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Disentangling Microbial Mediators of Malnutrition: Modeling Environmental Enteric Dysfunction

Environmental enteric dysfunction (EED) (also referred to as environmental enteropathy) is a subclinical chronic intestinal disorder that is an emerging contributor to early childhood malnutrition. EED is common in resource-limited settings, and is postulated to consist of small intestinal injury, d...

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Autores principales: Bartelt, Luther A., Bolick, David T., Guerrant, Richard L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6477186/
https://www.ncbi.nlm.nih.gov/pubmed/30630118
http://dx.doi.org/10.1016/j.jcmgh.2018.12.006
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author Bartelt, Luther A.
Bolick, David T.
Guerrant, Richard L.
author_facet Bartelt, Luther A.
Bolick, David T.
Guerrant, Richard L.
author_sort Bartelt, Luther A.
collection PubMed
description Environmental enteric dysfunction (EED) (also referred to as environmental enteropathy) is a subclinical chronic intestinal disorder that is an emerging contributor to early childhood malnutrition. EED is common in resource-limited settings, and is postulated to consist of small intestinal injury, dysfunctional nutrient absorption, and chronic inflammation that results in impaired early child growth attainment. Although there is emerging interest in the hypothetical potential for chemical toxins in the environmental exposome to contribute to EED, the propensity of published data, and hence the focus of this review, implicates a critical role of environmental microbes. Early childhood malnutrition and EED are most prevalent in resource-limited settings where food is limited, and inadequate access to clean water and sanitation results in frequent gastrointestinal pathogen exposures. Even as overt diarrhea rates in these settings decline, silent enteric infections and faltering growth persist. Furthermore, beyond restricted physical growth, EED and/or enteric pathogens also associate with impaired oral vaccine responses, impaired cognitive development, and may even accelerate metabolic syndrome and its cardiovascular consequences. As these potentially costly long-term consequences of early childhood enteric infections increasingly are appreciated, novel therapeutic strategies that reverse damage resulting from nutritional deficiencies and microbial insults in the developing small intestine are needed. Given the inherent limitations in investigating how specific intestinal pathogens directly injure the small intestine in children, animal models provide an affordable and controlled opportunity to elucidate causal sequelae of specific enteric infections, to differentiate consequences of defined nutrient deprivation alone from co-incident enteropathogen insults, and to correlate the resulting gut pathologies with their functional impact during vulnerable early life windows.
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spelling pubmed-64771862019-04-25 Disentangling Microbial Mediators of Malnutrition: Modeling Environmental Enteric Dysfunction Bartelt, Luther A. Bolick, David T. Guerrant, Richard L. Cell Mol Gastroenterol Hepatol Review Environmental enteric dysfunction (EED) (also referred to as environmental enteropathy) is a subclinical chronic intestinal disorder that is an emerging contributor to early childhood malnutrition. EED is common in resource-limited settings, and is postulated to consist of small intestinal injury, dysfunctional nutrient absorption, and chronic inflammation that results in impaired early child growth attainment. Although there is emerging interest in the hypothetical potential for chemical toxins in the environmental exposome to contribute to EED, the propensity of published data, and hence the focus of this review, implicates a critical role of environmental microbes. Early childhood malnutrition and EED are most prevalent in resource-limited settings where food is limited, and inadequate access to clean water and sanitation results in frequent gastrointestinal pathogen exposures. Even as overt diarrhea rates in these settings decline, silent enteric infections and faltering growth persist. Furthermore, beyond restricted physical growth, EED and/or enteric pathogens also associate with impaired oral vaccine responses, impaired cognitive development, and may even accelerate metabolic syndrome and its cardiovascular consequences. As these potentially costly long-term consequences of early childhood enteric infections increasingly are appreciated, novel therapeutic strategies that reverse damage resulting from nutritional deficiencies and microbial insults in the developing small intestine are needed. Given the inherent limitations in investigating how specific intestinal pathogens directly injure the small intestine in children, animal models provide an affordable and controlled opportunity to elucidate causal sequelae of specific enteric infections, to differentiate consequences of defined nutrient deprivation alone from co-incident enteropathogen insults, and to correlate the resulting gut pathologies with their functional impact during vulnerable early life windows. Elsevier 2019-01-07 /pmc/articles/PMC6477186/ /pubmed/30630118 http://dx.doi.org/10.1016/j.jcmgh.2018.12.006 Text en © 2019 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Bartelt, Luther A.
Bolick, David T.
Guerrant, Richard L.
Disentangling Microbial Mediators of Malnutrition: Modeling Environmental Enteric Dysfunction
title Disentangling Microbial Mediators of Malnutrition: Modeling Environmental Enteric Dysfunction
title_full Disentangling Microbial Mediators of Malnutrition: Modeling Environmental Enteric Dysfunction
title_fullStr Disentangling Microbial Mediators of Malnutrition: Modeling Environmental Enteric Dysfunction
title_full_unstemmed Disentangling Microbial Mediators of Malnutrition: Modeling Environmental Enteric Dysfunction
title_short Disentangling Microbial Mediators of Malnutrition: Modeling Environmental Enteric Dysfunction
title_sort disentangling microbial mediators of malnutrition: modeling environmental enteric dysfunction
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6477186/
https://www.ncbi.nlm.nih.gov/pubmed/30630118
http://dx.doi.org/10.1016/j.jcmgh.2018.12.006
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