Related Experiment Videos
Plasma-soluble CD30 in childhood tuberculosis: effects of disease severity, nutritional status, and vitamin A therapy
W A Hanekom1, G D Hussey, E J Hughes
1Division of Pediatric Infectious Diseases, Northwestern University Medical School, Chicago, Illinois 60614, USA. hanekow@rockvax.rockefeller.edu
Insights
Children with tuberculosis show high plasma-soluble CD30 (sCD30) levels, linked to nutritional status. Vitamin A supplementation modulated sCD30 levels during treatment.
Area of Science:
- Immunology
- Pediatrics
- Nutritional Science
Background:
- Plasma-soluble CD30 (sCD30) is derived from membrane-bound CD30, a marker for type 2 cytokine-producing cells.
- Tuberculosis in children is typically associated with type 1 lymphocyte cytokine responses.
- Disease severity and nutritional status may influence cytokine profiles and sCD30 levels in pediatric tuberculosis.
Purpose of the Study:
- To measure plasma-soluble CD30 (sCD30) levels in children diagnosed with tuberculosis.
- To investigate the association between sCD30 levels, disease severity, and nutritional status.
- To evaluate the impact of vitamin A supplementation on sCD30 levels during tuberculosis treatment.
Main Methods:
- Prospective analysis of plasma samples from 91 South African children diagnosed with tuberculosis.
- Measurement of sCD30 levels using enzyme immunoassay at diagnosis, and at 6 and 12 weeks of antituberculosis therapy.
- Comparison of sCD30 levels based on disease severity, nutritional indicators (weight percentile, kwashiorkor signs, hemoglobin), and vitamin A supplementation status.
Main Results:
- Children with tuberculosis exhibited elevated sCD30 levels at diagnosis (median 98 U/liter).
- Higher sCD30 levels were significantly associated with nutritional compromise (low weight percentile, kwashiorkor, low hemoglobin).
- Vitamin A supplementation led to a significant decrease in sCD30 levels over 12 weeks compared to placebo (P=0.02).
Conclusions:
- Elevated plasma-soluble CD30 (sCD30) in children with tuberculosis may indicate a type 2 cytokine response.
- Nutritional status is a significant factor associated with higher sCD30 levels in pediatric tuberculosis.
- Vitamin A therapy can modulate sCD30 levels during antituberculosis treatment, suggesting an interaction between vitamin A, immune response, and sCD30.
Abstract:
Plasma-soluble CD30 (sCD30) is the result of proteolytic splicing from the membrane-bound form of CD30, a putative marker of type 2 cytokine-producing cells. We measured sCD30 levels in children with tuberculosis, a disease characterized by prominent type 1 lymphocyte cytokine responses. We postulated that disease severity and nutritional status would alter cytokine responses and therefore sCD30 levels. Samples from South African children enrolled prospectively at the time of diagnosis of tuberculosis were analyzed. (Patients were originally enrolled in a randomized, double-blind placebo-controlled study of the effects of oral vitamin A supplementation on prognosis of tuberculosis.) Plasma samples collected at the time of diagnosis and 6 and 12 weeks later (during antituberculosis therapy) were analyzed. sCD30 levels were measured by enzyme immunoassay. The 91 children included in the study demonstrated high levels of sCD30 at diagnosis (median, 98 U/liter; range, 11 to 1,569 U/liter). Although there was a trend toward higher sCD30 levels in more severe disease (e.g., culture-positive disease or miliary disease), this was not statistically significant. Significantly higher sCD30 levels were demonstrated in the presence of nutritional compromise: the sCD30 level was higher in patients with a weight below the third percentile for age, in those with clinical signs of kwashiorkor, and in those with a low hemoglobin content. There was minimal change in the sCD30 level after 12 weeks of therapy, even though patients improved clinically. However, changes in sCD30 after 12 weeks differed significantly when 46 patients (51%) who received vitamin A were compared with those who had received a placebo. Vitamin A-supplemented children demonstrated a mean (+/- standard error of the mean) decrease in sCD30 by a factor of 0.99 +/- 0.02 over 12 weeks, whereas a factor increase of 1.05 +/- 0.02 was demonstrated in the placebo group (P = 0.02). We conclude that children with tuberculosis had high sCD30 levels, which may reflect the presence of a type 2 cytokine response. Nutritional compromise was associated with higher sCD30 levels. Vitamin A therapy resulted in modulation of sCD30 levels over time.