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Chronic T cell-mediated enteropathy in rural west African children: relationship with nutritional status and small bowel function

Chronic T cell-mediated enteropathy in rural west African children: relationship with nutritional status and small bowel function
Chronic T cell-mediated enteropathy in rural west African children: relationship with nutritional status and small bowel function
Previous studies from The Gambia have shown that poor childhood growth is resistant to all but the most intense nutritional intervention and highly dependent on small bowel permeability related to enteropathy. We thus aimed to characterize the mucosal inflammatory response in rural Gambian children in relation to intestinal permeability and nutritional status. Small bowel biopsies were taken from 38 rural Gambian children (age, 0.5-3 y) with a range of nutritional and clinical states (median weight z score, -4.6; range, 0.5 to -6.4), 75% of whom had diarrhea. Morphometry was performed with immunohistochemical analysis for a range of lineage and activation markers, including proinflammatory and regulatory cytokines, and related to current clinical status and gut permeability. Comparison was made with 19 age-matched U.K. controls. All Gambian children, regardless of nutritional status, had evidence of chronic cell-mediated enteropathy with crypt hyperplasia, villous stunting, and high numbers of intraepithelial lymphocytes. CD25+ cells were 20-fold higher than in U.K. controls. Although small bowel architecture was independent of nutritional status, T cell numbers rose and B cell numbers fell with worsening nutrition, and mucosal cytokine production became biased toward a proinflammatory response, with progressive decrease of transforming growth factor-ß expression. Tropical enteropathy predates the onset of marasmus and is characterized by a cell-mediated TH1 response. Protein-energy malnutrition is associated with reduction of regulatory immune responses in the mucosal microenvironment, potentially impairing the mechanisms of oral tolerance.
0031-3998
306-311
Campbell, David I.
7a02c4a4-8636-4d3d-b31f-91146fdbfaa3
Murch, Simon H.
42ecb341-5895-48d8-8606-90cf1f598b1e
Elia, Marinos
964bf436-e623-46d6-bc3f-5dd04c9ef4c1
Sullivan, Peter B.
592ac12c-fdc0-4758-8e8f-8d7fd90034ca
Sanyang, Mustapha S.
b6f2030b-cb88-4ba0-b3b2-9b77e3666dea
Jobarteh, Baba
0de66f34-51cd-4cc5-8fa6-112b55fdcedf
Lunn, Peter G.
b277f890-2d4d-40fd-aeca-ee415bff03b3
Campbell, David I.
7a02c4a4-8636-4d3d-b31f-91146fdbfaa3
Murch, Simon H.
42ecb341-5895-48d8-8606-90cf1f598b1e
Elia, Marinos
964bf436-e623-46d6-bc3f-5dd04c9ef4c1
Sullivan, Peter B.
592ac12c-fdc0-4758-8e8f-8d7fd90034ca
Sanyang, Mustapha S.
b6f2030b-cb88-4ba0-b3b2-9b77e3666dea
Jobarteh, Baba
0de66f34-51cd-4cc5-8fa6-112b55fdcedf
Lunn, Peter G.
b277f890-2d4d-40fd-aeca-ee415bff03b3

Campbell, David I., Murch, Simon H., Elia, Marinos, Sullivan, Peter B., Sanyang, Mustapha S., Jobarteh, Baba and Lunn, Peter G. (2003) Chronic T cell-mediated enteropathy in rural west African children: relationship with nutritional status and small bowel function. Pediatric Research, 54 (3), 306-311. (doi:10.1203/01.PDR.0000076666.16021.5E).

Record type: Article

Abstract

Previous studies from The Gambia have shown that poor childhood growth is resistant to all but the most intense nutritional intervention and highly dependent on small bowel permeability related to enteropathy. We thus aimed to characterize the mucosal inflammatory response in rural Gambian children in relation to intestinal permeability and nutritional status. Small bowel biopsies were taken from 38 rural Gambian children (age, 0.5-3 y) with a range of nutritional and clinical states (median weight z score, -4.6; range, 0.5 to -6.4), 75% of whom had diarrhea. Morphometry was performed with immunohistochemical analysis for a range of lineage and activation markers, including proinflammatory and regulatory cytokines, and related to current clinical status and gut permeability. Comparison was made with 19 age-matched U.K. controls. All Gambian children, regardless of nutritional status, had evidence of chronic cell-mediated enteropathy with crypt hyperplasia, villous stunting, and high numbers of intraepithelial lymphocytes. CD25+ cells were 20-fold higher than in U.K. controls. Although small bowel architecture was independent of nutritional status, T cell numbers rose and B cell numbers fell with worsening nutrition, and mucosal cytokine production became biased toward a proinflammatory response, with progressive decrease of transforming growth factor-ß expression. Tropical enteropathy predates the onset of marasmus and is characterized by a cell-mediated TH1 response. Protein-energy malnutrition is associated with reduction of regulatory immune responses in the mucosal microenvironment, potentially impairing the mechanisms of oral tolerance.

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Published date: 2003

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Local EPrints ID: 25344
URI: http://eprints.soton.ac.uk/id/eprint/25344
ISSN: 0031-3998
PURE UUID: 0ae3b15a-f59b-4456-a624-f3731bc96c31

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Date deposited: 06 Apr 2006
Last modified: 22 Jul 2022 20:30

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Contributors

Author: David I. Campbell
Author: Simon H. Murch
Author: Marinos Elia
Author: Peter B. Sullivan
Author: Mustapha S. Sanyang
Author: Baba Jobarteh
Author: Peter G. Lunn

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