In Vitro Lymphocyte Functions in Undernourished Children With Sickle Cell Anemia.

Area of Science:

• Pediatric Hematology
• Immunology
• Nutritional Science

Background:

• Children with sickle cell disease (SCD) often experience growth deficits and compromised immunity.
• The impact of mild to moderate malnutrition on lymphocyte function in SCD is not well understood.
• This study investigates the relationship between undernutrition and lymphocyte function in pediatric SCD patients.

Purpose of the Study:

• To examine the effects of undernutrition on in vitro lymphocyte proliferation and Interleukin-2 (IL-2) activity in children with SCD.
• To differentiate the impact of undernutrition on lymphocyte function based on SCD genotypes (HbSS/HbSβ° vs. HbSC).
• To identify specific nutritional markers associated with altered immune responses in children with SCD.

Main Methods:

• Measured anthropometric data (weight, height) and plasma protein levels (albumin, prealbumin, transferrin, RBP, AGP, CRP, ceruloplasmin) in 90 children with SCD.
• Assessed in vitro lymphocyte proliferation and IL-2 activity in response to phytohemagglutinin stimulation.
• Analyzed data based on SCD genotypes (HbSS, HbSβ°, SC) and nutritional/inflammatory status.

Main Results:

• Children with HbSS/HbSβ° genotypes showed significantly lower anthropometric measurements, hemoglobin, and hematocrit compared to HbSC.
• Lymphocyte proliferation was reduced in HbSS/HbSβ° children with undernutrition, particularly when combined with inflammation.
• Undernutrition, defined by low prealbumin or albumin plus RBP, significantly reduced lymphocyte proliferation in HbSS/HbSβ° patients; IL-2 activity was reduced by low prealbumin in both genotypes.
• Prealbumin, RBP, and hemoglobin levels positively correlated with in vitro lymphocyte functions.

Conclusions:

• Undernutrition significantly alters in vitro lymphocyte function in children with HbSS/HbSβ° SCD genotypes.
• The findings suggest that nutritional interventions, such as dietary supplements, could potentially improve immune function in these children.
• Immune function in children with HbSC genotype was not adversely affected by undernutrition or inflammation in this study.