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Nutrition and Infection ((Micronutrients and Infection, Vitamin A and…
Nutrition and Infection
Malnutrition almost always has infection as part of its
cause - this complicates understanding of the biology and affects treatment needs
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mucosal barriers-physical integrity, secretions
lymphoid organ size and cell #, especially thymus
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antibody quality and secreted antibody,
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innate immunity, inflammation,
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Enteropathogen infection contributes to (i) stunting, (ii) wasting, and (iii) micronutrient deficiencies.
Enteropathogen infection causes intestinal inflammation and diminished barrier and adsorptive functions of the gut.
In children (≤24 months old), gut dysfunction associated with enteric infections and undernutrition results in (i) diminished nutrient absorption from the gut, (ii) growth faltering, (iii) cognitive impairments, and (iv) impaired responses to childhood vaccines.
Underlying these hypotheses is a belief that enteric infections, malnutrition, and gut function interact, rather than act in isolation, to affect physical growth, cognitive development, and immune responses to vaccination
The incidence and prevalence of chronic undernutrition manifested as stunting is commonly observed, but the mechanistic causes are poorly understood.
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.
other immune parameters seem intact or elevated: leukocyte and lymphocyte counts are unaffected, and levels of immunoglobulins, particularly immunoglobulin A, are high.
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Serum concentrations of micronutrients have been shown to both increase (iron) and decrease (vitamin A and zinc) in re-sponse to infection, inflammation, or tissue injury
Re-peated exposure to pathogenic bacteria, viruses, and parasites may impact the nutritional status of an individual by competing for available micronutrients, and/or cause villus blunting and thus impair nutrient absorption
increased intestinal permeability to pathogens, endotoxins, and other macromolecules that can re-sult in the chronic stimulation of the immune system