Effect of zinc supplementation on immune and inflammatory responses in pediatric patients with shigellosis.
BACKGROUND
Several studies showed benefits of long-term zinc supplementation on the incidence, severity, and duration of diarrhea and on the incidence of respiratory infections. Prolonged zinc supplementation also improves cell-mediated immunity in severely malnourished children.


OBJECTIVE
We studied the effect of short-term zinc supplementation on intrinsic and specific immune and inflammatory responses in moderately malnourished children with acute shigellosis.


METHODS
A randomized, double-blind, placebo-controlled trial was conducted in Shigella-infected children aged 12-59 mo. Elemental zinc (20 mg) and a multivitamin containing vitamins A and D, thiamine, riboflavin, nicotinamide, and calcium at twice the recommended dietary allowance were given daily for 2 wk to the zinc group (n = 28), whereas the multivitamin alone was given to the control group (n = 28). Standard antibiotic therapy was given to all patients.


RESULTS
Serum zinc concentrations increased in both groups during convalescence; however, zinc supplementation showed a significant effect. The lymphocyte proliferation response in the zinc group increased relative to that in the control group (P = 0.002), but no significant effects were seen on concentrations of cytokines (interleukin 2 and interferon gamma) released from mitogen-stimulated mononuclear cells or on concentrations of cytokines (interleukin 2, interferon gamma, and interleukin 1beta) in feces. Among the antigen [lipopolysaccharide and invasion plasmid-encoded antigen (Ipa)]-specific antibodies, plasma Ipa-specific immunoglobulin G responses at day 30 were significantly higher in the zinc group than in the control group. However, the 2 groups did not differ significantly in the other antigen-specific responses in plasma and stool.


CONCLUSIONS
A 14-d course of zinc supplementation during acute shigellosis increases the lymphocyte proliferation response and the Ipa-specific immunoglobulin G response.
International Centre for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B): Centre for Health and Population Research, Dhaka, Bangladesh. rubhana@icddrb.org
Rubhana
R
Raqib
Swapan Kumar
SK
Roy
Muhammad Jubayer
MJ
Rahman
Tasnim
T
Azim
Syeda Shegufta
SS
Ameer
Jobayer
J
Chisti
Jan
J
Andersson
D000210:Acute-Phase Reaction; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000096:biosynthesis*; D001459:Bangladesh; D002478:Cells, Cultured; D015362:Child Nutrition Disorders / Q000188:drug therapy / Q000276:immunology*; D002675:Child, Preschool; D016207:Cytokines; D003967:Diarrhea / Q000188:drug therapy / Q000276:immunology; D019587:Dietary Supplements; D004311:Double-Blind Method; D004405:Dysentery, Bacillary / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D007223:Infant; D007249:Inflammation / Q000188:drug therapy / Q000276:immunology*; D016131:Lymphocyte Subsets / Q000187:drug effects; D008297:Male; D009751:Nutritional Requirements; D014815:Vitamins / Q000008:administration & dosage; D015032:Zinc / Q000008:administration & dosage* / Q000097:blood
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D016207:Cytokines; D014815:Vitamins; D015032:Zinc