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Hematological alterations in protein malnutrition.

Authors
  • Santos, Ed W1
  • Oliveira, Dalila C1
  • Silva, Graziela B1
  • Tsujita, Maristela1
  • Beltran, Jackeline O1
  • Hastreiter, Araceli1
  • Fock, Ricardo A1
  • Borelli, Primavera1
  • 1 Experimental Hematology Laboratory, Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil. , (Brazil)
Type
Published Article
Journal
Nutrition Reviews
Publisher
Oxford University Press
Publication Date
Nov 01, 2017
Volume
75
Issue
11
Pages
909–919
Identifiers
DOI: 10.1093/nutrit/nux041
PMID: 29025154
Source
Medline
Keywords
License
Unknown

Abstract

Protein malnutrition is one of the most serious nutritional problems worldwide, affecting 794 million people and costing up to $3.5 trillion annually in the global economy. Protein malnutrition primarily affects children, the elderly, and hospitalized patients. Different degrees of protein deficiency lead to a broad spectrum of signs and symptoms of protein malnutrition, especially in organs in which the hematopoietic system is characterized by a high rate of protein turnover and, consequently, a high rate of protein renewal and cellular proliferation. Here, the current scientific information about protein malnutrition and its effects on the hematopoietic process is reviewed. The production of hematopoietic cells is described, with special attention given to the hematopoietic microenvironment and the development of stem cells. Advances in the study of hematopoiesis in protein malnutrition are also summarized. Studies of protein malnutrition in vitro, in animal models, and in humans demonstrate several alterations that impair hematopoiesis, such as structural changes in the extracellular matrix, the hematopoietic stem cell niche, the spleen, the thymus, and bone marrow stromal cells; changes in mesenchymal and hematopoietic stem cells; increased autophagy; G0/G1 cell-cycle arrest of progenitor hematopoietic cells; and functional alterations in leukocytes. Structural and cellular changes of the hematopoietic microenvironment in protein malnutrition contribute to bone marrow atrophy and nonestablishment of hematopoietic stem cells, resulting in impaired homeostasis and an impaired immune response.

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