Nutritional Status and Lipid Profile in HIV-Infected Adults.

In the last decades, there have been many reports of HIV infection and abnormalities in lipid metabolism and cardiovascular disease (CVD). This study aims at describing the nutritional status of HIV-infected adults and its relation to lipid profile through traditional [total cholesterol (TC), HDL cholesterol (HDL), triglycerides (TG), non-HDL cholesterol and LDL cholesterol (LDL)] and other parameters [Apolipoprotein B (ApoB), fibrinogen, and high sensitive-C-reactive protein (hs-CRP)]. A cross-sectional descriptive study was performed. Body mass index (BMI) was calculated and references were taken from WHO. TC, HDL, TG and glucose were determined and non-HDL cholesterol and LDL were calculated. ApoB and fibrinogen were determined by quantitative radial immunodiffusion on agar plates (Diffuplate,Biocientífica SA,Argentina) and hs-CRP by immunoturbidimetric test. Qualitative variables were compared with the Chi-square test or Fisher's exact test. Quantitative variables were compared applying parametrics or nonparametric tests. Pearson test for correlations. Software SPSS 17.0. 97 patients were analyzed: 69.1% were men. 80% were on antiretroviral treatment. Average (SD) BMI was 24.3 (4.1) kg/m(2). 29.4% were overweight and 5.9% obese. Patients with a BMI ≥25.0 kg/m(2) presented significantly higher levels of TG, ApoB and glycemia than well-nourished people [246.1(169.0) vs. 142.9(78.4) mg/dL;p=0.029, 198.6(69.3) vs. 126.4(50.6) mg/dL;p=0.01 and 100 (3.2) vs. 90.2 (6.9) mg/dL;p=0.008 resp.] and a significantly decreased HDL [37.2(1.5) vs. 49.8(10.4) mg/dL;p<0.01]. No statistically significant correlation was found between ApoB and non-HDL (p=0,063). There was no evidence that there is a direct relation between Apo B and the other lipid parameters. The potential increase in CVD in this group of patients, would be related to the higher levels of TG, ApoB and overweight/obesity. Nutritional education is needed to promote a healthy weight to warn against the risk of cardiovascular disease.

Inflammatory biomarker profile in children with cystic fibrosis: preliminary study.

The aim of this preliminary study was to determine specific proteins, related to inflammation process and nutritional status as well as to total antioxidant capacity, in children suffering from cystic fibrosis (CF). The study was performed on 17 nonhospitalized children (12 boys and 5 girls) with CF aged 3 months to 10 years, who were assisted at the Nutrition Service from Pedro de Elizalde Hospital. Transferrin, transthyretin, ceruloplasmin (Cp), haptoglobin, C-reactive protein (CRP) and fibrinogen were measured by single radial immunodiffusion techniques. Total antioxidant capacity (TAC) was determined by a decolorization assay. Statistical analyses were performed by the Student's t test. Transferrin and transthyretin values were lower in CF patients in comparison with data obtained from healthy children (reference group, RG). The decreased transferrin concentration and the tendency towards low plasma transthyretin values suggested an abnormal nutritional status. However, higher Cp and haptoglobin levels were shown in patients than in RG. The fact that 23 and 50% of patients exceeded the desirable values for fibrinogen (<285.0 mg/dl) and CRP (<0.2 mg/dl), respectively, should be highlighted. The TAC (mM; Trolox equivalents) was shown to be lower in the CF group than in RG. The diminished TAC concomitant with an increased plasma Cp concentration would exacerbate the inflammatory status and could explain the depression of the immune system. These preliminary results could explain the need to include biochemical and functional parameters in the early nutritional status evaluation in CF patients in order to use appropriate nutritional and pharmacological therapies and consequently to improve their survival and quality of life.

Evaluación nutricional de pacientes pediátricos críticos: estudio preliminar / Nutritional evaluation of critical pediatric patients: Preliminary study

El objetivo del trabajo es evaluar el estado nutricional con respecto a hierro en un grupo de niños con diferentes patologías, al ingreso en terapia intensiva, a través de la determinación de hematocrito, concentración de hemoglobina, protoporfirinas eritrocitarias libres y analizar los niveles de fracciones séricas específicas: transferrina, proteína C reactiva y ceruloplasmina. En treinta y un pacientes (entre tres y cuarenta y ocho meses de edad) internados en la Unidad de Cuidados Intensivos Pediátricos con diferentes patologías, se determina hematocrito (Hto), la concentración de hemoglobina (g/dL) (Hb) por colorimetría, FEP por método Piomelli expresándose los resultados como FEP/Hto y FEP/Hb y transferrina, ceruloplasmina y preoteína C reactiva sérica (mg/dL) por inmunodifusión radial cuantitativa sobre placas...(AU)

Evaluación nutricional de pacientes pediátricos críticos: estudio preliminar / Nutritional evaluation of critical pediatric patients: Preliminary study

El objetivo del trabajo es evaluar el estado nutricional con respecto a hierro en un grupo de niños con diferentes patologías, al ingreso en terapia intensiva, a través de la determinación de hematocrito, concentración de hemoglobina, protoporfirinas eritrocitarias libres y analizar los niveles de fracciones séricas específicas: transferrina, proteína C reactiva y ceruloplasmina. En treinta y un pacientes (entre tres y cuarenta y ocho meses de edad) internados en la Unidad de Cuidados Intensivos Pediátricos con diferentes patologías, se determina hematocrito (Hto), la concentración de hemoglobina (g/dL) (Hb) por colorimetría, FEP por método Piomelli expresándose los resultados como FEP/Hto y FEP/Hb y transferrina, ceruloplasmina y preoteína C reactiva sérica (mg/dL) por inmunodifusión radial cuantitativa sobre placas...

Oral tolerance to dextrin mediated by specific suppressor T-cells induced in the intestinal intraepithelium and their systemic migration.

Antigens presented to the immune system through the oral route induce antigen specific secretory IgA and systemic unresponsiveness, termed oral tolerance (OT). We studied the induction of OT towards a diet antigen: dextrin (DEX) in rats that underwent protein deprivation and were further re-fed. Peyer's patches (PP), mesenteric lymph nodes (MLN) and spleen (Sp) cells from protein re-fed (R) rats mediated hyporesponsiveness after transfer into naïve recipient rats. Low numbers of MLN T cells transferred hyporesponsiveness while higher numbers transferred an enhancement of the delayed type hypersensitivity (DTH) reaction. MLN T cells were further separated based on their ability to bind Vicia villosa (VV). MLN VV- T cells, mainly CD8+, mediated hyporesponsiveness and MLN VV+ T cells (CD45RC+ CD4- CD8- cells) abrogated the hyporesponsiveness. Moreover, Sp DEX adherent T cells were mainly CD8+. Intestinal intraepithelial lymphocytes (iIELs) mainly CD8alpha+ gamma(delta)-TCR+ cells also inhibited the DTH response to DEX after transfer. The positive DTH response to another carbohydrate (levan) indicates the specificity of the suppression to dextrin. Therefore, our data indicate that after oral administration of DEX, two different populations of T cells were generated: one found only in the MLN that mediated DTH responses and the other one capable of migrating from the intestinal intraepithelium through PP and MLN to the Sp, mediating systemic tolerance.

Omega3 polyunsaturated fatty acids and maize flour diets.

OBJECTIVES: Nutrition disorders caused by a 6.5% maize protein diet (M), unbalanced in its indispensable amino acid pattern, provokes an arrest on cellular proliferation and maturation in the thymus of growing rats. We investigated the effect of diet supplementation with different amounts of omega3 polyunsaturated fatty acid (M = 0 mg/d, M1 = 12 mg/d, M2 = 24 mg/d, respectively) on thymus, plasma lipid concentrations, and hepatic tissue. METHODS: A well-nourished age-matched control group received stock diet from weaning. The animals (8 to 10 per group) received the diets for 9 d. At the end of the experimental period, they were killed, thymuses were removed, and cell number, absolute number of T cells labeled by the monoclonal antibody W3/13, plasma lipid profile (total cholesterol, triacylglycerols, high- and low-density lipoprotein cholesterols), and oxidative stress in hepatic tissue were determined. RESULTS: Only M2 reached the values of the control group when cell number and absolute number of T cells were compared. No statistical differences were observed among the M, M1, M2, and control group when high- and low-density lipoprotein cholesterols and hepatic lipid peroxidation were considered. CONCLUSIONS: The supplementation of a 6.5% maize protein diet with 24 mg/d of omega3 polyunsaturated fatty acid can recover the proliferation and absolute number of T cells labeled with W3/13 without affecting lipid profile and hepatic lipid peroxidation.

Nutrition disorders and immunologic parameters: study of the thymus in growing rats.

OBJECTIVES: We studied the effect of a low-quality dietary protein on cellular proliferation and maturation in the thymus of growing rats over time. METHODS: After weaning Wistar rats were fed a diet containing 6.5 g/100 g of corn flour for 6, 10, 18, and 45 d (M groups). For comparison, other rats were fed a diet containing 6.5 g/100 g of casein (Cas groups), and well-nourished age-matched control rats were fed a commercial laboratory diet (C groups). Food intake, body weight, thymus weight, total number of thymocytes, and the percentages of CD43(+) and Thy1(+) thymocyte phenotypic antigen determinants were measured. RESULTS: M versus Cas and C groups showed significant differences (P < 0.01) in body and thymus weights after 6 d of feeding, and the total number of thymocytes and the percentages of CD43(+) and Thy1(+) were significantly lower after 10 d of feeding. The results indicated that consuming a cereal diet for short or long periods causes thymus atrophy in growing rats, with significant reductions in the total number of T-cells concomitant with increases in the number of immature thymocytes. CONCLUSIONS: The data showed that, in addition to low-protein concentration, low-quality dietary protein is a limiting factor in certain steps of cellular intrathymic pathways, probably related to the requirement of specific amino acids for optimal immune response.

Activities of adenosine deaminase (ADA) and purine nucleoside phosphorylase (PNP) on undernourished and renourished rats' thymus.

We studied the effect of administration of a low quality dietary protein, from weaning onwards, on the thymus of undernourished rats and the posterior effect of refeeding with a high quality dietary protein. Changes in thymus weight and the activity of Adenosine Deaminase (ADA) and Purine Nucleoside Phosphorylase (PNP) on thymus, were determined. Wistar rats were suckled in groups of 14-16 per dam since birth to weaning (23 days) to obtain undernutrition. At weaning, a group of 14-16 rats received pre-cooked maize flour (Protein content: 6.5%) for 18 days. One group was sacrificed (M) and the other rats were refed with the casein diet (Protein content: 20%) during 20 days (R). The age-matched control groups were fed stock diet since 40 (C40) and 60 (C60) days of age, respectively. At the end of the experimental period, body (Bw) and thymus weight were determined. ADA and PNP activities were determined in thymocyte suspensions. Highly significant differences in thymus weight-expressed as mg or mg/Bw(0.75)-and the activity of ADA and PNP were observed in rats fed the experimental diet containing maize flour, when compared to the respective age-matched control. No statistical differences were observed between R and C60.The administration of a high quality dietary protein to undernourished weanling rats is capable to reverse the damage produced by the low quality dietary protein on thymus weight and ADA and PNP thymus activities.

Potential markers of the nutritional status in an experimental model.

The activity of adenine deaminase (ADA) and purine nucleoside phosphorylase (PNP) as potential nutritional markers was analyzed in an experimental model. Weanling Wistar rats were fed a protein-free diet ad libitum to obtain a severe degree of wasting. An age-matched control group received a stock diet. At the end of the experiment, body weight (BW) and thymus weight (TW) were determined. Activity of ADA and PNP was determined on thymocytes of protein-deprived and control rats; the results, expressed as micromoles of uric acid x 10(-1)/W (W = TW/BW(0.75)), were 17.0 +/- 2.6 versus 9.1 +/- 3.0 for ADA and 11.5 +/- 4.2 versus 3.9 +/- 1.0 for PNP (P < 0.01). These results suggest that the nutritional stress provoked by the administration of a protein-free diet from weaning onward affects the development of thymocytes. Moreover, the increase in the activity of ADA and PNP would be an alternative mechanism to avoid the accumulation of high levels of deoxynucleotides, which would be toxic for T lymphocytes. However, some investigators have observed an increase of ADA activity in human serum under some adverse conditions; for this reason and taking into account the present findings, it would be interesting to determine the relation between the activity of ADA and PNP in thymocytes and serum in experimental models to analyze and propose these biochemical parameters as potential and useful markers of nutritional status; it also would be interesting to test this relation in human studies.

[Nutritional status of surgical patients without apparent nutritional compromise]. / Estado nutricional de pacientes quirúrgicos sin aparente compromiso nutricional.

Nutritional status of 80 preoperative patients from programmed surgeries of hernias and lithiasis was studied by anthropometric and biochemical parameters. Nutritional deficiencies related to pathology were not expected in these patients. Results were as follows: 77% of the population showed overweight, being 15% obese. Prevalent protein intake, evaluated by the urea nitrogen/creatinine ratio, was adequate in 87.5% of the patients; however, patients presented 72% of albumin, 52% of prealbumin and 50% of RBP below reference values. Transferrin, ceruloplasmin, alpha 2-macroglobulin and haptoglobin were not decreased. Assessment of vitamin A, carotenes and vitamin C showed plasmatic levels below reference values in 16% of the patients for vitamin A, 5% for carotenes and 27% for vitamin C. Respect to calcium status, data of calcium/creatinine ratio show deficiency in 45% of the population. Respect to iron, the nutritional status was in general adequate, patients at risk being 5% by Htc, 11% by Hb, 5% by TS% and 12.5% by FEP, women showed over twice abnormal values than men. Although some isolated relations were observed, in this population sex, age and pathology were variable that did not affect in a relevant way the nutritional status. In spite of the individual analysis of each nutrient did not show important deficiencies, the analysis by patient showed that only a few of them (7%) presented an optimal biochemical profile with all the studied parameters within the reference values.

[Importance of n-3 polyunsaturated fatty acids (n-3 PUFA) in nutritional recovery]. / Importancia de los ácidos grasos poliinsaturados de la serie n-3 (AGPI n-3) en la recuperación nutricional.

Severe protein deprivation at weaning, may cause a stop in cellular proliferation and absolute number of T cells W3/13+ in the thymus of growing rats. The administration of a 20 g/100 casein recovery diet supplemented with 24 mg of n-3 PUFA during 9 days, counteracted this effect suggesting for these essential nutrients a dose-dependent response. No changes were observed in hemostastic factors such as protrombine time (QUICK) and partial active tromboplastine time (KPTT). Even though total plasma lipids showed no changes, the LDL-cholesterol fraction presented a low increment in agreement with international data. Daily administration of this supplemented diet did not show an increase in hepatic lipid peroxidation in the experimental group, suggesting that natural antioxidants and vitamin E provided by the diet might be playing a protective role.

Immunoglobulin M serum levels in females and pups of southern elephant seal (Mirounga leonina) during the suckling period.

This paper reports Immunoglobulin M (IgM) levels in serum samples from eight female-pup pairs of southern elephant seals (Mirounga leonina), at King George Island, Antarctica. IgM levels were determined on sera obtained from sequential sampling throughout the suckling period (approximately 23 days). The IgM concentration in southern elephant seal serum was measured by single radial immunodiffusion on agarose plates. Female IgM levels (123.5-613.0 mg/dL, n = 8) were significantly higher than pup levels (5.9-123.6 mg/dL, n = 8). Both groups showed an increasing trend throughout the entire suckling period, with significant differences in relation to stages of lactation. Pup IgM levels on the first day of life (mean +/- SD, 7.6 +/- 2.9 mg/dL, n = 3) suggest that endogenous synthesis takes place before birth.

Effect of RN-301 immunomodulator on bronchus-associated lymphoid tissue (BALT) in protein depleted rats at weaning.

It has been previously demonstrated in Wistar rats that severe protein deprivation at weaning, even after refeeding with a 20% casein diet for 21 days, provokes alterations in IgA+ B cell and T cell populations from gut and GALT (gut associated lymphoid tissue) that are reverted by immunomodulator IM-104. In the present report, we investigate the influence of RN-301 (quite similar to IM-104) given by the oral or subcutaneous route during the protein deprivation period, in the seeding of BALT with IgA+ B and CD5+ T cells. The immunomodulator RN-301 contains LPS from E. coli and membrane and ribosomal fractions of P. acne. Tissue sections of the lower respiratory tract were studied by immunohistochemistry. The immunomodulator RN-301 administered by the oral route favours the significant increase in the seeding of the BALT lamina propria with IgA+ B and CD5+ T cells (p < 0.001). However, the RN-301 given by the subcutaneous route does not favour the repopulation of the BALT lamina propria. The ribosomal fractions from P. acne associated with LPS from E. coli contained in the immunomodulator RN-301 administered by the oral route may rescue the small resting lymphocytes in the gut-associated lymphoid tissue (GALT). This event favours their proliferation and migration to the BALT.

[Effect of n-3 PUFA polyunsaturated fatty acids on the thymus of rats with severe protein depletion]. / Efecto de los ácidos grasos poliinsaturados n-3 PUFA sobre el timo de ratas con depleción proteica severa.

Severe protein deprivation at weaning provokes an arrest of cellular proliferation and maturation, and an increase of ADA and PNP activities in the thymus of growing rats. A 20% casein diet fed during 9 days was enough to reverse the effect on ADA and PNP. The supplementation with 24 mg/d of n-3 PUFA, was able to recover thymus' cellular proliferation and maturation.

Immunoglobulin A levels in southern elephant seal (Mirounga leonina) milk during the suckling period.

Immunoglobulin A (IgA) levels in milk samples from southern elephant seals at King George Island, Antarctica are reported. IgA levels were determined throughout the suckling period (approximately 23 days). The IgA concentration in southern elephant seal milk was lower than in other mammals and, unlike most mammalian milk, was not high during early lactation. There was not a definite pattern in IgA levels, which fluctuated within narrow limits throughout the suckling period (mean +/- SD, 30.81 +/- 6.38 mg IgA/100 g milk). If IgG was present, its level was too low to be detected by the method used. This is the first evidence in Southern elephant seal of the possibility of transmission of passive immunity after birth involving secretion of IgA in the milk.

Effect of low-quality dietary protein on the thymus of growing rats.

The status of the thymus of growing rats fed for 45 days after weaning on a low-quality dietary protein (7.5% maize) was compared with that in an age-matched control group receiving a diet containing casein at the same concentration. At the end of the feeding period, body weight (bw) was determined and the thymus was removed; its weight and cell number and the mature T-cell population--characterized by the monoclonal antibody W3/13 using the indirect immunofluorescence technique--were determined. Thymus weight expressed as mg/bw0.75 (3.9 +/- 0.75 vs 7.7 +/- 2.0), cell number (4.4 +/- 2.2 vs 26.3 +/- 7.6), and the absolute number of W3/13+ T cells (1.59 +/- 0.75 vs 17.8 +/- 5.4) were significantly lower (p less than 0.0005) in the experimental group than in the control group. The results suggest severe atrophy of the thymus of weaning animals chronically fed a low-quality protein.

[The lymphoid system and protein deficiency. Differentiation in the thymus and Peyer's patches]. / Sistema linfoide y deficiencia proteica. Diferenciación en timo y placas de Peyer.

A: Thymuses from protein deprived rats present: 1) a significant decrease in the absolute number of thymic cells bearing the CD5 phenotype (OX19+), as well as Thy 1.1 (OX7+). The predominant cell population was the one containing TdT (terminal deoxynucleotidyl transferase) as a sole marker: 2) in severely protein deprived rats followed by refeeding during 9 and 21 days, the existence of a small population of cells containing TdT as a sole marker. The TdT+W3/13+ cell population was restored but the CD4+ subpopulation (W3/25+) exists in lower numbers than in the age-matched controls. B: Severe protein deficiency at weaning, led to the presence in the Peyer's patches of very immature B-cells mostly c mu+OX7s mu-. Protein refeeding reinitiated the differentiation process as follows: 1) c mu+OX7+s mu- c mu-OX7-s mu+ as in the normal Peyer's patches; 2) however, switching of sIgM to sIgA-bearing cells was altered; 3) a low absolute number of W3/13+ and W3/25+ T-cells (CD4+) was found. C: Oral tolerance to dextrin evolved due to antigen specific CD8+ T-cells (found in Peyer's patches, mesenteric lymph nodes and spleen) and could be transferred to normal recipients.