PROTEIN-ENERGY MALNUTRITION DELAYS SMALL-INTESTINAL RECOVERY IN NEONATAL PIGS INFECTED WITH ROTAVIRUS

Infectious diarrheal diseases and protein-energy malnutrition (PEM) ar e major causes of child morbidity and mortality worldwide. In the pres ent study, PEM was superimposed on rotavirus infection in neonatal pig s to simulate chronic small intestinal stress in malnourished infants with viral gastroenteritis. Two-day-old cesarean-derived pigs (n = 39) were allotted to three treatment groups: 1) noninfected, full-fed; 2) infected, full-fed; and 3) infected, malnourished. Two days postinfec tion, severe diarrhea and weight loss (11%) were accompanied by reduct ions in villus height (60%) and lactase activity (78%) and increased c rypt depth (32%) in infected full-fed compared with noninfected pigs ( P < 0.05). Malnutrition blunted (P < 0.05) increases in crypt depth el icited by rotavirus. By 9 d postinfection, body weight was 59% less, v illus height and lactase activity remained lower (50%), and crypt dept h remained greater (62%) in infected full-fed compared with noninfecte d pigs (P < 0.05). However, diarrhea began to clear in infected full-f ed, but not in infected malnourished pigs, Plasma insulin-like growth factor-I (IGF-I) was reduced 68% and crypt depth was reduced 19% in in fected-malnourished compared with infected full-fed pigs (P < 0.05). S ixteen days postinfection, full-fed pigs had recovered from rotaviral infection; however, in infected-malnourished pigs, diarrhea and growth stasis persisted, and plasma IGF-I, villus height and alkaline phosph atase activity remained reduced compared with infected full-fed pigs ( P < 0.05), Overall, PEM prolonged diarrhea and delayed small-intestina l recovery, indicating that nutritional status during diarrhea is esse ntial for recovery from rotaviral enteritis.