Intestinal antimicrobial gene expression: Impact of micronutrients in malnourished adults during a randomized trial

Winnie Dhaliwal, Tamara Shawa, Moriam Khanam, Poonam Jagatiya, Michelo Simuyandi, Namwiinga Ndulo, Charles L Bevins, Ian R. Sanderson, Paul Kelly

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Background: Because both micronutrients and antimicrobial peptides protect against diarrhea, we looked for an effect on intestinal antimicrobial peptide gene expression during a randomized controlled trial of multiple micronutrient (MM) supplementation. Methods: Consenting adults ( n = 287) in Lusaka, Zambia, were randomized to receive a dailyMMsupplement or placebo and were followed up for 3.3 years, with a crossover after 2 years. Intestinal biopsy samples were obtained at annual intervals, and messenger RNA of the intestinal antimicrobial peptides human α defensin (HD) 5, HD6, human β-defensin (hBD) 1, hBD2, and LL-37 were quantified by real-time reverse-transcriptase polymerase chain reaction. Samples were also obtained during diarrhea episodes and after convalescence. Results: There was no effect overall of treatment allocation. However, in malnourished adults (body mass index ≤18.5), HD5 mRNA was increased by 0.8 log transcripts/μg total RNA in MM recipients, compared with HD5 mRNA in placebo recipients (P = 007). During diarrhea, HD5 expression was reduced by 0.8 log transcripts in placebo recipients (P = 02) but was not reduced in MM recipients, nor was it reduced after the crossover. Correlations between HD5 and nutritional status were found that were sex-specific but not explained by serum leptin or adiponectin concentrations. Conclusions: Micronutrient supplementation was associated with up-regulation of HD5 only in malnourished adults. Interactions between antimicrobial gene expression and nutritional status may help to explain the increased risk of infection in individuals with malnutrition.

Original languageEnglish (US)
Pages (from-to)971-978
Number of pages8
JournalJournal of Infectious Diseases
Issue number6
StatePublished - Sep 15 2010

ASJC Scopus subject areas

  • Infectious Diseases
  • Immunology and Allergy


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