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Red blood cell antioxidant enzyme concentrations in kwashiorkor and marasmus
A A Sive1, E F Subotzky, H Malan
1Department of Paediatrics and Child Health, University of Cape Town, Red Cross War Memorial Children's Hospital, South Africa.
Insights
Children with kwashiorkor have lower levels of key antioxidants like reduced glutathione (GSH) and glutathione peroxidase (GPX). Their antioxidant status differs significantly from well-nourished children and those with marasmus.
Area of Science:
- Biochemistry
- Pediatric Nutrition
- Oxidative Stress
Background:
- Kwashiorkor is linked to an imbalance between pro-oxidants and antioxidants, leading to excess free radicals.
- Antioxidant enzymes play a crucial role in mitigating oxidative damage.
Purpose of the Study:
- To investigate the antioxidant status in children with kwashiorkor.
- To compare antioxidant enzyme concentrations between kwashiorkor, marasmus, and healthy children.
Main Methods:
- Measured erythrocyte concentrations of catalase (CAT), superoxide dismutase (SOD), reduced glutathione (GSH), and glutathione peroxidase (GPX).
- Assessed thiobarbituric acid-reactive substances (TBARS) as a marker of lipid peroxidation.
- Compared levels in 22 children with kwashiorkor, 22 with marasmus, and 20 healthy children.
Main Results:
- CAT and SOD levels were similar across all groups and did not change during recovery.
- GSH and GPX were significantly lower in children with kwashiorkor.
- Elevated TBARS levels were observed in kwashiorkor, indicating increased lipid peroxidation.
Conclusions:
- Children with kwashiorkor exhibit a distinct antioxidant profile compared to marasmic and well-nourished children.
- GSH levels increased during recovery in kwashiorkor patients, but GPX did not, despite reduced lipid peroxidation.
- Further research is needed to determine if these antioxidant differences are causative or consequential to kwashiorkor.
Abstract:
Kwashiorkor may occur when an imbalance between pro- and antioxidants in malnourished children results in an excess of free radicals. The concentrations of the antioxidant enzymes catalase (CAT), superoxide dismutase (SOD), reduced glutathione (GSH) and glutathione peroxidase (GPX) were measured in erythrocytes of 22 children with kwashiorkor on admission to hospital and repeated on days 5, 10 and 30 of recovery. The concentrations were compared with those in 22 children with marasmus and in 20 children who were normally nourished but had infective illness necessitating their hospitalization. CAT and SOD were similar in all groups and did not change during recovery. GSH and GPX were significantly lower in kwashiorkor than in the other groups. Concentrations of thiobarbituric acid-reactive substances (TBARS), a marker of lipid peroxidation, were significantly elevated in children with kwashiorkor. During clinical recovery, GSH but not GPX concentrations rose despite an increase in plasma selenium levels and decreased concentrations of TBARS. These findings suggest that the antioxidant status of children with kwashiorkor differs from that of well nourished and marasmic children. Whether these differences are the cause of the consequence of the clinical picture is unresolved.
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