Effects of zinc supplementation as adjunct therapy on the systemic immune responses in shigellosis

Rahman, M. Jubayer; Sarker, Protim; Sk, Roy; Ahmad, Shaikh Meshbahuddin; Chisti, Jobayer; Azim, Tasnim; Mathan, M.; Sack, David A.; Andersson, Jan; Raqib, Rubhana

doi:10.1093/ajcn.81.2.495

Cited by 65 publications

(44 citation statements)

References 37 publications

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“…Because enteric diarrheal diseases are common in rural Bangladesh, the serum bactericidal response was evaluated against a nonpathogenic Escherichia coli K12 strain, which lacks the O surface antigens (16). The serum bactericidal assay similar to that used for Shigella was modified to optimize it for nonvirulent E. coli K12 (17). Bacteria grown in Mueller Hinton broth (MHB; Difco, Detroit, MI) at 37°C for 3 h were suspended in saline to an absorption of 0.4 at 600 nm [1 ҂ 10 8 colony-forming units (CFU)/mL], which was followed by serial dilution to a concentration of 1 ҂ 10 5 CFU/mL.…”

Section: Serum Bactericidal Responsementioning

confidence: 99%

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Low birth weight is associated with altered immune function in rural Bangladeshi children: a birth cohort study

Raqib

Alam

Sarker

et al. 2007

The American Journal of Clinical Nutrition

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Background: Low birth weight is generally an outcome of a fetal insult or nutritional insufficiency. Recent studies have shown that such exposure early in life may have long-term implications for later immunocompetence and susceptibility to infectious diseases. Objective: We aimed to investigate the effect of birth weight on immune function in preschool-age children. Design: A birth cohort cross-sectional study was conducted in children (n ҃ 132) aged 60.8 Ȁ 0.32 mo who were born in Matlab, a rural area of Bangladesh, and whose weight and length were measured within 72 h of birth. The outcome measures were thymopoiesis, T cell turnover, acute phase response, and percentage of lymphocytes. Results: Children born with low birth weight (2500 g; LBW group, n ҃ 66) had significantly higher concentrations of T cell receptor excision circles in peripheral blood mononuclear cells-a biomarker for thymopoiesis-and significantly higher serum bactericidal activity and C-reactive protein concentrations than did children born with normal birth weight (ͧ2500 g; NBW group, n ҃ 66) (P 0.05 for both). The LBW group children had significantly lower concentrations of interleukin 7 in plasma (P ҃ 0.02), shorter telomere length in peripheral blood mononuclear cells (P ҃ 0.02), and a lower percentage of CD3 T cells (P ҃ 0.06) than did the NBW group children. Conclusions: Greater peripheral T cell turnover (shorter telomeres and lower CD3 concentrations) due to immune activation (elevated C-reactive protein concentrations and bactericidal activity) may have resulted in a greater need for replenishment from the thymus (higher T cell receptor excision circles); these events may cause lower immune functional reserve in preschool-age children born with LBW. Thus, LBW has implications for immunocompetence and increased vulnerability to infectious diseases in later life.Am J Clin Nutr 2007;85:845-52.

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Section: Serum Bactericidal Responsementioning

confidence: 99%

“…The volume of 200 L/well was adjusted with MHB, and the plate was incubated in a shaker incubator (200 rpm) at 37°C for 16 h. The optical density of the plates was measured at 595 nm. The titer of the serum was defined as the reciprocal of the last dilution in which no growth was evident by visual inspection (17).…”

Section: Serum Bactericidal Responsementioning

confidence: 99%

Low birth weight is associated with altered immune function in rural Bangladeshi children: a birth cohort study

Raqib

Alam

Sarker

et al. 2007

The American Journal of Clinical Nutrition

Self Cite

124

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“…According to the applicant, zinc supplementation showed, for instance, a positive impact on the lymphocyte proliferation and the lipopolysaccharide-specific immunoglobulin G response in infants (Raqib et al, 2004) or on shigellacidal antibody response and on the proportions of CD20+ and CD20+CD38+ cells (Rahman et al, 2005). Several very recent trials and meta-analysis of studies done on infants and young children (Aggarwal et al, 2007;Garenne et al, 2007;Lazzerini et al, 2008;Lukacik et al, 2008) have confirmed that the impact of zinc supplementation on infants and young children is positive -reduction of the duration and severity of acute and persistent diarrhoea, thereby preventing and providing aid in the treatment of diarrhoea -even if there are some inconsistencies among studies owing to heterogeneity in zinc dosages, endpoints and study design.…”

Section: Health Relationship As Claimed By the Applicantmentioning

confidence: 99%

“…The applicant identified 14 human studies, including nine human intervention studies (Brooks et al, 2004;Mahalanabis et al, 2004;Rahman et al, 2005;Raqib et al, 2006;Bose et al, 2006;Coles et al, 2007;Garenne et al, 2007;Tielsch et al, 2007;Walker et al, 2007) and five meta-analyses or protocols for meta-analyses of human intervention studies (Abba and Garner, 2007;Aggarwal et al, 2007;Haider et al, 2008;Lazzerini and Ronfani, 2008;Lukacik et al, 2008) as relevant to the claim.…”

Section: Scientific Substantiation Of the Claimed Effectmentioning

confidence: 99%

Scientific Opinion on the substantiation of a health claim related to zinc and normal function of the immune system pursuant to Article 14 of Regulation (EC) No 1924/2006

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Following an application from Specialised Nutrition Europe (formerly IDACE), submitted pursuant to Article 14 of Regulation (EC) No 1924/2006 via the Competent Authority of France, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the scientific substantiation of a health claim related to zinc and normal function of the immune system. The food constituent, zinc, which is the subject of the health claim is sufficiently characterised. Normal function of the immune system is a beneficial physiological effect for infants and young children. A claim on zinc and function of the immune system in the general population has already been assessed with a favourable outcome. The Panel considers that the role of zinc in normal function of the immune system applies to all ages, including infants and young children (from birth to three years). The Panel concludes that a cause and effect relationship has been established between the dietary intake of zinc and normal function of the immune system. The following wording reflects the scientific evidence: “zinc contributes to normal function of the immune system”.

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“…responses as zinc therapy was associated with enhanced antigen-specific antibody responses, bactericidal antibody titers against Shigella, increased proportions of B cells and plasma cells and higher lymphocyte proliferation responses in the peripheral circulation during the early convalescent phase of shigellosis (Rahman et al, 2005). In earlier studies, supplementation of zinc to deficient rats was associated with rapid regeneration of intestinal mucosa and significant increase in their mass and reduced cholera toxin-induced secretion of water and electrolytes in the ileum (Roy and Tomkins, 1989;Roy et al, 2006b).…”

Section: Table 1cmentioning

confidence: 99%

Zinc supplementation in the management of shigellosis in malnourished children in Bangladesh

Raqib

Khatun

et al. 2007

Eur J Clin Nutr

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Objective: To assess the impact of zinc supplementation on clinical recovery, weight gain and subsequent growth and morbidity in moderately malnourished children with shigellosis. Design: A randomized, double-blind, controlled trial. Setting: Dhaka hospital of ICDDR,B: Centre for Health and Population Research, Dhaka, Bangladesh. Subjects: Fifty-six moderately malnourished children, aged 12-59 months with culture-proven shigellosis. Methods: Subjects were randomly allocated to receive zinc (20 mg/day elemental) in multivitamin syrup (intervention) or multivitamin syrup without zinc (control) in two equally divided doses daily for 2 weeks. All children received pivmecillinam in a dose of 15 mg/kg every 6 h for 5 days. After supplementation, children were followed in their respective homes every 2 weeks for 6 months. Results: Children receiving zinc recovered from acute illness significantly faster than the control children (Po0.05). The medians time (days) to recovery and disappearances of blood and mucous were significantly 50% shorter in the zinc-supplemented group compared to the control group. The mean body weight of zinc supplemented children increased significantly from 8.8 kg on admission to 9.2 kg (Po0.01) at recovery, which was not observed in the control children (from 9.3 to 9.6 kg; P ¼ 0.12). During the 6-month follow-up period, zinc-supplemented children had significantly fewer mean episodes of diarrhoea compared to the control children (2.2 vs 3.3; P ¼ 0.03). Conclusion: Zinc supplementation significantly shortens the duration of acute shigellosis, promotes better weight gain during recovery and reduces diarrhoeal morbidity during the subsequent 6 months.

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Effects of zinc supplementation as adjunct therapy on the systemic immune responses in shigellosis

Abstract: Adjunct therapy with zinc during acute shigellosis significantly improved seroconversion to shigellacidal antibody response and increased the proportions of circulating B lymphocytes and plasma cells.

Cited by 65 publications

References 37 publications

Low birth weight is associated with altered immune function in rural Bangladeshi children: a birth cohort study

Low birth weight is associated with altered immune function in rural Bangladeshi children: a birth cohort study

Scientific Opinion on the substantiation of a health claim related to zinc and normal function of the immune system pursuant to Article 14 of Regulation (EC) No 1924/2006

Zinc supplementation in the management of shigellosis in malnourished children in Bangladesh

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