Nutrition, Immunity and Infections: T Lymphocyte Subpopulations in Protein--Energy Malnutrition

Özkan, Hasan; Olgun, Nur; Şaçmaz, Ergun; Abacioglu, Hakan; Okuyan, Melahat; Çevik, Necla

doi:10.1093/tropej/39.4.257

Cited by 32 publications

(25 citation statements)

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“…In 17 of 21 studies, levels of C3 were depressed in malnourished children [89] [94] [99] [106] [124]–[125] [127]–[130] [144]–[154]. Two studies found C3 to correlate with albumin [94] [148], and with one exception [94], C3 levels were lower in children with oedematous than non-oedematous malnutrition [89] [146] [149] [150]–[151] [153].…”

Section: Resultsmentioning

confidence: 99%

“…Early studies identified T-lymphocytes as those forming rosettes with sheep red blood cells, while later studies used monoclonal antibodies to CD3. Using the rosette-method, 19 of 20 studies found lower levels of T-lymphocytes [28] [87] [93] [101] [128] [130] [144] [183] [186]–[187] [191] [199] [203]–[210]. Four studies using monoclonal CD3-antibodies and cell-counting by microscopy also found reduced levels of T-lymphocytes in malnourished children [144] [167]–[168] [207].…”

Section: Resultsmentioning

confidence: 99%

“…Using the rosette-method, 19 of 20 studies found lower levels of T-lymphocytes [28] [87] [93] [101] [128] [130] [144] [183] [186]–[187] [191] [199] [203]–[210]. Four studies using monoclonal CD3-antibodies and cell-counting by microscopy also found reduced levels of T-lymphocytes in malnourished children [144] [167]–[168] [207]. In contrast, only one flow cytometry study found lower levels of T-lymphocytes in malnourished children [211], while four did not [86] [94] [210] [212].…”

Section: Resultsmentioning

confidence: 99%

“…In children without HIV, two of four studies using monoclonal antibodies and microscopy found reduced levels of CD4+ lymphocyte in malnourished children [144] [168] [219] [207], while all seven flow cytometry-studies except one [211] found similar or higher levels [86] [90] [91] [94] [198] [212]. Bacterial infections were noted to reduce the CD4-count [86].…”

Section: Resultsmentioning

confidence: 99%

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The Immune System in Children with Malnutrition—A Systematic Review

et al. 2014

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BackgroundMalnourished children have increased risk of dying, with most deaths caused by infectious diseases. One mechanism behind this may be impaired immune function. However, this immune deficiency of malnutrition has not previously been systematically reviewed.ObjectivesTo review the scientific literature about immune function in children with malnutrition.MethodsA systematic literature search was done in PubMed, and additional articles identified in reference lists and by correspondence with experts in the field. The inclusion criteria were studies investigating immune parameters in children aged 1–60 months, in relation to malnutrition, defined as wasting, underweight, stunting, or oedematous malnutrition.ResultsThe literature search yielded 3402 articles, of which 245 met the inclusion criteria. Most were published between 1970 and 1990, and only 33 after 2003. Malnutrition is associated with impaired gut-barrier function, reduced exocrine secretion of protective substances, and low levels of plasma complement. Lymphatic tissue, particularly the thymus, undergoes atrophy, and delayed-type hypersensitivity responses are reduced. Levels of antibodies produced after vaccination are reduced in severely malnourished children, but intact in moderate malnutrition. Cytokine patterns are skewed towards a Th2-response. Other immune parameters seem intact or elevated: leukocyte and lymphocyte counts are unaffected, and levels of immunoglobulins, particularly immunoglobulin A, are high. The acute phase response appears intact, and sometimes present in the absence of clinical infection. Limitations to the studies include their observational and often cross-sectional design and frequent confounding by infections in the children studied.ConclusionThe immunological alterations associated with malnutrition in children may contribute to increased mortality. However, the underlying mechanisms are still inadequately understood, as well as why different types of malnutrition are associated with different immunological alterations. Better designed prospective studies are needed, based on current understanding of immunology and with state-of-the-art methods.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The Immune System in Children with Malnutrition—A Systematic Review

et al. 2014

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“…Last but not the least, malnutrition is the most common cause of immunodeficiency, and malnutrition in the uterus is one of the major causes of IUGR (Zijlstra et al, 1999;Özkan and Olgun, 1993). IUGR neonatal piglets might be good models of malnutrition research.…”

Section: Discussionmentioning

confidence: 99%