Cellular immune competence and diarrheal morbidity in malnourished Bangladeshi children: a prospective field study

Abstract

A year-long prospective study of 152 Bangladeshi children with mild to moderate protein-calorie malnutrition related nutritional status and cellular immune defects to morbidity due to diarrheal, respiratory, and febrile diseases. In children older than 36 mo, wasting correlated with skin test anergy to three recall antigens and with inability to initiate hypersensitivity to dinitrochlorobenzene. In this older age group, anergy was associated with a 58% increased attack rate and an 83% increased duration of diarrheal diseases but not with febrile or respiratory infections. In stepwise regression analysis, this anergy effect was independent of the small negative impact of poorer nutritional status on morbidity. Ninety-three percent of diarrheal illnesses lasting at least 14 d were among anergic children. Cellular immune incompetence, indicated by anergy of unknown etiology, is associated with increased diarrheal morbidity and may promote the vicious cycle of repeated infections and deteriorating nutritional status.

Effects of Dexamethasone and Transient Malnutrition on Rabbits Infected with AerosolizedMycobacterium tuberculosisCDC1551

“…To repeat this exact experiment would be unethical. Nonetheless, our data are consistent with studies on malnourished human beings: malnourished, BCG-vaccinated persons are more likely to be DTH skin test negative (15,16,29). Also, in malnourished individuals, other diagnostic tests for tuberculosis that depend on cellular immune responses, such as enzyme-linked immunospot assay or QuantiFERON-TB, may also have reduced sensitivity.…”

Peripheral Blood Lymphocyte Subsets in Infants with Diarrhea with and without Giardia Lamblia Infection

“…Because nutrition regulates cellular immune responsiveness (23,24), the question arises whether the above-mentioned observations can be attributed to differences in the nutritional status of the three groups of infants. The mean weight of infants with non-Giardia-associated diarrhea was lower than that of the other 11 Proportion of CD4+ PBL coexpressing two antigenic markers.…”

“…The lower weight of infants with non-Giardia diarrhea could also reflect some degree of malnutrition. In children over the age of 36 mo, malnutrition has been shown to result in impaired immune function as assessed by skin test reactivity (24). No such correlation was, however, found among children 12-35 mo of age (24).…”

“…In children over the age of 36 mo, malnutrition has been shown to result in impaired immune function as assessed by skin test reactivity (24). No such correlation was, however, found among children 12-35 mo of age (24). Skin tests to commonly encountered recall-antigens evaluate memory immune responsiveness and are dependent on memory T cells.…”

Undernutrition, infection and immune function

“…That impaired immunity has a functional consequence was shown by a study in malnourished Bangladeshi children: those who showed the fewest skin reactions to common bacterial antigens (i.e. the weakest cell-mediated immune response) had a greater incidence of diarrhoeal disease (Koster et al 1987;Baqui et al 1993). In addition to reduced protein availability, de®ciencies in speci®c amino acids may affect immune function.…”