Lymphocyte malnutrition

The massive atrophied change which takes place first in the thymus followed by the spleen could well explain the marked depressed function of thymus-dependent lymphocytes (T cells)—phytohemagglutinin-responsive cells—in peripheral blood of subjects with protein calorie malnutrition (J6, M18, S6, S12). 

Physiologically, these plasma changes are included here since they reflect impaired numbers or function of B-lymphocytes. Two broad categories are recognizable. First, such immunodeficiency states may exist on congenital basis and often do so with concurrent defects in the T cells (Fig. 1). Alternatively, severe reductions in immunoglobulin levels often develop in the course of chronic lymphocytic leukaemia and myeloma. Not dissimilar impairment of immune competence is found with nephrotic syndrome, protein-losing enteropathy or even malnutrition, and in these instances is equally profound. 

Velazjt)uez,. A., Teran, M., Baez, A., Gutierrez, J., and Rodriguez, R. (1995). Biotin supplementation affects lymphocyte carboxylases and plasma biotin in severe protein-energy malnutrition. Am. /. CJiti. j jdr. 61, 3S5-39L... 

Most research on the effect of folate deficiency on lymphoid cell metabolism has focused on the enzymes involved in pyrimidine synthesis. Defective interconversion of glycine and serine has been reported in peripheral lymphocytes from folate deficient patients due to folate malabsorption, malnutrition or treatment with phenytoin (Ellegaard and Esmann, 1972), methotrexate, (Ellegaard and Esmann, 1973). In fact estimation of serine formation in lymphocytes cultured with glycine and labeled formate is the basis for the test developed to detect early folate deficiency before the appearance of megaloblastic changes in the bone marrow and low RBC folate levels (Ellegaard and Esmann, 1973). 

Chandra, R, K, (1974) Rosette-forming T lymphocytes and cell mediated immunity in malnutrition. Br. Med. J. 3 608. 

Chandra, R. K. (1977a) Lymphocyte subpopulations in human malnutritions cytotoxic and suppressor cells. Pediatr. 59 423. 

Keusch, G. T., Urrutia, J. J., Guerrero, 0., Castaneda, G., and Douglas, S. D. 977c) Rosette forming lymphocytes in Guatemalan children with protein - calorie malnutrition. in "Malnutrition and the Immune Response R, M. Suskind, ed., Raven Press, N.Y. 

The fact that normal humans have a requirement for biotin has been clearly documented in two situations prolonged consumption of raw egg white and parenteral nutrition without biotin supplementation in patients with short bowel syndrome and other causes of malabsorption. Based on lymphocyte carboxylase activities and plasma biotin levels, some children with severe protein-energy malnutrition are biotin deficient. Investigators have speculated that the effects of biotin deficiency may be responsible for part of the clinical syndrome of protein-energy malnutrition. 

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