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Impact of Daily Preventive Zinc or Therapeutic Zinc Supplementation for Diarrhea on Plasma Biomarkers of Environmental Enteric Dysfunction among Rural Laotian Children: A Randomized Controlled Trial

Environmental enteric dysfunction (EED) may be ameliorated by zinc supplementation. The objective of this study was to investigate the impact of different forms of zinc supplementation on biomarkers of EED (i.e., plasma citrulline, kynurenine, and tryptophan concentrations and the kynurenine:tryptop...

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Autores principales: Wessells, K. Ryan, Hinnouho, Guy-Marino, Barffour, Maxwell A., Arnold, Charles D., Kounnavong, Sengchanh, Kewcharoenwong, Chidchamai, Lertmemongkolchai, Ganjana, Schuster, Gertrud U., Stephensen, Charles B., Hess, Sonja Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The American Society of Tropical Medicine and Hygiene 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008314/
https://www.ncbi.nlm.nih.gov/pubmed/31889508
http://dx.doi.org/10.4269/ajtmh.19-0584
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author Wessells, K. Ryan
Hinnouho, Guy-Marino
Barffour, Maxwell A.
Arnold, Charles D.
Kounnavong, Sengchanh
Kewcharoenwong, Chidchamai
Lertmemongkolchai, Ganjana
Schuster, Gertrud U.
Stephensen, Charles B.
Hess, Sonja Y.
author_facet Wessells, K. Ryan
Hinnouho, Guy-Marino
Barffour, Maxwell A.
Arnold, Charles D.
Kounnavong, Sengchanh
Kewcharoenwong, Chidchamai
Lertmemongkolchai, Ganjana
Schuster, Gertrud U.
Stephensen, Charles B.
Hess, Sonja Y.
author_sort Wessells, K. Ryan
collection PubMed
description Environmental enteric dysfunction (EED) may be ameliorated by zinc supplementation. The objective of this study was to investigate the impact of different forms of zinc supplementation on biomarkers of EED (i.e., plasma citrulline, kynurenine, and tryptophan concentrations and the kynurenine:tryptophan [KT] ratio) among young Laotian children. In a double-blind randomized controlled trial, 3,407 children aged 6–23 months were randomized into one of four groups: daily preventive zinc dispersible tablets (PZ; 7 mg zinc), daily multiple micronutrient powders (MNP; 10 mg zinc, 6 mg iron, and 13 other micronutrients), therapeutic zinc supplements for diarrhea treatment (TZ; 20 mg/day for 10 days), or daily placebo powder, and followed up for ∼36 weeks. Plasma samples at baseline and endline for 359 children were analyzed for citrulline, kynurenine, and tryptophan concentrations. At baseline, the prevalence of stunting and zinc deficiency was 37% and 76.5%, respectively. The mean plasma citrulline, kynurenine, and tryptophan concentrations were 24.6 ± 5.4 µmol/L, 3.27 ± 0.83 µmol/L, and 72.3 ± 12.9 µmol/L, respectively; the mean KT ratio (×1,000) was 45.9 ± 12.0. At endline, neither plasma citrulline, kynurenine, or tryptophan concentrations, nor the KT ratio differed among intervention groups (P > 0.05). In this population, PZ, MNP, and TZ had no overall effect on plasma concentrations of citrulline, kynurenine, and tryptophan, or the KT ratio. The need remains to better understand the etiology of EED, and the development of biomarkers to diagnose EED and evaluate the impact of interventions.
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spelling pubmed-70083142020-02-14 Impact of Daily Preventive Zinc or Therapeutic Zinc Supplementation for Diarrhea on Plasma Biomarkers of Environmental Enteric Dysfunction among Rural Laotian Children: A Randomized Controlled Trial Wessells, K. Ryan Hinnouho, Guy-Marino Barffour, Maxwell A. Arnold, Charles D. Kounnavong, Sengchanh Kewcharoenwong, Chidchamai Lertmemongkolchai, Ganjana Schuster, Gertrud U. Stephensen, Charles B. Hess, Sonja Y. Am J Trop Med Hyg Articles Environmental enteric dysfunction (EED) may be ameliorated by zinc supplementation. The objective of this study was to investigate the impact of different forms of zinc supplementation on biomarkers of EED (i.e., plasma citrulline, kynurenine, and tryptophan concentrations and the kynurenine:tryptophan [KT] ratio) among young Laotian children. In a double-blind randomized controlled trial, 3,407 children aged 6–23 months were randomized into one of four groups: daily preventive zinc dispersible tablets (PZ; 7 mg zinc), daily multiple micronutrient powders (MNP; 10 mg zinc, 6 mg iron, and 13 other micronutrients), therapeutic zinc supplements for diarrhea treatment (TZ; 20 mg/day for 10 days), or daily placebo powder, and followed up for ∼36 weeks. Plasma samples at baseline and endline for 359 children were analyzed for citrulline, kynurenine, and tryptophan concentrations. At baseline, the prevalence of stunting and zinc deficiency was 37% and 76.5%, respectively. The mean plasma citrulline, kynurenine, and tryptophan concentrations were 24.6 ± 5.4 µmol/L, 3.27 ± 0.83 µmol/L, and 72.3 ± 12.9 µmol/L, respectively; the mean KT ratio (×1,000) was 45.9 ± 12.0. At endline, neither plasma citrulline, kynurenine, or tryptophan concentrations, nor the KT ratio differed among intervention groups (P > 0.05). In this population, PZ, MNP, and TZ had no overall effect on plasma concentrations of citrulline, kynurenine, and tryptophan, or the KT ratio. The need remains to better understand the etiology of EED, and the development of biomarkers to diagnose EED and evaluate the impact of interventions. The American Society of Tropical Medicine and Hygiene 2020-02 2019-12-30 /pmc/articles/PMC7008314/ /pubmed/31889508 http://dx.doi.org/10.4269/ajtmh.19-0584 Text en © The American Society of Tropical Medicine and Hygiene This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Articles
Wessells, K. Ryan
Hinnouho, Guy-Marino
Barffour, Maxwell A.
Arnold, Charles D.
Kounnavong, Sengchanh
Kewcharoenwong, Chidchamai
Lertmemongkolchai, Ganjana
Schuster, Gertrud U.
Stephensen, Charles B.
Hess, Sonja Y.
Impact of Daily Preventive Zinc or Therapeutic Zinc Supplementation for Diarrhea on Plasma Biomarkers of Environmental Enteric Dysfunction among Rural Laotian Children: A Randomized Controlled Trial
title Impact of Daily Preventive Zinc or Therapeutic Zinc Supplementation for Diarrhea on Plasma Biomarkers of Environmental Enteric Dysfunction among Rural Laotian Children: A Randomized Controlled Trial
title_full Impact of Daily Preventive Zinc or Therapeutic Zinc Supplementation for Diarrhea on Plasma Biomarkers of Environmental Enteric Dysfunction among Rural Laotian Children: A Randomized Controlled Trial
title_fullStr Impact of Daily Preventive Zinc or Therapeutic Zinc Supplementation for Diarrhea on Plasma Biomarkers of Environmental Enteric Dysfunction among Rural Laotian Children: A Randomized Controlled Trial
title_full_unstemmed Impact of Daily Preventive Zinc or Therapeutic Zinc Supplementation for Diarrhea on Plasma Biomarkers of Environmental Enteric Dysfunction among Rural Laotian Children: A Randomized Controlled Trial
title_short Impact of Daily Preventive Zinc or Therapeutic Zinc Supplementation for Diarrhea on Plasma Biomarkers of Environmental Enteric Dysfunction among Rural Laotian Children: A Randomized Controlled Trial
title_sort impact of daily preventive zinc or therapeutic zinc supplementation for diarrhea on plasma biomarkers of environmental enteric dysfunction among rural laotian children: a randomized controlled trial
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008314/
https://www.ncbi.nlm.nih.gov/pubmed/31889508
http://dx.doi.org/10.4269/ajtmh.19-0584
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