Dataset Information

Modifying gut integrity and microbiome in children with severe acute malnutrition using legume-based feeds (MIMBLE): A pilot trial.

ABSTRACT: Case fatality among African children with severe acute malnutrition remains high. We report a 3-arm pilot trial in 58 Ugandan children, comparing feeds targeting disordered gastrointestinal function containing cowpea (CpF, n = 20) or inulin (InF, n = 20) with conventional feeds (ConF, n = 18). Baseline measurements of gut permeability (lactulose:mannitol ratio 1.19 ± SD 2.00), inflammation (fecal calprotectin 539.0 μg/g, interquartile range [IQR] 904.8), and satiety (plasma polypeptide YY 62.6 pmol/l, IQR 110.3) confirm gastrointestinal dysfunction. By day 28, no differences are observable in proportion achieving weight gain >5 g/kg/day (87%, 92%, 86%; p > 0.05), mortality (16%, 30%, 17%; p > 0.05), or edema resolution (83%, 54%, 91%; p > 0.05) among CpF, InF, and ConF. Decreased fecal bacterial richness from day 1 (abundance-based coverage estimator [ACE] 53.2) to day 7 (ACE 40.8) is observed only in ConF (p = 0.025). Bifidobacterium relative abundance increases from day 7 (5.8% ± 8.6%) to day 28 (10.9% ± 8.7%) in CpF (corrected p = 1.000). Legume-enriched feeds support aspects of gut function and the microbiome. Trial registration PACTR201805003381361.

SUBMITTER: Calder N

PROVIDER: S-EPMC8149470 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

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Modifying gut integrity and microbiome in children with severe acute malnutrition using legume-based feeds (MIMBLE): A pilot trial.

Calder Nuala N Walsh Kevin K Olupot-Olupot Peter P Ssenyondo Tonny T Muhindo Rita R Mpoya Ayub A Brignardello Jerusa J Wang Xuedan X McKay Eleanor E Morrison Douglas D Holmes Elaine E Frost Gary G Maitland Kathryn K

Cell reports. Medicine 20210518 5

Case fatality among African children with severe acute malnutrition remains high. We report a 3-arm pilot trial in 58 Ugandan children, comparing feeds targeting disordered gastrointestinal function containing cowpea (CpF, n = 20) or inulin (InF, n = 20) with conventional feeds (ConF, n = 18). Baseline measurements of gut permeability (lactulose:mannitol ratio 1.19 ± SD 2.00), inflammation (fecal calprotectin 539.0 μg/g, interquartile range [IQR] 904.8), and satiety (plasma polypeptide YY 62.6 p ...[more]

PMID: 34095882

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Project description:BackgroundChildren with severe acute malnutrition are treated with antibiotics as outpatients. We aimed to determine the effect of 7 days of amoxicillin on acute and long-term changes to the gut microbiome and antibiotic resistome in children treated for severe acute malnutrition.MethodsWe conducted a secondary analysis of a randomised, double-blinded, placebo-controlled trial (NCT01613547) of amoxicillin in children (aged 6-59 months) with severe acute malnutrition treated as outpatients in Madarounfa, Niger. We randomly selected 161 children from the overall cohort (n=2399) for initial 12-week follow-up from Sept 23, 2013 to Feb 3, 2014. We selected a convenience sample of those 161 children, on the basis of anthropometric measures, for follow-up 2 years later (Sept 28 to Oct 27, 2015). Children provided faecal samples at baseline, week 1, week 4, week 8, week 12, and, for those in the 2-year follow-up cohort, week 104. We conducted metagenomic sequencing followed by microbiome and resistome profiling of faecal samples. 38 children without severe acute malnutrition and six children with severe acute malnutrition matching the baseline ages of the original cohort were used as reference controls.FindingsIn the 12-week follow-up group, amoxicillin led to an immediate decrease in gut microbiome richness from 37·6 species (95% CI 32·6-42·7) and Shannon diversity index (SDI) 2·18 (95% CI 1·97-2·39) at baseline to 27·7 species (95% CI 22·9-32·6) species and SDI 1·55 (95% CI 1·35-1·75) at week 1. Amoxicillin increased gut antibiotic resistance gene abundance to 6044 reads per kilobase million (95% CI 4704-7384) at week 1, up from 4800 (3391-6208) at baseline, which returned to baseline 3 weeks later. 35 children were included in the 2-year follow-up; the amoxicillin-treated children (n=22) had increased number of species in the gut microbiome compared with placebo-treated children (n=13; 60·7 [95% CI 54·7-66·6] vs 36·9 [29·4-44·3]). Amoxicillin-treated children had increased Prevotella spp and decreased Bifidobacterium spp relative to age-matched placebo-treated children, indicating a more mature, adult-like microbiome.InterpretationAmoxicillin treatment led to acute but not sustained increases in antimicrobial resistance genes and improved gut microbiome maturation 2 years after severe acute malnutrition treatment.FundingBill & Melinda Gates Foundation; Médecins sans Frontières Operational Center Paris; National Institute of Allergy and Infectious Diseases; National Institute of General Medical Sciences; Eunice Kennedy Shriver National Institute of Child Health and Human Development; Edward Mallinckrodt Jr Foundation; Doris Duke Foundation.

Project description:BackgroundLegumes, important components of a healthy diet, may exert their health benefits through the influence of the gut microbiome. However, this hypothesis has not been well investigated.ObjectiveThis study aimed to examine the associations between long-term legume consumption and the gut microbiome among elderly Chinese.MethodsThe gut microbiome was profiled by 16S ribosomal RNA sequencing in 2302 Chinese adults enrolled in 2 large cohort studies, the Shanghai Women's Health Study and Shanghai Men's Health Study. Legume consumption, including peanuts, soy foods, and other beans, was assessed by food-frequency questionnaires prior to the stool collection. The associations of legume consumption with microbiome diversity and taxa abundance were evaluated by linear or negative binomial hurdle models, adjusting for sociodemographics, lifestyle factors, and BMI. False discovery rate (FDR)-corrected P values (PFDR) < 0.1 were considered significant.ResultsRespectively, 52% and 48% of study participants were male and female. The mean age at stool collection was 68.03 y for females and 70.28 y for males. Total legume consumption was not associated with gut microbiome ɑ-diversity; however, male peanut consumers had a higher Chao1 index (β = 22.52, P = 0.01), whereas peanut consumption was associated with decreased Shannon (β = -0.03, P = 0.02) and Simpson (β = -0.002, P = 0.04) indexes among females. In female and male combined analyses, total legume consumption was associated with increased Enterobacteriales (β = 0.30, PFDR = 0.06). Within this order, an unclassified genus in the family Enterobacteriaceae was positively associated with total legume (β = 0.46, PFDR = 0.03) and peanut (β = 0.59, PFDR = 0.01) consumption. Stratified analyses showed significant associations were primarily confined to females and participants without metabolic conditions.ConclusionsLegume consumption was associated with gut microbiome diversity and abundance of some bacteria in elderly Chinese. Associations were significant only among 1 sex group. Further research, including large-scale prospective studies and feeding trials, is needed to fully understand the role of the gut microbiome in legume-health associations.

Dataset Information

Modifying gut integrity and microbiome in children with severe acute malnutrition using legume-based feeds (MIMBLE): A pilot trial.

Publications

Modifying gut integrity and microbiome in children with severe acute malnutrition using legume-based feeds (MIMBLE): A pilot trial.

Similar Datasets

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