Effect of malnutrition in Ecuadorian children on titers of serum antibodies to various microbial antigens

Abstract

The titers of serum antibodies to natural infection with enteric and respiratory pathogens, to a food antigen and to tetanus and diphtheria toxoid were evaluated by enzyme-linked immunosorbent assay in 1,554 Ecuadorian children younger than 5 years of age. The nutritional status of the children was assessed by anthropometry and measurement of biochemical status indicators. The children were enrolled in a representative national nutrition and health survey. Antibody titers were analyzed as a function of the nutritional status of the children. For 12 of 14 antibody concentrations tested, underweight children showed lower antibody titers than did control children. The difference was statistically significant for antibody to both T-cell-dependent antigens (tetanus toxoid, rotavirus, respiratory syncytial virus) and T-cell-independent antigens (lipopolysaccharide, polyribosyl-ribitol phosphate, capsular polysaccharide). When children with a recent episode of diarrhea were excluded, many of the differences remained significant. When these children were further classified by age, only difference in titers of antibodies to respiratory syncytial virus and tetanus toxoid remained significant. No statistically significant difference was detected between underweight and control children with respect to protective antibody levels to four bacterial antigens. Anemic children showed significantly lower antibody levels to both T-cell-dependent and T-cell-independent antigens than did control children, and a higher proportion of anemic children had diphtheria antitoxin below a conservatively defined protective antibody level. No major differences in antibody titers were seen between children with different retinol and zinc concentrations in serum.

Effect of malnutrition on serum and milk antibodies in Zairian women

“…The effect of malnutrition on the immune responses of infants and children has been well documented (8,14). In fact, it has been proposed that infants and children in the developing world constitute the largest population with acquired immunodeficiency attributed to the consequences of protein-energy malnutrition on the immune system (23).…”

Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE)

“…Neither ZnD nor zinc supplementation has an appreciable effect on responses to bacille Calmette-Guérin ( 301 ), diphtheria and tetanus toxoid ( 388 ), rabies ( 389 ), influenza ( 390 ), Haemophilus influenza type b ( 321 ), and pneumococcal vaccines ( 389 , 391 ). Zinc supplementation, however, may improve antibody responses to cholera vaccination in children ( 392 ).…”

Evaluating Associations Between Vaccine Response and Malnutrition, Gut Function, and Enteric Infections in the MAL-ED Cohort Study: Methods and Challenges

“…A study addressing anti-measles antibody production showed a significant delay in anti-measles antibody production in malnourished children compared with well-nourished children [39]; however, the malnourished children caught up over time. Additionally, an observational study in Ecuador found low mean IgG and IgM antibody titers to tetanus toxoid in stunted children, but there was no difference in antibodies to diphtheria toxin [3], whereas a small study in Egypt described low diphtheria toxoid antitoxin levels in severely malnourished children assessed 21 days after vaccination [40]. The use of multiple assay formats complicates the comparison of these studies in different settings.…”

“…Among the most important is the timing of antigen exposure(s), including age of first presentation and the interval between vaccine doses. Other factors may include infections (recent and/or frequent diarrhea, respiratory illness, other concurrent infections) [1,2], malnutrition, particularly micronutrient deficiencies (vitamin A, iron, and zinc deficiency), stunting and wasting [3][4][5], intestinal dysfunction (malabsorption, inflammation, overgrowth) [6], maternal exposures (maternal antibody level, breastfeeding) [7], and early exposures to environmental antigens influenced by high population density, sanitation, or siblings [8].…”