Neutropenia is defined as a condition of abnormally low number of neutrophils, as a result of granulocyte disorder of that leads to Immunodeficiency with lower than normal circulating white blood cells. Patients with neutropenia are susceptible to bacterial infections causes of neutropenic sepsis.
Neutropenia is either
problems in the production of the cells by the bone marrow and
destruction of the cells from somewhere else in the body, if neutrophil
count falls below 1,000 cells per microliter of blood.
Neutropenia can be classified into acute and chronic types, depending to the duration of the illness. Some researchers divided severity of the disease, depending to the absolute neutrophil count (ANC) and is described as follows(a).
1. Mild neutropenia, when the ANC falls below a lower limit of 1500 per mm3 (1.5 x 109 /1), but remains higher than 1000 per mm3 (1.0 x 109 /1).
2. Moderate neutropenia, when the ANC falls between 500 per mm3 and 1000 per mm3 (0.5 x 109 /1 - 1.0 x 109 /1)
3. Severe neutropenia, when the ANC falls below 500 per mm3 (0.5 x 109 /1)
Preventions
Phytochemicals to prevent Neutropenia
1. Epigallocatechin-3-gallate
One of the proposed health benefits of consuming green tea
is its protective effect on autoimmune diseases. Research on the
immunopathogenesis of autoimmune diseases has made significant
progression in the past few years and several key concepts have been
revised. T cells, particularly CD4(+) T helper (Th) cells, play a key
role in mediating many aspects of autoimmune diseases. Upon antigenic
stimulation, naïve CD4(+) T cells proliferate and differentiate into
different effector subsets. Th1 and Th17 cells are the pro-inflammatory
subsets of Th cells responsible for inducing autoimmunity whereas
regulatory T cells (Treg) have an antagonistic effect. Green tea
and its active ingredient, epigallocatechin-3-gallate (EGCG), have been
shown to improve symptoms and reduce the pathology in some animal
models of autoimmune diseases(43)
2. Allicin
Allicin treatment enhanced the production of pro-inflammatory mediators
such as IFN-γ, TNF, IL-12p70 and NO. The absolute numbers of CD4+ T
cells, DCs and macrophages were significantly higher in allicin-treated
mice. In addition, allicin promoted the maturation of CD11c+ DCs,
whereas it did not cause major changes in IL-4 and the level of
anti-inflammatory cytokine IL-10(44).
3. Curcumin
In the study to investigate the bioavailablity of a well-established dietary antiinflammatory, curcumin, and examines its effect on adaptive immunity, found that long-term, low-dose, oral consumption of curcumin
activates peroxisome proliferator-activated receptor-gamma, deactivates
type 1 response, inhibits inducible nitric oxide synthase, and
interferes with adaptive immunity
to exacerbate the pathogenesis of Leishmania donovani infection in
vivo. These in vivo effects can be correlated to activities on infected
residential macrophages in vitro. Therefore, when reactive radicals
generated from inflammation play the dominant role in elimination of
pathogens, excessive use of the antioxidative supplements may compromise
microbial defense(45).
4. Carotenoids
In the study to investigate the effects of orally administered carotenoids from natural sources on the non-specific defense mechanisms of rainbow trout in a nine-week feeding trial, showed that dietary carotenoids from both D. salina and P. rhodozyma can modulate some of the innate defense mechanisms in rainbow trout(46).
E.3. Antioxidant to prevent Neutropenia
1. Selenium
Dietary selenium (]Se), mainly through its incorporation into selenoproteins, plays an important role in inflammation and immunity. Adequate levels of Se are important for initiating immunity,
but they are also involved in regulating excessive immune responses and
chronic inflammation. Evidence has emerged regarding roles for
individual selenoproteins in regulating inflammation and immunity,
and this has provided important insight into mechanisms by which Se
influences these processes, according to the study by the University of
Hawaii(47).
2. Vitamin D and C
Inflammatory responses are operationally characterized by pain, redness,
heat and swelling at the site of infection and trauma. Mast cells
reside near small blood vessels and, when activated, release potent
mediators involved in allergy and inflammation. Vitamin D modulates
contraction, inflammation and remodeling tissue. Therapy targeting vitamin D3 signaling may provide new approaches for
infectious and inflammatory skin diseases by affecting both innate and
adaptive immune functions. Vitamin C is also an anti-oxidant well-known as an anti-scurvy agent in humans. Vitamin C
inhibits peroxidation of membrane phospholipids and acts as a scavenger
of free radicals and is also required for the synthesis of several
hormones and neurotransmitters. In humans, vitamin C reduces the duration of common cold symptoms, even if its effect is not clear. Supplementation of vitamin C
improves the function of the human immune system, such as antimicrobial
and natural killer cell activities, lymphocyte proliferation,
chemotaxis and delayed-type hypersensitivity(48).
3. Zinc
T cell functions were affected adversely even when the deficiency of zinc was mild in humans. Characteristically during zinc deficiency, the serum thymulin activity (a thymic hormone) was decreased which was restored following zinc supplementation. Our studies also showed that zinc
deficiency caused an imbalance between TH1 and TH2 functions. The
production of IFN-g, IL-2, TNF-a (products of TH1 cells) were decreased,
whereas the production of IL-4, IL-6 and IL-10 (products of TH2) were
not affected during zinc deficiency. T cell subpopulation studies revealed that the CD4+ CD45RA+ to CD4+ CD45RO+ ratio was decreased as a result of zinc deficiency, suggesting that zinc may be required for the regeneration of new CD4+ T cells. zinc
deficiency decreased NK cell lytic activity and caused a decrease in
the percentage of CD8+ CD73+ T cells which are known to be predominantly
precursors of cytotoxic T cells. In a suitable cell culture model our
studies revealed that the gene expression of a DNA synthesizing enzyme
TK was affected adversely which resulted in delayed cell cycle and
decreased cell growth(49).
4. Resveratrol
In the study to evaluate the immune modulating effect of low dose of resveratrol by the
Chinese Academy of Sciences, showed that resveratrol
(0.75-6 micromol/L) concentration-dependently promoted lymphocyte
proliferation and IL-2 production induced by ConA. Sac induced IL-12 and
IFN-gamma (interferon type II) production were also
concentration-dependently enhanced by resveratrol, while IL-10 production was inhibited. Resveratrol (4 mg/kg, ig) promoted DTH response of mouse, which was suppressed by ethanol (16 %, w/v) consumption(50).
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Sources
(a) http://www.neutropenia.ca/about/what-is-neutropenia
(43) http://www.ncbi.nlm.nih.gov/pubmed/22020144
(44) http://www.ncbi.nlm.nih.gov/pubmed/22873687
(45) http://www.ncbi.nlm.nih.gov/pubmed/18794851
(46) http://www.ncbi.nlm.nih.gov/pubmed/15123294
(47) http://www.ncbi.nlm.nih.gov/pubmed/21955027
(48) http://www.ncbi.nlm.nih.gov/pubmed/23830380
(49) http://www.ncbi.nlm.nih.gov/pubmed/9823012
(50) http://www.ncbi.nlm.nih.gov/pubmed/12370094
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