title: Reduced production of immunoregulatory cytokines in vitamin A- and zinc-deficient Indonesian infants.
abstract: OBJECTIVE
  To determine effects of vitamin A, zinc and iron deficiency in Indonesian infants on the ability to produce immunoregulatory cytokines.
  
  
  METHODS
  Immunological assessment was done in 59 infants participating in a cross-sectional nutritional survey in rural West Java, Indonesia. Production of T-helper cell type-1 (Th1, cell-mediated) cytokines interferon-gamma (IFN-gamma), interleukin-12 (IL-12), interleukin-18 (IL-18) and T-helper cell type-2 (Th2, humoral) cytokine interleukin-6 (IL-6) were measured after stimulation with lipopolysaccharide and phytohemagglutinin in an ex vivo whole blood culture system. Circulating neopterin concentrations were determined as an indicator of in vivo macrophage activity.
  
  
  RESULTS
  Of the infants, 48% were vitamin A deficient, 44% were anemic (with 17% having iron deficiency anemia), and 17% were zinc deficient. Vitamin-A deficient infants had significantly reduced ex vivo production of IFN-gamma, but also significantly higher circulating neopterin concentrations. Production of IFN-gamma and IL-12 were strongly correlated, IFN-gamma and IL-18 production were not. Zinc deficiency was accompanied by significantly reduced white blood cell counts and reduced ex vivo production of IL-6. Iron status was not related to cytokine production.
  
  
  CONCLUSIONS
  This study shows that in vitamin A deficiency there is Th1 dominance in a steady state, combined however with impairment of the Th1 response after stimulation, whereas in zinc deficiency, there is a decreased Th2 response. Overall, vitamin A deficiency and zinc deficiency have marked albeit different effects on the immunocompetence of infants, affecting both cell-mediated and humoral components of the immune system.
authors.affiliation: Department of Internal Medicine, University Hospital Nijmegen, The Netherlands. Wieringa@tiscali.nl
authors.forename: F T
authors.initials: FT
authors.lastname: Wieringa
authors.forename: M A
authors.initials: MA
authors.lastname: Dijkhuizen
authors.forename: C E
authors.initials: CE
authors.lastname: West
authors.forename: J
authors.initials: J
authors.lastname: van der Ven-Jongekrijg
authors.forename: J W M
authors.initials: JW
authors.lastname: van der Meer
mesh_terms: D000917:Antibody Formation; D015331:Cohort Studies; D016207:Cytokines / Q000096:biosynthesis* / Q000097:blood; D003677:Deficiency Diseases / Q000097:blood / Q000276:immunology*; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D007214:Indonesia; D007223:Infant; D007371:Interferon-gamma / Q000096:biosynthesis; D018664:Interleukin-12 / Q000096:biosynthesis; D020382:Interleukin-18 / Q000096:biosynthesis; D015850:Interleukin-6 / Q000096:biosynthesis; D007501:Iron / Q000276:immunology; D000090463:Iron Deficiencies; D008297:Male; D019798:Neopterin / Q000097:blood / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology; D014802:Vitamin A Deficiency / Q000097:blood / Q000276:immunology*; D015032:Zinc / Q000172:deficiency* / Q000276:immunology
chemical_list: D016207:Cytokines; D020382:Interleukin-18; D015850:Interleukin-6; D018664:Interleukin-12; D019798:Neopterin; D007371:Interferon-gamma; D007501:Iron; D015032:Zinc