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Low levels of essential fatty acids are related to impaired delayed skin hypersensitivity in malnourished chronically ill elderly people
Author(s) -
CEDERHOLM T. E.,
BERG A. B.,
JOHANSSON E. K.,
HELLSTRÖM K. H.,
PALMBLAD J. E. W.
Publication year - 1994
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.1994.tb01113.x
Subject(s) - medicine , delayed hypersensitivity , immunology , physiology , immune system
Abstract Essential fatty acid (FA) deficiency, which may accompany protein‐energy malnutrition (PEM), has been associated with impaired inflammatory reactions. We evaluated this relationship by analysing FA profiles and delayed cutaneous hypersensitivity in 20 malnourished elderly non‐cancer patients and in 20 age‐matched control patients. As indicated by serum cholesterol and serum triglycerides, the lipid levels were decreased by about one‐third in the subjects with PEM. In comparison with the controls, there was a reduction in the ω 3 FA (e.g. eicosapentanoate) in total serum lipids (mgl ‐1 ) and serum phospholipids (%) of 40% and 47%, respectively. Reductions in serum ω 6 FA (e.g. linoleate and arachidonate) levels corresponded to the drop in total FA concentrations (30%). The cutaneous hypersensitivity was impaired in 14 of the malnourished patients. The magnitude of the skin reaction was positively correlated ( P < 0·05) to the concentrations of eicosapentanoate in serum lipids and serum phospholipids, as well as to the linoleate concentration in total serum lipids. Six of the malnourished patients took part in a nutritional intervention programme for 3 months. In parallel with an improvement in the nutritional status there was a 35% increase ( P < 0·05) in the total ω 3 FA serum concentration. Negative skin tests became positive and the median skin induration enlarged threefold ( P < 0·05). Thus, deficiency of ω 3 FA might be one factor contributing to cutaneous anergy in elderly malnourished patients.