RESTORATIVE EFFECT OF TOTAL PARENTERAL-NUTRITION ON NATURAL-KILLER-CELL ACTIVITY IN MALNOURISHED CANCER-PATIENTS

Decreased natural killer cell activity (NKCA) is associated with malnu trition in both cancer and non-cancer patients. We have studied the ef fect of total parenteral nutrition (TPN) on NKCA in 9 malnourished can cer patients, candidates for surgery. TPN was administered for a media n of 10 days (range 7 - 11), providing 1.5-fold the estimated resting energy expenditure, with 30% as fat. Calorie:nitrogen ratio was 150:1. Basal human recombinant interferon-alpha 2a (rIFN-alpha 2a) and human recombinant IL-2 (rIL-2) activated NKCA were measured, as were the ma in nutritional parameters, prior to and after TPN. NKCA increased in a ll patients and reached the normal range in 5, 3 and 4 subjects, respe ctively, for basal, rIFN-alpha 2a and rIL-2 activated NKCA. As regards nutritional assessment, body weight and IgM levels significantly incr eased from 47.7 to 50.1 kg and from 174 to 237 mg/dl, respectively. Th is study demonstrates that a Ill-day TPN course increases and sometime s restores normal NKCA. Such effect was constant and preceded nutritio nal changes.