Rosangela da Silva

Níveis plasmáticos de vitamina A em crianças carentes com pneumonia na fase aguda e após recuperação

OBJECTIVE: The aim of this study was to examine the plasma retinol of children in the acute phase of pneumonia and after recovery and to investigate the association between plasma levels of retinol after recovery with socioeconomic variables, nutritional status and severity of pneumonia. METHODS: A prospective cohort study which included 40 low-income hospitalized children with pneumonia, aged 6 months to 5 years. We evaluated: plasma retinol level during the acute phase and after recovery, years of schooling of the head of the family, per capita income, birth weight, nutritional status, hemoglobin levels and severity of pneumonia. RESULTS: Mean plasma retinol levels were significantly higher after recovery than during the acute phase of infection (1.4±0.6 vs. 1.7±0.6 µmol/l, p = 0.03). The frequency of inadequate plasma retinol levels (< 1.05 µmol/l) was 32.5 and 17.5% for the acute phase and after recovery, respectively. There were no statistically significant associations between plasma retinol deficiency and the clinical and epidemiological variables studied. More severe pneumonia was observed in 30/40 (75%) of the patients. There was no statistically significant association between plasma retinol inadequacy after recovery and severity of pneumonia (4/30 - 13.3% vs. 3/10 - 30.0%, p = 0.34). CONCLUSION: Serum retinol levels were significantly higher after recovery than during the acute phase of pneumonia. There was no statistically significant association between the deficiency of serum retinol and the clinical and epidemiological variables studied.

Risk of Atherosclerosis in Patients with Ataxia Telangiectasia

Background and Aims: Evaluate the nutritional status, plasma concentration of vitamin E and markers of cardiovascular risk in ataxia telangiectasia (AT) patients. Methods: Cross-sectional study with 13 patients with AT and 22 healthy controls, evaluating the following factors: nutritional status, food intake, lipid profile, plasma concentration of vitamin E, malondialdehyde and high sensitivity C-reactive protein, linking them with atherosclerosis risk in AT patients. Results: Average age was 14.6 in the AT group, 30.8% were malnourished and 23.1% had stunting. A greater impairment of lean body mass was found in these patients. Concentrations of triglycerides (TG), total cholesterol (CT), LDL-c, non-HDL cholesterol (NHDL-c) were significantly higher in patients and HDL-c, lower. Vitamin E/total lipids and vitamin E/TG ratios were lower in the AT group, and significant inverse correlation between these ratios and NHDL-c, CT/HDL-c, and LDL-c/HDL-c, log TG/HDL-c was observed in the AT group. Alanine aminotransferase correlated directly and significantly with NHDL-c, CT/HDL-c and LDL-c/HDL-c, in patients. Conclusion: The alterations of lipid metabolism biomarkers suggestive of atherosclerotic risk of male AT patients coupled with lower vitamin E/total lipids ratio and low lean body mass may complicate the clinical course of the disease and emphasizes the importance of multidisciplinary care, routine monitoring of cardiovascular biomarkers and appropriate nutritional guidance.

Vitamin D and primary immunodeficiencies.

Some of the recognized actions of vitamin D include immunological effects such as keeping tolerance and to promote protective immunity. These functions are related to the blocking of B cell differentiation and immunoglobulin secretion as well as decreased production of inflammatory cytokines. The aim of this study was to describe the frequency of vitamin D deficiency in patients with primary immunodeficiencies. We studied 31 patients: 14 with Ataxia-telangiectasia (11 male, mean age 13.1±4.9 years) and 17 with Common variable immunodeficiency (8 males, mean age 28.5±11.3 years). Classification of nutritional status and percentage of fat mass were evaluated. 25-hydroxyvitamin D was analyzed by high performance liquid chromatography and deficiency was Short Communication Paulino et al.; BJMMR, 7(12): 1035-1038, 2015; Article no.BJMMR.2015.419 1036 considered when 25-hydroxyvitamin D< 20 ng/mL. Malnutrition was the most common nutritional disorder: 7/14 (50%) and 4/17 (23.5%) in Ataxia-telangiectasia and Common variable immunodeficiency groups, respectively. We found a high percentage of 25-hydroxyvitamin D deficiency in the Ataxia-telangiectasia group 6/14 (42.8%) and Common variable immunodeficiency group 3/17 (17.6%). There was no association between vitamin D deficiency and high-sensitivity C-reactive protein, lymphocyte count (CD3, CD4 and CD8) and body fat percentage. Considering the frequency of autoimmune diseases and infections in patients with primary immunodeficiencies, strict monitoring of the vitamin levels are recommended with the aim to reduce morbidity.

Higher Cardiovascular Risk in Common Variable Immunodeficiency and X-Linked Agammaglobulinaemia Patients

Introduction: Common variable immunodeficiency and X-linked agammaglobulinaemia are primary immunodeficiencies classified as antibody deficiencies, and they both result in hypogammaglobulinaemia. Objective: Evaluate the lipid profile and other cardiovascular risk biomarkers in CVID and XLA patients. Methods: In total, 24 patients and 12 healthy controls matched by age and gender were included in the study. We evaluated anthropometric measurements, and seric total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), triglycerides (TG), apo A-I, small dense LDL (sdLDL), C-reactive protein (CRP), and tumour necrosis factor alpha (TNF-alpha), myeloperoxidase (MPO), cholesteryl ester transfer protein (CETP), and lecithin cholesterol acyltransferase (LCAT) were assessed. Results: CRP (p = 0.008) and TNF-alpha (p < 0.001) concentrations were significantly higher, whereas HDL-c (p = 0.025) and apo A-I (p = 0.013) levels were significantly lower in patients than in the controls. In the patient group, a negative and significant correlation was observed between HDL-c and TNF-alpha (r = -0.406; p = 0.049) and between HDL-c and TG (r = -0.641; p = 0.001). Conclusion: Common variable immunodeficiency and X-linked agammaglobulinaemia patients presented themselves with increased inflammatory markers associated with a decreased HDL-c and apo A-I levels, which can predispose to a high cardiovascular risk.

BIO051 Interaction drug/nutrient of drugs used by patients with primary immunodeficiency

The primary immunodeficiencies (PID) are a group of diseases of more than 150 genetically determined conditions that feature a heightened susceptibility to infections. Recurrent or unusual infections lead to the use of medicines that may interact with food/nutrients that impair the absorption and utilization of nutrients, or even interfere with the action of the drug.