NEUTROPHIL FUNCTION IN CHILDREN WITH KWASHIORKOR

  • 1 January 1976
    • journal article
    • research article
    • Vol. 88  (3) , 450-461
Abstract
Peripheral blood polymorphonuclear neutrophil (PMN) function was investigated in 46 children with kwashiorkor (without overt infection) in the Ivory Coast, West Africa. In vitro chemotactic response, candidacidal activity and kinetic studies of metabolism during phagocytosis were performed. Postphagocytic morphological events were evaluated by EM. The reduction of nitroblue tetrazolium (NBT), measurement of enzyme activities, activity of glycolysis and hexose monophosphate shunt (HMS) activity were assessed. The extent of iodide incorporation into trichloroacetic acid (TCA)-precipitable protein by phagocytizing PMN and thyroid hormone degradation were measured. Chemotactic response was reduced at early time intervals (30, 60 and 120 min) and reached control values after 180 min. PMN of controls killed 32.13 .+-. 11.10% of Candida albicans after 60 min; PMN from kwashiorkor patients killed 18.55 .+-. 7.74% (P < 0.01). HMS activity for resting PMN of kwashiorkor children was higher than controls, and during particle ingestion the extent of stimulation was comparable to controls. EM assessment of phagocytic vacuole formation and degranulation showed no difference between PMN from kwashiorkor and control subjects. Incorporation of 131I into TCA-precipitable proteins by phagocytizing PMN from kwashiorkor children was reduced in comparison to controls, with either viable or heat-killed lactobacilli [Lactobacillus]. No impairment of thyroxine (T4) degradation was observed for PMN from kwashiorkor cases. PMN from kwashiorkor patients show toxic granules, Doehle bodies, evidence of high baseline NBT reduction and glucose decarboxylation. Functional studies indicate impaired kinetics of chemotaxis, diminished candidacidal activity and reduced iodination. Enzymatic activities of resting cells are normal. Lactate production, HMS activity during phagocytosis and morphological events are not impaired. Impaired in vitro microbicidal activity, increased resting metabolism and decreased iodination by PMN may be related to the high incidence of infection in kwashiorkor.