British Journal of Nutrition

Review Article

Cocoa: antioxidant and immunomodulator

Emma Ramiro-Puiga1 and Margarida Castella1 c1

a1 Department of Physiology, Faculty of Pharmacy, University of Barcelona, Av. Joan XXIII s/n 08028, Barcelona, Spain


Cocoa, a product consumed since 600 BC, is now a subject of increasing interest because of its antioxidant properties, which are mainly attributed to the content of flavonoids such as ( − )-epicatechin, catechin and procyanidins. Moreover, recent findings suggest a regulatory effect of cocoa on the immune cells implicated in innate and acquired immunity. Cocoa exerts regulatory activity on the secretion of inflammatory mediators from macrophages and other leucocytes in vitro. In addition, emerging data from in vivo studies support an immunomodulating effect. Long-term cocoa intake in rats affects both intestinal and systemic immune function. Studies in this line suggest that high-dose cocoa intake in young rats favours the T helper 1 (Th1) response and increases intestinal γδ T lymphocyte count, whereas the antibody-secreting response decreases. The mechanisms involved in this activity are uncertain; nonetheless, because redox-sensitive pathways control immune cell function, the action of cocoa flavonoids on modulating cell signalling and gene expression deserves investigation.

(Received April 16 2008)

(Revised October 06 2008)

(Accepted October 13 2008)

(Online publication January 06 2009)


c1 Corresponding author: Dr Margarida Castell, fax +34 93 403 59 01, email


Abbreviations: PBMC, peripheral blood mononuclear cells; TCR, T cell receptor; Th, T helper