Protein-energy malnutrition and micro-nutrient deficiencies: Possible culprits in susceptibility and severity of visceral leishmaniasis
Visceral leishmaniasis (VL) is a widespread highly morbid tropical infection. Protein-calorie and micro-nutrient deficiencies contribute to susceptibility and disease severity. This study aimed to delineate the effects of protein-calorie malnutrition, selenium (Se), zinc (Zn), and copper (Cu)] level...
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Wolters Kluwer Medknow Publications
2025-06-01
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| Series: | Annals of Medical Science and Research |
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| Online Access: | https://journals.lww.com/10.4103/amsr.amsr_52_24 |
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| author | B. M. Younis A. M. Musa A. M. Abdelraouf W. S. E. Saeed M. A. Saeed M. A. Magzoub A. A. Beshir M. E. E. Elfaki Elyazeed N. Suliman M. A. Awad Eljeed A. J. Suleiman E. A. G. Khalil |
| author_facet | B. M. Younis A. M. Musa A. M. Abdelraouf W. S. E. Saeed M. A. Saeed M. A. Magzoub A. A. Beshir M. E. E. Elfaki Elyazeed N. Suliman M. A. Awad Eljeed A. J. Suleiman E. A. G. Khalil |
| author_sort | B. M. Younis |
| collection | DOAJ |
| description | Visceral leishmaniasis (VL) is a widespread highly morbid tropical infection. Protein-calorie and micro-nutrient deficiencies contribute to susceptibility and disease severity. This study aimed to delineate the effects of protein-calorie malnutrition, selenium (Se), zinc (Zn), and copper (Cu)] level derangements on immune responses in VL patients. Following informed consent, 77 sequential parasitologically confirmed VL patients and 112 apparently healthy controls were recruited. Weight for height Z-score (WHZ), albumin, Se, Zn, and Cu were markers for protein-calorie and micro-nutrient disturbances. Leishmanin skin test (LST), direct agglutination test (DAT), and IL-10/TNF-α/IFN-γ levels in supernatants of soluble Leishmania–antigen whole blood-stimulated samples were measured as indicators of immune responses. VL patients have significantly lower baseline WHZ levels compared to controls (−2.2 ± 1.1 and −1.4 ± 1.3, respectively, P = 0.0006). Albumin levels were similarly reduced (2.9 and 3.4 g/dL, P = 0.06). Patients had marginally significant lower Se levels compared to controls (57.6 ± 13.1 and 61.7 ± 13.4 µg/L, respectively, P = 0.04). Pretreatment Se levels were significantly lower compared to post-treatment ones (56.9 ± 13.1 and 65.2 ± 22.1 µg/dL, respectively, P = 0.02). Zn levels were significantly lower in patients compared to controls (36.2 ± 17.3 and 72.9 ± 12.5 µg/L, respectively, P = 0.0002). Cu levels were four-fold higher in patients compared to controls [median 336 and 73.5 µg/L, respectively P = 0.00001]. The Cu:Zn ratio was significantly higher in patients compared to controls (9.6 and 1.0, respectively, P = 0.0001). LST was non-reactive in all VL patients with DAT levels >6400. Pre- and post-VL treatment levels of IFN-γ and IL-10 levels were comparable in patients and controls. Pretreatment TNF-α levels were significantly higher compared to post-treatment ones (median: 64.1 and 36.7 pg/mL, respectively, P = 0.0002). Five per cent (6/112, 5.4%) of the healthy controls developed VL during follow-up, and 15.2% (17/112) developed subclinical infection with LST conversion in 14/17 (82.4%, mean induration of 8.5 ± 2.6 mm). Three (3/17, 17.6%) converted in DAT and LST. Low WHZ, Se, and Zn levels with high Cu/Cu: Zn ratios probably increase susceptibility to VL. |
| format | Article |
| id | doaj-art-e3b5889e7920468ab82ead8d3a1be2d8 |
| institution | Kabale University |
| issn | 2949-785X 2949-7868 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Medical Science and Research |
| spelling | doaj-art-e3b5889e7920468ab82ead8d3a1be2d82025-08-20T03:59:32ZengWolters Kluwer Medknow PublicationsAnnals of Medical Science and Research2949-785X2949-78682025-06-014Suppl 1S103S10810.4103/amsr.amsr_52_24Protein-energy malnutrition and micro-nutrient deficiencies: Possible culprits in susceptibility and severity of visceral leishmaniasisB. M. YounisA. M. MusaA. M. AbdelraoufW. S. E. SaeedM. A. SaeedM. A. MagzoubA. A. BeshirM. E. E. ElfakiElyazeed N. SulimanM. A. Awad EljeedA. J. SuleimanE. A. G. KhalilVisceral leishmaniasis (VL) is a widespread highly morbid tropical infection. Protein-calorie and micro-nutrient deficiencies contribute to susceptibility and disease severity. This study aimed to delineate the effects of protein-calorie malnutrition, selenium (Se), zinc (Zn), and copper (Cu)] level derangements on immune responses in VL patients. Following informed consent, 77 sequential parasitologically confirmed VL patients and 112 apparently healthy controls were recruited. Weight for height Z-score (WHZ), albumin, Se, Zn, and Cu were markers for protein-calorie and micro-nutrient disturbances. Leishmanin skin test (LST), direct agglutination test (DAT), and IL-10/TNF-α/IFN-γ levels in supernatants of soluble Leishmania–antigen whole blood-stimulated samples were measured as indicators of immune responses. VL patients have significantly lower baseline WHZ levels compared to controls (−2.2 ± 1.1 and −1.4 ± 1.3, respectively, P = 0.0006). Albumin levels were similarly reduced (2.9 and 3.4 g/dL, P = 0.06). Patients had marginally significant lower Se levels compared to controls (57.6 ± 13.1 and 61.7 ± 13.4 µg/L, respectively, P = 0.04). Pretreatment Se levels were significantly lower compared to post-treatment ones (56.9 ± 13.1 and 65.2 ± 22.1 µg/dL, respectively, P = 0.02). Zn levels were significantly lower in patients compared to controls (36.2 ± 17.3 and 72.9 ± 12.5 µg/L, respectively, P = 0.0002). Cu levels were four-fold higher in patients compared to controls [median 336 and 73.5 µg/L, respectively P = 0.00001]. The Cu:Zn ratio was significantly higher in patients compared to controls (9.6 and 1.0, respectively, P = 0.0001). LST was non-reactive in all VL patients with DAT levels >6400. Pre- and post-VL treatment levels of IFN-γ and IL-10 levels were comparable in patients and controls. Pretreatment TNF-α levels were significantly higher compared to post-treatment ones (median: 64.1 and 36.7 pg/mL, respectively, P = 0.0002). Five per cent (6/112, 5.4%) of the healthy controls developed VL during follow-up, and 15.2% (17/112) developed subclinical infection with LST conversion in 14/17 (82.4%, mean induration of 8.5 ± 2.6 mm). Three (3/17, 17.6%) converted in DAT and LST. Low WHZ, Se, and Zn levels with high Cu/Cu: Zn ratios probably increase susceptibility to VL.https://journals.lww.com/10.4103/amsr.amsr_52_24micro-nutrient deficienciesprotein-caloriesusceptibilityvisceral leishmaniasis |
| spellingShingle | B. M. Younis A. M. Musa A. M. Abdelraouf W. S. E. Saeed M. A. Saeed M. A. Magzoub A. A. Beshir M. E. E. Elfaki Elyazeed N. Suliman M. A. Awad Eljeed A. J. Suleiman E. A. G. Khalil Protein-energy malnutrition and micro-nutrient deficiencies: Possible culprits in susceptibility and severity of visceral leishmaniasis Annals of Medical Science and Research micro-nutrient deficiencies protein-calorie susceptibility visceral leishmaniasis |
| title | Protein-energy malnutrition and micro-nutrient deficiencies: Possible culprits in susceptibility and severity of visceral leishmaniasis |
| title_full | Protein-energy malnutrition and micro-nutrient deficiencies: Possible culprits in susceptibility and severity of visceral leishmaniasis |
| title_fullStr | Protein-energy malnutrition and micro-nutrient deficiencies: Possible culprits in susceptibility and severity of visceral leishmaniasis |
| title_full_unstemmed | Protein-energy malnutrition and micro-nutrient deficiencies: Possible culprits in susceptibility and severity of visceral leishmaniasis |
| title_short | Protein-energy malnutrition and micro-nutrient deficiencies: Possible culprits in susceptibility and severity of visceral leishmaniasis |
| title_sort | protein energy malnutrition and micro nutrient deficiencies possible culprits in susceptibility and severity of visceral leishmaniasis |
| topic | micro-nutrient deficiencies protein-calorie susceptibility visceral leishmaniasis |
| url | https://journals.lww.com/10.4103/amsr.amsr_52_24 |
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