EFFECT OF RE-NUTRITION ON HUMORAL AND CELL-MEDIATED-IMMUNITY IN SEVERELY MALNOURISHED CHILDREN

Colombian children (43) suffering from either kwashiorkor (21), combined protein-calorie malnutrition (11) or marasmus (11) were hospitalized and provided a high protein, high calorie diet for 4-5 wk. Improvement in clinical and nutritional status was accompanied by significant increases in levels of serum IgG, IgM and C3 [complement component 3] and by significant decreases in serum IgA, especially in infants with kwashiorkor. Skin test reactions to purified protein derivative and candidin improved during renutrition. Lymphocyte blastogenesis after stimulation in vitro with phytohemagglutinin and pokeweed mitogen increased rapidly during hospitalization. After 1 yr posttreatment, cell-mediated immune responses, both in vivo and in vitro, had diminished. Some aspects of the immune response are affected to a different degree in kwashiorkor, marasmus and combined malnutrition. Short-term nutritional rehabilitation has a differential effect on the long-term restoration of various aspects of immunity.