New insights into environmental enteric dysfunction

@article{Trehan2016NewII,
  title={New insights into environmental enteric dysfunction},
  author={Indi Trehan and Paul Kelly and Nurmohammad Shaikh and Mark J Manary},
  journal={Archives of Disease in Childhood},
  year={2016},
  volume={101},
  pages={741 - 744}
}
Environmental enteric dysfunction (EED) has been recognised as an important contributing factor to physical and cognitive stunting, poor response to oral vaccines, limited resilience to acute infections and ultimately global childhood mortality. The aetiology of EED remains poorly defined but the epidemiology suggests a multifactorial combination of prenatal and early-life undernutrition and repeated infectious and/or toxic environmental insults due to unsanitary and unhygienic environments… Expand
Pathophysiology of environmental enteric dysfunction and its impact on oral vaccine efficacy
TLDR
There is limited evidence of disturbed innate immunity, B cell disturbances including aggregation into lymphoid follicles, and autoantibody generation, and the possibility of dendritic cell anergy, which could help explain oral vaccine failure. Expand
Environmental enteric dysfunction and growth.
TLDR
According to the analyzed evidence, the control of environmental enteric dysfunction is very important for the full expression of growth, development, and vaccine response in the pediatric age group. Expand
Environmental enteric dysfunction pathways and child stunting: A systematic review
TLDR
It is suggested that certain EED biomarkers may require reconsideration, particularly those most difficult to measure, such as microbial translocation and intestinal permeability, because of the lack of evidence of relationships among domains and between each domain with stunting. Expand
Lactoferrin and lysozyme to reduce environmental enteric dysfunction and stunting in Malawian children: study protocol for a randomized controlled trial
TLDR
A prospective randomized placebo-controlled parallel-group randomized controlled trial is conducted to determine if a daily supplement of lactoferrin and lysozyme, two important proteins found in breast milk, can decrease the burden of EED and stunting in rural Malawian children aged 12–23 months old. Expand
Supplementation With Lactoferrin and Lysozyme Ameliorates Environmental Enteric Dysfunction: A Double-Blind, Randomized, Placebo-Controlled Trial
INTRODUCTION: Environmental enteric dysfunction (EED) predisposes children throughout the developing world to high rates of systemic exposure to enteric pathogens and stunting. EffectiveExpand
Understanding the role of the gut in undernutrition: what can technology tell us?
TLDR
The technology landscape for potential solutions to improve assessment of gut function is surveyed, focussing on devices that could be deployed at point-of-care in low-income and middle-income countries (LMICs) and the approaches that are currently most suitable for deployment and development. Expand
Position paper: The potential role of optical biopsy in the study and diagnosis of environmental enteric dysfunction
TLDR
Many of the techniques discussed could also be adapted to monitor the impaired intestinal barrier in other settings such as IBD, autoimmune enteropathies, coeliac disease, graft-versus-host disease, small intestinal transplantation or critical care. Expand
Characterizing the metabolic phenotype of intestinal villus blunting in Zambian children with severe acute malnutrition and persistent diarrhea
TLDR
Intestinal villus blunting is associated with several metabolic perturbations in hospitalized children with severe undernutrition, which include altered muscle metabolism, reinforcing the link between EED and growth faltering, and a disruption in the biochemical exchange between the gut microbiota and host. Expand
Environmental Enteric Dysfunction is Associated with Carnitine Deficiency and Altered Fatty Acid Oxidation
TLDR
Future studies are needed to corroborate the presence of secondary carnitine deficiency among children with EED and to understand how these metabolic derangements may negatively affect the growth and development of young children. Expand
Tropical Enteropathies
TLDR
The nature of the mucosal lesion and the relationship with microbial translocation which is currently thought to link a failure of mucosal barrier function and the cascade of systemic inflammation which inhibits growth are demonstrated. Expand
...
1
2
3
4
...

References

SHOWING 1-10 OF 37 REFERENCES
Environmental Enteric Dysfunction: An Overview
TLDR
A narrative review of the current understanding of Environmental enteric dysfunction: epidemiology, pathogenesis, therapies, and relevance to child health. Expand
Assessment of Environmental Enteric Dysfunction in the SHINE Trial: Methods and Challenges
TLDR
The aims are to describe the evolution of EED during infancy, ascertain its contribution to stunting, and investigate the impact of the randomized interventions on the EED pathway. Expand
Assessment of environmental enteropathy in the MAL-ED cohort study: theoretical and analytic framework.
  • M. Kosek, R. Guerrant, +17 authors S. Babji
  • Medicine
  • Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2014
TLDR
The underlying theoretical and analytical frameworks informing the methodology proposed by the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study are addressed. Expand
Environmental enteric dysfunction: pathogenesis, diagnosis, and clinical consequences.
  • G. Keusch, D. Denno, +15 authors Thomas Brewer
  • Medicine
  • Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2014
TLDR
A historical approach is provided and recommendations to define and validate a working clinical diagnosis and to guide critical research in this area to effectively proceed are provided. Expand
Environmental enteropathy and malnutrition: do we know enough to intervene?
TLDR
The first randomized controlled phase I trial of an anti-inflammatory drug for EE was found to be safe in short-term treatment of a small number of severely malnourished children, although efficacy was not established. Expand
Diet and specific microbial exposure trigger features of environmental enteropathy in a novel murine model
TLDR
It is demonstrated that early-life consumption of a moderately malnourished diet, in combination with iterative oral exposure to commensal Bacteroidales species and Escherichia coli, remodels the murine small intestine to resemble features of EE observed in humans. Expand
Environmental Enteric Dysfunction Includes a Broad Spectrum of Inflammatory Responses and Epithelial Repair Processes
TLDR
A novel microarray method to overcome limitation of RNA sequencing to interrogate the host transcriptome in feces in Malawian children with EED identified 12 transcripts associated with the severity of EED, including chemokines that stimulate T-cell proliferation, Fc fragments of multiple immunoglobulin families, interferon-induced proteins, and mediators that dampen cellular responses to hormones. Expand
An Exposome Perspective on Environmental Enteric Dysfunction
TLDR
This work highlighted exposome approaches for investigating the potential influence of environmental chemical exposures on EED development, including a role for toxicant modulation of gut immune system and microbiome function, and evaluated the suite of environmental chemicals as candidates in the composite of EED biomarkers. Expand
Implications of Acquired Environmental Enteric Dysfunction for Growth and Stunting in Infants and Children Living in Low- and Middle-Income Countries
TLDR
Changes in small bowel function early in infancy in developing countries are increasingly being demonstrated, probably accompanied by altered mucosal architecture in most individuals, including reduced enterocyte mass and evidence of immune activation and inflammation in the mucosa, which may be a cause of growth faltering and stunting in young children. Expand
Preventing environmental enteric dysfunction through improved water, sanitation and hygiene: an opportunity for stunting reduction in developing countries
TLDR
It is suggested that a package of baby‐WASH interventions that interrupt specific pathways through which feco‐oral transmission occurs in the first two years of a child's life may be central to global stunting reduction efforts. Expand
...
1
2
3
4
...