the Gastrointestinal tract (GIT),
and the respiratory and genitourinary systems which
provide barrier protection, and1-3
2. Cellular and protein defence mechanisms that create
an initial inflammatory response. These include mast
cells, neutrophils, macrophages, dendritic cells, and
natural killer cells.1-3
Innate/natural immunity is not generally triggered by
an antigen and therefore doesn’t trigger an “immune
response”.
Inflammation
Inflammation is a series of events involving biochemical
and cellular processes in vascular tissues. It occurs in
response to several challenges including pathogens, cell
damage and exposure to toxic compounds. The overall
function of inflammation is to move plasma and blood
(and therefore nutrients and inflammatory mediators) to
the injured tissues to promote healing and tissue repair.6,12
As inflammatory processes occur within seconds of an
injury or breach of our first line defensive systems, occurs
in the same way each time it is triggered and does not
involve an “immune response” triggered by an antigen,
inflammation is generally considered to be non-specific
and therefore a part of our innate system of defence.6
Inflammation is marked by five physical and visual
indicators: redness (rubor), swelling (tumour), heat
(calor), pain (dolor) and loss of function (function laesa).
Non-visual processes include vasodilation, increases in
vascular permeability creating an exudate of plasma, and
the accumulation of white blood cells at the injury site.
Several phases of the inflammatory response occur, each
involving different cellular and biochemical mediators.
All processes aim to destroy and remove injurious
substances from the site of inflammation, isolate and
confine the injurious substances to limit the damage they
may cause, trigger, and enhance the immune response
and finally promote tissue healing.6,12
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The inflammatory response occurs via three classical
pathways: NF-κB, JAK-STAT, MAPK. All pathways
are stimulated by the release of cytokines which are
themselves released in response to tissue injury. The initial
release of cytokines stimulates the subsequent cascaded
release of more cytokines, proteins, enzymes, and cells that
influence and regulate the progression of the response.13
As mentioned above, the inflammatory process is a co-
ordinated series of events that employs several cells and
biochemical mediators at different stages to manage
the inflammatory process and interact with the immune
response. It occurs in four phases: 13
1. Cell surface pattern receptors recognise
injurious agents.
2. Inflammatory pathways activated.
3. Pro-inflammatory substances are released.
4. Inflammatory cells recruited.
After inflammatory cells have been recruited, processes
known as opsonization, and phagocytosis can occur.
Opsonization is a process whereby a pathogen is
“prepared” for destruction (phagocytosis). During
opsonization, foreign pathogens are “tagged” so that they
can be easily identified by phagocytic cells/phagocytes.
This process will use “opsonins” as tags (antibodies (IgG),
complement factors, fibronectin etc) and works to prevent
repulsion between the negatively charged cell walls of a
pathogen and a host immune cell and allow binding with
specific receptors. This allows phagocytes to identify
and take up pathogens, kill them, and prevent them from
replicating and spreading. Phagocytosis, therefore, is the
process by which phagocytes (neutrophils, monocytes,
macrophages, dendritic cells, eosinophils, and osteoclasts)
can ingest and eliminate pathogens and abnormal or
senescent cells.16-18 It firstly involves the recognition of
opsonized/tagged microbial pathogens or senescent cells,
binding of the opsonized compounds to a phagocyte
and its subsequent ingestion into a plasma membrane
derived vesicle known as a phagosome.17,18 From here,
the phagosome shuttles the pathogen or cellular
fragment through the cytoplasm where it fuses with
other cellular components to become a phagolysosome.
The phagolysosome then becomes acidified and is
enzymatically degraded.18
Phagocytosis occurs when the identified particles are
larger than 0.5µm and takes care of billions of cells each
day. It is therefore not only an important mechanism for
immune defence, but also vital for tissue homoeostasis.17
Table 1. provides a summary of all cells and substances
that are involved in inflammatory and immune responses,
their source, and their role in immunity.

Diagram 2: The Process of Phagocytosis

Microbe or
other particle
Chemotaxis and adherence
Plasma 1
of microbe to phagocyte
membrane
1
Ingestion of microbe
2
by phagocyte
Pseudopods
3 Formation of a phagosome
2
4 Fusion of the phagosome
with a lysosome to form
Phagosome a phagolysosome
3 (phagocytic
Cytoplasm vesicle) Digestion of ingested
5
Lyosome microbe by enzymes
Phagolysosomes
Formation of residual
4 6
Digestive body containing
enzymes indigestible material
H+
5 Residual
Discharge of waste
Partially body 7
digested materials
microbe
Phagocyte
Indigestible 7
material 6

Legend: Immunoglobulin G Other opsonins Fcγ receptor Enzyme pool

Complement protein Actin Complement receptor

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Table 1: Cells and Other Compounds that Mediate Innate Immunity and Inflammation.5,6,9,12,14,15,16,17
Substance Description
Neutrophils • From the myeloid progenitor line and active
in innate immunity.
• Classified as granulocytes.
• Phagocytic leukocytes. Dead neutrophils are
removed from the site as a white exudate
commonly known as “pus”.
• Most common leukocyte found in the blood.
• Lifespan of minutes to days.
Monocytes, • From the myeloid progenitor line and active
Macrophages & in innate immunity.
Dendritic Cells • The largest of all blood cells.
• Phagocytic leukocytes that perform the
same functions as neutrophils but for a
longer period.
• Monocytes differentiate into macrophages
which are more aggressive phagocytes.
• Monocytes can also differentiate into
dendritic cells.
• Macrophages are often recruited/activated
by lymphokines secreted by T-cells.
Lymphokines increase the phagocytic
activity of macrophages, increasing their
size, plasma membrane area, and capacity
for glucose metabolism.
Eosinophils • From the myeloid progenitor line and active
in innate immunity.
• Granulocytes that contain:
1. Biochemicals that manage the vascular
effects of serotonin and histamine.
2. A caustic substance that can dissolve the
surface tissues of parasites.
• Have a lifespan of minutes to days.
Basophils • From the myeloid progenitor line and active
in innate immunity.
• Classified as granulocytes.
• Least common leukocyte found in the blood.
Platelets/ • From the myeloid progenitor line and active • Control bleeding if vascular injury has occurred
Thrombocytes in innate immunity.
• Fragments of megakaryocytes in bone
marrow that shed into the blood. Platelets
contain compounds known as alpha-granules
which carry proteins and inflammatory
factors such as chemokines and neutrophil
activating proteins.
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Function
• The first cells to arrive on scene.
• Ingest bacteria, dead cells, and cellular debris
(phagocytosis).
• Program antigen presenting cells.
• Active during pathogenic infections and
inflammation.
• Arrive at the inflammatory site after neutrophils.
• Ingest bacteria, dead cells, and cellular debris
(very effective phagocytes).
• Both macrophages and dendritic cells present
antigens to lymphocytes – both are types of
antigen presenting cell.
• Both macrophages and dendritic cells produce
cytokines and growth factors.
• Dendritic cells localise bacteria in the skin and
mucosa and migrate to regional lymph nodes,
where they trigger antigen-specific T- and
B-cells.
• Dendritic cells assist in the differentiation of
T-cells into T-helper cells.
• Active in inflammation.
• Help to control the inflammatory response.
• Act directly against parasites by binding to
them and secreting highly caustic proteins that
cause extensive damage to the parasite’s outer
membranes.
• Phagocytosis.
• Release antihistamines.
• Active in allergic inflammation and parasitic
infections.
• Promote inflammation.
• Release histamine (causes vasodilation).
• Release heparin to inhibit blood clotting.
• Active in allergic inflammation and parasitic
infections.
(forms clots).
• Can induce the acute phase response (involved
in the instigation and mediation of the
inflammatory response).
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Substance Description
Mast cells • From the myeloid progenitor line and active
in innate immunity.
• Considered the most important activator
of the inflammatory response.
• Cellular repositories of granules that reside
in the matrix of connective tissues and
epithelial surfaces.
Natural Killer • From the lymphoid progenitor line and
Cells active in innate immunity. Also has traits for
the adaptive immune system – they cannot
respond in an antigen-specific way; however,
they can detect and attack certain virus
infected cells and tumours.
• Act similarly to cytotoxic T-Cells (described
below) as they differentiate along the same
pathway but only partially.
• They perform antibody-dependent cellular
cytotoxicity (ADCC): they do not recognise
or bind to antigens, they recognise
antibodies.
• Arrive at the site of inflammation after
neutrophils.
Complement • The complement system consists of several
different proteins and enzymes, making
up about 10% of all serum proteins in
circulation.
• Activated via three pathways: the classical
pathway, the MB-Lectin pathway, and the
Alternate Pathway. It can be activated in
either the innate or the adaptive immune
system.
• Once activated, the complement system
participates in every inflammatory response.
Leukotrienes & • Synthesised by mast cells.
Prostaglandins • PGs are long chain unsaturated fatty acids
(PGs) produced from arachidonic acid. There are
4 groups (E, A, F and B).
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Function
• Initiate the inflammatory response.
• Activated mast cells, release cytokines
chemokines, histamine, prostaglandins
and leukotrienes. This process is known as
degranulation.
• Active in allergic inflammation.
• Recognise chemical changes on the surfaces
of cell membranes that have been infected by
pathogens.
• NK cells possess Fc receptors that can bind to
the Fc region on antibodies that have coated
target cells and destroy these cells.
• Opsonisation.
• Active in viral infections and cancer.
• Interacts with pathogens to mark them for
destruction by phagocytes.
• Supports and enhances the opsonisation of
bacteria by antibodies.
• Induces a series of inflammatory responses.
• Directly kills pathogens.
• Leukotrienes are fatty substances that function
in smooth muscle contraction, blood vessel
permeability and neutrophil and eosinophil
chemotaxis (movement).
• Leukotrienes are more active in the later stages
of inflammation as they stimulate slower and
more prolonged responses than other mediators
like histamine.
• Prostaglandins also increase vascular
permeability and neutrophil chemotaxis but are
also responsible for generating pain.
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The Adaptive Immune System
The adaptive/acquired immune system is our secondary
(specific) defence system and takes over if our innate
immune system is not able to adequately control the
harmful substance. It contains features that offer either
cellular (T-cell driven, macrophages, cytokines) or
humoral (B-cell driven antigen specific/antibody-based/
immunoglobulin) responses against specific pathogens,
antigens or altered cells (i.e. it fights pathogens or
antigens directly).5 In order for it to act against specific
targets/pathogens/antigens, the adaptive immune
system develops a memory for that pathogen/antigen
and is therefore slower to respond. This is termed “active
acquired immunity” and occurs during natural exposure
to an antigen or a vaccine. It utilises several types of
cells and compounds called antibodies, cytokines and
immunoglobulins. Cell-mediated and humoral-mediated
immune responses are described below.
“Passive acquired immunity” occurs when preformed
antibodies are transferred from a host to a recipient.
An example of this is the immunity acquired by an infant
through breastmilk, or to a foetus from the mother
during pregnancy. Antibodies can also be given as a
medication (IV administered monoclonal antibodies) as
a short-term or acute treatment to help supplement the
immune system in emergencies such as snake bites or
tetanus exposure. Passive acquired immunity is generally
temporary whereas active acquired immunity provides
long-term protection.6
The Cell-Mediated Immune Response: T-cells/T-
lymphocytes “Attack infected cells”.
Immature lymphocytes (white blood cells) that proliferate
in the thymus gland mature into immunocompetent T-cells
that can recognise antigens via cell membrane bound
receptors. These receptors act as detection features
that can attach to a specific pathogen. These detection
features develop over the course of a few days upon initial
exposure during which time the T-cells become “matched”
to a particular pathogen (Primary Immune Response).
Subsequent infections can stimulate the immediate
creation of large numbers of the “matched” or customised
T-cells allowing for the pathogen to be responded to
immediately (Secondary Immune Response).5
Once an antigen enters the system it is transported
to the spleen and then on to the lymph nodes where
it encounters phagocytic cells such as macrophages
and is ingested. After this, it goes through a system of
“processing”. The first phase of processing occurs after
the antigen has been ingested and degraded by the
phagocyte. Part of the antigen is “re-expressed” on the
cellular membrane of the phagocyte which then “presents”
it to a T or B-cell. This type of phagocyte is called an
antigen-presenting cell. Processing and presentation are
vital steps in the adaptive immune process.6
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There are five types of mature T-cells:6
1. Memory cells: responsible for the accelerated response
during a second antigenic challenge (the secondary
immune response).
2. Lymphokine producing cells: involved in the
inflammatory response and produce compounds such
as lymphokines which act as mediators that influence
other cells including macrophages.
3. Cytotoxic/Killer T-cells (CD8+): mediate the direct
killing of target cells such as infected cells, tumours,
or grafts. This function requires cellular contact
and binding. Cytotoxic T-cells then produce toxic
substances to destroy the cell.
4. T-helper cells (CD4+): facilitate both cell-mediated and
humoral immune responses.
5. T-Suppressor Cells: facilitate both cell-mediated and
humoral immune responses.
All T-cells have T-cell receptors (TCRs) which interact
with class 1 and 2 Major Histocompatibility Complex
proteins (MHCs). MHCs on other cells are loaded with
protein-based receptor-bound surface antigens and are
responsible for presenting these antigens to T-cells. Class
one MHCs appear on nucleated cells and are recognised
by CD8+ cells, as they contain CD8 co-receptors, whereas
class 2 MHCs activate CD4+ cells as they contain CD4
co-receptors.11,12 As well as the CD co-receptors, T-cells
also have other co-receptors on their surface known as
chemokines which function to stimulate white blood cell
migration during the immune response.12
Cytokines
T-cells (mostly CD4+ cells) produce cytokines. Cytokines
are chemical “messengers” that enable communication
among various types of white blood cells including
macrophages and lymphocytes. Cytokines produced
by macrophages/monocytes are known as monokines,
and cytokines produced by lymphocytes are known as
lymphokines.6
Several cytokines are released during an adaptive
immune response. Interleukins (ILs) are sent from one
leukocyte to another. They are produced by either
macrophages or lymphocytes when stimulated by an
antigen or inflammation.6 Viral infections and tumour
growth stimulate the release of the lymphokine known
as interferon. Tumour necrosis factor is produced by
macrophages, T-cells, and NK cells in response to
infection by gram negative bacteria.6
Cytokine stimulation influences cells in several ways
and functions to preserve cell survival, proliferation,
differentiation, and functional activity against immune
challenges.6
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Diagram 3: Cell-mediated Immunity and B-Cell Activation.

Pathogen
ie. a virus Dead cell
‘Antigen’ Killer T-cell

Pathogen is Cytotoxic T-cell

broken down into (Killer T-cell)
components in the destroys infected
phago lyosome body cell Macrophages
T-lymphocyte phagocytise
Macrophage adopts Receptor (T-cell) and digest
the pathogen protein
(Phagocytosis –
see Diagram 2)
Activation
Antigen
antibody
Macrophage presents complexes
components of
the pathogen to a
T-lymphocyte First specific antibodies
against the antigen

Proliferation

B-lymphocyte
(B-cell) Plasma cells produce
specific antibodies

Memory B-cells can later induce the

secondary immune response upon
renewed contact with the same pathogen

The Humoral Immune Response: B-cells/B-lymphocytes
“Attack invaders outside the cell”.
B-cells are activated by either T-helper cells or by a free,
soluble bacterial protein (immunogen/antigen) rather
than receptor-bound protein-based antigens like T-cells.12
Antigens that can stimulate the B-cell directly are called
T-independent antigens. Antigens that are unable to
produce an immune response independently require the
intervention of T-helper cells.6
Once activated, the B-cells are also “matched” to the
specific pathogen that the activating T-cell was originally
matched with. These B-cells then differentiate into plasma
cells. Plasma cells are “protein-making” cells involved in
the humoral immune response against several pathogens
including bacteria, viruses, fungi and parasites,
as well as cellular antigens, chemicals and other toxic
or synthetic substances.
Upon antigen induced stimulation, plasma cells produce
glycoproteins known as antibodies/immunoglobulins.
Because only matched B-cells become activated by the
T-cells, the antibodies/immunoglobulins that the B-cells
produce are specific to the invading pathogen.5
B-cells can also differentiate into a type of cell known
as a Memory-B cell. The function of a Memory B-cell
is to “remember” the specific antigen that caused a
previous reaction. B-cells have the ability to recognise
and remember up to 100 million different antigens.6

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Table 2: Cells and Other Compounds that Mediate the Adaptive Immune System.5,6,9,12,14,15

Substance Description Function

T-Cells • From the lymphoid progenitor line
and active in adaptive immunity.
• T-cells contain antigen receptors on
cell membranes.
• Circulate between blood and
lymphoid tissues.
• Differentiate into effector/cytotoxic/killer
T-cells when they encounter an antigen
or detect a cell that has been infected.
• Utilise chemical messengers to activate
other immune cells.
B-cells • From the lymphoid progenitor line and
active in adaptive immunity.
• Contain antigen receptors on cell
membranes.
• Circulate between blood and lymphoid
tissues.
• Differentiate into antibody-secreting
plasma cells when they encounter an
antigen.
Cytokines • Produced by T-Cells (largely CD4+ cells).
• Chemical messengers or “hormones” of
the immune system.
Antibodies/ • Produced by B-cells.
immunoglobulins
• Recognise antigens and produce
antibodies/immunoglobulins to bind
and eliminate them.
• Active in infectious diseases.
• Generate antibodies and
immunoglobulins that protect against
infection and disease.
• Antibodies are specific to a particular
target.
• Remembers specific antigens that cause
disease to provide defence against future
infections.
• Active during infectious diseases.
• The function of cytokines is in
communication. Enhances response of
lymphocytes and other cells to antigens
and other foreign substances.
• Assists in T-cell growth and maturation.
• Attract macrophages, neutrophils, and
other white blood cells.
• Identify specific pathogens and bind
to them.
• Various functions depending upon the
type and location of the specific Ig
(more information below).

Antibodies/immunoglobulins Antibodies circulate in various tissue fluids and serum,

and can recognise antigens from previous infections,
Immunoglobulins are produced by B-cells in response
bind to them and either destroy them by attracting
to a challenge by an antigen. They are found in
phagocytic cells, or transporting them to lymphoid
blood and other body fluids. Antibodies are types of
tissues (described below).6,8,9 There are five types of
immunoglobulins that are known to have specificity for
immunoglobulins in humans: IgM, IgG, IgA, IgE and
particular antigens.6
IgD, each having a role in different tissues.8
They function to identify specific (matched) pathogens
Antibody binding promotes phagocytosis (in bacterial
or their toxins (antigens) and bind to them. This action
infections), mast cell degranulation (seen in allergic
neutralises antigen activity as it inhibits them from
responses), destruction of tumours and the activation
binding to other cells. Immunoglobulins attract other
of macrophages and dendritic cells. They are also able
immune cells which can then destroy the invading antigen,
to activate the complement system, prepare (opsonize)
they can also activate proteins to assist. Immunoglobulins
microbes for phagocytosis, prevent the attachment
and anti-bodies generally assist in the adaptive (specific)
of microbes to mucosal surfaces and neutralise toxins
immune response.5,8
and viruses.6,8

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Diagram 4: Types of Antibodies.

5 Types of Antibodies
Antibodies or immunoglobulins (Ig) are Y-shaped proteins that
recognise unique markers (antigens) on pathogens.

IgA IgD IgE IgG IgM

Secreted into B-cell receptor. Binds to mast Binds to Fixes complement.
mucous, saliva, Stimulates cells and phagocytes. Main antibody of
tears, colostrum. the release basophils. Main blood primary responses.
Tags pathogens of IgM. Allergy and antibody for B-cell receptor.
for destruction. antiparasitic secondary Immune system
activity. responses. memory.
Crosses
placenta.

Table 3: Immunoglobulins and their Function.5,6,9

Immunoglobulin Active during Function Other notes

IgA Inflammation • “Immune exclusion” – protecting IgA is the main immunoglobulin
the epithelial tissues of the GIT, found in secretions in the tears,
Pathogenic infections
respiratory tract, and urogenital tract saliva, colostrum, and the intestinal,
by inhibiting the ingress of a number genital & respiratory tracts.
of organisms and mucosal antigens.
• Controls the symbiotic relationship
between host and commensal
bacteria.
• Down-regulates inflammation.
• Activates complement system.
• Protects epithelial surfaces of
digestive, genital, and respiratory
tracts.
IgM Primary immune • Activates complement pathway.
response to infectious
• Involved in immune system memory.
agents or antigens
IgG Secondary immune • Involved in phagocytosis in The only immunoglobulin that
response to pathogenic infections. crosses the placenta and is therefore
pathogens the most abundant immunoglobulin
• Highly protective against
found in newborns.
encapsulated bacteria.
• Protects neonates from infectious
diseases by crossing the placenta.

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Table 3: Immunoglobulins and their Function.5,6,9 (continued)

Immunoglobulin Active during Function Other notes

IgE Parasitic infections • Binds to high affinity receptors on The most important host defence
mast cells and basophils. against parasitic infections.
Allergic reactions
IgD May be involved in • Main functions against pathogens Small amounts in serum.
pathogenic infections unknown.
of mucosal tissues
• May play a role in antigen-triggered
lymphocyte differentiation.
• May improve mucosal homeostasis
and immune system vigilance in
mucosal tissues.
• May stimulate the release of IgM.

Diagram 5: Classification of the Immune System.

Immune System

Innate Immunity Adaptive Immunity

Blood-borne Physical barriers T-cell immunity B-cell immunity

(cell-mediated immunity) (humoral immunity)

Complement Whole T-cells

Phagocytes 1. Skin Antigen exposure
cascade released into:
2. Mucous
membranes
3. Saliva
Alternative Lymphoblasts
1. Neutrophils 4. Flushing action
pathway Suppressor Helper Cytotoxic
2. Macrophages of urine and tears T-cells T-cells T-cells
3. Basophils 5. Stomach acid
4. Eosinophils Plasma cells Clonal B-cells
5. Natural killer cells

Death of the body’s Antiobodies Memory B-cells

Stops infection cells that are infected
before it enters with a virus or
Death of dangerous the body otherwise damaged
organisms Complement
cascade

Direct killing Classical

of bacteria pathway

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Table 4: Broad Summary of Immune System Classification and Function.5,6,7,8,9

INNATE/NON-SPECIFIC – Fast immunity

“Provides defences that protect the host as needed against any and all invaders”
Type of Protection Site Activity/Function
Barrier (anatomical Integumentary system • Sebaceous glands secrete antibacterial and antifungal fatty acids
and biochemical) and lactic acid.
• Perspiration contains lysozyme which attacks the cell walls of
gram-positive bacteria.
• All secretions create an acidic environment (ph3-5), making it
inhospitable to most bacteria
Gastrointestinal system • Saliva contains lysozyme which attacks the cell walls of gram-
positive bacteria.
• Gastric acid and bile acids make the gastrointestinal tract
inhospitable to most pathogens.
• Secretory IgA protects mucosa from several different micro-
organisms and mucosal antigens
Eyes/conjunctivae • Tears contains lysozyme which attacks the cell walls of gram-
positive bacteria.
Mechanical Integumentary system • Skin cell sloughing/desquamation
Respiratory system • Respiratory mucous acts as a “trap” catching bacteria or other
pathogenic or toxic material.
• Coughing triggered by ciliary movement then helps to eliminate
infected material
Gastrointestinal system • Salivation and swallowing assists removal of noxious material
• Vomiting reflex stimulated when a pathogen enters the stomach.
• Natural laxation/clearance by peristalsis if pathogen enters
intestines
Genitourinary system • Urine flushes out invading pathogens.
• Mucous linings of reproductive tracts “trap” pathogens and
eventually make their way out of the body.
Eyes/conjunctivae • Tears assist with washing away foreign bodies and pathogens from
the eyes.
General Entire microbiome • Produce several chemicals that can inhibit the growth of
pathogens.
• “Crowding out” phenomenon which inhibits pathogenic
colonisation.
Cellular/inflammatory At site of injury or • Blood vessels dilate and become more permeable which increases
(secondary innate invasion blood flow to the site bringing with it cells and fluids that isolate,
defence – Inflammatory destroy, and remove pathogens and start the healing process.
phase is triggered if the • Stimulates a fever to make the system inhospitable to most
external barriers have pathogens.
been compromised.
• Involves many different plasma systems (clotting system,
Begins within seconds
complement system, kinin system).
of injury or invasion).
• Involves many different cell types involved in phagocytosis
(neutrophils, eosinophils, monocytes, macrophages, fixed
mononuclear phagocytes).

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Immune Support

ADAPTIVE/SPECIFIC – Slow immunity

“Confers permanent or long-term protection against specific micro-organisms”
Type of Protection Cells Involved Activity/Function
Cellular T-Cells/lymphocytes & • T-cells produce chemical messengers (cytokines) that mediate the
Cytokines activity of other T-cells.
• Directly kill target cells by binding to them and then producing
toxic substances to destroy them.
• Trigger B-cell activity.
• Cytokines (lymphokines, monokines, interleukins and interferon)
– chemical messengers or “hormones” of the immune system. The
function of cytokines is in communication. Enhances response
of lymphocytes and other cells to antigens and other foreign
substances.
Humoral B-Cells/lymphocytes, • React with antigens and generate diverse antibodies that protect
plasma cells, antibodies against infection and disease.
& immunoglobulins • Remembers specific antigens that cause disease.

THE LYMPHATIC SYSTEM Lymphatic vessels are in almost every area of the body
with the exception of the bone marrow and epidermis,
The Lymphatic system is often described as a component
and other areas that do not have a blood supply.20
of the circulatory/cardiovascular system. This is because
one of its main functions is to move fluid from the blood The lymphatic system plays a vital role in immune defence
and tissues throughout a series of vessels (lymphatic by transporting antigens, leukocytes, and other immune
vessels) parallel to the venous system and away from the cells around the body, picking up the waste products of
peripheral areas of the body. However, it also serves a immune activity along the way.
critical role in immune system function.19,20
Lymphatic Nodes and Nodules
Unlike the cardiovascular system, the lymphatic system
Lymph nodes (often called lymph glands) are small bean-
doesn’t have a “pump” to facilitate circulation of the
shaped tissues that lie at points along the lymphatic vessels.
lymphatic fluid through the lymphatic vessels.4 Local
There are around 600-800 lymph nodes in the body that
pressure is exerted upon the vessels by movements
range in size from 1-2cm. They are located in the neck,
instigated by smooth muscles, skeletal muscles and
under the arms near the mammary glands, in the groin and
respiratory function. Valves also exist inside the vessels
throughout the abdomen. The lymph nodes are the location
to prevent the lymphatic fluid from moving backwards.20
for lymph filtration (allowing T- and B-cells to be exposed
Lymphatic fluid is a watery, yellowish substance that is to any possible antigens), cell recycling and the destruction
made of extracellular fluid, lymphocytes, bacteria, cellular of discarded compounds via phagocytosis which is why the
debris, plasma proteins (mostly albumin) and other cells nodes can swell during periods of increased activity which
that have leaked out of blood capillaries and into the may be due to infection or malignancy.4,6,19,20
interstitial space. From here it is picked up by the tiny
The lymph nodes consist of an internal medulla and
lymphatic capillaries.19,20 As well as lymphatic vessels and
an outer cortex. The cortex can be further divided into
lymphatic fluid, the lymphatic system also consists of
inner and outer sections. Mature B-cells reside in the
lymphatic nodes or glands, tonsils, the thymus gland,
outer cortex. Mature T-cells reside in the inner cortex.4
the bone marrow and the spleen.19
The lymph nodes are the primary site for the maturation
Together, the vessels, nodes and other organs and tissues of these types of cells which occurs after being
of the lymphatic system function to channel lymphatic transported from the bone marrow and thymus gland
fluid (lymph), collecting discarded cellular debris, proteins and upon an antigen-mediated immune challenge.19,20
and other particles that require elimination, and filtering it
along the way in the nodes. The lymph is finally returned
to the bloodstream where the discarded particles and
other debris can be effectively expelled from the body,
either via the liver or the kidneys.20

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Immune Support

Diagram 6:
The Lymphatic System.

Tonsil
Cervical Lymph
Nodes
Subclavian Vein

Thymus Gland

Axillary Lymph Nodes

Thoracic Duct
Spleen

Lymph Node

Appendix
Inguinal Lymph Nodes

Hematopoietic
stem cells

Red Blood
Red Bone Marrow Cells
Popliteal Lymph Nodes
Bone Marrow

White blood
cells

Platelets

Diagram 7: Afferent lymphatic

Blood capillaries around
lymphatic nodule
The Lymph Node. vessels

Vein

Trabeculae Artery

Valve
Lymph flow
Cortical sinus

Cortex Lymphatic nodule Efferent lymphatic vessel

Germinal centre

Capsule
Medulla
(medullary cord
and medullory sinus)

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Immune Support

Table 5: Location and Function of Lymph Nodes.19

Name Location Function

Preauricular lymph nodes
Submental and subauxillary groups
Superficial cervical lymph nodes
Superficial cubital or supratrochlear
lymph nodes
Axillary Lymph nodes
Inguinal lymph nodes
Just in front of the ear.
In the floor of the mouth.
Run along the sternocleidomastoid
muscle in the neck.
Just above the bend in the elbow.
20-30 large lymph nodes deep
within the underarm and upper
chest.
In the groin.
Drain the superficial tissues and skin on the
lateral side of the head and face.
Drain lymph from the nose, lips and teeth.
Drain lymph which has already drained
through the other nodes, from the head
and neck.
Drain lymph from the forearm.
Drain lymph from the arm, upper part of
the thoracic wall including the breast.
Drain lymph from the leg and external
genitals.

The Tonsils The Thymus Gland

Tonsils are large masses of lymphoid tissue that protect
the mouth and the back of the throat from pathogens
that may come into the system via the mouth or the
nostrils and are therefore part of our first line of defence.19
There are three tonsils: The palatine tonsils located on
each side of the throat, the pharyngeal tonsils (adenoids)
near the posterior opening of the nasal cavity and the
lingual tonsils located at the base of the tongue.19
The Spleen
The spleen is a small, oval shaped organ in the left
hypochondrium, underneath the diaphragm, behind
the fundus of the stomach, and just above the left
kidney and descending colon.4,19 It is made up of
lymphoid tissue and can increase or decrease in size
depending on its level of activity (high levels of activity
such as infection can enlarge the spleen), or our age
(the size of the spleen decreases as we age).19 At any
one time, the spleen can house up to a quarter of the
body’s lymphocytes.4
The spleen contains a large number of blood vessels,
some of which are covered in lymphatic tissue that
contains white blood cells including macrophages and
lymphocytes. This is called the “white pulp” of the spleen.
Other splenic tissues are filled with red blood cells and
are called the “red pulp”.4,19
The red pulp is the site for haematopoiesis and the
storage location for platelets, and functions to filter the
blood, remove old red blood cells and recycle iron. The
white pulp functions in phagocytosis as blood is filtered
through the splenic tissues and performs other immune
functions that involve the activation of T- and B-cells
such as synthesising opsonizing antibodies.4,19,21
The thymus gland is considered a primary organ of the
lymphatic system and therefore the immune system. It is
located in the mediastinum just under the thyroid gland.
It is unique in that it atrophies over the lifespan to the
point where it becomes largely dysfunctional fatty tissue
as we experience advanced old age. A process called
“involution”. It is at its largest at puberty.19,22
It consists of both inner and outer segments (the medulla
and cortex respectively) that contain epithelial, dendritic,
mesenchymal, and endothelial cells. It also contains
macrophages and developing lymphocytes – a key clue to
the function of the thymus gland. The thymus gland has
two identified functions: 1. It is the final site of lymphocyte
development before birth, and 2. After birth, it secretes a
group of hormones collectively called thymosin. Thymosin
stimulates the maturation of lymphocytes into mature
T-cells.4,19,22
The thymus gland is where developing T-cells get
exposure to “self” cells and therefore learn to identify
non-self or foreign substances. T-cells that can bind to
non-self-antigens with high affinity are let out of the
thymus to circulate through the body.22
The Bone Marrow
The bone marrow is made up of soft spongy tissue
(myeloid tissue) and has a highly specialised function:
that of blood cell production which takes place in
the medullary cavities of the long bones such as the
femur the humerus and the ribs.19
There are two types of bone marrow:19
1. Red bone marrow: contains multipotential/pluripotent
hematopoietic stem cells – the parent cells for
haematopoiesis.
2. Yellow bone marrow: made up mostly of fat and
gradually replaces the red marrow as we age, and is
largely inactive.

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Immune Support

HERBAL AND NUTRIENT SUPPORT Anti-inflammatory – to control the release of cytokines

Pertinent actions:
The Immune system can be affected by several
endogenous factors. These may include an individual’s
age and involuting thymus gland (decrease in circulating
T-cells), gender, nutritional status, genetic background,
medications etc. The calibre of the immune response
is largely dependent on these factors, as well as the
intensity of the antigen or injury.6
Actions that may be required in protocols aimed at
supporting the immune system can include but are
not limited to:
and down-regulate other inflammatory pathways,
particularly if immune dysfunction has caused over-
activity and tissue damage is being caused.4
Antioxidant – Antioxidants foods and nutrients can
support immune system health and function by modifying
cell-mediated immune responses. Antioxidants also help
to prevent the damage to healthy tissues that can result
from phagocytic activity against infections.4
Anti-microbial – Anti-microbial medicines can support both
the innate and adaptive immune responses by offering
additional activity, particularly in recurrent infections.4
Immune enhancement – May be able to offer secondary
support to increase phagocytic activity when required.4

Table 6: Nutritional and Herbal Substances for the Immune System.4,14,23-46

Substance Source Action/Function

Vitamin C Citrus fruits, • Antioxidant that protects phagocytes.
strawberries, kiwi • Immunostimulant: enhances activity of NK cells, T- and B-cells.
fruit, capsicum,
• Leukocytes maintain high levels of ascorbic acid (20-100 times
broccoli
that of plasma) which correlates with their function.
• Improves neutrophil chemotaxis.
• Deficiency of vitamin C lowers phagocyte activity and delays
wound healing.
• Antioxidant function assists innate defensive mechanisms in the gut – prevents
N-nitroso-compounds which are potential mutagens.
• Helps to regenerate and maintain other antioxidants.
• Assists in white blood cell differentiation processes (assists in
T-cell gene expression).
• Stimulates production of interferons.
• Stimulates production of IgG and IgM.
• Stimulates the synthesis of humoral thymus factor.
• Essential for the formation of collagen and therefore wound
healing processes.
• Antihistamine activity.
Vitamin D Food sources • Immunomodulatory: enhances immune response to both bacterial
not adequate. and viral agents.
Good sources • Promotes differentiation and activity of macrophages.
include sunshine
• Influences cytokine production and release – may promote innate
and Vitamin D3
immunity and inhibit adaptive immunity.
supplements
• Plays a role in haematopoiesis.
Vitamin A Liver, oily fish, • Potent immunomodulator and antioxidant.
eggs, green • Deficiency reduces IgG and IgE.
leafy vegetables,
• Deficiency reduces the function of neutrophils, macrophages, and NK cells and
tomatoes, orange
impairs the antibody response and T- and B-cell function.
and yellow
vegetables • Maintains the health of epithelial barrier tissues involved in innate immunity.
• Inhibits prolonged inflammatory activity.
• Vitamin A stores are positively correlated with NK cell activity.
• Increases lymphocyte proliferation.
• Increases the production of antibodies and the function of neutrophils,
NK cells, macrophages and T- & B-lymphocytes.

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Immune Support

Table 6: Nutritional and Herbal Substances for the Immune System.4,14,23-46 (continued)

Substance Source Action/Function

Tocotrienols Rice bran oil, • Potent antioxidant (antioxidant activity of tocotrienols up to 60% greater than
grapefruit seed oil, alpha-tocopherol).
oats, hazelnuts, • Decreases release of proinflammatory cytokines (anti-inflammatory).
olive oil, flaxseed oil
• Regulates immunocompetence: increases humoral antibody production,
Supplemental form increases resistance to bacterial infections, increases cell-mediated immune
Bixa orellana – function, improves the T-cell response, increases NK cell activity.
100% tocotrienols • Tocotrienols have an unsaturated tail which allows for greater penetration into
cell membranes and therefore greater effects than tocopherols which have a
saturated tail.
• Tocotrienol molecules have a smaller polar head and a shorter tail than
tocopherols which allows for greater flexibility and movement through the cell
and higher tissue distribution than alpha-tocopherol.
Selenium Brazil nuts, seafood, • Inhibits activation of NF-κB (anti-inflammatory).
meat, eggs • Potent antioxidant (component of the antioxidant enzyme glutathione
peroxidase).
• Maintains cell mediated immunity.
• Immunomodulatory: improves activation and proliferation of B-lymphocytes,
enhances T-lymphocyte function.
• Selenium concentration decrease significantly during acute infections
suggesting an increased need, increased excretion, or decreased absorption
during these periods. Supplementation may be required to normalise Se levels
during acute infections.
Iron Red meat, dark • Low plasma iron can reduce the cytotoxic capacity of phagocytes.
green leafy • Iron deficiency can decrease resistance to infection, reduce T-lymphocyte
vegetables proliferation, induce atrophy of the thymus gland and inhibits thymocyte
(spinach), chicken proliferation.
or turkey, shellfish • Vital for the proliferation of all cells in the body including those of
the immune system.
• Supports T-cell maturation.
Zinc Oysters, red meat, • Stimulates neutrophilic phagocytosis.
fish, pomegranate, • Involved in monocyte differentiation, and cytokine, T-cell and B-cell receptor
avocado, pumpkin protein production.
seeds • Inhibits inflammation via NF-KB signalling.
• Enhances platelet activity and aggregation.
• Reduces the accumulation of oxidative stress and pro-inflammatory markers
including C-reactive protein, IL-6, monocyte chemoattractant protein-1 (MCP-1)
and secretary cell adhesion molecules.
• Involved in thymus hormone stimulation of T-cells.
• Antioxidant: Protects against free radical species that result from macrophage
activity.
• Anti-viral (against up to 40 viruses).
• Deficiency impairs macrophage and neutrophil function, NK cell and
complement activity, T-cell proliferation, lymphocyte response and CD4+ cell
proliferation.
Beta-glucans Mushrooms Cordyceps sinensis:
• Modulates IL-6 production by the activation of macrophages.
• Enhances secretion of haematopoietic growth factors which can
modulate both local and systemic immune functions.
• Antioxidant.
• Antibacterial.
• Antiviral.
• Tonic.

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Immune Support

Table 6: Nutritional and Herbal Substances for the Immune System.4,14,23-46 (continued)

Substance Source Action/Function

Beta-glucans Mushrooms Lentinula edodes (Shitake):
(continued) (continued) • Antibacterial.
• Antiviral.
• Tonic.
• Stimulates T-cell and macrophage immune response.
• Induces Th1 immune responses. (T helper cell Type 1).
Grifola frondosa (Maitake):
• Immunomodulatory.
• Tonic.
• Anti-viral.
• Antibacterial.
Ganoderma lucidum (Reishi):
• Antibacterial.
• Antifungal.
• Anti-viral.
• Immunomodulatory.
• Anti-inflammatory.
• Antioxidant.
• Tonic (lung).
• Decreases cell proliferation, improves specific and non-specific immune
responses, and regulates inflammatory processes.
Quercetin Onions, citrus fruits, • Antioxidant: direct free radical scavenging, and metal chelation
apples, parsley, • Anti-inflammatory: modulates neutrophil function and inhibits cytokines,
dark cherries, leukotrienes and prostaglandins. Inhibits COX-2 and NF-KB
grapes and berries • Antiviral
• Anti-allergy: useful for mast cell derived allergic responses as it inhibits
activating receptors on mast cell membranes (has a negative effects on
intracellular signalling events that are initiated by activating receptors)
• Stabilises membranes of mast cells, neutrophils and basophils,
preventing degranulation and subsequent histamine and pro-inflammatory
cytokine release
• Decreases the expression of high affinity IgE receptors and inhibits IgE
production by B-cells
• Inhibits transcription of histidine decarboxylase (enzyme that converts
histidine to histamine)
• Increases neutrophil chemotaxis and the phagocytic activity of macrophages
• Regulates T-cell function
• Reduces the expression of vasoactive intestinal polypeptide which mediates
capillary permeability and platelet aggregation during inflammatory processes
Lauric acid Coconut oil, • Anti-microbial against bacteria, viruses and yeasts/funguses.
supplemental • Anti-inflammatory.
• Promotes T-cell proliferation.
• Inhibits the production of a variety of exotoxins by group A streptococci and
staphylococci.
Larix arabino- Supplemental • Prebiotic: helps to improve gut mediated immunity.
galactans • Immunostimulant: promotes immune system responsivity –
useful in chronic infections.
• Strengthens the immune response.
• Stimulates NK cell activity and cytotoxicity.
• Anti-inflammatory.

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Immune Support

Table 6: Nutritional and Herbal Substances for the Immune System.4,14,23-46 (continued)

Substance Source Action/Function

NAC Chicken, turkey, • Antioxidant (precursor to glutathione).
yoghurt, cheese, • Mucolytic and respiratory protectant.
eggs, sunflower • Anti-viral.
seeds, supplemental • Anti-inflammatory: reduces cytokine expression.
• Supports mucosal immunity: aids in the production of secretory IgA and
prevents pathogenic bacteria from adhering to mucosal surfaces.
• Inhibits excessive IgE and IgG4 production.
• Disrupts biofilms: reduces tenacity and thickness and prevents biofilm
formation (reduces extracellular polymeric substances and weakens disulfide
bonds that maintain biofilm architecture.
Glutathione Cruciferous • Antioxidant that protects immune cell integrity and the cell damaging effects
vegetables, garlic, of complement system proteins.
onions, eggs, • Promotes the synthesis, proliferation and activity of NK cells, T-cells,
nuts, legumes, lymphocytes and dendritic cells.
supplemental • Anti-viral.
• Regulates cell proliferation and cytokine production.
• Adequate glutathione levels are vital for the activity of macrophages
phagocytes, and lymphocytes.
• Deficiency associated with suboptimal immune strength and function.
Probiotics Supplemental, • Help to improve gut mediated immunity and innate barrier function in the
(general) yoghurt, fermented gut: reduce luminal pH, promotes secretion of antimicrobial peptides, inhibits
foods bacterial invasion (“crowding out”), reduce local inflammation and stimulates
mucin production.
• Immunomodulation: Increases the antibody response and stimulates
phagocytosis.
• Reduces inflammation.
• Some species are anti-microbial (Bacillus coagulans, Lactobacillus acidophilus).
• Some probiotics seem to modulate non-specific cellular and humoral immunity,
possibly by stimulating lymphocyte and macrophage activity, and modulating
cytokine production by mononuclear cells.
Allium sativum Herbal medicine, • Enhances lymphocyte proliferation and T-cell responsiveness.
(garlic) garlic bulbs • Anti-inflammatory: reduces the activity of nuclear factor (NF)-kB, a
transcription factor.
• Stimulates macrophage proliferation.
• Alliin increases the phagocytic function of peripheral blood leukocytes
and monocytes.
• Antioxidant.
• Can protect against the age-related decline in immune function.
• Warming expectorant: Increases blood flow to the respiratory mucosa,
decreases the thickness of mucous by altering its mucopolysaccharide
constituents -> creates a sensation of clearing catarrh and shifting
congestion up from the lungs.

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Immune Support

Table 6: Nutritional and Herbal Substances for the Immune System.4,14,23-46 (continued)

Substance Source Action/Function

Echinacea Herbal medicine • Major immunomodulatory herb for acute infections and long-term
purpurea immune support.
(Echinacea) • Antimicrobial, antiviral, antiseptic, immune stimulant, immunomodulator,
ßanti-inflammatory, anti-fungal and antioxidant.
• Anti-catarrhal.
• Shortens duration and intensity of colds and other upper respiratory tract
infections.
• Supports the immune system through the non-specific cellular and humoral
immune response.
• Increasing macrophage proliferation and phagocytosis.
• Affects specific immunity by increasing the levels and activity of
T-lymphocytes, neutrophils, and natural killer cells.
• Stimulates cytokine and chemokine production.
• Augments primary and secondary IgG responses to antigens.
Astragalus Herbal medicine • Strengthens and restores immune function.
membranaceus • Increases numbers and activity of circulating macrophages, neutrophils
(Astragalus) and T- & B-lymphocytes within 8-12 hours of administration.
• Increases antibody response.
• Increases numbers of circulating platelets within 4 hours of administration.
• Promotes NK cell activity.
• Immunomodulator.
• Anti-inflammatory.
• Antioxidant.
• Anti-viral.
• Prebiotic: helps to improve gut mediated immunity.
Andrographis Herbal medicine • Antiviral, immune-stimulant, anti-tumour, antimicrobial, astringent, antiseptic,
paniculata analgesic, antipyretic, anti-inflammatory, expectorant and restorative.
• Involved in the maturation of T-cells and dendritic cells.
• Delays antibody response in hypersensitivity.
• Specific for upper respiratory tract infections including the common
cold and influenza.
• Anti-inflammatory.
• Stimulates lymphocyte cell proliferation.
• Stimulates both antigen-specific and non-specific immunity.
Sambucus Herbal Medicine, • Antiviral, antibacterial, immune stimulant, expectorant, mucolytic,
nigra elder berries anti-catarrhal and diaphoretic.
Elderberry • Antioxidant.
• Inhibits replication of viruses.
• Upper Respiratory Tract tonic.
Urtica dioica Herbal medicine • Antiallergy due to quercetin content: anti-inflammatory and mast cell
Nettle stabilising effects.
• Decreases histamine release from basophils and mast cells.
• Antiviral.

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Immune Support

Substance Source Action/Function

Uncaria Herbal medicine • Antioxidant.
tomentosa • Anti-inflammatory (supresses NF-KB cells).
Cats claw
• Immunostimulant.
Calendula Herbal medicine • Lymphatic tonic.
officinalis • Improves Lymphatic circulation, aiding in toxin removal.
Marigold
• Potent anti-inflammatory, particularly in wound healing.
• Anti-microbial, anti-bacterial, anti-viral.

References available on request.

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