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Complement activity in children with protein-calorie malnutrition
Insights
Children with severe protein calorie malnutrition (PCM) show impaired complement system function, indicated by low hemolytic complement (CH50) activity. Nutritional recovery restores CH50 levels, suggesting diet is crucial for immune system repair.
Area of Science:
- Immunology
- Nutritional Science
- Pediatrics
Background:
- The complement system is a critical part of innate immunity.
- Severe protein calorie malnutrition (PCM) can impact immune function.
- Hemolytic complement (CH50) activity is a measure of complement system integrity.
Purpose of the Study:
- To evaluate the complement system's hemolytic complement (CH50) activity in children with severe PCM.
- To assess changes in CH50 activity during hospital admission and recovery.
- To investigate the presence of anticomplementary (AC) activity in PCM patients.
Main Methods:
- Utilized the hemolytic complement (CH50) assay.
- Monitored 28 children with severe PCM during hospitalization and recovery.
- Compared CH50 activity with 17 healthy control subjects.
- Assessed serum anticomplementary (AC) activity.
Main Results:
- Children with kwashiorkor had significantly lower CH50 activity on hospital days 1 and 4 compared to controls.
- CH50 activity normalized by day 8 and became significantly higher than controls by day 50.
- 40% of PCM children showed anticomplementary (AC) activity, which decreased significantly during recovery.
- A significant inverse correlation was found between CH50 titer and AC activity in PCM serum.
Conclusions:
- The complement system is functionally compromised in children with severe PCM.
- Adequate dietary intake is essential for the repair of complement system function.
- Anticomplementary activity may contribute to depressed complement function in untreated PCM.
Abstract:
Using the hemolytic complement (CH50) assay, we evaluated the complement system of 28 children with severe protein calorie malnutrition (PCM) during their hospital admission and recovery. The mean CH50 activity in children with kwashiorkor was significantly less on hospital days 1 and 4 than in 17 healthy control subjects. On day 8 it rose to normal, and by day 50 it was significantly higher than the controls. The mean CH50 titer of 16 well-nourished febrile children was, in contrast to that of untreated PCM, significantly greater than the healthy controls. Of the children with PCM, 11 (40%) evidenced anticomplementary (AC) activity in their serum on either day or 1 or 4, but only two (7%) had detectable serum AC activity during later convalescence. Significantly, the CH50 titer in a PCM serum correlated inversely to the amount of AC activity in that serum (P less than 0.01). These results indicate that, in children with PCM, the complement system is compromised functionally, and that its repair coincides with intake of adequate diet. The presence of AC activity provides a possible mechanism for depressed complement activity in some untreated PCM children.