IMMUNE-RESPONSES DURING RECOVERY FROM PROTEIN-ENERGY MALNUTRITION

Protein-energy malnutrition (PEM) is a worldwide problem. Infants and children from developing countries and elderly people from all around the world are the two main groups suffering from PEM. PEM induces prof ound immunodeficiency, characterized mainly by decreased cell-mediated immunity, and also by decreased humoral and non-specific immunity. No n-specific immune deficiency is of particular importance for defences against infections and its decrease in PEM may further deteriorate nut ritional and immune status, pushing patients into a vicious and dramat ic circle. Refeeding such patients and the restoration of their nutrit ional status lead to improvement in all immune responses: a strong ass ociation between the evolution of these two responses is always observ ed during refeeding. The need for specific nutrients to restore immune functions during refeeding of PEM patient has been extensively studie d in the past years. This review describes the pathophysiological mech anisms of immune consequences of PEM and of immune restoration with re feeding, and in addition focuses upon some nutrients of particular imp ortance, namely glutamine, zinc and vitamin E. Particular attention at the elderly patients with PEM, a growing population for which the imp ortance of is directed at the elderly patients with PEM, a growing pop ulation for which the importance of undernutrition on prognosis is not yet fully recognized.