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Does Massive Bowel Resection in Newborns Affect Further Immunity in Children?
Katarzyna Sznurkowska1, Anna Borkowska1, Agnieszka Zagierska1
1Department of Paediatrics, Pediatric Gastroenterology, Allergology and Nutrition, Medical University of Gdańsk, Nowe Ogrody 1-6, 80-803 Gdańsk, Poland.
Insights
Children with short bowel syndrome (SBS) show altered peripheral lymphocyte subsets, though not clinical immunodeficiency. Further follow-up is needed to monitor these changes in adaptive immunity.
Area of Science:
- Pediatric Immunology
- Gastroenterology
- Surgical Oncology
Background:
- Massive small intestine resection causes short bowel syndrome (SBS), impacting gut-associated lymphoid tissue and immunocompetent cells.
- The gut-associated lymphoid tissue is the largest immune organ in humans, crucial for immune cell development and function.
Purpose of the Study:
- To investigate the influence of bowel resection on adaptive immunity in children with SBS.
- To analyze peripheral lymphocyte subsets and serum immunoglobulins in pediatric SBS patients.
Main Methods:
- Study included 15 children with SBS requiring home parenteral nutrition.
- Flow cytometry was used to evaluate lymphocyte subsets: T, B, NK, CD4+, CD8+, and activated T cells.
Main Results:
- Significant differences observed in B, T, CD8+, and NK cell percentages in SBS patients.
- Lower absolute NK cell counts in the SBS group compared to controls.
- Inverse correlation between lymphocyte counts (total, B, T, CD4+) and age in SBS patients.
Conclusions:
- Children with SBS do not exhibit clinical immunodeficiency or significant deficits in peripheral lymphocyte subsets.
- A trend towards decreasing lymphocyte subpopulations over time suggests the need for extended monitoring.
- Longer follow-up is essential to understand the long-term adaptive immunity in pediatric SBS.
Background:
The massive resection of the small intestine leading to short bowel syndrome (SBS) deprives an organism of many immunocompetent cells concentrated in gut-associated lymphoid tissue, the largest immune organ in humans. We have aimed to access the influence of bowel resection on adaptive immunity in children, based on peripheral lymphocyte subsets and serum immunoglobulins.
Methods:
15 children who underwent bowel resection in the first months of their life and required further home parenteral nutrition were enrolled into the study. Based on flow cytometry, the following subsets of lymphocytes were evaluated: T, B, NK, CD4+, C8+, and activated T cells.
Results:
Statistically significant differences were found for the rates of lymphocytes B, T, CD8+, and NK cells. The absolute count of NK cells was lower in the SBS group than in the control group. Absolute counts of lymphocytes, lymphocytes B, T, CD4+, and percentages of lymphocytes CD4+, and activated T cells inversely correlated with age in SBS group.
Conclusions:
Children with SBS do not present with clinical signs of immunodeficiency as well as deficits in peripheral lymphocyte subsets and serum immunoglobulins. The tendency of the lymphocyte subpopulations to decrease over time points out the necessity for longer follow- up.
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