ROLE OF INFLAMMATORY CYTOKINES IN THE DEVELOPMENT OF PROTEIN ENERGY MALNUTRITION
Protein-energy malnutrition (PEM) is a major public health concern, particularly in developing countries where it contributes significantly to childhood morbidity and mortality. Evidence increasingly highlights the role of inflammatory cytokines as critical mediators in PEM, linking immune dysfunction with metabolic imbalance and impaired growth. The objective of this review is to examine the role of inflammatory cytokines in the development and progression of PEM, focusing on their effects on appetite regulation, nutrient metabolism, immune function, and growth outcomes. By synthesizing findings from clinical studies, experimental models, and epidemiological data, the review aims to provide a comprehensive understanding of cytokine-driven mechanisms in malnutrition. Methodologically, a structured search of peer-reviewed literature was conducted across PubMed, Scopus, and Web of Science, prioritizing studies published in the last two decades. Keywords included “protein-energy malnutrition,” “cytokines,” “inflammation,” “immune response,” and “child nutrition.” Relevant articles were critically analyzed to identify consistent patterns, mechanistic insights, and areas of divergence in current knowledge. Results indicate that elevated pro-inflammatory cytokines such as TNF-α, IL-6, and IL-1β are associated with anorexia, muscle wasting, impaired intestinal absorption, and increased susceptibility to infections. These cytokines interfere with insulin-like growth factor signaling, impair protein synthesis, and compromise gut integrity, thereby perpetuating nutritional deficits and worsening PEM outcomes. In conclusion, inflammatory cytokines are active drivers in the progression of PEM. Their influence on metabolic imbalance, appetite suppression, and immune dysfunction underscores the need for integrated interventions that combine nutritional rehabilitation with immunomodulatory strategies. Addressing cytokine dysregulation may provide a pathway to breaking the cycle of malnutrition and infection, ultimately improving survival and growth outcomes in vulnerable populations.
Keywords: Protein-energy malnutrition, Inflammatory cytokines, Immune dysfunction, Child nutrition, TNF-α.
