Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The devastating orofacial gangrenous disease known as cancrum oris (noma) is still commonly seen in underprivileged Nigerian children. These children are usually victims of such stressors as chronic malnutrition, numerous endemic communicable diseases and severe adverse physical conditions which may lead to depletion of their adaptive resources or produce physiological maladaptation to additional stressors. Measles is the most common infection preceding the development of noma in Nigerian children. Acquired immunodeficiency as well as the impaired endocrine balance of the chronically malnourished permits, for example, widespread infection with the measles virus. Anergy resulting from the combination of malnutrition and measles virus infection promotes selective overgrowth and invasion by an infective consortium consisting of anaerobic organisms and other species capable of elaborating necessary growth factors for the former. Because of the pre-existing depletion of adaptive physiologic resources in the malnourished child, the infection is not readily contained locally as necrotizing ulcerative gingivitis but instead spreads rapidly to the next naturally occurring anatomical barriers. This is then followed by continuing necrosis and possible sequestration as exemplified by noma.
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PMID:Infectious oral necrosis (cancrum oris) in Nigerian children: a review. 286 38

Human immunodeficiency virus (HIV) establishes latent infection in CD4 lymphocytes and macrophages. It can destroy CD4 cells by direct virus cytotoxicity, indirectly through the host response against HIV-infected cells, or by both means. Cells of the macrophage lineage are generally not destroyed but can serve as a reservoir of virus. HIV also causes functional impairment in remaining infected and uninfected cells. After exposure to infection by sexual, blood or maternofetal contact, about half the contacts become infected with HIV. Factors influencing the inoculum derived from the infected person include type of contact, phase of infection and local factors enhancing HIV replication or excretion. In the exposed person, genetic factors and systemic or local events such as infection or inflammatory injury may influence relative susceptibility. After infection with HIV, a number of outcomes may be seen, including symptomless carriage, with or without lymphadenopathy, or symptomatic disease, including the AIDS-related complex, acquired immune deficiency syndrome and HIV encephalopathy. Infection, multiple pregnancy and infancy are associated with increased or more rapid progression to symptomatic disease; malnutrition and immunosuppressive drugs may exert a similar effect. Genetic factors appear to affect disease susceptibility. Mechanisms influencing progression can be divided into those affecting the rate of HIV replication, those that determine the host response to HIV, and those mediated by other immunosuppressive influences. The host's balance with HIV thus resembles that of a tightrope walker, any force tending to tip him towards a catastrophic and irretrievable decline.
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PMID:Factors affecting the natural history of human immunodeficiency virus infection. 290 7

To date, the acquired immunodeficiency syndrome (AIDS) has been identified in over 50 children in the US, including those with associated hemophilia, high-risk environmental factors (Haitian background, parental intravenous drug abuse, or prostitution), and blood transfusions. The evaluation of an infant or young child in whom AIDS is suspected requires exclusion of congenital disorders of immune function. A specific test is not currently available, but inclusion criteria for childhood AIDS have been developed. The diseases accepted as indicative of underlying cellular immunodeficiency children are the same as those used in defining AIDS in adults, with the exclusion of congenital infections such as toxoplasmosis or herpes simplex virus infection in the 1st month of life or cytomegalovirus infection in the 1st 6 months of life. Specific conditions that must be excluded in children are primary immunodeficiency diseases (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome, ataxia-telangiectasia, neutrophil function abnormality) and secondary immuno-deficiency associated with immunosuppressive therapy, lymphoreticular malignancy, or starvation. Almost all young children with AIDS have hepatosplenomegaly, interstitial pneumonitis, and poor growth. The average age of 36 US child AIDS victims studied in detail was 5 months at presentation with findings suggestive of severe immunodeficiency. Mucocutaneous candidiasis was present in 75% of these 36 children, and Pneumocystis carinii and cytomegalovirus were each isolated from 30% of cases. Normal T4:T8 ratios occur in about 15% of pediatric AIDS cases. Laboratory evidence of polyclonal hypergammaglobulinemia generally supports the AIDS diagnosis. Recurrent infection and malnutrition are major problems in the clinical management of child AIDS patients.
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PMID:Acquired immune deficiency syndrome in childhood. 298 8

Current socioeconomic conditions in India would make an epidemic of acquired immunodeficiency syndrome (AIDS) an overwhelming national disaster. Although no cases of AIDS have been detected in India to date, efforts must begin immediately to prevent such an occurrence. The Government must launch health education campaigns about behaviors that place individuals at risk of infection. Screening for human immunodeficiency virus (HIV) infection of travellers coming into India from affected countries should be given serious consideration. Since urban areas located at ports are likely to be the sites of introduction of HIV into India, these areas should be targeted for health education campaigns. Of concern is the adoption by certain sectors of the urban upper class of a Western life-style, including homosexuality and intravenous drug use. Unlike developed countries, India lacks the scientific laboratories, research facilities, equipment, and medical personnel to deal with an AIDS epidemic. In addition, factors such as cultural taboos against discussion of sexual practices, poor coordination between local health authorities and their communities, widespread poverty and malnutrition, and a lack of capacity to test and store blood would severely hinder the ability of the Government to control AIDS if the disease did become widespread.
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PMID:AIDS: a serious challenge to public health. 300 27

Seroprevalence to human immunodeficiency virus (HIV) was determined among 368 children 2 to 14 years of age who were admitted to the pediatric service at Mama Yemo Hospital in Kinshasa, Zaire. Forty (11%) of these patients and only one (1%) of 92 healthy siblings of these patients were HIV seropositive (chi 2 = 8.68, P less than .01). Seropositivity was associated with previous hospitalization, receipt of a blood transfusion prior to the current hospitalization (odds ratio 3.1; 95% confidence interval, 1.5 to 6.4), receipt of medical injections during the past year, and smaller household size. Clinically, HIV seropositivity was associated with the diagnoses of malnutrition and pneumonia. A higher proportion of seropositive children died during the current hospitalization (4/40 v 10/328); when patients with malaria were excluded, the in-hospital mortality of seropositive children was more than eight times higher than that of seronegative children (Fisher exact test, P = .006). Clarification of clinical, immunologic, and epidemiologic features of childhood HIV infection is urgently required because HIV appears to account for or complicate a substantial proportion of pediatric hospitalizations in Kinshasa.
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PMID:Human immunodeficiency virus seroprevalence in pediatric patients 2 to 14 years of age at Mama Yemo Hospital, Kinshasa, Zaire. 302 Apr 92

The immune system plays a key role in the body's ability to fight infection and reduce the risk of developing tumors, autoimmune and degenerative disease. Nutritional deficiencies and excesses influence various components of the immune system. Early studies investigating the association between nutrition and immunity focused on generalized protein-energy malnutrition, particularly in children in developing countries. The extent of immunological impairment depends not only on the severity of malnutrition but on the presence of infection and on the age of onset of nutritional deprivation, among other factors. In industrialized nations, immune function has been shown to be compromised in many malnourished hospitalized patients, small-for-gestational age infants, and the elderly. Obesity also may adversely influence immune function. Imbalances of single nutrients are relatively uncommon in humans, and investigations of protein and amino acids and specific vitamins, minerals, and trace elements generally are carried out in experimental animals. Deficiencies of protein and some amino acids, as well as vitamins A, E, B6 and folate, are associated with reduced immunocompetence. In contrast, excessive intake of fat, in particular polyunsaturated fatty acids (e.g. linoleic and arachidonic acids), iron, and vitamin E are immunosuppressive. Trace elements modulate immune responses through their critical role in enzyme activity. Both deficiency and excess of trace elements have been recognized. Although dietary requirements of most of these elements are met by a balanced diet, there are certain population groups and specific disease states which are likely to be associated with deficiency of one or more of these essential elements. The role of trace elements in maintenance of immune function and their causal role in secondary immunodeficiency is increasingly being recognized. There is growing research concerning the role of zinc, copper, selenium, and other elements in immunity and the mechanisms that underlie such roles. The problem of interaction of trace elements and immunity is a complex one because of the frequently associated other nutritional deficiencies, the presence of clinical or subclinical infections which in themselves have a significant effect on immunity, and finally the altered metabolism due to the underlying disease. There are many practical applications of our recently acquired knowledge regarding nutritional regulation of immunity.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Nutrition, immune response, and outcome. 309 56

The role of nutritional factors in the management of acquired immunodeficiency syndrome-related, or epidemic, Kaposi's sarcoma (EKS) is complex, since there are known interactions between malnutrition, immunodeficiency, and cancer. Malnutrition is a well-established cause of immune aberrations, which are seen in deficiencies of both protein and energy, as well as specific nutrients, particularly trace metals. Conversely, malnutrition is a common result of both cancer and immunodeficiency. Cancer patients without an obviously immunological pathogenesis frequently have malnutrition and cachexia, mainly as a result of a decreased dietary intake and poorly defined host-tumor interactions (commonly labeled "hypermetabolic"). Patients with primary immunodeficiency syndromes similarly experience a triad of diarrhea, malabsorption, and weight loss, which are responsible for the development of malnutrition. This triad is common in patients with AIDS, with or without the presence of Kaposi's sarcoma. The specific mechanisms of these interactions in EKS patients are largely unexplored; although some can be explained by the enteropathic effects of opportunistic infections, others can not. Some investigators have advocated careful nutritional evaluation of all AIDS patients, with vigorous nutritional support to be provided where assessment reveals suboptimal nutritional status. Specific nutrient deficiencies have been reported, of which selenium may be the most interesting; preliminary data indicate that it may be responsible for a malnutrition-related immunodepression seen with AIDS. Such supportive measures may significantly improve symptomatic relief, but there is as yet no evidence that they alter the course of the disease.
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PMID:Nutritional factors in epidemic Kaposi's sarcoma. 311 Sep 57

Immunodeficiency syndromes associated with protein-energy malnutrition (PEM) have been documented extensively, although to date the mechanism underlying these defects remains uncharacterized. In this study, we have evaluated T, B, and antigen-presenting cell functions of malnourished mice fed a 4% protein diet compared with litter-mate controls fed a 20% protein diet. Spleen cells from malnourished mice presented both soluble foreign protein and allogeneic MHC antigens less efficiently than control mice. However, T cells from malnourished animals demonstrated effective or enhanced specific T-cell activation when stimulated with allogeneic cells, while B cells from protein-deprived animals responded normally in proliferative responses to T-cell driven cognate and non-cognate, as well as mitogen, stimulation. To assess further antigen-presenting cell function, three requirements for successful antigen presentation were evaluated. First, the proliferation of the IL-1-dependent cloned T-cell line D10 demonstrated a slight deficiency in IL-1 production by malnourished splenic antigen-presenting cells, and the addition of saturating amounts of IL-1 to the assay could partially reconstitute function. Second, quantitative cell-sorter analysis revealed minimal deficiencies of spleen-cell Ia expression. Third, antigen-processing function was assayed in vitro by using processed antigen fragments; no improvement in protein-deprived antigen-presenting function resulted. Together, these findings suggest that either decreased Ia glycoprotein expression on a critical subset of antigen-presenting cells (APCs) or a quantitative deficiency in such a subset of cells, or both, underlie the defective antigen-presenting cell function observed in chronic protein deprivation (CPD).
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PMID:Defective antigen presentation in chronically protein-deprived mice. 313 Mar 10

In the efforts to develop a vaccine for human immunodeficiency virus (HIV), attention has focused on sub-Saharan Africa, where large populations at risk for HIV infection could be studied easily. Cross cultural bioethics must be examined to address the ethical implications and cultural obstacles of such research. Autonomy and informed consent are difficult to achieve in cultures with limited personal choice. In some cultures, individual personhood is secondary to social relationships in the tribe or village. Language barriers, illiteracy, and the lack of knowledge about modern science all make it difficult to adequately inform participants. While the Helsinki Declaration emphasizes that a subject's well-being takes precedence over the interests of science and society, health policy decisions in nonautonomous populations often place state interests over the individual. Political sensitivities have been aroused by attempts to attribute the origin of AIDS to western or central Africa, leading political controversy and discrimination against Africans. Foreign researchers often exclude African participation once they have obtained the body fluid samples for study. Without joint collaboration and education, human research in developing countries can easily become exploitative. Justice dictates that research subjects be chosen for scientific reasons, not due to easy availability or ability to be manipulated. In vaccine development, Africans should not experience a disproportionate amount of risk without an equal share in the benefits. Furthermore, malnutrition, malaria, tuberculosis, and many other diseases present more urgent health problems to the developing world than AIDS. The health care priorities of the developing nations must be considered.
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PMID:Ethical considerations of human investigation in developing countries: the AIDS dilemma. 317 36

The health of developing country populations in Africa where there is a high incidence of human immunodeficiency virus (HIV) infection is already seriously compromised by malnutrition and endemic diseases such as tuberculosis. Not only may HIV infection compromise currently used methods for the treatment of tropical diseases, but there may be a synergistic relationship between HIV and other diseases. Epidemiologic studies are thus needed to identify and quantify and such interactions. At present, evidence of such interactions may be limited by the fact that tropical diseases are most prevalent in rural areas while HIV cases have so far been concentrated in urban areas. However, any unexplained rise in the incidence or severity of a specific disease in areas where HIV is prevalent should be investigated as a possible interaction effect. Likewise, if the progression from HIV infection to acquired immunodeficiency syndrome (AIDS) seems to be occurring particularly rapidly in an area, AIDS patients should be examined for the presence of other diseases that may be triggering AIDS. Possible interactions between HIV infection and tropical diseases can be set forth in a schematic form in which both are divided into 3 infection states--uninfected, infected without clinical symptoms, and infected and diseases--and arrows are used to represent the transitions between states and possible interactions.
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PMID:Investigating interactions between HIV infection and tropical diseases. 322 76


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