Humoral and Cellular Immune Responses to Streptococci, Influenza and Other Antigens in Australian Aboriginal School Children

Abstract

SYNOPSIS Aboriginal school children with elevated erythrocyte sedimentation rates were selected, and associated features of growth retardation, hyperimmunoglobulinaemia, high streptococcal carrier rates and antibody levels, and high loads of bowel parasite infestation, noted previously, were confirmed. Medical records showed these children to have had significant growth retardation in infancy, which suggested an association with previous protein‐calorie malnutrition. Antibody responses of these children to influenza vaccine were significantly poorer than controls, both in the magnitude of antibody rise and the proportion of children showing significant rises in titre. Some improvement in antibody response followed treatment of chronic streptococcal infection, or of bowel parasites. Cell‐mediated immune responses, as measured by lymphocyte transformation in vitro in response to specific antigens streptolysin O, tetanus toxoid, non‐specific mitogens PHA and streptolysin S, and also by delayed hypersensitivity reactions to monilia antigen on skin testing, were diminished in children with high ESR, relative to controls. However, enhanced cellular responses in the abnormal children occurred to influenza A2 antigen, and to streptococcal group A polysaccharide, the latter possibly explaining chronic low‐grade tissue damage noted previously in these children. These findings are discussed in relation to resistance to infection and the pathogenesis of rheumatic fever, and a possible basis suggested in acquired change in function of the thymus, perhaps related to protein‐calorie malnutrition in infancy.

Indigenous child health: Are we making progress?

“…Jose and Welch of QIMR surveyed 12 Aboriginal communities in northern Queensland, also confirming elevated ESRs in children . Compared with controls, the high ESR group had more retardation of growth, enteric parasites, respiratory infections, elevated serum immunoglobulins and carriage of group A streptococci.…”

Migration inhibitory factor production by lymphoid cells of Australian Aboriginal children with moderate protein-calorie malnutrition

“…Similar inhibition of skin reactions to Candida were reported in more severely undernourished populations (Chandra, 19 7 2 ;Edelman et al, 1973). It is assumed that most individuals from these communities are immunised naturally against Candida as 70 -80% of adequately nourished children over the age of one year have shown positive Candida skin tests (Jose et aL, 1970;Edelman et al, 1973). Moreover, Aboriginal children with PCM have a high rate of isolation of Candida albicans from the gut (Gracey e t al., 1974).…”

“…Defective antigen handling at the level of the macrophage has been demonstrated in malnourished animals resulting in impaired production and avidity of antibody (Passwell et al, 1974). Depression of primary antibody responses and of some aspects of phagocytic cell function have also been demonstrated to occur in growth retarded aboriginal children (Jose et al, 1970. The administration of lymphocyte transfer factor from a suitably sensitised donor may bypass this form of block in antigen recognition (Brown and Katz, 1967), and might have therapeutic potential in the malnourished child.…”

Effect of a Low Protein Diet on IgE Antibody Responses in Balb/c Mice

“…Cell-mediated immune responsiveness is profoundly im paired in some studies on human malnutri tion [12] but not in others [11]. Serum im munoglobulin levels of all isotypic classes are, by contrast, elevated in children suffer ing from protein calorie malnutrition [4,10] and have been attributed to the increased antigenic challenge of chronic infections in malnourished children.…”