Thymolymphatic Deficiency and Depression of Cell-Mediated Immunity in Protein-Calorie Malnutrition

Smythe, P. M.; Brereton-Stiles, G.G.; Grace, H.J.; Mafoyane, A.; Schonland, M; Coovadia, Hoosen; Loening, W. E. K.; Parent, M; Vos, G. H.

doi:10.1016/s0140-6736(71)90267-4

Cited by 467 publications

(142 citation statements)

References 18 publications

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“…Severe malnutrition, which may jeopardize cellular immunity, has been implicated by some into triggering the disease 20,29 . However, the low frequency of children with severe malnutrition observed in the present study and the complete recovery of nutritional status after treatment, suggest that the malnutrition may be secondary to the PCM.…”

Section: Discussionmentioning

confidence: 99%

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Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome

Pereira

Bucaretchi

Barison

et al. 2004

Rev. Inst. Med. trop. S. Paulo

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SUMMARY From February, 1981 to May, 2001, 63 children under 15 y old (ages 2 -15 y, median = 8 y, mean ± 1 SD = 8 ± 3 y) presenting 70 episodes of Paracoccidioidomycosis were admitted. The main clinical manifestations and laboratory features observed upon admission were: lymph node enlargement (87.1%), fever (75.7%), weakness (48.6%), pallor (41.4%), hepatomegaly (40%), splenomegaly (35.7%), anemia (90%), hypergammaglobulinemia (88.5%), eosinophilia (75.5%) and hypoalbuminemia (72.5%). Moderate to severe malnutrition was detected in 35.7% of the episodes (Gomez's criterion). Radiographic and technetium studies showed bone lesions in 20 of the episodes, most of them being multiple lytic lesions, involving both long (70%) and plain bones (30%). First line treatment consisted of an association of sulfametoxazole-trimethoprin, which was used, exclusively, in 50 episodes. Follow-up of hemoglobin levels, number of eosinophils in the peripheral blood, albumin and gammaglobulin serum levels revealed significant sequential improvement one and six months after hospital admission, being quite useful to evaluate treatment effectiveness. Six patients died (9.3%) and four developed sequelae (6.3%) . In conclusion, the juvenile and disseminated forms can be observed in about 70% of the episodes of PCM occurring in children younger than 15 y old, most of them presenting with a febrile lymphoproliferative syndrome associated to anemia, eosinophilia and hypergammaglobulinemia.

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Section: Discussionmentioning

confidence: 99%

“…Deaths may be attributed to the severity of the disseminated forms of PCM in some children, probably immunocompromised by both PCM and malnutrition 20,25,29 .…”

Section: Radiologymentioning

confidence: 99%

Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome

Pereira

Bucaretchi

Barison

et al. 2004

Rev. Inst. Med. trop. S. Paulo

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“…In severe malnutrition in children there is good evidence of atrophy of the thymus and lymphatic tissues (32)(33)(34) , and an interesting hypothesis has been put forward that thymic impairment programmed in early life carries forward into susceptibility to infection in adult life (35) . More recently, dendritic cell function has been shown to be markedly impaired in severely-malnourished children (36) but these studies nicely illustrate the difficulty of interpreting data in severe clinical malnutrition.…”

Section: Nutrition Influences Host Defencementioning

confidence: 99%

Nutrition, intestinal defence and the microbiome

Kelly

2010

Proc. Nutr. Soc.

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The interaction between nutrition and infection was the subject of important work by several groups in the 1960s. The explosion of knowledge in immunology, including innate immunity, has led to increased understanding of the impact of nutrition on host defence, but much more work needs to be done in this area. In the last decade an increasing volume of work has opened up the previously obscure world of human endogenous flora. This work suggests that the microbiome, the total genetic pool of the microbiota, contributes to the already complex interaction between nutrition and infectious disease. The established concept that nutritional status, host defence and infection all impact on each other now has to be expanded into a multiple interaction, with the microbiota interacting with all three other elements. There is good evidence that the microbiome programmes host defence and drives a metabolome that impacts on energy balance, and indeed on some micronutrients. In turn, host defence shapes the microbiome, and nutritional status, particularly micronutrient status, helps determine several elements of host defence. While interventions in this area are in their infancy, the understanding of interactions that already have an enormous impact on global health is now at a threshold. The present review explores the evidence for these interactions with a view to putting potential interventions into the context of a conceptual framework.

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“…When atrophy of thymus and peripheral lymphoid organs is found in a toxicity study present at a dose level where there is also a reduction in body weight when compared with control animals, special emphasis should be given to the possibility that the atrophy is produced by undernutrition, 24,25 considering depression of cellular immunity as the most important factor in the morbidity and mortality of human patients with malnutrition. 26 The impairment of cell-mediated immune reactions may be related to increased serum levels of glucocorticoids as found in children with protein calorie malnutrition 27 and in undernourished young rats. 28 However, moderate chronic protein or amino acid restriction in mice and rats inhibits the humoral immune response, does not impair cell-mediated immunity, reduces the incidence of spontaneous tumors, and increases the resistance to transplantable tumors.…”

Section: Indirect Effectsmentioning

confidence: 99%

Immune Suppression as Related to Toxicology

Vos

2007

Journal of Immunotoxicology

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Thymolymphatic Deficiency and Depression of Cell-Mediated Immunity in Protein-Calorie Malnutrition

Cited by 467 publications

References 18 publications

Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome

Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome

Nutrition, intestinal defence and the microbiome

Immune Suppression as Related to Toxicology

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