Child Salivary SIgA and Its Relationship to Enteric Infections and EED Biomarkers in Maputo, Mozambique

• Type of Material: Article
• Authors: Frederick G. B. Goddard, Emory University; Jacqueline Knee, Georgia Institute of Technology; Trent Sumner, Georgia Institute of Technology; Rassul Nala, Minist Saude Maputo Mozambique; Thomas CLASEN, Emory University; Joe Brown, Georgia Institute of Technology
• Language: English
• Date: 2020-05-01
• Publisher: MDPI Publishing
• Publication Version: Final Published Version
• Copyright Statement: © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/ijerph17093035
• Title of Journal or Parent Work: International Journal of Environmental Research and Public Health
• Volume: 17
• Issue: 9
• Grant/Funding Information: This study was funded by a grant from the Bill and Melinda Gates Foundation (OPP1137224). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
• Keywords: IGA; infectious diseases; enteric pathogens; Environmental Sciences & Ecology; Environmental Sciences; Diagnosis; Secretory component; Public, Environmental & Occupational Health; Immunoglobulin; global health; Malnutrition; Transport; Enteropathogens; immunology; Immunity; salivary antibodies; Homeostasis; Developing countries; Science & Technology; Life Sciences & Biomedicine
• Research Categories: Health Sciences, Immunology; Environmental Sciences; Health Sciences, Public Health; Biology, Ecology

Abstract

Characterizing child immunological responses to enteric infections with antibody detection in serum can be challenging in resource-constrained field settings, because sample collection requires trained individuals and its invasive procedure may lead to low response rates, especially among children. Saliva may present a promising non-invasive alternative. The objectives of this research were to compare salivary antibody levels in children to enteric infections and biomarkers of environmental enteric dysfunction (EED). We collected saliva samples from children aged one to six years enrolled in a sanitation trial in Maputo, Mozambique, and characterized salivary secretory immunoglobulin A (SIgA) concentrations with enzyme-linked immunosorbent assays. We used multilevel linear models to analyze cross-sectional associations between salivary SIgA and the number of concurrent enteric pathogen infections, as well as EED biomarkers in matched stool samples. Median salivary SIgA concentrations in this study population were 54 μg/mL (inter-quartile range (IQR): 34, 85 μg/mL), and SIgA levels were similar between children of different ages. SIgA was lower in children experiencing a higher number of concurrent infections −0.04 log μg/mL (95% confidence interval (CI): −0.08 to −0.005 log μg/mL), but was not associated with any of the included EED biomarkers. Contrary to evidence from high-income countries that suggests salivary SIgA increases rapidly with age in young children, the high prevalence of enteric infections may have led to a suppression of immunological development in this study sample and could in part explain the similar SIgA levels between children of different ages.