Thymus gland size during recovery from complicated severe acute malnutrition: A prospective study of the role of probiotics
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Thymus gland size during recovery from complicated severe acute malnutrition: A prospective study of the role of probiotics. / Nabukeera Barungi, Nicolette; Grenov, Benedikte; Friis, Henrik; Lanyero, Betty; Namusoke, Hanifa; Mupere, Ezekiel; Michaelsen, Kim F.; Mølgaard, Christian; Christensen, Vibeke Bak; Rytter, Maren Johanne Heilskov.
In: Paediatrics and international child health, Vol. 39, No. 2, 2019, p. 95-103.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Thymus gland size during recovery from complicated severe acute malnutrition: A prospective study of the role of probiotics
AU - Nabukeera Barungi, Nicolette
AU - Grenov, Benedikte
AU - Friis, Henrik
AU - Lanyero, Betty
AU - Namusoke, Hanifa
AU - Mupere, Ezekiel
AU - Michaelsen, Kim F.
AU - Mølgaard, Christian
AU - Christensen, Vibeke Bak
AU - Rytter, Maren Johanne Heilskov
N1 - CURIS 2019 NEXS 192
PY - 2019
Y1 - 2019
N2 - Background: Children with severe acute malnutrition (SAM) are prone to infections due to immune dysfunction including severe thymus atrophy which recovers during nutritional rehabilitation.Aim: To investigate predictors of thymus size recovery, including probiotics during nutritional rehabilitation of children admitted with complicated SAM.Methods: In this prospective study nested in a randomized controlled trial, children 6-59 months admitted with SAM received standard care and either probiotics or placebo during hospitalization until 8 weeks post-discharge. Thymus size was measured using ultrasound at admission, discharge, 8 weeks post-discharge and among 27 community controls. Predictors of thymus size recovery were assessed using linear regression.Results: Among 388 children with SAM, mean (SD) thymus size was 1.06 cm2 (0.41), 1.24 cm2 (0.48), 2.85 cm2 (1.07) and 4.2 cm2 (0.93) at admission, discharge, follow-up and in the healthy controls respectively (p < 0.05).Probiotics did not affect thymus recovery. During both inpatient therapeutic care (ITC) and outpatient therapeutic care (OTC), thymus recovery correlated positively with anthropometry but negatively with caregiver-perceived illness severity and Haemoglobin <8 g/dl. Negative predictors of thymus recovery during ITC included grade 3 oedema (β -0.13, 95%CI -0.25; -0.01), dermatosis (β -0.21, 95%CI -0.41; -0.01), C-reactive protein (CRP) >15mg/L (β -0.13, 95%CI -0.25; -0.02) and neutrophils (β -0.01, 95%CI -0.02; -0.002). During OTC, HIV negatively predicted thymus recovery.Conclusion: Children with SAM failed to regain thymus size at 8 weeks post-discharge. Probiotics did not predict thymus recovery during nutritional rehabilitation. More research is needed to find interventions which can accelerate immune recovery.
AB - Background: Children with severe acute malnutrition (SAM) are prone to infections due to immune dysfunction including severe thymus atrophy which recovers during nutritional rehabilitation.Aim: To investigate predictors of thymus size recovery, including probiotics during nutritional rehabilitation of children admitted with complicated SAM.Methods: In this prospective study nested in a randomized controlled trial, children 6-59 months admitted with SAM received standard care and either probiotics or placebo during hospitalization until 8 weeks post-discharge. Thymus size was measured using ultrasound at admission, discharge, 8 weeks post-discharge and among 27 community controls. Predictors of thymus size recovery were assessed using linear regression.Results: Among 388 children with SAM, mean (SD) thymus size was 1.06 cm2 (0.41), 1.24 cm2 (0.48), 2.85 cm2 (1.07) and 4.2 cm2 (0.93) at admission, discharge, follow-up and in the healthy controls respectively (p < 0.05).Probiotics did not affect thymus recovery. During both inpatient therapeutic care (ITC) and outpatient therapeutic care (OTC), thymus recovery correlated positively with anthropometry but negatively with caregiver-perceived illness severity and Haemoglobin <8 g/dl. Negative predictors of thymus recovery during ITC included grade 3 oedema (β -0.13, 95%CI -0.25; -0.01), dermatosis (β -0.21, 95%CI -0.41; -0.01), C-reactive protein (CRP) >15mg/L (β -0.13, 95%CI -0.25; -0.02) and neutrophils (β -0.01, 95%CI -0.02; -0.002). During OTC, HIV negatively predicted thymus recovery.Conclusion: Children with SAM failed to regain thymus size at 8 weeks post-discharge. Probiotics did not predict thymus recovery during nutritional rehabilitation. More research is needed to find interventions which can accelerate immune recovery.
KW - Faculty of Science
KW - Probiotics
KW - Severe malnutrition
KW - Thymus recovery
U2 - 10.1080/20469047.2018.1535871
DO - 10.1080/20469047.2018.1535871
M3 - Journal article
C2 - 30382002
VL - 39
SP - 95
EP - 103
JO - Paediatrics and international child health
JF - Paediatrics and international child health
SN - 2046-9047
IS - 2
ER -
ID: 204465619