Brief report. Study of plasma albumin, transferrin, and fibronectin in children with mild to moderate protein-energy malnutrition

Hassanein, E. A.; Assem, Hala M.; Rezk, Mohamed M; El-Maghraby, Randa M.

doi:10.1093/tropej/44.6.362

Cited by 10 publications

(7 citation statements)

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“…Results for α-1-antitrysin were inconsistent [128]. So-called negative acute phase proteins like transferrin [94] [130], α-2-HS-glycoprotein [135], fibronectin [133] [138] and pre-albumin [122] [138]–[139] were consistently reduced in malnourished children, even without infections.…”

Section: Resultsmentioning

confidence: 99%

“…Only one study found lower CRP levels in malnourished than well-nourished children with similar infections, despite higher levels of IL-6 [129]. So-called negative APP were uniformly low in children with malnutrition and infection, including transferrin [94] [127] [130]–[133], α-2-HS-glycoprotein [134]–[136], pre-albumin [122], fibronectin [132], and α-2-macroglobulin[127].…”

Section: Resultsmentioning

confidence: 99%

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The Immune System in Children with Malnutrition—A Systematic Review

et al. 2014

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BackgroundMalnourished children have increased risk of dying, with most deaths caused by infectious diseases. One mechanism behind this may be impaired immune function. However, this immune deficiency of malnutrition has not previously been systematically reviewed.ObjectivesTo review the scientific literature about immune function in children with malnutrition.MethodsA systematic literature search was done in PubMed, and additional articles identified in reference lists and by correspondence with experts in the field. The inclusion criteria were studies investigating immune parameters in children aged 1–60 months, in relation to malnutrition, defined as wasting, underweight, stunting, or oedematous malnutrition.ResultsThe literature search yielded 3402 articles, of which 245 met the inclusion criteria. Most were published between 1970 and 1990, and only 33 after 2003. Malnutrition is associated with impaired gut-barrier function, reduced exocrine secretion of protective substances, and low levels of plasma complement. Lymphatic tissue, particularly the thymus, undergoes atrophy, and delayed-type hypersensitivity responses are reduced. Levels of antibodies produced after vaccination are reduced in severely malnourished children, but intact in moderate malnutrition. Cytokine patterns are skewed towards a Th2-response. Other immune parameters seem intact or elevated: leukocyte and lymphocyte counts are unaffected, and levels of immunoglobulins, particularly immunoglobulin A, are high. The acute phase response appears intact, and sometimes present in the absence of clinical infection. Limitations to the studies include their observational and often cross-sectional design and frequent confounding by infections in the children studied.ConclusionThe immunological alterations associated with malnutrition in children may contribute to increased mortality. However, the underlying mechanisms are still inadequately understood, as well as why different types of malnutrition are associated with different immunological alterations. Better designed prospective studies are needed, based on current understanding of immunology and with state-of-the-art methods.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The Immune System in Children with Malnutrition—A Systematic Review

et al. 2014

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“…Acutely malnourished children are generally deficient in multiple nutrients concurrently (19, 106), but the pattern and extent of deficiencies is extremely heterogeneous (both between individuals in the same setting, but especially between different settings and regions) and abnormalities in nutrient trafficking mean some body compartments may even experience nutrient excess. For example, despite whole-body iron deficiency, free iron may be high in plasma due to protein deficiency limiting production of the iron-transporter protein transferrin (124, 125) or actively sequestered in macrophages during infection to restrict iron availability for pathogens (22). Ideally, diets used for animal models of undernutrition should be based on either: (i) nutrient intake profiles of undernourished children in a defined setting, or (ii) levels of existing nutrients, ideally taking into account the circulating nutrient pool as well as any tissue stores.…”

Section: Improving Assessment Of Immune Function In Undernutritionmentioning

confidence: 99%

Current Understanding of Innate Immune Cell Dysfunction in Childhood Undernutrition

2019

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Undernutrition affects millions of children in low- and middle-income countries (LMIC) and underlies almost half of all deaths among children under 5 years old. The growth deficits that characterize childhood undernutrition (stunting and wasting) result from simultaneous underlying defects in multiple physiological processes, and current treatment regimens do not completely normalize these pathways. Most deaths among undernourished children are due to infections, indicating that their anti-pathogen immune responses are impaired. Defects in the body's first-line-of-defense against pathogens, the innate immune system, is a plausible yet understudied pathway that could contribute to this increased infection risk. In this review, we discuss the evidence for innate immune cell dysfunction from cohort studies of childhood undernutrition in LMIC, highlighting knowledge gaps in almost all innate immune cell types. We supplement these gaps with insights from relevant experimental models and make recommendations for how human and animal studies could be improved. A better understanding of innate immune function could inform future tractable immune-targeted interventions for childhood undernutrition to reduce mortality and improve long-term health, growth and development.

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“…[7][8][9][10][11] Bu amaçla albümin, transferin, prealbümin (Transthyretin) ve fibronektin gibi serum proteinleri kullanılmaktadır. 4,8,13,15 Serum transferrin plazmada demiri taşıyan bir beta-globulindir. Transferrinin plazma düzeyleri beslenme etmenlerinden ve demir metabolizmasından etkilenir.…”

Section: Discussionunclassified

Serum transferrin levels in children with protein-energy malnutrition

Aydoğdu¹

2013

Dicle Med J

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Objective: Although the diagnosis of patients with severe malnutrition is easy, it is very difficult to recognize patients with mild and moderate malnutrition. A variety of methods attempts to develop for early diagnosis of these cases. In this study, we evaluated the serum transferrin and albumin levels in children with mild, moderate and severe protein-energy malnutrition (PEM). Materials and methods:Children admitted to our policlinic, aged between 3 and 25 months, 45 subjects with PEM and 39 healthy subjects (control group) were evaluated. According to the Gomez, Waterlow and Kanawati subjects with PEM were divided in 3 subgroups mild, moderate and severe PEM. Anthropometric measurements and biochemical results of 4 groups were compared.Results: For albumin levels in mild to moderate PEM groups, 37.7% sensitivity, and 28.5% specificity, positive predictive value 54%; negative predictive value 16.6% was found. For severe PEM sensitivity, specificity, positive predictive value and negative predictive value were 71%, 62.5%, 45%, and 83.3% respectively.With respect to the levels of transferrin, a significant difference was found between mild PEM-control and moderate PEM-control groups (p<0.05). There was no significant difference between the other groups (p>0.05). Conclusion:Our study results showed that albumin is a weak indicator in mild-moderate PEM. In these cases, serum transferrin level reduces before decreasing of albumin level, thus it may be an early sensitive finding that can be used as a sensitive parameter in the diagnosis of early stages of malnutrition.

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Brief report. Study of plasma albumin, transferrin, and fibronectin in children with mild to moderate protein-energy malnutrition

Cited by 10 publications

References 0 publications

The Immune System in Children with Malnutrition—A Systematic Review

The Immune System in Children with Malnutrition—A Systematic Review

Current Understanding of Innate Immune Cell Dysfunction in Childhood Undernutrition

Serum transferrin levels in children with protein-energy malnutrition

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