Malnutrition in children is frequently associated with an
increased incidence of infection. Apoptosis of immune cells in
undernourished organisms may cause an increase in the organism's
susceptibility to diseases related to immune suppression. Lymphocyte
apoptosis was described in malnutrition. The role of factor of apoptosis
signal (fas,CD95) in apoptosis of lymphocyte populations in malnourished
children is still unclear.
Objective: This study investigated apoptosis in T lymphocytes in different
types of malnutrition and the role of Fas in lymphocyte apoptosis and its
relation to clinical and laboratory parameters of malnutrition.
Study design: Sixty-three malnourished infants and children were compared
to 27 healthy controls. Beside thorough history and clinical examination,
laboratory investigations and flow cytometry assessment of T lymphocytes
were done. The viability of T lymphocytes was determined by combination of
fluorescence dye 7-amino actinomycin, CD95 and CD3.
Results: There was significant increase in apoptotic T-cells in the patients
compared to the controls. There was up-regulation of Fas expression in
CD3+ cells. Furthermore CD3+/CD95+ cells were less viable than
CD3+/CD95- cells of the patients and than CD3+/CD95+ cells of the
controls. All the clinical and laboratory parameters of the studied patients
showed no significant correlations with any of the apoptotic indices.
Conclusion: Increased apoptosis in T lymphocytes in malnourished children
may be the cause of the decrease in lymphocyte count in their peripheral
blood. This in turn may be the cause of decreased cell mediated immunity
and the more common occurrence of infection in such patients. Upregulation
of Fas may be the cause of apoptosis in T lymphocytes in these
malnourished children.