Serum opsonic activity in acute protein-energy malnutrition

Phagocytic host defence mechanisms require both normally functioning cells and humoral factors. For example, activated complement components and/or specific immunoglobulin are essential for effective ingestion and killing of bacteria by neutrophils, and complement is especially important early in infection, before specific antibody has been produced. Abnormalities of serum complement have previously been reported in malnutrition, and the present study investigated the levels of serum opsonins in children with protein-energy malnutrition (PEM).Opsonic activity for Escherichia coli and Staphylococcus aureus was depressed in acute PEM patients, but recovered to higher levels with treatment. This depression was detected only when low concentrations of serum (10-20 ml/litre) were used. Marked and persistent opsonin deficiencies were associated with poor clinical response. Reduced opsonic activity may adversely affect host defence mechanisms and contribute to morbidity and mortality from pyogenic infections in PEM. Replacement therapy with fresh or fresh frozen plasma might restore opsonic activity in these patients and reduce the risk of septicaemia and its attendant high mortality.