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Nutrition clinique et métabolisme
Volume 14, n° 3
pages 201-205 (septembre 2000)
Doi : S0985-0562(00)80023-0
Mucoviscidose: inflammation, stress oxydant, infection. Essais de manipulation nutritionnelle
Cystic fibrosis: nutritional therapy against inflammation, oxidative stress, and infection
 

Anne Munck
 Service de gastroentérologie et nutrition pédiatrique, hôpital Robert Debré, 48, boulevard Serrurier, 75019 Paris, France 

Résumé

L'infection broncho-pulmonaire chronique est la cause principale de morbidité et de mortalité dans la mucoviscidose. L'inflammation pulmonaire participe à la dégradation respiratoire ; elle n'est pas uniquement engendrée par l'infection puisqu'elle est déjà présente chez de jeunes nourrissons avant même que l'on puisse identifier des germes pathogènes. L'étude des lavages bronchoalvéolaires note la présence accrue de polynucléaires neutrophiles et de cytokines proinflammatoires. Par ailleurs, le stress oxydant produit un excès de radicaux libres qui majorent la réponse inflammatoire. Enfin, les acides gras polyinsaturés de la série n -6 peuvent être source de leucotriènes et de prostaglandines proinflammatoires.

Certains essais récents de manipulations nutritionnelles tentent soit d'améliorer la balance oxydants/antioxydants, soit de privilégier la production de protaglandines anti-inflammatoires par les acides gras polyinsaturés n -3. Ces résultats préliminaires nécessitent des études plus complètes afin d'être intégrés dans la prise en charge globale de la maladie.

The full text of this article is available in PDF format.
Summary

In cystic fibrosis, broncho-pulmonary infection is a leading cause of morbidity and mortality. Pulmonary inflammation contributes to the deterioration of respiratory function; it is only partly explained by infection since it is already present in newborns in the absence of clearly identified pathogenous agent. Analysis of broncho-alveolar fluids show an increase in polymorphonuclear cells and pro-inflammatory cytokines. On the other hand, inflammatory processes are majored by the production of large amounts of free radicals while polyunsaturated n-6 fatty acids can generate leukotriene and pro-inflammatory prostaglandines.

New therapeutic approaches are aimed at improving anti-oxidant defence or favouring the synthesis of anti-inflammatory prostaglandines from polyunsaturated n-3 fatty acids. Larger studies are needed before these therapies can become an integral part of the treatment of these patients.

The full text of this article is available in PDF format.

Keyword : acides gras poly-insaturés, anti-oxydants, cytokines, radicaux libres

Keywords : anti-oxydants, cytokines, free radicals, polyunsaturated fatty acids




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