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Journal of Parenteral and Enteral Nutrition
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In Vitro Leukocyte Endogenous Mediator Production Is Not Impaired following Surgical Stress in Moderately Malnourished Patients

John L. Duncan

Nutrition/Metabolism Laboratory, Cancer Research Institute, New England Deaconess Hospital, Boston, Massachusetts

Lyle L. Moldawer

Nutrition/Metabolism Laboratory, Cancer Research Institute, New England Deaconess Hospital, Boston, Massachusetts

Bruce R. Bistrian

Nutrition/Metabolism Laboratory, Cancer Research Institute, New England Deaconess Hospital, Boston, Massachusetts

George L. Blackburn

Nutrition/Metabolism Laboratory, Cancer Research Institute, New England Deaconess Hospital, Boston, Massachusetts

Leukocyte endogenous mediator (LEM), a protein produced by phagocytizing cells, plays a critical role in the metabolic response to injury and infection. There is an important interaction between protein-calorie malnutrition and the capacity of cells to produce LEM, since severely malnourished or severely stressed individuals, have a reduced capacity to produce LEM. The leukocytes of 10 mildly to moderately malnourished patients undergoing elective major surgery, a moderate stress, had an intact ability to produce LEM on preoperative assessment. This ability was not affected by a 5-day postoperative period of hypocaloric nutrient intake despite a significant loss of body protein in one-half of the patients and a significant fall in serum protein concentrations. These results suggest a high biologic priority for LEM production during the metabolic response to injury and for infection. (Journal of Parenteral and Enteral Nutrition 8:174-177, 1984)

Journal of Parenteral and Enteral Nutrition, Vol. 8, No. 2, 174-177 (1984)
DOI: 10.1177/0148607184008002174
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