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Stunting as a Risk Factor for Asthma: The Role of Vitamin D, Leptin, IL-4, and CD23+

Stunting, which results from chronic malnutrition, is common in children from low- and middle-income countries. Several studies have reported an association between obesity and asthma. However, only a handful of studies have identified stunting as a significant risk factor for wheezing, a symptom of...

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Autores principales: Sapartini, Gartika, Wong, Gary W.K., Indrati, Agnes Rengga, Kartasasmita, Cissy B., Setiabudiawan, Budi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9503774/
https://www.ncbi.nlm.nih.gov/pubmed/36143913
http://dx.doi.org/10.3390/medicina58091236
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author Sapartini, Gartika
Wong, Gary W.K.
Indrati, Agnes Rengga
Kartasasmita, Cissy B.
Setiabudiawan, Budi
author_facet Sapartini, Gartika
Wong, Gary W.K.
Indrati, Agnes Rengga
Kartasasmita, Cissy B.
Setiabudiawan, Budi
author_sort Sapartini, Gartika
collection PubMed
description Stunting, which results from chronic malnutrition, is common in children from low- and middle-income countries. Several studies have reported an association between obesity and asthma. However, only a handful of studies have identified stunting as a significant risk factor for wheezing, a symptom of asthma, although the underlying mechanism remains unclear. This article aimed to review possible mechanisms underlying asthma in stunted children. Overall, changes in diet or nutritional status and deficiencies in certain nutrients, such as vitamin D, can increase the risk of developing asthma. Vitamin D deficiency can cause linear growth disorders such as stunting in children, with lower levels of 25(OH)D found in underweight and stunted children. Stunted children show a decreased lean body mass, which affects lung growth and function. Low leptin levels during undernutrition cause a Th1–Th2 imbalance toward Th2, resulting in increased interleukin (IL)-4 cytokine production and total immunoglobulin E (IgE). Studies in stunted underweight children have also found an increase in the proportion of the total number of B cells with low-affinity IgE receptors (CD23+). CD23+ plays an important role in allergen presentation that is facilitated by IgE to T cells and strongly activates allergen-specific T cells and the secretion of Th2-driving cytokines. Stunted children present with low vitamin D and leptin levels, impaired lung growth, decreased lung function, and increased IL-4 and CD23+ levels. All of these factors may be considered consequential in asthma in stunted children.
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spelling pubmed-95037742022-09-24 Stunting as a Risk Factor for Asthma: The Role of Vitamin D, Leptin, IL-4, and CD23+ Sapartini, Gartika Wong, Gary W.K. Indrati, Agnes Rengga Kartasasmita, Cissy B. Setiabudiawan, Budi Medicina (Kaunas) Review Stunting, which results from chronic malnutrition, is common in children from low- and middle-income countries. Several studies have reported an association between obesity and asthma. However, only a handful of studies have identified stunting as a significant risk factor for wheezing, a symptom of asthma, although the underlying mechanism remains unclear. This article aimed to review possible mechanisms underlying asthma in stunted children. Overall, changes in diet or nutritional status and deficiencies in certain nutrients, such as vitamin D, can increase the risk of developing asthma. Vitamin D deficiency can cause linear growth disorders such as stunting in children, with lower levels of 25(OH)D found in underweight and stunted children. Stunted children show a decreased lean body mass, which affects lung growth and function. Low leptin levels during undernutrition cause a Th1–Th2 imbalance toward Th2, resulting in increased interleukin (IL)-4 cytokine production and total immunoglobulin E (IgE). Studies in stunted underweight children have also found an increase in the proportion of the total number of B cells with low-affinity IgE receptors (CD23+). CD23+ plays an important role in allergen presentation that is facilitated by IgE to T cells and strongly activates allergen-specific T cells and the secretion of Th2-driving cytokines. Stunted children present with low vitamin D and leptin levels, impaired lung growth, decreased lung function, and increased IL-4 and CD23+ levels. All of these factors may be considered consequential in asthma in stunted children. MDPI 2022-09-07 /pmc/articles/PMC9503774/ /pubmed/36143913 http://dx.doi.org/10.3390/medicina58091236 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Sapartini, Gartika
Wong, Gary W.K.
Indrati, Agnes Rengga
Kartasasmita, Cissy B.
Setiabudiawan, Budi
Stunting as a Risk Factor for Asthma: The Role of Vitamin D, Leptin, IL-4, and CD23+
title Stunting as a Risk Factor for Asthma: The Role of Vitamin D, Leptin, IL-4, and CD23+
title_full Stunting as a Risk Factor for Asthma: The Role of Vitamin D, Leptin, IL-4, and CD23+
title_fullStr Stunting as a Risk Factor for Asthma: The Role of Vitamin D, Leptin, IL-4, and CD23+
title_full_unstemmed Stunting as a Risk Factor for Asthma: The Role of Vitamin D, Leptin, IL-4, and CD23+
title_short Stunting as a Risk Factor for Asthma: The Role of Vitamin D, Leptin, IL-4, and CD23+
title_sort stunting as a risk factor for asthma: the role of vitamin d, leptin, il-4, and cd23+
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9503774/
https://www.ncbi.nlm.nih.gov/pubmed/36143913
http://dx.doi.org/10.3390/medicina58091236
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