Impact of dietary aflatoxin on immune development in Gambian infants: a cohort study.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
20 07 2021
Historique:
entrez: 21 7 2021
pubmed: 22 7 2021
medline: 5 8 2021
Statut: epublish

Résumé

Chronic aflatoxin (AF) exposure has been shown to occur at high levels in children from sub-Saharan Africa (SSA), and has been associated with growth retardation and immune dysfunction. Our objective was to investigate the impact of AF exposure on immune development in early infancy using thymic size and antibody (Ab) response to vaccination as indicators of immune function. A total of 374 infants born between May 2011 and December 2012 were enrolled into the current study. These infants were recruited from a larger, randomised trial examining the impact of nutritional supplementation of mothers and infants on infant immune development (the Early Nutrition and Immune Development Trial). Thymic size (Thymic Index, TI) was measured by sonography at 1 week, 8 weeks, 24 weeks and 52 weeks of infant age. Infants were given the diphtheria-tetanus-pertussis (DTP) vaccine at 8 weeks, 12 weeks and 16 weeks of age, and Ab responses to each vaccine measured at 12 weeks and 24 weeks of age. AF-albumin (AF-alb) adduct levels in infant blood were measured by ELISA as the biomarker of AF exposure. The geometric mean (GM) level of AF-alb increased with age. Only half of infants had detectable AF-alb with a GM of 3.52 pg/mg at 24 weeks, increasing to 25.39 pg/mg at 52 weeks, when 98% of infants had AF-alb >limit of detection. Significant negative association of AF-alb level with TI was seen in infants during the first 24 weeks, especially at 8 weeks of age (p<0.001), which is the time point of fastest thymus growth. There were no associations between AF exposure level and Ab response to pertussis and tetanus, but a significant positive correlation was observed between AF-alb level and Ab titre to diphtheria (p<0.005). High levels of AF exposure during early infancy may impact on infant immune development. ISRCTN49285450.

Sections du résumé

BACKGROUND
Chronic aflatoxin (AF) exposure has been shown to occur at high levels in children from sub-Saharan Africa (SSA), and has been associated with growth retardation and immune dysfunction. Our objective was to investigate the impact of AF exposure on immune development in early infancy using thymic size and antibody (Ab) response to vaccination as indicators of immune function.
METHODS
A total of 374 infants born between May 2011 and December 2012 were enrolled into the current study. These infants were recruited from a larger, randomised trial examining the impact of nutritional supplementation of mothers and infants on infant immune development (the Early Nutrition and Immune Development Trial). Thymic size (Thymic Index, TI) was measured by sonography at 1 week, 8 weeks, 24 weeks and 52 weeks of infant age. Infants were given the diphtheria-tetanus-pertussis (DTP) vaccine at 8 weeks, 12 weeks and 16 weeks of age, and Ab responses to each vaccine measured at 12 weeks and 24 weeks of age. AF-albumin (AF-alb) adduct levels in infant blood were measured by ELISA as the biomarker of AF exposure.
RESULTS
The geometric mean (GM) level of AF-alb increased with age. Only half of infants had detectable AF-alb with a GM of 3.52 pg/mg at 24 weeks, increasing to 25.39 pg/mg at 52 weeks, when 98% of infants had AF-alb >limit of detection. Significant negative association of AF-alb level with TI was seen in infants during the first 24 weeks, especially at 8 weeks of age (p<0.001), which is the time point of fastest thymus growth. There were no associations between AF exposure level and Ab response to pertussis and tetanus, but a significant positive correlation was observed between AF-alb level and Ab titre to diphtheria (p<0.005).
CONCLUSIONS
High levels of AF exposure during early infancy may impact on infant immune development.
TRIAL REGISTRATION NUMBER
ISRCTN49285450.

Identifiants

pubmed: 34285011
pii: bmjopen-2021-048688
doi: 10.1136/bmjopen-2021-048688
pmc: PMC8292809
doi:

Substances chimiques

Aflatoxins 0
Antibodies, Bacterial 0
Diphtheria-Tetanus-Pertussis Vaccine 0

Banques de données

ISRCTN
['ISRCTN49285450']

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e048688

Subventions

Organisme : Medical Research Council
ID : MC-A760-5Q×00
Pays : United Kingdom

Informations de copyright

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Ya Xu (Y)

School of Medicine, University of Leeds, Leeds, UK.

Sophie Moore (S)

Department of Women and Children's Health, King's College London, London, UK.

Gaoyun Chen (G)

Queen's University Belfast, Belfast, UK.

Patrick Nshe (P)

MRC Unit The Gambia at LSHTM, Banjul, Gambia.

Tisbeh Faye-Joof (T)

MRC Unit The Gambia at LSHTM, Banjul, Gambia.

Andrew Prentice (A)

MRC Unit The Gambia at LSHTM, Banjul, Gambia.

Yun Yun Gong (YY)

School of Food Science and Nutrition, University of Leeds, Leeds, UK.

Michael Routledge (M)

School of Medicine, University of Leeds, Leeds, UK medmnr@leeds.ac.uk.
School of Food and Biological Engineering, Jiangsu University, Zhenjiang, China.

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