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Promising Biomarkers of Environmental Enteric Dysfunction: A Prospective Cohort study in Pakistani Children.

ABSTRACT: Environmental Enteric Dysfunction (EED), a syndrome characterized by chronic gut inflammation, contributes towards stunting and poor response to enteric vaccines in children in developing countries. In this study, we evaluated major putative biomarkers of EED using growth faltering as its clinical proxy. Newborns (n?=?380) were enrolled and followed till 18 months with monthly anthropometry. Biomarkers associated with gut and systemic inflammation were assessed at 6 and 9 months. Linear mixed effects model was used to determine the associations of these biomarkers with growth faltering between birth and 18 months. Fecal myeloperoxidase (neutrophil activation marker) at 6 months [??=?-0.207, p?=?0.005], and serum GLP 2 (enterocyte proliferation marker) at 6 and 9 months [6M: ??=?-0.271, p?=?0.035; 9M: ??=?-0.267, p?=?0.045] were associated with decreasing LAZ score. Ferritin at 6 and 9 months was associated with decreasing LAZ score [6M: ??=?-0.882, p?

SUBMITTER: Iqbal NT

PROVIDER: S-EPMC5813024 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Promising Biomarkers of Environmental Enteric Dysfunction: A Prospective Cohort study in Pakistani Children.

Iqbal Najeeha Talat NT Sadiq Kamran K Syed Sana S Akhund Tauseefullah T Umrani Fayyaz F Ahmed Sheraz S Yakoob Mohammad Yawar MY Rahman Najeeb N Qureshi Shahida S Xin Wenjun W Ma Jennie Z JZ Hughes Molly M Ali Syed Asad SA

Scientific reports 20180214 1

Environmental Enteric Dysfunction (EED), a syndrome characterized by chronic gut inflammation, contributes towards stunting and poor response to enteric vaccines in children in developing countries. In this study, we evaluated major putative biomarkers of EED using growth faltering as its clinical proxy. Newborns (n = 380) were enrolled and followed till 18 months with monthly anthropometry. Biomarkers associated with gut and systemic inflammation were assessed at 6 and 9 months. Linear mixed ef ...[more]

PMID: 29445110

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Project description:OBJECTIVES:Environmental enteric dysfunction (EED) may inhibit growth and development in low- and middle-income countries, but available assessment methodologies limit its study. In rural Bangladesh, we measured EED using the widely used lactulose mannitol ratio (L:M) test and a panel of intestinal and systemic health biomarkers to evaluate convergence among biomarkers and describe risk factors for EED. METHODS:In 539 18-month-old children finishing participation in a randomized food supplementation trial, serum, stool, and urine collected after lactulose and mannitol dosing were analyzed for biomarkers of intestinal absorption, inflammation, permeability and repair, and systemic inflammation. EED scores for each participant were developed using principal component analysis and partial least squares regression. Associations between scores and L:M and with child sociodemographic and health characteristics were evaluated using regression analysis. RESULTS:EED prevalence (L:M?>?0.07) was 39.0%; 60% had elevated acute phase proteins (C-reactive protein >5 mg/L or ?-1 acid glycoprotein >100 mg/dL). Correlations between intestinal biomarkers were low, with the highest between myeloperoxidase and ?-1 antitrypsin (r?=?0.33, P?<?0.01), and biomarker values did not differ by supplementation history. A 1-factor partial least squares model with L:M as the dependent variable explained only 8.6% of L:M variability. In adjusted models, L:M was associated with child sex and socioeconomic status index, whereas systemic inflammation was predicted mainly by recent illness, not EED. CONCLUSIONS:Impaired intestinal health is widespread in this setting of prevalent stunting, but a panel of serum and stool biomarkers demonstrated poor agreement with L:M. Etiologies of intestinal and systemic inflammation are likely numerous and complex in resource-poor settings, underscoring the need for a better case definition with corresponding diagnostic methods to further the study of EED.

Dataset Information

Promising Biomarkers of Environmental Enteric Dysfunction: A Prospective Cohort study in Pakistani Children.

Publications

Promising Biomarkers of Environmental Enteric Dysfunction: A Prospective Cohort study in Pakistani Children.

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