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American Journal of Clinical Nutrition, Vol. 85, No. 3, 845-852, March 2007
© 2007 American Society for Nutrition

ORIGINAL RESEARCH COMMUNICATION

Low birth weight is associated with altered immune function in rural Bangladeshi children: a birth cohort study1,2,3

Rubhana Raqib, Dewan S Alam, Protim Sarker, Shaikh Meshbahuddin Ahmad, Gul Ara, Mohammed Yunus, Sophie E Moore and George Fuchs

1 From the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B): Centre for Health and Population Research, Dhaka, Bangladesh (RR, DSA, PS, SMA, GA, and MY); the MRC International Nutrition Group, London School of Hygiene and Tropical Medicine, London, United Kingdom (SEN); and the Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR (GF)

Background: Low birth weight is generally an outcome of a fetal insult or nutritional insufficiency. Recent studies have shown that such exposure early in life may have long-term implications for later immunocompetence and susceptibility to infectious diseases.

Objective: We aimed to investigate the effect of birth weight on immune function in preschool-age children.

Design: A birth cohort cross-sectional study was conducted in children (n = 132) aged 60.8 ± 0.32 mo who were born in Matlab, a rural area of Bangladesh, and whose weight and length were measured within 72 h of birth. The outcome measures were thymopoiesis, T cell turnover, acute phase response, and percentage of lymphocytes.

Results: Children born with low birth weight (<2500 g; LBW group, n = 66) had significantly higher concentrations of T cell receptor excision circles in peripheral blood mononuclear cells—a biomarker for thymopoiesis—and significantly higher serum bactericidal activity and C-reactive protein concentrations than did children born with normal birth weight (≥2500 g; NBW group, n = 66) (P < 0.05 for both). The LBW group children had significantly lower concentrations of interleukin 7 in plasma (P = 0.02), shorter telomere length in peripheral blood mononuclear cells (P = 0.02), and a lower percentage of CD3 T cells (P = 0.06) than did the NBW group children.

Conclusions: Greater peripheral T cell turnover (shorter telomeres and lower CD3 concentrations) due to immune activation (elevated C-reactive protein concentrations and bactericidal activity) may have resulted in a greater need for replenishment from the thymus (higher T cell receptor excision circles); these events may cause lower immune functional reserve in preschool-age children born with LBW. Thus, LBW has implications for immunocompetence and increased vulnerability to infectious diseases in later life.

Key Words: Low birth weight • T cell receptor excision circles • TRECS • telomere • CD3 T cells • C-reactive protein






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