T. Cederholm et al., Impaired leukotriene C4 generation in granulocytes from protein-energy malnourished chronically ill elderly, J INTERN M, 247(6), 2000, pp. 715-722
Citations number
44
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Objective. The dysregulation of the immune and inflammatory systems observe
d in protein-energy malnutrition (PEM) may be partly due to perturbation of
essential fatty acid metabolism. In this study, we assessed the calcium io
nophore A23187-induced generation of the arachidonate metabolites leukotrie
ne B4 (LTB4) and leukotriene C4 (LTC4) in isolated granulocyte suspensions.
Design. Case-control study.
Setting. A university-affiliated acute care hospital in urban Stockholm.
Subjects. Fourteen severely malnourished elderly subjects with stable non-m
alignant disorders (age 74 +/- 1 years, mean +/- SEM) and 12 healthy age-ma
tched controls were examined.
Main outcome measures. Leukotrienes were analysed by high-performance liqui
d chromatography. Body mass index (BMI, kg m(-2)) and delayed cutaneous hyp
ersensitivity (DCH) reaction were determined.
Results. BMI was 16.5 +/- 0.5 and 26.2 +/- 0.9 kg m(-2) (mean +/- SE) in th
e malnourished group and controls (P < 0.001), respectively. DCH was 8.5 mm
(median) in patients and 29.5 mm in controls (P < 0.001). LTC4 generation
in granulocytes from PEM patients was half of that of controls (9.1 +/- 2.0
vs. 17.8 +/- 5.2 pmol mL(-1), P < 0.05) when cells were stimulated with 0.
2 mu mol L-1 of A23187, and 13.7 +/- 2.5 and 27.2 +/- 7.5 pmol mL(-1), resp
ectively (NS), upon stimulation with 1.0 mu mol L-1 of A23187. LTB4 product
ion in PEM patients and controls did not differ at any of the two calcium i
onophore concentrations. LTC4 production correlated with BMI (r = 0.41, P <
0.05), but there was no significant correlation between DCH and LTB4 or LT
C4 production.
Conclusion. Protein-energy malnutrition is accompanied by perturbation of l
eukotriene synthesis, which may be one factor underlying the dysregulation
of inflammatory responses in the depleted patient.