Effect of nutrition support on immune deficits in children with β-thalassemia

Increased morbidity and mortality due to infections is a feature of thalassemia major. The nutrition and immune status of 12 thalassemic children was characterized before and after one month of intensive nutrition support. Lymphocyte proliferation to Con A (p=0.008) and PPD (p=0.002) was depressed at baseline, and the response to Con A (p=0.005) and PHA (p=0.031)) both improved after the support period. There was no correlation of zinc status with lymphocyte proliferation, however normal baseline zinc status was associated with improvement of proliferation. %CD4 increased (p=0,036) but serum immunoglobulins, elevated on admission, were not significantly affected by the intervention. C3 was uniformly depressed but increased (p=0.037) and became normal in two children. C4 was below normal in 5 children and CH50 activity was normal in all children on admission and were not significantly influenced by the intervention. We conclude that thalassemic children have abnormalities of lymphocyte function and key complement components that are responsive to nutrition support. Zinc status appears to have an important role in lymphocyte function that requires further definition.