Christie Noble (United Kingdom)
Queen Mary University of London Blizard InstituteAuthor Of 1 Presentation
THE IMMUNE PROFILE OF LOW BIRTH WEIGHT INFANTS IN RURAL ZIMBABWE
Abstract
Backgrounds:
Low birthweight (LBW) infants, encompassing those born small-for-gestational age (SGA) and/or preterm, have poor health outcomes in developing countries, including increased risk of vaccine failure, infection and death. The role of immune development and inflammation remain poorly understood in LBW infants. This study aimed to ascertain biomarkers of enteropathy, T-cell activation and systemic inflammation associated with LBW.
Methods
Using stored samples from a large cluster-randomised trial in rural Zimbabwe, we measured biomarkers of enteropathy and systemic inflammation using ELISA, and T-cell activation by flow cytometry, comparing: (i) term, appropriate for gestational age (AGA); (ii) preterm, AGA; (iii) term, SGA; and (iv) preterm SGA. We used generalised estimating equations and generalised linear models to explore differences between groups.
Results:
We include data from 1574 infants with visits at 1-3 months of age. Faecal biomarkers of intestinal inflammation were associated with LBW: compared to term AGA infants, neopterin was raised in premature SGA infants (mean 7.54nmol/L vs. 6.67nmol/L; P<0.01); myeloperoxidase was raised in premature AGA infants (8.11 ng/ml vs. 7.95; P=0.01); and alpha-1 antitrypsin was raised in premature AGA infants (13.60ng/ml vs.13.04ng/ml; p=0.03). Compared to term AGA infants, term SGA infants had higher proportions of activated (HLA-DR+) and proliferating (Ki67+) CD4+ T-cells (13.4% vs. 7.9% (P<0.01) and 8.0% vs. 3.2% (P=0.02), respectively). These effects were consistent after adjusting for plausible confounders. There were no differences in C-reactive protein between groups.
Conclusions/Learning Points:
We identified associations between LBW, intestinal inflammation and T-cell activation, with prematurity having greater association with gut inflammation and SGA with lymphocyte activation. Mechanistic studies are needed to determine whether these pathways might be amenable to intervention to improve clinical outcomes among LBW infants.