The jejunal mucosa in kwashiorkor.

Burman, David

doi:10.1136/adc.40.213.526

Cited by 72 publications

(27 citation statements)

References 12 publications

(3 reference statements)

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“…Histologically, this is characterized by atrophy and effacement of the skin layers, hyperkeratosis and a pronounced cutaneous inflammatory response [14][15][16], providing a potential portal of entry for pathogens. An extensive enteropathy has long been recognized in children with severe malnutrition, characterized by mucosal inflammatory infiltrate, villous atrophy and compromised intestinal barrier function [17]. It has also been noted since the 1960s that a small intestinal abnormality, originally termed tropical enteropathy, is almost universally seen among apparently healthy people living in developing countries [18,19], but it is only relatively recently that attention has refocused on this condition.…”

Section: (A) Mucosal Barrier Dysfunctionmentioning

confidence: 99%

Malnutrition and vaccination in developing countries

Prendergast

2015

Phil. Trans. R. Soc. B

124

103

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Malnutrition contributes to an estimated 45% of deaths among children under 5 years of age in developing countries, predominantly due to infections. Malnourished children therefore stand to benefit hugely from vaccination, but malnutrition has been described as the most common immunodeficiency globally, suggesting that they may not be able to respond effectively to vaccines. The immunology of malnutrition remains poorly characterized, but is associated with impairments in mucosal barrier integrity, and innate and adaptive immune dysfunction. Despite this, the majority of malnourished children can mount a protective immune response following vaccination, although the timing, quality and duration of responses may be impaired. This paper reviews the evidence for vaccine immunogenicity in malnourished children, discusses the importance of vaccination in prevention of malnutrition and highlights evidence gaps in our current knowledge.

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Section: (A) Mucosal Barrier Dysfunctionmentioning

confidence: 99%

Malnutrition and vaccination in developing countries

Prendergast

2015

Phil. Trans. R. Soc. B

124

103

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“…[1][2][3][4][5] 18 Small segments (1-5-2-5 cm) of all killed animals were quickly obtained from proximal jejunum, just beyond the ligament of Treitz and from distal ileum, 2-3 cm proximal to the ileocaecal valve. These segments were placed serosal side down on a piece of cardboard, immersed in Bouin's fixative for 72 hours and embedded in paraffin; blocks were sectioned on the same microtome, at the same setting of 4 ,um and stained by haematoxylin and eosin for qualitative examination of the mucosa and by Periodic Acid-Schiff reaction for measurements.…”

Section: From Departments Of Pathology and Medicine (Nutrition Divisionmentioning

confidence: 99%

Morphometric study of the small intestinal mucosa in young, adult, and old rats submitted to protein deficiency and rehabilitation.

Rodrigues¹,

Camargo²,

Coelho³

et al. 1985

Gut

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SUMMARY Linear and stereological morphometric methods were applied to the jejunal and ileal mucosa of young, adult, and old male Wistar rats submitted to protein deficiency and rehabilitation. The animals were fed ad libitum a 2% casein diet during 42 days and then received a 20% casein diet for 30 days. Food intake, body weights, and plasma protein concentrations were recorded. In the young protein deficient rats values of mucosal height, surface area, and volume of the lamina propria were significantly lower than those of their age controls in both jejunum and ileum. In adults the differences were less marked and in the old rats all parameters were found to be unaltered by the protein deficient diet. The surface-to-volume ratio showed no significant differences between control and protein deficient in all three age groups, meaning that villus pattern did not change with protein deficiency. On rehabilitation, a striking difference between jejunum and ileum was observed in the young rats; all parameters returned to control levels in the jejunum, while they remained lower than those of their controls in the ileum.

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“…Jejunal biopsies were normal for African subjects in Africa (Cook et al 1969;Cook et al 1973). It seems from this study that significant malabsorption does not occur in association with malnutrition unless marked mucosal changes, which are occasionally seen in severe kwashiorkor (Burman, 1965 ;Stanfield, Hutt & Tunnicliffe, 1965), are present. The concentrations of glucose, glycine and glycylglycine in the perfusion solutions were higher than are likely to be present in the human jejunum in vivo; however, values for such concentrations are scanty.…”

Section: G C Cook I974 Discussionmentioning

confidence: 90%

Jejunal absorption rates of glucose, glycine and glycylglycine in Zambian African adults with malnutrition

Cook

1974

Br J Nutr

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I. Absorption rates of glucose (from a 200 mM solution), glycine (from a 100 mM solution), and glycylglycine (from a 50 mM solution) have been estimated in six Zambian African adults with clinical evidence of malnutrition. A double-lumen tube technique was used to determine absorption rates from a 300 mm section of jejunum in vivo.2. Two of the subjects had ileal tuberculosis and Kaposi's sarcoma respectively. A third probably had abdominal tuberculosis. Three of them had pellagra. Mean serum albumin concentration was 24 (14-43) g/l. Absorption rates have been compared with those in Zambian Africans (control subjects), previously studied, who had no clinical evidence of malnutrition, systemic infection or of gastrointestinal disease.3. Mean glucose, glycine and glycylglycine absorption rates in the malnourished subjects were not significantly different from those in the control subjects. Mean net water absorption rate from the glucose solution was similar in the malnourished subjects and controls; during the glycine and glycylglycine perfusions the mean net absorption rate was, however, significantly lower in the malnourished subjects (P < 0.01 and P < 0.05 respectively); mean net water transfer during the glycine perfusions was towards the jejunal lumen in the malnourished subjects. One subject with pellagra had an abnormal excretion of D-XylOSe after a 25 g oral load; all other tests were normal. 4.It seems probable that malnutrition must be very severe, with jejunal mucosal abnormalities, before absorption rates of glucose, glycine and glycylglycine are significantly altered. The present study does not support the view that subclinical malnutrition is important in producing malabsorption of dietary components in Zambian African subjects. Systemic bacterial infections, and raised serum y-globulin and immunoglobulin IgG concentrations have previously been associated with an impairment of glucose absorption rate in Zambian African subjects; those factors seem much more likely than subclinical malnutrition to be relevant, in the context of absorption, in the pathogenesis of overt malnutrition.

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The jejunal mucosa in kwashiorkor.

Cited by 72 publications

References 12 publications

Malnutrition and vaccination in developing countries

Malnutrition and vaccination in developing countries

Morphometric study of the small intestinal mucosa in young, adult, and old rats submitted to protein deficiency and rehabilitation.

Jejunal absorption rates of glucose, glycine and glycylglycine in Zambian African adults with malnutrition

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