{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T03:16:49Z","timestamp":1793503009197,"version":"4.5.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100002558","name":"Warren Alpert Foundation","doi-asserted-by":"publisher","award":["#6005415"],"award-info":[{"award-number":["#6005415"]}],"id":[{"id":"10.13039\/100002558","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007265","name":"Boston University School of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Undernutrition is the leading population-attributable risk factor for tuberculosis (TB), yet whether associated immune impairments are reversible with nutritional rehabilitation remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In Tuberculosis: Learning the Impact of Nutrition (Puducherry, India), 105 QuantiFERON-positive household contacts were stratified by body mass index (BMI) (&amp;lt;18.5 vs \u226518.5\u2005kg\/m2). Participants with low BMI (n = 53) received 6 months of food rations plus a daily multiple micronutrient supplement (MMS) without iron. Fourteen cytokines were measured by Luminex in supernatants from the unstimulated (Nil) and Mycobacterium tuberculosis (Mtb)-antigen-stimulated (TB2) IGRA assays at baseline and 6 months; 11 with acceptable detection rates constituted the primary analytic set. Linear regression tested associations of weight and hemoglobin change with composite immune pathway scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At baseline, participants with low BMI had attenuated Mtb-specific Th1 cytokine responses (interaction geometric mean ratio [GMR] 0.70 for IFN-\u03b3, 0.55 for IL-2; both P = .005), despite comparable or elevated innate and regulatory cytokines. After 6 months, Th1 responses increased (interferon gamma change GMR 1.41, 95% CI 1.10\u20131.80, P = .005, q = 0.06; interleukin-2 1.63, 1.01\u20132.63, P = .046, q = 0.25, suggestive). This increase reflected falling unstimulated background, not higher stimulated output. Weight gain was unrelated to composite scores but associated with elevated concentrations of 7 of 14 cytokines (all P &amp;lt; .05). Hemoglobin gain was inversely associated with Th17 and proinflammatory scores but not Th1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Six months of combined food rations and daily MMS were followed by improved antigen-specific Th1 cytokine responses, suggesting that this impairment may be partially reversible on a clinically feasible timescale. As a single-arm study without a concurrent comparator with undernutrition measured at follow-up, observed changes cannot be causally attributed to the intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trials Registration<\/jats:title>\n                    <jats:p>NCT03598842.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiag464","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T13:53:26Z","timestamp":1788616406000},"source":"Crossref","is-referenced-by-count":1,"title":["Attenuated\n                    <i>Mycobacterium tuberculosis<\/i>\n                    -Specific Th1 Cytokine Responses in Household Contacts With Undernutrition and Their Partial Reconstitution During 6 Months of Nutritional Support"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0019-9545","authenticated-orcid":false,"given":"Lindsey 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,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1793-9160","authenticated-orcid":false,"given":"Arthur","family":"VanValkenburg","sequence":"additional","affiliation":[{"name":"Center for Data Science, Division of Infectious Disease, Department of Medicine, Rutgers New Jersey Medical School , Newark, New Jersey ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3913-5562","authenticated-orcid":false,"given":"Meagan","family":"Karoly","sequence":"additional","affiliation":[{"name":"Boston Medical Center , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4319-9788","authenticated-orcid":false,"given":"Madolyn R","family":"Dauphinais","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Medicine, Boston University Chobanian & 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Boston, Massachusetts ,","place":["USA"]},{"name":"Kimba's Kitchen , West Palm Beach, Florida ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3654-9874","authenticated-orcid":false,"given":"Sheetal","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Medicine, Center for Emerging Pathogens, Rutgers New Jersey Medical School , Newark, New Jersey ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noyal Mariya","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Puducherry ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0528-6805","authenticated-orcid":false,"given":"Sonali","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Department of Preventive and Social 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