Reduced tetanus antibody titers in overweight children

Abstract

Under-nutrition impairs immune responses, but far less is known about the impact of overnutrition, such as obesity, on the response to vaccines. We measured the effect of childhood overweight status on inflammatory mediators, circulating immunoglobulins and tetanus antibodies in fifteen overweight children (BMI > 85 age-adjusted percentile) and 15 age-matched normal weight controls. Fitness was measured by a progressive ramp type exercise test. Lean body mass (LBM) and fat mass were determined by DXA. Tumor necrosis factor-a (TNF-a), interleukin-6 (IL-6), interleukin-1 β (IL-1β) and interleukin-1 receptor antagonist (IL-1ra) were used to assess the inflammatory status; and circulating immunoglobulins (IgM, IgA, IgG and IgG subclasses) and specific IgG titer to tetanus were used to assess humoral immunity. Overweight children had higher LBM and percent fat mass, and lower peak VO 2 normalized to body weight. IL-6 was significantly higher in the obese children (2.6 ± 0.3 vs. 1.3 ± 0.3 pg/ml, in overweight and normal weight children, respectively; p < 0.05). No significant differences were found in TNF-a, IL-1β and IL-1ra between the groups. No significant differences were found in immunoglobulin levels (IgM, IgA, IgG and IgG subclasses) between the groups. Anti-tetanus IgG antibodies were significantly lower in the overweight children compared to normal weight controls (2.4 ± 0.6 vs. 4.2 ± 0.5 IU/ml, in overweight and normal weight children, respectively; p < 0.05). The reduced specific antibody response to tetanus in obese children and adolescent might be due to mechanical factors such as lower relative vaccination dose, or reduced absorption from the injection site due to increased adipose tissue, or related to reduce immune response due to the chronic low grade inflammation expressed by the higher levels of IL-6.

A Humoral Immune Defect Distinguishes the Response to Staphylococcus aureus Infections in Mice with Obesity and Type 2 Diabetes from That in Mice with Type 1 Diabetes

“…In this report, we demonstrate an impaired adaptive immune response in mice with obesity-associated T2D. In agreement with our results, clinical studies have shown that obesity is associated with an impaired humoral immune response to influenza vaccination (20), and obese children have reduced titers to the tetanus vaccine (21). A genetic model of T2D also displayed an impaired immunoglobulin response to West Nile virus (32).…”

“…One clinical study demonstrated an impaired humoral immune response to influenza vaccination in obese patients (20). Another group demonstrated reduced titers to tetanus vaccine in obese children (21). Although these studies are valuable in assessing the immune response of obese patients, more studies must be completed to determine the mechanism behind altered adaptive immunity, as well as to determine the response of diabetics to live pathogens, such as S. aureus.…”

Association of atopic dermatitis with being overweight and obese: A systematic review and metaanalysis

“…75 The increased secretion of these proinflammatory molecules leads to a chronic low-grade inflammatory state and may predispose patients to hypersensitivity reactions. 21,[75][76][77][78] Adipokines, such as leptin and adiponectin, are also produced and released by adipocytes. Leptin has been found to enhance T cell survival and stimulate the production of proinflammatory cytokines, including tumor necrosis factorealpha, interferon-gamma, and interleukins 6, 12, and 2, thereby playing an important role in the modulation of the immune system.…”

Impaired dendritic cell functions disrupt antigen-specific adaptive immune responses in mice with nonalcoholic fatty liver disease

“…NAFLD patients are susceptible to infection and exhibit reduced responses to vaccinations [12,13]. In addition, many NAFLD patients are also chronically infected with hepatitis B virus and hepatitis C virus [14,15].…”