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Pathobiome driven gut inflammation in Pakistani children with Environmental Enteric Dysfunction
Najeeha T Iqbal1,2, Sana Syed1,3, Furqan Kabir1
1Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Plos One
|August 24, 2019
Summary
Environmental Enteric Dysfunction (EED) in children is linked to enteropathogen infections, causing growth faltering. Targeting these pathogens with vaccines may prevent stunting.
Area of Science:
- Pediatrics
- Infectious Diseases
- Gastroenterology
Background:
- Environmental Enteric Dysfunction (EED) is a significant cause of stunting in children under five in low- and middle-income countries.
- EED results from repeated exposure to enteropathogens and toxins, leading to malabsorption and impaired linear growth.
- Understanding the link between pathogen burden and EED biomarkers is crucial for developing effective interventions.
Purpose of the Study:
- To investigate the association between enteropathogen infections and linear growth faltering in a birth cohort.
- To analyze the correlation between pathogen burden and specific biomarkers of EED.
- To identify key enteropathogens contributing to growth impairment in early childhood.
Main Methods:
- A longitudinal birth cohort study with 272 children, tracking monthly anthropometric measurements (Length for Age Z score - LAZ) up to 18 months.
- Fecal samples analyzed using a customized TaqMan array card to detect 40 enteropathogens at 6 and 9 months.
- Linear regression models used to assess the impact of specific enteropathogen infections on changes in linear growth (ΔLAZ) and EED biomarkers (MPO, Reg1b, flagellin IgA).
Main Results:
- Presence of any enteropathogen correlated with increased levels of serum flagellin IgA and fecal/serum Reg1b.
- Specific pathogens like Campylobacter and ETEC LT were associated with increased MPO levels at 6 months.
- Giardia infection correlated with elevated Reg1b and anti-flic IgA.
- Multiple enteropathogen infections in early life showed a negative correlation with ΔLAZ and altered gut inflammatory/permeability markers.
Conclusions:
- Early-life enteropathogen infections are associated with impaired linear growth and EED biomarkers.
- The findings highlight the detrimental impact of pathogen burden on child development.
- A combination vaccine targeting common enteropathogens could be a viable strategy for preventing stunting.
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