Effect of renutrition on natural and cell-mediated immune response in infants with severe malnutrition

Abstract

Background: Diabetic neuropathy affects 50% 66% of patients with diabetes mellitus. Oxidative stress generates nerve dysfunction by causing segmental demyelinization and axonal degeneration. Antioxidants are considered to be the only etiologic management for diabetic polyneuropathy, and statins such as rosuvastatin increase nitric oxide bioavailability and reduce lipid peroxidation. The aim of this study was to evaluate the antioxidant effect of rosuvastatin in diabetic polyneuropathy.Methods: We conducted a randomized, double-blind, placebo-controlled Phase IIa clinical trial in patients with type 2 diabetes and diabetic polyneuropathy (DPN) stage $1b. We allocated subjects to two parallel groups (1:1) that received rosuvastatin 20 mg or placebo for 12 weeks. Primary outcomes were neuropathic symptom score, disability score, and nerve conduction studies, and secondary outcomes were glycemic control, lipid and hepatic profile, lipid peroxidation, and nerve growth factor beta (NGF-?) levels.Results: Both groups were of similar age and duration since diagnosis of diabetes and DPN. We observed improvement of DPN in the rosuvastatin group from stage 2a (88.2%) to stage 1b (41.2%), improvement of neuropathic symptom score from 4.5 2 to 2.4 1.8, and significant (P=0.001) reductions of peroneal nerve conduction velocity (from 40.8 2.2 to 42.1 1.6 seconds) and lipid peroxidation (from 25.4 2 to 12.2 4.0 nmol/mL), with no significant change in glycemic control or ?-NGF.Conclusion: The severity, symptoms, and nerve conduction parameters of DPN improved after 12 weeks of treatment with rosuvastatin. These beneficial effects appear to be attributable to reductions in lipid peroxidation and oxidative stress. " 2014 Hernández-Ojeda et al.",,,,,,"10.2147/DMSO.S65500",,,"http://hdl.handle.net/20.500.12104/41000","http://www.scopus.com/inward/record.url?eid=2-s2.0-84907879862&partnerID=40&md5=42cc87cac37fffb3d27fb63e2b00ca86

http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=25214797",,,,,,,,"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy",,"401

407",,"7",,"Scopus

MEDLINE",,,,,,"Diabetic polyneuropathy; Nerve conduction; Nerve growth factor beta; Oxidative stress; Rosuvastatin",,,,,,"Effect of rosuvastatin on diabetic polyneuropathy: A randomized, double-blind, placebo-controlled Phase IIa study",,"Article" "44653","123456789/35008",,"García-De La Torre, I.; Salazar-Páramo, M., C.U.C.S., Department of Immunology and Rheumatology, University of Guadalajara, Guadalajara, Jalisco, Mexico; Salmón-De La Torre, G., Unidad de Reumatología y Medicina Familiar, ISSSTE, Guadalupe, Zacatecas, Mexico",,"García-De La Torre, I.

Salazar-Paramo, M.

Salmon-De La Torre, G.",,"1996",,"Mixed connective tissue disease (MCTD) was described as a distinct clinical syndrome in 1972. Since then many cases have been reported in the literature worldwide. In this study we present our experience with a group of 17 Mexican patients with this syndrome, and we analyze their clinical and serological features, as well as the causes of death in these patients. The patients are Mexican mestizos living in Guadalajara and most of them have been followed-up at Hospital General de Occidente for a period of 1-10 years. The female/male ratio was 16:1, and their age ranged from 14-55 years with a mean of 29 years. The disease duration bus ranged from 1-17 years, with a mean of 6 years. Among the clinical manifestations we have found a high frequency of lymphadenopathy when compared with published series (13/17 or 76%), and the laboratory findings in our patients included a very high polyclonal increase of gammaglobulins (93%), lymphopenia (76%), direct immunofluorescence speckled nuclear epidermal deposits in skin biopsies (75%) and positive rheumatoid factor (65%). Other clinical and serological features were similar to those reported in other series of patients with MCTD. Six of the 17 patients have died (35%), and in 3 of them (17.5%) the cause of death was due to an infectious disease that suddenly presented, and apparently was not related to a concomitant high dose of steroids or malnutrition in the patients. It seems that in addition to the already well known autoimmune abnormalities that occur in MCTD, there are other features like the presence of lymphadenopathy, the high polyclonal increase of gammaglobulins, and the lymphopenia, that reflect the profound disturbance of the immune system in this syndrome, possibly contributing to the sudden appearance of a severe infections disease in some of our patients.",,,,,,,,,"http://hdl.handle.net/20.500.12104/42874","http://www.scopus.com/inward/record.url?eid=2-s2.0-0030432226&partnerID=40&md5=db801e19441a5552f2c290403e7e29c1",,,,,,"03-abr",,"Molecular Biology Reports",,"153

157",,"23",,"Scopus

WOS",,,,,,"anti-U1-RNP antibody; mixed connective tissue disease; mortality in MCTD",,,,,,"Mixed connective tissue disease. A clinico-serological study of 17 cases",,"Article" "42776","123456789/35008",,"Vásquez-Garibay, E., Instituto de Nutrición Humana, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Jalisco, Mexico, Instituto de Nutrición Humana, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Salvador Quevedo y Zubieta 750, S.L., C.P. 44340, Guadalajara, Jalisco, Mexico; Campollo-Rivas, O., Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Jalisco, Mexico; Romero-Velarde, E., Instituto de Nutrición Humana, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Jalisco, Mexico; Méndez-Estrada, C., Unidad de Estudios de Nutrición Infantil, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Jalisco, Mexico; García-Iglesias, T., Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Jalisco, Mexico; Alvizo-Mora, J.G., Instituto de Nutrición Humana, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Jalisco, Mexico; Vizmanos-Lamotte, B., Departamento de Reproducción Humana, Crecimiento Y Desarrollo Infantil, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Jalisco, Mexico",,"Vasquez-Garibay, E.

Campollo-Rivas, O.

Romero-Velarde, E.

Mendez-Estrada, C.

García-Iglesias, T.

Alvizo-Mora, J.G.

Vizmanos-Lamotte, B.",,"2002",,"Background: The purpose of this study was to evaluate whether a 4-week nutritional recovery period with a starting infant formula and 3.35 kJ/mL energy density would favorably affect the natural and cell-mediated immune response in infants with severe and primary protein-energy malnutrition. Methodology: The study included 12 severely malnourished infants, 3 to 18 months of age. For 2 weeks, infants were fed a starting infant formula, with energy density increased to 0.8 kcal/mL, through a nasogastric tube. Infants were fed "ad libitum" for 2 more weeks. On the fifth day, 837 kJ/kg and 4 g/kg protein were given daily. At the beginning and at the end of the 4-week period, weight, length, phagocytosis, microbicidal activity, chemotaxis, and cell proliferation indices were measured. Null hypothesis was rejected with a paired t test and a P value less than 0.05. Results: After the 4-week period of nutritional recovery, the weight and length indicators and the four immunologic assays showed significant increase (P < 0.005). Conclusion: The study demonstrated that a 4-week nutritional recovery period with a starting infant formula and 0.8 kcal/mL energy density favorably affected the natural and cell-mediated immune response in infants with severe protein-energy malnutrition. " 2002 Lippincott Williams & Wilkins, Inc.