Host defense in malnutrition

[摘要] It has not been possible to relate a particular immune failure or deficiency to absence of a specific nutrient. All of these studies have viewed the totality of malnutrition and, yet, it would seem reasonable to expect that specific nutrient deficiencies would affect the response differently and that the almost infinite number of possible interactions among nutrients may have their particular effect. Furthermore, it has not been possible to evaluate any of these studies in terms of the influences that infections themselves have brought to bear. These considerations have led us to conclude that studies of man cannot be carried out with a precision required for the definitive answers. This is not a defeatist notion, but rather a value judgment that prompts us to recommend a more intensive series of investigations in animal model systems, the conclusions of which could then be applied selectively to clinical studies of man.The important question that must be considered is possible nutritional interventions in severely infected patients, such as those undergoing major surgery or immunosuppressive therapy. Potential dangers of using live attenuated viral vaccines in malnourished populations must be evaluated. It is necessary to assess the possibility that such vaccine viruses unchecked by normal immune response in malnourished individuals may lead to the establishment of states of latency and, ultimately, slow infections.The need for further studies has been given recognition by a workshop conference held in May 1975 under the title "Malnutrition and the Immune Response"; the proceedings are soon to be published in book form.57 The question of the influences of infection upon the state of nutrition has also been considered in a recent workshop, the proceedings of which will also be published.58 We believe that the current critical approach to this important health problem will generate answers long wanting. When these answers do become available, they will guide us into better care not only of the malnourished in the developing world, but also of those in the industrialized countries.

[学科分类] 儿科学