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[Immunologic characteristics of undernutrition. I. The undernourished patient in nutritional recovery]
A Amesty-Valbuena1, M Diez-Ewald, M de Villarroel
1Cátedra de Microbiología, Escuela de Medicina, Universidad del Zulia, Maracaibo, Venezuela.
Insights
Childhood malnutrition impairs immune competence, increasing disease risk. Nutritional recovery improved immune markers like C3 complement, secretory IgA, and CD4 lymphocytes, indicating reversibility of immune deficits.
Area of Science:
- Pediatric Nutrition
- Immunology
- Public Health
Context:
- Childhood malnutrition is a significant global health issue, particularly in developing nations.
- It is linked to altered immune responses, increased susceptibility to infections, and higher mortality rates.
- Undernourished children exhibit compromised immunocompetence, impacting overall health outcomes.
Purpose:
- To investigate the impact of malnutrition on immune competence in children aged 5-24 months.
- To assess the reversibility of immune alterations following a nutritional recovery program.
- To compare immune parameters in malnourished children with a healthy control group.
Summary:
- A study of 12 malnourished children (including kwashiorkor and marasmus) and 10 healthy controls examined immune markers over 8 weeks.
- Key findings revealed significantly lower C3 complement, secretory IgA (IgAs), and CD3/CD4 lymphocytes in malnourished children.
- These immune deficits, including low C3, IgAs, and CD3-CD4 lymphocytes, were reversible after the nutritional recovery program.
Impact:
- Demonstrates that malnutrition-induced immune deficiencies in children are reversible with nutritional intervention.
- Highlights the importance of nutritional recovery programs in restoring immune function and potentially reducing infection-related morbidity and mortality.
- Provides insights into specific immune markers (C3, IgAs, CD4) that can be monitored during recovery from childhood malnutrition.
Abstract:
Malnutrition in children is a well known critical factor that determines immunocompetence changes with altered immune response and higher risk to many diseases, especially in developing countries. Moreover, it is related to increased morbi-mortality rates mainly due to infections. For those reasons, 12 undernourished children, age 5 to 24 months were studied along 8 weeks at the Nutritional Recovery Center of Chiquinquira Hospital in Maracaibo, Venezuela. There were 5 cases of kwashiorkor, 5 marasmatics, 1 mixed marasmus/kwashiorkor and 1 case with moderate malnutrition. After a control blood sample was taken and cutaneous tests were done, a nutritional recovery program was began. At regular time intervals and at the end of the study, tests were done again by measuring seric immunoglobulins (IgG, IgA, IgM), secretory IgA (IgAs), C3 and C4 complement, lymphocytic sub-populations, and auto antibodies; cutaneous hipersensitivity tests were also done. As a control group, 10 apparently healthy children of matching age and sex were also studied with the same parameters. Results show that basal seric Igs did not differ significantly from the control group and did not change along the recovery program period, but there was a significant decrease in IgAs at all times of the study. C4 did not change and C3 was lower than control (p < 0.05) but returned to normal value at the end of the recovery period. CD3 and CD4 lymphocytes showed the same pattern. Only two patients showed positive skin tests and auto antibodies were not detected. It is concluded that there is indeed an altered immune competence with low levels of C3, IgAs, and CD3-CD4 lymphocytes that is reversible after nutritional recovery.