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Clinical and Diagnostic Laboratory Immunology, September 1999, p. 690-695, Vol. 6, No. 5
International Centre for Diarrhoeal Disease
Research, Bangladesh, GPO Box 128, Dhaka 1000, Bangladesh
Received 25 January 1999/Returned for modification 15 March
1999/Accepted 24 May 1999
A prospective study was conducted with Bangladeshi children with
rotavirus (RV) diarrhea to assess whether nutritional and clinical
parameters, RV serotypes, levels of interleukin-10 (IL-10), tumor
necrosis factor alpha (TNF-
1071-412X/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Immune Response of Children Who Develop Persistent
Diarrhea following Rotavirus Infection
), and gamma interferon (IFN-
), and
RV-specific antibody titers in plasma and stool were associated with
the development of persistent diarrhea. Children with watery diarrhea
for 6 to 8 days, selected from the Dhaka Hospital of the International
Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), were
enrolled in the study and monitored until diarrhea improved. Children
were classified as having acute diarrhea (AD) if diarrhea resolved
within 14 days of onset and as having persistent diarrhea (PD) if
diarrhea persisted for more than 14 days after onset. Uninfected,
control children (n = 13) from the Nutrition Follow-Up
Unit of ICDDR,B were also enrolled. Of the 149 children with diarrhea
enrolled, 29 had diarrhea with RV alone, of which 19 had AD and 10 developed PD. Samples of stool and blood were collected from all
children on enrollment. Stool samples were collected again from
children when they developed PD. Of the 10 children who had an initial
RV infection and then developed PD, only one had persistent RV
infection. Plasma levels of IL-10 and TNF-
were higher in children
with diarrhea compared to uninfected controls but were similar in
children with AD and PD. Plasma IFN-
levels were higher in children
who developed PD than in those with AD (P = 0.008) or
uninfected controls (P = 0.001). In stools, the levels
of TNF-
, the only cytokine detected, were similar in the three
groups of children. RV-specific immunoglobulin G (IgG) titers in plasma
were higher in uninfected children than in those with AD
(P < 0.001) or PD (P = 0.024) but
titers were similar in children with AD and PD. RV-specific IgA titers
in plasma and stool were similar in the three groups of children. From
all observed parameters, only elevated plasma IFN-
levels were
associated with subsequent development of PD. However, a larger sample
size is necessary to substantiate this observation.
*
Corresponding author. Mailing address: Laboratory
Sciences Division, ICDDR,B, GPO Box 128, Dhaka 1000, Bangladesh. Phone: 880 2 871751. Fax: 880 2 883116. E-mail: tasnim{at}icddrb.org.
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