David Ode

The Immune Response in Protein-Energy Malnutrition and Single Nutrient Deficiencies

Protein-energy malnutrition (PEM) (undernutrition or overnutrition) is one of the nutritional problems recognized by the WHO as public health problems in different parts of the world. The others are nutritional anemias, vitamin A deficiency, and iodine deficiency. Primary PEM (undernutrition) has long been regarded as a problem of underprivileged, low-socioeconomic groups, especially those from less developed countries. Although severe malnutrition (kwashiorkor and/or marasmus) are rare except in countries hit by natural disasters such as drought and war, mild and moderate malnutrition are quite common. The prevalence of this form of malnutrition varies from 21 to 70% depending on the continent and/or country (Rao and Naider, 1977; Suskind et al., 1990). This form of malnutrition may not be any less deleterious on the immune response than severe malnutrition, especially when it occurs in the context of poor sanitation, infections, and multiple nutritional deficiencies.

Effects of iron deficiency on the secretion of interleukin‐10 by mitogen‐activated and non‐activated murine spleen cells

Interleukin (IL)‐10 plays crucial regulatory roles in immune responses by inhibiting the secretion of several cytokines (IL‐2, IL‐12, interferon‐gamma (IFN‐γ)) and lymphocyte proliferation. Iron deficiency, a public health problem for children, alters these immune responses. To determine whether these changes are related to altered IL‐10 secretion, we measured IL‐10 in 24 and 48 h supernatant of spleen cell cultures from iron deficient (ID), control (C), pairfed (PF), and ID mice fed the control diet (iron repletion) for 3 (R3) and 14 (R14) days (d, n = 12/group). Mean levels of hemoglobin, hematocrit, and liver iron stores varied as follows: C ≈ PF ≈ R14 > R3 > ID (P < 0.01). Mean baseline IL‐10 levels of ID mice tended to be higher than those of other groups (P > 0.05, ANOVA). Mean IL‐10 levels secreted by concanavalin A (Con A) and antibody raised against cluster of differentiation molecule 3 (anti‐CD3)‐treated cells (±background) were lower in ID than in C (48 h) and iron replete mice (P < 0.05). Underfeeding also reduced IL‐10 secretion by anti‐CD3‐treated cells (48 h, P < 0.05). Lymphocyte proliferative responses to anti‐CD3 ± anti‐CD28 antibodies were lower in ID than in C and PF mice, and they were corrected by iron repletion (P < 0.05). IL‐10 levels negatively correlated with indicators of iron status (r ≤ −0.285) and lymphocyte proliferation (r ≤ −0.379 [r ≤ −0.743 for ID mice]), but positively correlated with IFN‐γ levels (r ≤ 0.47; P < 0.05). Data suggest that iron deficiency has a generalized deleterious effect on cells that secrete both cytokines. Reduced IL‐10 secretion by activated cells does not overcome the inhibition of lymphocyte proliferation due to other factors of T cell activation that are regulated by iron. J. Cell. Biochem. 90: 278–286, 2003.

Gamma/delta T-cell lymphoma as a recurrent complication after transplantation.

We present a case of gamma-delta (γδ) T-cell lymphoma as a recurrent event in a pediatric liver transplant recipient. Liver transplantation was performed during infancy in an 18-month-old black girl because of cryptogenic cirrhosis. The patient received immunosuppression with cyclosporine and prednisone. Five years after transplantation, the patient was found to have a γδ T-cell lymphoma located in retroperitoneal nodes. She received chemotherapy and did well, remaining disease-free for 6 years. She remained only on prednisone for prevention of graft rejection, but was noted to have a non-tender skin nodule that upon biopsy proved to be again a γδ T-cell lymphoma. However, comparison of tissue from both tumors revealed that the second occurrence of this malignancy was a de novo event, differing from the first by immunophenotypic and immunohistochemical characteristics, and TCR rearrangement. The patient continues to do well, without evidence of disease recurrence, after being treated again with chemotherapy. A summary of the literature is presented and comparison of our case is made.

Retinoblastoma: A review

Retinoblastoma is the most common primary ocular malignancy in childhood, usually occurring below the age of five. Recent advances in molecular biology have enabled understanding of retinoblastoma tumorigenesis as well as detecting carriers of the mutant retinoblastoma allele. It is possible now to predict prenatally whether a child carries the retinoblastoma genome. This has enabled early detection of retinoblastoma and improved outcome. Also these children are at risk for mesenchymal tumors in early adult life necessitating life long vigilance. Great strides have been made in the management of retinoblastoma. Introduction of a new pathological staging system and addition of combination chemotherapy for extraocular disease has led to more than 80% long term disease free survivors in this group of patients, who earlier had a very poor outcome. For localized intraocular disease, local treatment seems to be all that is necessary. Newer radiation techniques have helped preserve useful vision and reduced radiation related side effects.

IN VITRO IMMUNE RESPONSES IN SICKLE CELL DISEASE (SCD) CHILDREN AS A FUNCTION OF VITAMIN A STATUS. † 712

IN VITRO IMMUNE RESPONSES IN SICKLE CELL DISEASE (SCD) CHILDREN AS A FUNCTION OF VITAMIN A STATUS. † 712

CORRELATIONS BETWEEN PLASMA RETINOL AND CLINICAL STATUS IN CHILDREN WITH SICKLE CELL DISEASE (SCD). 713

CORRELATIONS BETWEEN PLASMA RETINOL AND CLINICAL STATUS IN CHILDREN WITH SICKLE CELL DISEASE (SCD). 713