Neutrophil function in children with kwashiorkor

Area of Science:

• Immunology
• Nutritional Science
• Pediatrics

Background:

• Kwashiorkor, a severe form of malnutrition, is associated with increased susceptibility to infections.
• The role of peripheral blood polymorphonuclear neutrophil (PMN) function in the pathogenesis of infection in kwashiorkor remains incompletely understood.

Purpose of the Study:

• To investigate the in vitro function of peripheral blood PMNs in children with kwashiorkor.
• To assess specific functional parameters including chemotaxis, candidacidal activity, metabolic activity during phagocytosis, and iodination.

Main Methods:

• Functional assays were performed on PMNs from 46 children with kwashiorkor and control subjects.
• Methods included chemotaxis assays, Candida albicans killing assays, nitroblue tetrazolium (NBT) reduction, enzyme activity measurements, hexose monophosphate shunt (HMS) activity, and iodide incorporation studies.
• Electron microscopy was used to evaluate postphagocytic morphological events.

Main Results:

• PMNs from kwashiorkor patients showed impaired chemotactic response at early time points and diminished candidacidal activity against Candida albicans.
• While resting HMS activity was higher in kwashiorkor PMNs, stimulation during phagocytosis was comparable to controls.
• Reduced iodide incorporation into TCA-precipitable proteins was observed in phagocytizing PMNs from kwashiorkor patients, suggesting impaired iodination.

Conclusions:

• Peripheral blood PMN function is impaired in children with kwashiorkor, characterized by reduced chemotaxis, diminished candidacidal activity, and decreased iodination.
• These functional deficits in PMNs may contribute to the increased incidence of infections in kwashiorkor.
• Further research is warranted to explore therapeutic strategies targeting PMN function in malnourished children.