NDLI: Undernutrition, the acute phase response to infection, and its effects on micronutrient status indicators.

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Undernutrition, the acute phase response to infection, and its effects on micronutrient status indicators.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Bresnahan, Kara A. Tanumihardjo, Sherry A.
Description	Author Affiliation: Bresnahan KA ( Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI.); Tanumihardjo SA ( Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI sherry@nutrisci.wisc.edu.)
Abstract	Infection and undernutrition are prevalent in developing countries and demonstrate a synergistic relation. Undernutrition increases infection-related morbidity and mortality. The acute phase response (APR) is an innate, systemic inflammatory reaction to a wide array of disruptions in a host's homeostasis, including infection. Released from immune cells in response to deleterious stimuli, proinflammatory cytokines act on distant tissues to induce behavioral (e.g., anorexia, weakness, and fatigue) and systemic effects of the APR. Cytokines act to increase energy and protein requirements to manifest fever and support hepatic acute phase protein (APP) production. Blood concentrations of glucose and lipid are augmented to provide energy to immune cells in response to cytokines. Additionally, infection decreases intestinal absorption of nutrients and can cause direct loss of micronutrients. Traditional indicators of iron, zinc, and vitamin A status are altered during the APR, leading to inaccurate estimations of deficiency in populations with a high or unknown prevalence of infection. Blood concentrations of APPs can be measured in nutrition interventions to assess the time stage and severity of infection and correct for the APR; however, standardized cutoffs for nutrition applications are needed. Protein-energy malnutrition leads to increased gut permeability to pathogens, abnormal immune cell populations, and impaired APP response. Micronutrient deficiencies cause specific immune impairments that affect both innate and adaptive responses. This review describes the antagonistic interaction between the APR and nutritional status and emphasizes the need for integrated interventions to address undernutrition and to reduce disease burden in developing countries.
File Format	HTM / HTML
ISSN	21618313
e-ISSN	21565376
DOI	10.3945/an.114.006361
Journal	Advances in Nutrition: An International Review Journal
Issue Number	6
Volume Number	5
Language	English
Publisher	Oxford University Press
Publisher Date	2014-11-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Nutritional Sciences Acute-phase Reaction Blood Infection Physiopathology Malnutrition Micronutrients Nutritional Status Anemia, Iron-deficiency Complications Iron, Dietary Deficiency Nutritional Requirements Vitamin A Vitamin A Deficiency Zinc Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Nutrition and Dietetics Medicine Food Science

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