|Nutrition in pediatric HIV infection: setting the research agenda. Nutrition and immune function: overview.|| ||Beisel WR.
| ||"Protein/energy malnutrition ... generally lead to atrophy of lymphoid tissues and dysfunctions of cell mediated immunity... which allow infectious diseases to fluorish. These closely linked events can initiate a "downhill spiral" or a "vicious cycle" that leads inexorably to death... Protein energy malnutrition causes a marked repression of cell-mediated immunity and the function of T-lymphocytes. Malnourished children show anergy with loss of delayed dermal hypersensitivity reactions and a decrease or reversal of the CD4/CD8 cell ratio... In contrast, B-lymphocyte numbers and functions appear to be maintained. While existing antibody production is conserved or even increased during malnutrition, antibody responses and antibody affinity are impaired... Deficiencies of single essential nutrients with important roles in nucleic acid synthesis and metabolism appear to cause derangements in immunological functions that are quite similar to those seen in protein energy malnutrition ... Both vitamin A and zinc deficiencies are characterized by lymphoid tissue atrophy and depressed cellular immunity ..."|
| ||J Nutr, 1996 oct, 126(10 Suppl):2611S-2615S||1996|
|Nutrients as modulators of anergy in acquired immune deficiency syndrome.|| ||Hegde HR, Woodman RC, Sankaran K
| ||The authors found that reduced CD4 counts were a natural physiological effect of malnutrition, and comment that both HIV and malnutrition lead to a state of anergy with failure of cell-mediated immunity. They also point out that HIV usually occurs in conjunction with several other stressors of the immune system: "micronutrient abnormalities, concomitant infections, and genetic factors are some of the compounding co-factors which furthur contribute to the deterioration of immune functions in AIDS patients".|
| ||J Assoc Physicians India, 1999 march, 47(3): 318-25||1999|
|Nutrition and the immune system: an introduction.|| ||Chandra RK
| ||"Nutrition is a critical determinant of immune responses and malnutrition the most common cause of immunodeficiency worldwide. Work done in the past 25 years has confirmed that impaired immunity is a critical adjunct factor in malnutrition-associated infections. ... Lymphoid atrophy is a dramatic feature of protein energy malnutrition. ... Delayed hypersensitivity cutaneous responses are markedly depressed. It is not uncommon to have complete anergy to a battery of different antigens. These changes are observed in moderate deficiencies as well... the proportion of helper T-lymphocytes (CD4+ T-cells) is markedly decreased, and the ratio of CD4 to CD8 cells is significantly lower than in well-nourished control subjects." Figure 3 on page 462S shows that the percentage of CD4+ T-cells in normal well-nourished children is about 45%, while the percentage in malnourished children is only 25%.|
| ||Am J Clin Nutr, 1997 aug, 66(2) :460S-463S||1997|
|Nutrition and immunity with emphasis on infection and autoimmune disease.|| ||Harbige LS
| ||This paper mentions lowered CD4+ lymphocytes, decreased T-cell function, and anergy and increase in antibody levels which is also seen in people diagnosed HIV-positive, specifically serum IgG, IgM, IgA, and IgD. The main addition is the mention of specific infections that are particularly common in people who are malnourished: "Among the many infectious organisms commonly associated with protein energy malnutrition are Paramyxovirus (Measles), Rotaviruses, Mycobacterium tuberculosis, E-coli, Shigella, E-histolytica, and Pneumocystis carinii."|
| ||Nutrition and Health, 1996, 10; 285-312.||1996|
|Randomized trial effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV-1-infected women in Tanzania.|| ||Fawzi, W.W., Msamanga, G.I., Spiegelman, D., et al.
| ||The influence of diet on T cells counts in peripheral blood in 1,075 HIV-infected pregnant women who had poor nutritional status were studied. The CD4+ T cell counts of the women who received multivitamin increased from 424/ÁL to 596/ÁL during six months of proper feeding.|
| ||The Lancet 351:1447-1482, 1998||1998|
|Idiopathic CD4+ T lymphopenia in older persons.|| ||Kaiser, F. E., and J. E. Morley.
| ||"Survey of the association of idiopathic CD4+ T cell lymphocytopenia in older persons with protein energy undernutrition and unusual infections/colonizations... Five subjects aged 61 to 87 years, with unusual organisms and/or either marasmus or kwashiorkor, were noted to have absolute CD4+ and CD8+ T cell lymphocytopenia. All were HIV negative... T cell lymphocytopenia may not be a uncommon finding in malnourished older persons, but additional studies to determine its prevalence need to be undertaken."|
| ||J Am Geriatr Soc, 1994, 42(12):1291-4.||1994|
|Cell-Mediated immune responses in malnourished host.|| ||Fakhir, S., Ahmad, P., Faridi, M.A., and Rattan, A.
| ||Fakhir evaluated 100 severely malnourished children and found that these children had a significant reduction in the absolute lymphocytes count and T cells count|
| ||J. Trop. Pediatr. 35(4):175-8, 1989||1989|