Protein Energy Malnutrition Decreases Immunity and Increases Susceptibility to Influenza Infection in Mice

Background. Protein energy malnutrition (PEM), a common cause of secondary immune deficiency in children, is associated with an increased risk of infections. Very few studies have addressed the relevance of PEM as a risk factor for influenza. Methods. We investigated the influence of PEM on suscepti...

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Bibliographic Details
Published in:The Journal of infectious diseases 2013-02, Vol.207 (3), p.501-510
Main Authors: Taylor, Andrew K., Cao, Weiping, Vora, Keyur P., De La Cruz, Juan, Shieh, Wun-Ju, Zaki, Sherif R., Katz, Jacqueline M., Sambhara, Suryaprakash, Gangappa, Shivaprakash
Format: Article
Language:English
Subjects:
Animals
Antibodies, Viral - immunology
Antibody Specificity - immunology
Biological and medical sciences
CD8-Positive T-Lymphocytes - immunology
Diet
Diet, Protein-Restricted
Disease Models, Animal
Disease Susceptibility - immunology
Female
Fundamental and applied biological sciences. Psychology
Infections
Infectious diseases
Influenza
Influenza A Virus, H1N1 Subtype - immunology
Influenza virus
Lung - immunology
Lung - pathology
Lung - virology
Lungs
Malnutrition
Medical sciences
Mice
Microbiology
Mortality
Orthomyxoviridae
Orthomyxoviridae Infections - complications
Orthomyxoviridae Infections - immunology
Orthomyxoviridae Infections - mortality
Protein energy malnutrition
Protein-Energy Malnutrition - complications
T lymphocytes
Viruses
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Summary:Background. Protein energy malnutrition (PEM), a common cause of secondary immune deficiency in children, is associated with an increased risk of infections. Very few studies have addressed the relevance of PEM as a risk factor for influenza. Methods. We investigated the influence of PEM on susceptibility to, and immune responses following, influenza virus infection using isocaloric diets providing either adequate protein (AP; 18%) or very low protein (VLP; 2%) in a mouse model. Results. We found that mice maintained on the VLP diet, when compared to mice fed with the AP diet, exhibited more severe disease following influenza infection based on virus persistence, trafficking of inflammatory cell types to the lung tissue, and virus-induced mortality. Furthermore, groups of mice maintained on the VLP diet showed significantly lower virus-specific antibody response and a reduction in influenza nuclear protein-specific CD8⁺ T cells compared with mice fed on the AP diet. Importantly, switching diets for the group maintained on the VLP diet to the AP diet improved virus clearance, as well as protective immunity to viral challenge. Conclusions. Our results highlight the impact of protein energy on immunity to influenza infection and suggest that balanced protein energy replenishment may be one strategy to boost immunity against influenza viral infections.
ISSN:0022-1899
1537-6613
1537-6613
DOI:10.1093/infdis/jis527