Enteric pathogens relationship with small bowel histologic features of environmental enteric dysfunction in a multicountry cohort study

作者：Najeeha Talat Iqbal, Sarah Lawrence, Tahmeed Ahmed, Kanta Chandwe, Shah Mohammad Fahim, Eric R. Houpt, Furqan Kabir, Paul Kelly, Jie Liu, Mustafa Mahfuz, Monica Mweetwa, Kelley VanBuskirk, Phillip I. Tarr, Donna M. Denno, Kumail Ahmed, Sheraz Ahmed, Md. Ashraful Alam, S. Asad Ali, Beatrice Amadi, Subhasish Das, Md. Amran Gazi, Rashidul Haque, Md. Mehedi Hasan, Md. Shabab Hossain, Aneeta Hotwani, Shahneel Hussain, Junaid Iqbal, Sadaf Jakhro, Ta-Chiang Liu, Ramendra Nath Mazumder, Christopher A Moskaluk, Abdul Khalique Qureshi, Shyam S Raghavan, Masudur Rahman, Najeeb Rahman, Kamran Sadiq, Shafiqul Alam Sarker, Peter B Sullivan, Guillermo J Tearney, Fayaz Umrani, Omer H Yilmaz, Kanekwa Zyambo · 发表于：American Journal of Clinical Nutrition · 年份：2024 · DOI：10.1016/j.ajcnut.2024.02.026 · 被引用次数：9 · 研究领域：Viral gastroenteritis research and epidemiology、Gastrointestinal motility and disorders、Celiac Disease Research and Management

BACKGROUND: Environmental Enteric Dysfunction (EED) is an acquired disorder of asymptomatic altered gut function, the etiology of which is unknown. EED is postulated to be a major contributor to growth faltering in early childhood in regions where early-life enteropathogenic carriage is prevalent. Few studies have examined the critical organ (the upper small bowel) with enteropathogens in the evolution of small bowel disease. OBJECTIVES: The objective of this study was to determine if fecal enteropathogenic detection predicts subsequent EED histology. METHODS: Fecal samples were obtained from undernourished children aged <2 y without diarrhea enrolled in 3 cohort studies, who failed nutritional intervention and subsequently underwent endoscopy. Duodenal biopsies from 245 (Bangladesh n = 120, Pakistan n = 57, and Zambia n = 68) children were scored using a semiquantitative histologic grading protocol. Thirteen enteropathogens were sought in common across the 3 centers using TaqMan array cards (TAC) (Bangladesh and Pakistan) and the Luminex platform (Zambia). An additional 18 pathogens and 32 virulence loci were sought by TAC and included in sensitivity analyses restricted to TAC data. RESULTS: Multivariable linear regressions adjusting for study center, age at stool collection, and stool-to-biopsy interval demonstrated the following: 1) an association of norovirus and Shigella detection with subsequent enterocyte injury [β 0.2 (95% CI: 0.1, 0.3); P = 0.002 and β 0.2 (95% CI: 0...