National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy.
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
J Trop Pediatr. 2019 Dec 1;65(6):617-625. doi: 10.1093/tropej/fmz022.
HIV-exposed uninfected (HEU) infants show a high rate of morbidity. We aimed to investigate on biomarkers of immune activation/microbial translocation in HEU infants, evaluating the impact that infections/malnutrition can have on biomarker levels during the first year of life.
Clinical data of 72 Malawian infants were recorded monthly and correlated with levels of soluble CD14 (sCD14), lipopolysaccharide-binding protein (LBP) and intestinal fatty acid-binding protein (I-FABP), analyzed longitudinally.
Levels of sCD14 and LBP showed a significant age-related increase. Higher levels of LBP (19.4 vs. 15.2 μg/ml) were associated with stunting, affecting 30% of the infants. The association remained statistically significant after adjusting for cytomegalovirus acquisition, malaria and respiratory infections (p = 0.031). I-FABP levels were significantly increased in infants experiencing gastrointestinal infections (1442.8 vs. 860.0 pg/ml, p = 0.018).
We provide evidence that stunting is associated with an enhanced inflammatory response to microbial products in HEU children, suggesting that malnutrition status should be taken into consideration to better understand the alteration of the immune profile of HEU infants living in poor socioeconomic settings.
HIV 暴露但未感染（HEU）婴儿发病率较高。我们旨在研究 HEU 婴儿的免疫激活/微生物易位生物标志物，评估感染/营养不良对生命第一年生物标志物水平的影响。
记录 72 名马拉维婴儿的临床数据，并每月记录一次，并与可溶性 CD14（sCD14）、脂多糖结合蛋白（LBP）和肠脂肪酸结合蛋白（I-FABP）水平进行相关性分析，进行纵向分析。
sCD14 和 LBP 水平呈显著的年龄相关增加。较高的 LBP 水平（19.4 与 15.2μg/ml）与生长迟缓有关，影响了 30%的婴儿。在调整巨细胞病毒感染、疟疾和呼吸道感染后，该相关性仍具有统计学意义（p=0.031）。经历胃肠道感染的婴儿 I-FABP 水平显著升高（1442.8 与 860.0pg/ml，p=0.018）。
我们提供的证据表明，生长迟缓与 HEU 儿童对微生物产物的炎症反应增强有关，这表明应考虑营养不良状况，以更好地了解生活在贫困社会经济环境中的 HEU 婴儿免疫特征的改变。
