Effect of vitamin A and protein-calorie undernutrition on immune responses.
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Biomedical subjects
Publications and source records attributed to V Ramalingaswami.
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In view of increased susceptibility to tuberculosis in protein malnutrition, the phenomenon of accelerated granulomatous response by the macrophage was studied in rabbits immunized and subsequently challenged with BCG. Dietary protein depletion resulted in marked retardation of macrophage mobilization and granuloma formation in various organs. The granulomatous index was low in most organs. The granulomas were few, small, abortive and ill-formed by loosely knit epithelioid cells and giant cells. This deficiency of macrophage function might limit the effectiveness of BCG vaccination in the malnourished host.
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The paper describes a study, carried out over 16 years, of the use of iodized salt for the control of endemic goitre in a valley of the Himalayan foothills. From 1956, salt was fortified with either potassium iodide or potassium iodate to provide an estimated daily intake of 200 mug per head. There was a progressive and significant decline in goitre prevalence, together with a return of the pattern of iodine metabolism to within normal limits. It is concluded that endemic goitre can be successfully controlled by iodization of domestic salt.
Two groups of guinea pigs were maintained on high-protein and low-protein diets and immunized with intradermal BCG. Protein deficiency was accompanied by marked inhibition of local and systemic immune responses: a) The BCG nodule was poorly formed. There was marked delay and deficiency in the mobilization of macrophages. b) The draining lymph node was atrophic and showed little or no proliferation of lymphoid cells in the paracortical area. Macrophage accumulation occurred late but became diffuse and marked, in contrast to its consistent scarcity in the BCG nodule. c) In either location epithelioid cell transformation was retarded. Well-formed mature epithelioid cell granulomas were not seen. d) Bacilli persisted for a long time in the skin and lymph node lesions, e) Tuberculin sensitivity was greatly impaired in one-fifth of animals and absent in others. These findings were suggestive of macrophage dysfunction and depression of cell-mediated immunity to BCG in the protein-deficient guinea pig.
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