The immune system in children with malnutrition - a systematic review

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The immune system in children with malnutrition - a systematic review. / Rytter, Maren Johanne Heilskov; Kolte, Lilian; Briend, André; Friis, Henrik; Christensen, Vibeke Brix.

I: P L o S One, Bind 9, Nr. 8, e105017, 2014.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Harvard

Rytter, MJH, Kolte, L, Briend, A, Friis, H & Christensen, VB 2014, 'The immune system in children with malnutrition - a systematic review', P L o S One, bind 9, nr. 8, e105017. https://doi.org/10.1371/journal.pone.0105017

APA

Rytter, M. J. H., Kolte, L., Briend, A., Friis, H., & Christensen, V. B. (2014). The immune system in children with malnutrition - a systematic review. P L o S One, 9(8), [e105017]. https://doi.org/10.1371/journal.pone.0105017

Vancouver

Rytter MJH, Kolte L, Briend A, Friis H, Christensen VB. The immune system in children with malnutrition - a systematic review. P L o S One. 2014;9(8). e105017. https://doi.org/10.1371/journal.pone.0105017

Author

Rytter, Maren Johanne Heilskov ; Kolte, Lilian ; Briend, André ; Friis, Henrik ; Christensen, Vibeke Brix. / The immune system in children with malnutrition - a systematic review. I: P L o S One. 2014 ; Bind 9, Nr. 8.

Bibtex

@article{ee4601c745c84e148aab738023d517dd,
title = "The immune system in children with malnutrition - a systematic review",
abstract = "BACKGROUND: Malnourished 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.OBJECTIVES: To review the scientific literature about immune function in children with malnutrition.METHODS: A 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.RESULTS: The 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.CONCLUSION: The 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.",
author = "Rytter, {Maren Johanne Heilskov} and Lilian Kolte and Andr{\'e} Briend and Henrik Friis and Christensen, {Vibeke Brix}",
note = "CURIS 2014 NEXS 268",
year = "2014",
doi = "10.1371/journal.pone.0105017",
language = "English",
volume = "9",
journal = "P L o S One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "8",

}

RIS

TY - JOUR

T1 - The immune system in children with malnutrition - a systematic review

AU - Rytter, Maren Johanne Heilskov

AU - Kolte, Lilian

AU - Briend, André

AU - Friis, Henrik

AU - Christensen, Vibeke Brix

N1 - CURIS 2014 NEXS 268

PY - 2014

Y1 - 2014

N2 - BACKGROUND: Malnourished 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.OBJECTIVES: To review the scientific literature about immune function in children with malnutrition.METHODS: A 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.RESULTS: The 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.CONCLUSION: The 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.

AB - BACKGROUND: Malnourished 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.OBJECTIVES: To review the scientific literature about immune function in children with malnutrition.METHODS: A 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.RESULTS: The 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.CONCLUSION: The 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.

U2 - 10.1371/journal.pone.0105017

DO - 10.1371/journal.pone.0105017

M3 - Journal article

VL - 9

JO - P L o S One

JF - P L o S One

SN - 1932-6203

IS - 8

M1 - e105017

ER -

ID: 123736167