Malnutrition mortality studied

Correcting a critical shortage of glutathione (GSH), the body's main antioxidant, could help reverse a life-threatening malnutrition syndrome that affects millions of Third-World children each year, say CNRC scientists.

Their research could also help solve a nutritional mystery that has puzzled scientists for more than 30 years: Why do food shortages trigger two very different malnutrition syndromes--one often lethal, the other easy-to-treat--among children living in famine-stricken areas?

"About half the children who suffer severe protein-calorie malnutrition develop a syndrome called marasmus," said Dr. Farook Jahoor, a Baylor professor of pediatrics. "Although these children have the stick-thin appearance many associate with severe malnutrition, they are quite easy to treat because they have few complications and nearly always survive."

In contrast, malnourished children who develop kwashiorkor, a syndrome characterized by edema, an enlarged liver, poor immune function, and sometimes, even congestive heart failure. Although edema often masks their physical wasting, these children are seriously ill, slow to recover and can suffer death rates as high as 25 percent. 

Jahoor suspected that many of the complications associated with kwashiorkor could stem from oxidative cell damage caused by a shortage of GSH.

"Without the neutralizing effect of glutathione, cell membranes are vulnerable to free-radical damage, the immune system can't function properly and harmful toxins build up, which could be linked to fatty deposits in the liver and other symptoms seen in kwashiorkor," he said.

A study conducted at the Tropical Metabolism Research Unit, University of the West Indies, in Jamaica confirmed his suspicions.

"Children hospitalized with kwashiorkor had much lower GSH synthesis rates and blood levels, and higher levels of compounds that signal oxidative cell damage than those with marasmus," he said.

Jahoor traced the GSH shortfall to low blood levels of two amino acids: cysteine, which the body needs to make GSH, and methionine, which can be converted into cysteine.

During the second phase of the study, children hospitalized with kwashiorkor are being given cysteine supplements to improve their GSH status. Although preliminary results are promising, Jahoor cautions that the real test will be whether the therapy speeds the children's recovery and improves survival rates.

"Every year, more than 200 million children are affected by food shortages. Until the factors causing world famines are resolved, we hope our work will help ease the suffering and reduce deaths among the children," he said.