Cytokine-induced malnutrition

TNF-a is identical to cachetin, a protein that suppresses completely the lipoprotein lipase of adipose tissue and is believed to be responsible for cachexia, a condition of general ill health, malnutrition, weight loss, and wasting of muscle that accompanies cancer and other chronic diseases. Nevertheless, TNF-a may be overproduced in obesity as well. It has been suggested that abnormal production of TNF-a may induce cachexia while abnormal action of the cytokine may cause obesity.233 Some TNF receptors have "death domains" and trigger apoptosis, while other receptors promote proliferation and differentiation via transcription factor NF-kB.242... 

Cachexia is loss of weight, muscle atrophy, fatigue, weakness and significant loss of appetite. It is seen in patients with cancer, acquired immunodeficiency syndrome (AIDS), chronic obstructive pulmonary disease and congestive heart failure. Underlying causes are poorly understood, but there is an involvement of inflammatory cytokines, such as TNF-a, IFN-y, IL-6 and tumour-secreted proteolysis-inducing factor. Related syndromes are kwashiorkor and marasmus, although these are most often symptomatic of severe malnutrition. 

The different re-nutrition diets not only were able to reestablish the number of immune cells in the lamina propria of the small intestine, but also the functionality of them. Malnutrition induces impairment in the cytokine production by the intestinal immune cells, which was reverted when the re-nutrition diets were supplemented with PFM or BFS, reaching values near to those observed in the well-nourished control group (Figure 8.1). This finding is very important considering the role of cytokines in the enhancement of the immune response during a vaccination process (Rizza et al. 2002). 

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