A study of some changes of cell-mediated immunity in protein energy malnutrition

This work was done to assess both monocytic and lymphocytic functions and to identify their role in the altered immunocompetence in protein energy malnutrition (PEM). This was accomplished through the evaluation of the phagocytic function and the in vitro production of interleukin 1 and interleukin 2 (IL-1 and IL-2) from cultured mononuclear cells. Forty patients with PEM within the age of (5-20 months) and twenty normal healthy subjects of matched age and sex were studied. They were subjected to complete blood picture, total serum protein, serum albumin, C3, C4, monocyte phagocytic function and in vitro production of both IL-1 and Il-2 from cultured mononuclear cells. Patients were graded on the basis of their clinical findings into three groups: Marasmic, marasmic kwashiorkor and Kwashiorkor. The study revealed that monocyte phagocytosis, complement components, in vitro production of IL-1 and IL-2 were significantly lower in the patients group when compared to normal control group, this increase was most obvious in the marasmic Kwashiorkor and Kwashiorkor groups. In addition, mononuclear cells from the infected patients produced less IL-1, Il-2 although the total leucocytic count was significantly increased than in the non-infected patients, indicating a functional rather than numerical cellular impairment. It was concluded that both monocytic and lymphocytic functions were impaired in PEM. This functional impairment may be involved in the failure of development of specific immune response and predisposed to increased susceptibility to infection in these patients.