Duodenal Microbiota in Stunted Undernourished Children with Enteropathy

作者：Robert Yuzen Chen, Vanderlene Liu Kung, Subhasish Das, Md. Shabab Hossain, Matthew C. Hibberd, Janaki L. Guruge, Mustafa Mahfuz, Sharmin Begum, Mujibur Rahman, Shah Mohammad Fahim, Md. Amran Gazi, Rashidul Haque, Shafiqul Alam Sarker, Ramendra Nath Mazumder, Blanda Di Luccia, Kazi Ahsan, Elizabeth A. Kennedy, Jesús M. Santiago-Borges, Dmitry A. Rodionov, Semen A. Leyn, Andrei L. Osterman, Michael J. Barratt, Tahmeed Ahmed, Jeffrey I. Gordon · 发表于：New England Journal of Medicine · 年份：2020 · DOI：10.1056/nejmoa1916004 · 被引用次数：177 · 研究领域：Gut microbiota and health、Child Nutrition and Water Access、Digestive system and related health

BACKGROUND: Environmental enteric dysfunction (EED) is an enigmatic disorder of the small intestine that is postulated to play a role in childhood undernutrition, a pressing global health problem. Defining the incidence of this disorder, its pathophysiological features, and its contribution to impaired linear and ponderal growth has been hampered by the difficulty in directly sampling the small intestinal mucosa and microbial community (microbiota). METHODS: In this study, among 110 young children (mean age, 18 months) with linear growth stunting who were living in an urban slum in Dhaka, Bangladesh, and had not benefited from a nutritional intervention, we performed endoscopy in 80 children who had biopsy-confirmed EED and available plasma and duodenal samples. We quantified the levels of 4077 plasma proteins and 2619 proteins in duodenal biopsy samples obtained from these children. The levels of bacterial strains in microbiota recovered from duodenal aspirate from each child were determined with the use of culture-independent methods. In addition, we obtained 21 plasma samples and 27 fecal samples from age-matched healthy children living in the same area. Young germ-free mice that had been fed a Bangladeshi diet were colonized with bacterial strains cultured from the duodenal aspirates. RESULTS: Of the bacterial strains that were obtained from the children, the absolute levels of a shared group of 14 taxa (which are not typically classified as enteropathogens) were negative...