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      Malnutrition and Infection: Complex Mechanisms and Global Impacts

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      Author(s): * ,
      Publication date (Electronic):
      Journal: PLoS Medicine
      Publisher: Public Library of Science

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          Abstract

          The authors discuss current concepts and controversies surrounding the complex influences of malnutrition on infection and immunity, and point to practical consequences of countermeasures in acute malnutrition.

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          Leptin modulates the T-cell immune response and reverses starvation-induced immunosuppression.

          G. M. Lord, G Matarese, J K Howard … (1998)
          Nutritional deprivation suppresses immune function. The cloning of the obese gene and identification of its protein product leptin has provided fundamental insight into the hypothalamic regulation of body weight. Circulating levels of this adipocyte-derived hormone are proportional to fat mass but maybe lowered rapidly by fasting or increased by inflammatory mediators. The impaired T-cell immunity of mice now known to be defective in leptin (ob/ob) or its receptor (db/db), has never been explained. Impaired cell-mediated immunity and reduced levels of leptin are both features of low body weight in humans. Indeed, malnutrition predisposes to death from infectious diseases. We report here that leptin has a specific effect on T-lymphocyte responses, differentially regulating the proliferation of naive and memory T cells. Leptin increased Th1 and suppressed Th2 cytokine production. Administration of leptin to mice reversed the immunosuppressive effects of acute starvation. Our findings suggest a new role for leptin in linking nutritional status to cognate cellular immune function, and provide a molecular mechanism to account for the immune dysfunction observed in starvation.
          Article 0 comments Cited 403 times – based on 0 reviews     Review now
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            Survival for immunity: the price of immune system activation for bumblebee workers.

            Y Moret, P Schmid-Hempel (2000)
            Parasites do not always harm their hosts because the immune system keeps an infection at bay. Ironically, the cost of using immune defenses could itself reduce host fitness. This indirect cost of parasitism is often not visible because of compensatory resource intake. Here, workers of the bumblebee, Bombus terrestris, were challenged with lipopolysaccharides and micro-latex beads to induce their immune system under starvation (i.e., not allowing compensatory intake). Compared with controls, survival of induced workers was significantly reduced (by 50 to 70%).
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              Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria, and measles.

              Laura Caulfield, Mercedes de Onis, Monika Blössner … (2004)
              Previous analyses derived the relative risk (RR) of dying as a result of low weight-for-age and calculated the proportion of child deaths worldwide attributable to underweight. The objectives were to examine whether the risk of dying because of underweight varies by cause of death and to estimate the fraction of deaths by cause attributable to underweight. Data were obtained from investigators of 10 cohort studies with both weight-for-age category ( -1 SD) and cause of death information. All 10 studies contributed information on weight-for-age and risk of diarrhea, pneumonia, and all-cause mortality; however, only 6 studies contributed information on deaths because of measles, and only 3 studies contributed information on deaths because of malaria or fever. With use of weighted random effects models, we related the log mortality rate by cause and anthropometric status in each study to derive cause-specific RRs of dying because of undernutrition. Prevalences of each weight-for-age category were obtained from analyses of 310 national nutrition surveys. With use of the RR and prevalence information, we then calculated the fraction of deaths by cause attributable to undernutrition. The RR of mortality because of low weight-for-age was elevated for each cause of death and for all-cause mortality. Overall, 52.5% of all deaths in young children were attributable to undernutrition, varying from 44.8% for deaths because of measles to 60.7% for deaths because of diarrhea. A significant proportion of deaths in young children worldwide is attributable to low weight-for-age, and efforts to reduce malnutrition should be a policy priority.
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                Author and article information

                Journal
                Journal ID (nlm-ta): PLoS Med
                Journal ID (publisher-id): pmed
                Title: PLoS Medicine
                Publisher: Public Library of Science (San Francisco, USA )
                ISSN (Print): 1549-1277
                ISSN (Electronic): 1549-1676
                Publication date (Print): May 2007
                Publication date (Electronic): 1 May 2007
                Volume: 4
                Issue: 5
                Electronic Location Identifier: e115
                Author notes
                *To whom correspondence should be addressed. E-mail: Ulrich.Schaible@ 123456lshtm.ac.uk
                Article
                Publisher ID: 06-PLME-RIT-0448R2
                DOI: 10.1371/journal.pmed.0040115
                PMC ID: 1858706
                PubMed ID: 17472433
                SO-VID: bd2f6c1d-c1a7-40dd-b3af-c2c1f2bed30c
                Copyright © Copyright: © 2007 Schaible and Kaufmann. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                Page count
                Pages: 7
                Categories
                Subject: Research in Translation
                Subject: Immunology
                Subject: Immunology
                Subject: Infectious Diseases
                Subject: Infectious Diseases
                Subject: Non-Clinical Medicine
                Subject: Non-Clinical Medicine
                Subject: Nutrition
                Subject: Pediatrics and Child Health
                Subject: Pediatrics and Child Health
                Subject: Public Health and Epidemiology
                Subject: Public Health and Epidemiology
                Subject: Public Health and Epidemiology
                Subject: Public Health and Epidemiology
                Subject: Virology
                Subject: Virology
                Subject: Infectious Diseases
                Subject: Nutrition and Metabolism
                Subject: Pediatrics
                Subject: Medicine in Developing Countries
                Subject: HIV Infection/AIDS
                Custom metadata
                citation Schaible UE, Kaufmann SHE (2007) Malnutrition and infection: Complex mechanisms and global impacts. PLoS Med 4(5): e115. doi: 10.1371/journal.pmed.0040115

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