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Cell-mediated immune defects and infection. A study of malnourished hospitalized children
Insights
Severe malnutrition in hospitalized children depresses T cell immunity, leading to more infections. This study found a strong link between low E rosette (T cell) counts and increased illness in US pediatric patients.
Area of Science:
- Pediatrics
- Immunology
- Nutrition Science
Background:
- Severe protein-calorie malnutrition is linked to weakened cell-mediated immunity and higher infection rates in developing countries.
- The immune status of malnourished children in developed countries requires further investigation.
Purpose of the Study:
- To investigate the association between severe malnutrition, cell-mediated immunity, and infectious illness incidence in hospitalized US children.
- To determine if depressed T cell counts correlate with increased infections in this population.
Main Methods:
- Studied 23 hospitalized US children diagnosed with severe malnutrition.
- Assessed cell-mediated immunity using E rosette assays (measuring T cells) before nutritional therapy.
- Categorized patients into groups based on E rosette values (<50% abnormal, >50% normal).
Main Results:
- Eleven of 23 patients with E rosette values <50% experienced 18 clinical infections, including four sepsis episodes.
- One patient with normal E rosette values (>50%) had only one minor infection.
- A significant association was found between depressed cellular immunity (low E rosettes) and increased infections.
Conclusions:
- Depressed T cell immunity, indicated by low E rosette counts, is associated with a higher incidence of infections in malnourished hospitalized US children.
- Other host defense mechanisms, such as complement and phagocytic function, may also be compromised, contributing to increased infections.
Abstract:
Severe protein calorie malnutrition in children in developing countries has been characterized by noticeable depression of cell-mediated immunity and an increased manifestation of infectious illnesses. We studied 23 hospitalized US children whose admitting diagnoses included severe malnutrition to see if similar findings existed. Children were divided into two groups based on the percentage of E rosettes (T cells) prior to nutritional therapy. Those with E rosette values less than 50% were considered to have noticeably abnormal cell-mediated immunity. Eleven of the 23 patients who had rosette values less than 50% had 18 clinical infections, including four episodes of sepsis. One of the 23 children with normal (> 50%) E rosettes had one minor infection. It was concluded that depressed cellular immunity as measured by E rosette is associated with an increased incidence of infectious illness in the malnourished hospitalized pediatric patient in the United States. Other defects in host defenses, ie, defects in complement and phagocytic function, may also have contributed to the increased number of clinical infections noted in these patients.