RESUMO
The objective of this study is to investigate the roles of leukotrienes [LTs] and essential fatty acids [EFA] in the pathophysiology of severe protein energy malnutrition [PEM]. Plasma cysteinyl LTs [LTC[4], LTD[4], LTE[4]] and plasma EFA levels were measured by ELISA and gas liquid chromatography after plasma extraction respectively, in 40 severely malnourished children with kwashiorkor [n=20] and marasmus [n=20]. Ten well nourished children of matching age served as control. The cysteinyl LTs level was significantly higher in kwashiorkor group than in marasmic or control groups [p<0.05]. The plasma fatty acid patterns in malnourished children indicated changes characteristic of EFA deficiency, with lower linoleic acid [LA], alpha-linolenic acid [alpha LNA], arachidonic acid [AA] and docosahexaenoic acid [DHA] levels, accompanied by significantly higher oleic acid levels in both malnourished groups. The lowest values of LA and alpha-LNA were detected in marasmic group and the lowest levels of AA and DHA were in kwashiorkor group [p<0.05]. There was an inverse correlation between AA and LTs levels in children with kwashiorkor. Clinical problems associated with kwashiorkor such as hair and skin changes, edema, psychomotor alteration and hepatomegaly were significantly correlated directly with LTs and in versely with AA levels. The findings of this study suggest that cysteinyl LTs and EFA deficiency are involved in the pathophysiology of PEM particularly kwashiorkor and that severe PEM is associated with impaired FA desaturation and elongation pathways