7.1. Interactions between energy, protein and amino acid intakes and cytokine responses

It has long been known that undernourished subjects show a decreased, negative nitrogen balance in response to injury. They also have lower levels of pyrexia and leucocytosis and a smaller rise in protein turnover. There is also some evidence that in undernutrition the cytokine response is impaired, as if the body were attempting to maintain the integrity of its tissues at the expense of the appropriate response to infection and injury. This is an area where there is a clear need for more fundamental research.