Daily preventive zinc supplementation increases the antibody response against pathogenic Escherichia coli in children with zinc insufficiency: a randomised controlled trial
Chidchamai Kewcharoenwong, Myint Myint Sein, Arnone Nithichanon, Aranya Khongmee, K Ryan Wessells, Guy-Marino Hinnouho, Maxwell A Barffour, Sengchanh Kounnavong, Sonja Y Hess, Charles B Stephensen, Ganjana Lertmemongkolchai, Chidchamai Kewcharoenwong, Myint Myint Sein, Arnone Nithichanon, Aranya Khongmee, K Ryan Wessells, Guy-Marino Hinnouho, Maxwell A Barffour, Sengchanh Kounnavong, Sonja Y Hess, Charles B Stephensen, Ganjana Lertmemongkolchai
Abstract
Zinc deficiency impairs the antibody-mediated immune response and is common in children from lower-income countries. This study aimed to investigate the impact of different zinc supplementation regimens (7, 10 or 20 mg/day elemental zinc)-therapeutic dispersible zinc tablets (TZ), daily multiple micronutrient powder (MNP), daily preventive zinc tablets (PZ) and placebo powder (control)-and compare between baseline and endline antibody production against pathogenic Escherichia coli in Laotian children (aged 6-23 months). Fifty representative plasma samples of each treatment group were randomly selected from 512 children to determine anti-E. coli IgG antibody levels and avidity. Of the 200 children, 78.5% had zinc deficiency (plasma zinc concentration < 65 µg/dL) and 40% had anaemia before receiving zinc supplementation. aAfter receiving the TZ, MNP or PZ regimen, the plasma anti-E. coli IgG levels were significantly increased compared with baseline; the effect on the antibody level was more pronounced in children with zinc deficiency. Interestingly, there was increased anti-E. coli IgG avidity in the control and PZ groups. This study suggests that PZ might be the optimal zinc supplementation regimen to increase both the quantity and quality of antibody responses in children with zinc deficiency. Clinical trial registration: https://ichgcp.net/clinical-trials-registry/NCT02428647 (NCT02428647, 29/04/2015).
Conflict of interest statement
The spouse of SYH worked for the Bill & Melinda Gates Foundation, which provided part of the financial support. The other authors declare no competing interests.
© 2022. The Author(s).
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References
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