ACUTE-PHASE PROTEIN RESPONSE TO INFECTION IN SEVERE MALNUTRITION

It is not known whether malnourished infants can mount a comprehensive acute-phase protein (APP) response and, if so, whether this is achiev ed by increasing APP synthesis rates. To address these issues, we meas ured lj the plasma concentrations of five APPs (C-reactive protein, al pha(1)-acid glycoprotein, alpha(1)-antitrypsin, haptoglobin, and fibri nogen) and 2) the synthesis rates of three APPs (alpha(1)-antitrypsin, haptoglobin, and fibrinogen) using a constant intragastric infusion o f[H-2(3)]leucine in nine infected marasmic children at similar to 2 da ys postadmission (study 1), similar to 9 days postadmission when infec tions had cleared (study 2), and similar to 59 days postadmission at r ecovery (study 3). Except for fibrinogen, the plasma concentrations of all APPs were higher in study 1 than in studies 2 and 3. Although the rate of synthesis of haptoglobin was significantly greater in study 2 than study 2, the rates of fibrinogen and alpha(1)-antitrypsin synthe sis were similar in all three studies. These results show that Ii seve rely malnourished children can mount an APP response to infection whic h does not include fibrinogen and 2) the APP response is accomplished through different mechanisms.